Ivermectin - Old Drug, New Tricks?

Abstract

Ivermectin is one of the most important drugs in veterinary and human medicine for the control of parasitic infection and was the joint focus of the 2015 Nobel Prize in Physiology or Medicine, some 35 years after its remarkable discovery. Although best described for its activity on glutamate-gated chloride channels in parasitic nematodes, understanding of its mode of action remains incomplete. In the field of veterinary medicine, resistance to ivermectin is now widespread, but the mechanisms underlying resistance are unresolved. Here we discuss the history of this versatile drug and its use in global health. Based on recent studies in a variety of systems, we question whether ivermectin could have additional modes of action on parasitic nematodes.

Figure 1

Chemical Structure of Ivermectin. Ivermectin consists of a mixture of two homologues: 5-O-dimethyl-22,23-dihydroavermectin B_1a and B_1b in a ratio of 80:20.

Figure 2

Key Figure: Ivermectin Targets Identified So Far Ivermectin has a broad range of activities in a variety of systems.