Targeting Human Onchocerciasis: Recent Advances Beyond Ivermectin

Onchocerciasis, also called river blindness, is a neglected tropical disease which is in desperate need of a therapeutic revolution. This debilitating disease, endemic in 31 countries in sub-Saharan Africa, Yemen, and Latin America, is a leading cause of blindness in the developing world. The infection is caused by the filarial parasitic nematode Onchocerca volvulus that is transmitted to humans by the black fly Simulium spp. Its pathology, whose symptoms are onchodermatitis, musculoskeletal pain, and various stages of blindness, is a result of the death of the microfilariae in the skin and eyes. This review covers the drug design and early detection fields of this pathology and pays particular attention to the period after the introduction of ivermectin, which is the only drug available for mass treatment. The emergence of ivermectin resistance justifies the crucial need to identify new drug targets and agents that can effectively treat onchocerciasis.