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Rethinking Drug Response in Leishmania: Identifying the Genomic Determinants of Persistence

Objective

Drug resistance (DR) in Leishmania is a growing clinical challenge, yet often viewed too simplistically, overlooking the diversity of drug responses and survival strategies. Drug sensitivity (DS) and persistence are among these neglected responses, though essential for optimizing treatment: DS and DR reveal collateral sensitivities, while persistence, a dormant, slow- or non-growing drug response state, could drive treatment relapse. This means persistence enables survival during therapy and regrowth once drug pressure subsides, a state considered a transient, non-genetic adaptation entered stochastically or by stress. However, growing evidence, including our prior work, supports the hypothesis that specific mutations and other genomic pre-adaptations can alter the frequency of parasite subpopulations entering a persister state, challenging its classical genetic separation from DR and DS.
In PERSIST we will test this hypothesis by combining in vitro and in vivo genome-wide CRISPR cytosine base-editing loss-of-function screens developed by my group with persister-labelling and drug-treatment approaches to systematically map the genetic determinants of DS, DR, and persistence in mammalian-stage Leishmania amastigotes. Additionally, using lineage-tracing screens with barcoded parasite populations, we will test whether stochastic and stress-induced persisters exhibit a “memory effect” that predisposes subpopulations toward persistence. Finally, mutants and cell lines with altered persistence frequency will be tested for in vivo survival in sand flies and host niches, and profiled at transcriptomic, epigenetic, and metabolomic levels to uncover key persistence mechanisms.
By revealing the genomic and functional basis of persistence and integrating it with DR and DS, PERSIST will transform our understanding of Leishmania drug response, guide new combination therapies for the neglected tropical disease leishmaniasis, and provide insights into persistence across pathogens.

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HORIZON-ERC - HORIZON ERC Grants

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(opens in new window) ERC-2026-STG

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Host institution

JULIUS-MAXIMILIANS-UNIVERSITAT WURZBURG
Net EU contribution

Net EU financial contribution. The sum of money that the participant receives, deducted by the EU contribution to its linked third party. It considers the distribution of the EU financial contribution between direct beneficiaries of the project and other types of participants, like third-party participants.

€ 1 053 561,00
Address
SANDERRING 2
97070 Wuerzburg
Germany

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Region
Bayern Unterfranken Würzburg, Kreisfreie Stadt
Activity type
Higher or Secondary Education Establishments
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Total cost

The total costs incurred by this organisation to participate in the project, including direct and indirect costs. This amount is a subset of the overall project budget.

€ 1 053 561,00

Beneficiaries (2)