# Differential Emodepside Efficacy in Drug-Resistant and Drug-Susceptible Ancylostoma caninum Highlights Variability in Potassium Channel Activity

## TL;DR

A study found that emodepside works better against drug-resistant hookworms, possibly due to differences in potassium channel activity.

## Contribution

The study reveals that drug-resistant hookworms show increased susceptibility to emodepside, linked to SLO-1 potassium channel activity.

## Key findings

- Emodepside was more effective against drug-resistant Ancylostoma caninum larvae than drug-susceptible ones.
- The drug-resistant isolate's sensitivity to emodepside was reversed by a BK channel inhibitor, penitrem A.
- These results suggest SLO-1 channel activity influences anthelmintic efficacy in hookworms.

## Abstract

Multi-anthelmintic resistance in hookworms poses a significant challenge to both human and veterinary health, underscoring the need for novel treatment strategies. In this study, we evaluated the in vitro efficacy of three anthelmintics—pyrantel, ivermectin, and emodepside—against L3 larvae of drug-susceptible (WMD) and triple-anthelmintic-resistant (BCR) isolates of Ancylostoma caninum. While pyrantel was largely ineffective and ivermectin induced high mortality in both isolates, emodepside displayed a surprising trend: the drug-resistant BCR isolate was more susceptible than the drug-susceptible WMD isolate. To explore the underlying mechanism, we performed survival assays in the presence of penitrem A, a BK channel (SLO-1) inhibitor. The addition of penitrem A reversed the enhanced emodepside sensitivity in BCR, implicating elevated basal expression of SLO-1 channels as a potential factor. These findings suggest that emodepside, via its action on SLO-1, may offer a promising therapeutic avenue to combat multidrug-resistant hookworm infections.