What mechanism do helminths use to develop resistance to anthelmintics?

Helminths can develop resistance to anthelmintics through the alteration of drug target sites. Many anthelmintic drugs work by binding to specific receptors or enzymes that are crucial for the survival and reproduction of the parasites. When a helminth alters these target sites, whether by mutation or other biochemical changes, the drug may no longer be able to effectively bind to its target, rendering it ineffective. This mechanism of resistance represents a significant challenge in the treatment of helminth infections, as it can lead to reduced efficacy of commonly used medications and necessitate the development of new therapeutic strategies.

Increased metabolism of drugs, decreased absorption of drugs, and modification of excretion pathways can also contribute to resistance, but the primary and most widely recognized mechanism involves alterations in the target sites. By focusing on altering the sites of action, helminths can directly circumvent the effects of drugs that would otherwise disrupt their physiological processes.