The potential of live attenuated vaccines against Cutaneous Leishmaniasis

Cutaneous Leishmaniasis is a serious public health problem, typically affecting poor populations with limited access to health care. Control is largely dependent on chemotherapies that are inefficient, costly and challenging to deliver. Vaccination is an attractive and feasible alternative because long-term protection is typical in patients who recover from the disease. No human vaccine is yet approved for use, but several candidates are at various stages of testing. Live attenuated parasites, which stimulate long-term immune protection, have potential as effective vaccines, and their challenges relating to safety, formulation and delivery can be overcome. Here we review current data on the potential of live attenuated Leishmania vaccines and discuss possible routes to regulatory approval. •Leishmaniasis is a vaccinable disease.•Live attenuated Leishmania parasites can stimulate long term protection from disease.•We discuss challenges and possible routes to approval of live attenuated Leishmania vaccines.