The use of the larval development assay for predicting the in vivo efficacy of levamisole against Haemonchus contortus and Trichostrongylus colubriformis

The larval development assay has been used for many years to measure the sensitivity of the free-living life stages of trichostrongylid nematodes to anthelmintics. The assay has applications in both drug discovery and the diagnosis of drug resistance. We revisited the usefulness of the larval development assay for diagnosis of resistance to levamisole using field-derived isolates of Haemonchus contortus and Trichostrongylus colubriformis showing varying levels of resistance to this drug in vivo. Each of the resistant isolates showed a plateau in their larval development assay dose-response at the highest drug concentrations tested, representing a highly-resistant fraction, amounting to between 6.9 and 55.1% of the populations. The remaining population fractions for the resistant isolates showed IC50 values from 1.4- to 17.8-fold higher than their corresponding susceptible isolate of the same species. We used a data set from the DrenchRite® test user manual to derive equations describing the relationship between the IC50 values for these low / moderate resistance components of each population and in vivo drug efficacy, and then used these equations to estimate the expected in vivo efficacy of levamisole against this population component of each isolate. A combination of this expected efficacy, with the known zero efficacy of the drug in vivo against the highly-resistant population fractions in each isolate, allowed us to calculate a predicted drug efficacy for the whole population for each isolate. The predicted levamisole efficacies for the three resistant H. contortus isolates were 88.8, 84.1 and 43.7%. These compared favourably with the actual efficacy of the drug against these isolates as determined in faecal egg count reduction tests or total worm count studies: 79, 66.3 and 40.6%, respectively. Similarly, for T. colubriformis, predicted efficacies of 82.0 and 1.8% compared favourably with the actual efficacies of 65-92 % and 0%, respectively. This study illustrates the usefulness of the larval development assay as a diagnostic tool for predicting in vivo efficacy of levamisole against H. contortus and T. colubriformis.