“…The role of cky-1 in ivermectin resistance is supported by the following: (1) genetic differentiation between susceptible and resistant strains around this locus relative to genome-wide variation that is replicated in geographically and genetically diverse strains here and elsewhere ( Baltrušis et al., 2022 ; Doyle et al., 2019a ; Rezansoff et al., 2016 ; Sallé et al., 2019 ), (2) the presence of non-synonymous variants that are highly differentiated before and after treatment, (3) increased gene expression of cky-1 in resistant strains relative to a susceptible strain (supported by genome-wide RNA-seq [ Laing et al., 2022 ]), and (4) knockdown of the C. elegans ortholog leading to hypersensitivity to ivermectin. We acknowledge that overexpression of cky-1 in C. elegans does not recapitulate the high levels of ivermectin resistance seen in H. contortus or, for example, by concurrent mutation of glutamate-gated chloride channels in C. elegans ( Dent et al., 2000 ); while this may argue against cky-1 as a universal mediator of resistance, it likely reflects the challenge of using a heterologous expression system in which there is an assumption that the biology (and, therefore, response to treatment) is concordant between the free-living and parasitic species, and/or may reflect the multigenic nature of ivermectin resistance in different species ( Evans et al., 2021 ; Streit, 2021 ; Wit et al., 2021 ). Given the lack of an obvious causal non-synonymous variant, we hypothesize that a non-coding variant that influences the expression of cky-1 is under selection in resistant strains of H. contortus ; however, such variants are difficult to validate without genotype and transcriptional phenotype data from a large number of individual worms.…”