Leishmania tropica promastigotes that are highly resistant to methotrexate, a dihydrofolate reductase inhibitor, have been developed. Organisms resistant to 1 mM methotrexate have a 40-fold increase in dihydrofolate reductase which is associated with thymidylate synthetase, and they contain amplified regions of DNA that may be directly visualized on stained gels of restriction digests. The amplified DNA in these organisms is about 56 Idlobases in length, has a copy number about 80-fold higher than that of wild-type organisms, and constitutes about 10% of the nuclear DNA. When the methotrexate-resistant L. tropica are propagated in drug-free medium, the dihydrofolate reductase-thymidylate synthetase protein and the amplified DNA decrease in a parallel fashion until they are indistinguishable from the levels in wild-type organisms. However, when these apparent revertants are again challenged with 1 mM methotrexate, enzyme overproduction and DNA amplification occur rapidly. As in mammalian cells, it appears that drug resistance in parasitic protozoa may be mediated by gene amplification.Drug resistance in protozoan parasites was first described early in this century by Paul Ehrlich in his studies on the chemotherapy of trypanosomiasis (1). Since then, numerous instances of drug-resistant Trypanosoma (2, 3), Leishmania (3), and Plasmodium (4) have been documented. There are relatively few drugs that are curative agents for the diseases caused by pathogenic protozoa, and the emergence of drug-resistant organisms is a particularly serious problem. Furthermore, because knowledge of the mechanisms of drug resistance in protozoan parasites is limited, no rational approaches exist for circumventing or avoiding this problem.We have embarked upon investigations to define the molecular bases of drug resistance in pathogenic protozoa. In this report, we describe the development and properties of methotrexate (MTX)-resistant strains of Leishmania tropica promastigotes. We show that resistant organisms overproduce the drug target-a bifunctional dihydrofolate reductase (DHFR)-thymidylate synthetase (TS) enzyme-and amplify certain regions of DNA. These properties are unstable when selective pressure of MTX is removed but rapidly reemerge when organisms are reexposed to normally lethal concentrations of the drug. Last, we show that only a 10-fold increase in gene copy number in these protozoa may be detected by direct visualization of ethidium bromide-stained gels of DNA restriction digests.MATERIALS EC50 values refer to the concentration of MTX that inhibited the growth rate by 50%; unless otherwise specified, one passage refers to five generations of growth, or a 32-fold expansion in cell number, followed by reseeding in fresh medium. Cells were counted by using a Coulter Counter ZBI.Selection of MTX-Resistant Cel Lines. MTX-resistant strains of L. tropica promastigotes were obtained by using a stepwise selection process. Cells were seeded at approximately 106/ml in medium containing the specified amount of MTX. When th...