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A small structural “bump” on a molecule might be the big breakthrough EPM care has been waiting for. We sit down with researcher and clinician Izabela de Assis Rocha to unpack how bumped kinase inhibitors exploit a tiny difference between parasite and mammalian kinases to hit Sarcocystis neurona where it hurts—motility, invasion, and replication—while sparing the horse. It’s a molecular strategy with practical promise, and the conversation bridges the stall, the lab, and the future of equine neurology.

We break down the science behind CDPK1, the gatekeeper residue that drives selectivity, and why unique parasite structures like the apical complex and apicoplast open new therapeutic lanes. Then we move into what really matters for care: pharmacokinetics and clinical fit. BKI-1708 shows strong systemic distribution that positions it as a prophylactic candidate, while early data on BKI-1553 suggests better CNS penetration and a path toward active EPM treatment. Isabella explains how EPM’s dead-end host biology may lower the risk of widespread resistance, a rare bright spot in the antiparasitic landscape.

Clinical trials are the hard part. With no robust experimental infection model and fewer than 1% of exposed horses developing disease, enrolling enough cases takes patience and teamwork. We talk about building pragmatic, clinician-led studies, harmonizing diagnostics and neurologic scoring, and tracking relapse to find outcomes that matter to horses and owners. The One Health angle also shines through: BKIs show activity against equine piroplasmosis and have potential roles in toxoplasmosis and cryptosporidiosis, linking equine research to human and livestock health.

If you care about evidence-based equine neurology, new antiparasitic strategies, and turning elegant biochemistry into barn-side change, this is your roadmap. Subscribe, share with a colleague who manages EPM cases, and leave a review to help more veterinarians find the show. What question would you ask about bringing BKIs into practice?

AJVR article: https://doi.org/10.2460/ajvr.25.07.0270

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