HLA antigens associated to amoebic abscess of the liver in Mexican mestizos

Association between Entamoeba histolytica infection and human leukocyte antigen HLA- DRB1

BACKGROUND

Entamoeba histolytica is the parasitic amoeba which caused amebiasis in human and responsible of 100,000 deaths every year. There is currently no vaccine against this parasite. The innate and adaptive immunity are important in protection against infection.

AIM OF THE STUDY

To investigate the association between HLA-DRB1 and Entamoeba histolytica infection.

PATIENTS AND METHODS

The study is a case-controlled consisted from thirty Iraqi Arab Muslims patients with Entamoeba histolytica infection. The patients were consulted medical city and AL-Karama hospital for the period between May 2016 till February 2017. The control groups were sex and age matched with patient study group, they were consisted of thirty Iraqi Arab Muslims healthy individuals. HLA-DRB1 was done by SSOP method.

RESULTS

A total of 30 patients with Entamoeba histolytica infection were participated in this study. Their ages were range from 21 to 55 years. Males were 83.3% and the rest were females. The other is 30 control group was sex and age matched with patient study group. There was an increased frequency of HLADRB1*03:0101 and *11:0101 in patients group compared to control group (P = 0.002, Odds ratio = 7.42, 95% CI:2.07 to 26.55) and (P = 0.01, Odd ratio = 4.29, 95% CI: 1.41 to 13.06) respectively.

CONCLUSIONS

HLA-DRB1*03:0101 and HLA-DRB1*110,101 may have a role in susceptibility to amebiasis.

A review of the proposed role of neutrophils in rodent amebic liver abscess models

Host invasion by Entamoeba histolytica, the pathogenic agent of amebiasis, can lead to the development of amebic liver abscess (ALA). Due to the difficulty of exploring host and amebic factors involved in the pathogenesis of ALA in humans, most studies have been conducted with animal models (e.g., mice, gerbils, and hamsters). Histopathological findings reveal that the chronic phase of ALA in humans corresponds to lytic or liquefactive necrosis, whereas in rodent models there is granulomatous inflammation. However, the use of animal models has provided important information on molecules and mechanisms of the host/parasite interaction. Hence, the present review discusses the possible role of neutrophils in the effector immune response in ALA in rodents. Properly activated neutrophils are probably successful in eliminating amebas through oxidative and non-oxidative mechanisms, including neutrophil degranulation, the generation of free radicals (O₂⁻, H₂O₂, HOCl) and peroxynitrite, the activation of NADPH-oxidase and myeloperoxidase (MPO) enzymes, and the formation of neutrophil extracellular traps (NETs). On the other hand, if amebas are not eliminated in the early stages of infection, they trigger a prolonged and exaggerated inflammatory response that apparently causes ALAs. Genetic differences in animals and humans are likely to be key to a successful host immune response.

Genomic DNA microarrays for Entamoeba histolytica: applications for use in expression profiling and strain genotyping

The parasite Entamoeba histolytica is a causative agent of dysentery and liver abscesses. Found predominantly in developing countries, this parasitic infection is responsible for significant morbidity and mortality. We have developed a genomic DNA microarray for E. histolytica. The array composed of 11,328 clones contains >2000 unique genes and was utilized for expression profiling and comparative genomic hybridizations of Entamoeba strains. We present a synopsis of our results to date and potential future applications of microarray technology for the study of Entamoeba biology.

Comparative genomic hybridizations of Entamoeba strains reveal unique genetic fingerprints that correlate with virulence

Variable phenotypes have been identified for Entamoeba species. Entamoeba histolytica is invasive and causes colitis and liver abscesses but only in approximately 10% of infected individuals; 90% remain asymptomatically colonized. Entamoeba dispar, a closely related species, is avirulent. To determine the extent of genetic diversity among Entamoeba isolates and potential genotype-phenotype correlations, we have developed an E. histolytica genomic DNA microarray and used it to genotype strains of E. histolytica and E. dispar. On the basis of the identification of divergent genetic loci, all strains had unique genetic fingerprints. Comparison of divergent genetic regions allowed us to distinguish between E. histolytica and E. dispar, identify novel genetic regions usable for strain and species typing, and identify a number of genes restricted to virulent strains. Among the four E. histolytica strains, a strain with attenuated virulence was the most divergent and phylogenetically distinct strain, raising the intriguing possibility that genetic subtypes of E. histolytica may be partially responsible for the observed variability in clinical outcomes. This microarray-based genotyping assay can readily be applied to the study of E. histolytica clinical isolates to determine genetic diversity and potential genotypic-phenotypic associations.

The pathogenicity of Entamoeba histolytica is related to the capacity of evading innate immunity

The host and parasite factors that influence susceptibility to Entamoeba histolytica infection and disease are not well understood. Entamoeba histolytica pathogenicity has been considered by focusing principally on parasite rather than host factors. Thus, research has concentrated on explaining the molecular differences between pathogenic E. histolytica and non-pathogenic E. dispar. However, the amoeba molecules considered most important for host tissue destruction (amoebapore, galactose/N-acetyl galactosamine inhibitable lectin, and cysteine proteinases) are present in both pathogenic E. histolytica and non-pathogenic E. dispar. In addition, the genetic differences in pathogenicity among E. histolytica isolates are unlikely to completely explain the different outcomes of infection. Considering that the principal difference between pathogenic and non-pathogenic amoebas lies in their surface coats, we propose that pathogenicity of the amoebas is related to the composition and properties of the surface coat components (or pathogen-associated molecular patterns, PAMPs), and the ability of innate immune response to recognize these components and eliminate the parasite. According to this hypothesis, a key feature that may distinguish pathogenic (E. histolytica) from non-pathogenic (E. dispar) strains is whether or not they can overcome innate immune defences. A corollary of this hypothesis is that in susceptible individuals the PAMPs are either not recognized or they are recognized by a set of Toll-like receptors (TLRs) that leads to an inflammatory response. In both cases, the result is tissue damage. On the contrary, in resistant individuals the innate/inflammatory response, induced through the activation of a different set of TLRs, eliminates the parasite.

Increased frequency of HLA-DR3 and complotype SC01 in Mexican mestizo patients with amoebic abscess of the liver

Our preliminary study (31 patients) of HLA frequencies and amoebic abscess of the liver (AAL) in Mexican mestizos was extended to include 110 patients with this condition. The previously found increase in HLA-B16 was not confirmed, but the frequency of HLA-DR3 was again found significantly increased in patients with AAL when compared to the normal, ethnically matched control population, both in its isolated (35.5% vs 12.7%) and in the HLA-A2, DR3 haplotypic version (20.9% vs 4.5%). Moreover, seven of the 17 HLA specificities that were found to be individually different at P (yet not at PC) level in patients with AAL when compared to the control population, were actually HLA-DR3 containing haplotypes. HLA-DR3 may thus encode a risk factor(s) for AAL, at least in the Mexican mestizo population. Furthermore a significant increase in the complotype SC01 and its haplotypic version SC01, DR4 were identified in 45 non selected patients with AAL when compared to normal controls (31.1% vs 6.7% and 17.8% vs 0% respectively). Even though a relationship between allelic forms of complement components and their function has not been fully established, this complotype could represent a risk factor as well, since complement appears to play a role in host defence against amoebic invasion. Finally, no extended haplotype preference was found in these AAL patients.