Isoenzyme profile as parameter to differentiate pathogenic strains of Entamoeba histolytica in Brazil

South American Entamoeba dispar strains produce amoebic liver abscesses with different pathogenicities and evolutionary kinetics

Amoebiasis is a protozoan disease caused by Entamoeba histolytica, and presents a geographic distribution of worldwide amplitude, high incidence, sometimes accompanied by severe clinical manifestations such as amoebic colitis and Amoebic Liver Abscess (ALA), remaining as a public health problem in developing countries. Entamoeba dispar is another species of amoeba that infects approximately 12% of the world's population, and it has previously been classified as noninvasive. However, E. dispar has already been isolated from patients with symptomatic non-dysenteric colitis, as well as its DNA sequences were detected and genotyped in samples from patients with dysenteric colitis, and patients with ALA, suggesting that this species could also be involved in the development of lesions in the large intestine and liver of human beings. In this context, this study aims to evaluate the ability of isolated strains of Entamoeba dispar in South America to cause liver damage, and to better characterize histopathological findings in 3, 8, 12 and 16 days after infection (DAI). Firstly, we assessed whether trophozoites from MCR, ACFN, ICS, ADO and VEJ E. dispar strains, and EGG Entamoeba histolytica strain differed in their in vitro phagocytosis ability, being related to greater ability to phagocyte with greater virulence. Then, we investigate and characterize histopathological changes present in the liver of mice induced by different strains of E. dispar. Our results demonstrated that trophozoites from E. dispar strains are capable of phagocyting human erythrocytes, but in lower amounts than Entamoeba histolytica. In addition, we described and characterized the lesions in different periods after infection by different E. dispar strains, and identified ACFN as the most pathogenic strain, followed by MCR. The large areas of necrosis produced by the ACFN strain as the eighth DAI, which also show high parasitism, led to 100% mortality. On the other hand, the ICS, ADO and VEJ strains did not produce mortality, and this was correlated with the presence of well-developed chronic granulomatous inflammation, necrosis absorption throughout the infection, and regeneration of the liver parenchyma. The greater pathogenicity of the ACFN strain strongly suggests that this strain could be producing higher levels of virulence factors. As the experimental infection, the heterogeneity of biological behavior of different Entamoeba dispar strains could be involved in the development of undiagnosed human clinical conditions.

Co-infection by Salmonella enterica subsp. Enterica serovar typhimurium and Entamoeba dispar pathogenic strains enhances colitis and the expression of amoebic virulence factors

Amebiasis is the most severe protozoan infection affecting the human intestine, and the second leading cause of death among parasitic diseases. The mechanisms of amoebic virulence factors acquisition are poorly understood, and there are few studies showing the interaction between Entamoeba dispar and bacteria. Salmonella enterica subsp. enterica serovar typhimurium is also a common cause of gastroenteritis in humans. Considering the high rates of amebiasis and salmonellosis, it is possible that these diseases may co-exist in the human intestine, leading to co-infection. Due to the scarcity of studies showing the influence of enteropathogenic bacteria on amoebic virulence, our research group proposed to evaluate the impact of S. typhimurium on E. dispar trophozoites. We assessed whether co-infection of S. typhimurium and E. dispar can change the progression of amoebic colitis, and the inflammatory response profile in the caecum mucosa, using a co-infection experimental model in rats. In vitro assays was used to investigate whether S. typhimurium induces changes in amoebic virulence phenotype. In the present work, we found that S. typhimurium co-infection exacerbates amoebic colitis and intestinal inflammation. The in vitro association of S. typhimurium and E. dispar trophozoites contributed to increase the expression of amoebic virulence factors. Also, we demonstrated, for the first time, the cysteine proteinase 5 expression in E. dispar MCR, VEJ and ADO strains, isolated in Brazil. Together, our results show that S. typhimurium and E. dispar co-infection worsens amoebic colitis, possibly by increasing the expression of amoebic virulence factors.

Weissella paramesenteroides WpK4 ameliorate the experimental amoebic colitis by increasing the expression of MUC-2 and the intestinal epithelial regeneration

AIMS

This study evaluates the action of Weissella paramesenteroides WpK4 on amoebic colitis.

METHODS AND RESULTS

Weissella paramesenteroides WpK4 was administered in Entamoeba dispar infected and noninfected mice and clinical parameters were evaluated. Following 7 days, the caeca were collected for histopathology, morphometry and immunohistochemical staining of MUC-2, CDC-47 and IgA. The treatment reduced diarrhoea and the presence of blood in the faeces and diminished the area of necrosis, also causing weight gain. Also, the addition of this bacterium enhanced the expression of the mucin (MUC-2). The reduction in necrosis and increased CDC-47 expression indicates significant epithelial regeneration. The negative correlation between CDC-47 and the necrosis area reveals that the bacterium favoured the recovery of the necrotic regions and the positive correlation found between the expression of MUC-2 and CDC-47 indicates that the epithelial regeneration also supports the synthesis of MUC-2.

CONCLUSIONS

Weissella paramesenteroides WpK4 was able to increase the protection of the intestinal mucosa against experimental amoebic colitis through the increase of MUC-2 and epithelial regeneration.

SIGNIFICANCE AND IMPACT OF THE STUDY

Weissella paramesenteroides WpK4 presents the potential to become a complementary tool in the treatment of amoebic colitis.

Comparison of hemolytic activity of the intermediate subunit of Entamoeba histolytica and Entamoeba dispar lectins

Galactose and N-acetyl-D-galactosamine-inhibitable lectin of Entamoeba histolytica has roles in pathogenicity and induction of protective immunity in rodent models of amoebiasis. Recently, the intermediate subunit of the lectin, Igl1, of E. histolytica has been shown to have hemolytic activity. However, the corresponding lectin is also expressed in a non-virulent species, Entamoeba dispar, and another subunit, Igl2, is expressed in the protozoa. Therefore, in this study, we compared the activities of Igl1 and Igl2 subunits from E. histolytica and E. dispar using various regions of recombinant Igl proteins expressed in Escherichia coli. The recombinant E. dispar Igl proteins had comparable hemolytic activities with those of E. histolytica Igl proteins. Furthermore, Igl1 gene-silenced E. histolytica trophozoites showed less hemolytic activity compared with vector-transfected trophozoites, indicating that the expression level of Igl1 protein influences the activity. These results suggest that the lower hemolytic activity in E. dispar compared with E. histolytica reflects the lower expression level of Igl1 in the E. dispar parasite.

Entamoeba dispar: Could it be pathogenic

Amebiasis is a disease caused by the protozoan parasite Entamoeba histolytica. This ameba can colonize the human intestine and persist as a commensal parasite, similar to Entamoeba dispar, an ameba considered to be non-pathogenic. The similarities between E. histolytica and E. dispar make the latter an attractive model for studies aimed at clarifying the pathogenesis of amebiasis. However, in addition to being an interesting experimental model, this relative of E. histolytica remains poorly understood. In the 1990, it was believed that E. dispar was unable to produce significant experimental lesions. This scenario began to change in 1996, when E. dispar strains were isolated from symptomatic patients in Brazil. These strains were able to produce liver and intestinal lesions that were occasionally indistinguishable from those produced by E. histolytica. These and other findings, such as the detection of E. dispar DNA sequences in samples from patients with amebic liver abscess, have revived the possibility that this species can produce lesions in humans. The present paper presents a series of studies on E. dispar that begin to reveal a new facet of this protozoan.

Influence of inflammation on parasitism and area of experimental amoebic liver abscess: an immunohistochemical and morphometric study

The influence of inflammation on the number of trophozoites and on the murine amoebic liver abscess area following infection with Entamoeba histolytica and E. dispar was evaluated. Immunohistochemistry and digital morphometry were used to identify and quantify the trophozoites, neutrophils, macrophages, and lesions. Positive correlation was observed between the number of trophozoites and inflammatory cells. A significant decrease in parasitism and inflammation in groups treated with dexamethasone was observed. The scarceness or absence of trophozoites in the treated groups suggest the importance of the inflammatory response in the production of amoebic hepatic abscesses in spite of the inherent virulence of the parasite being decisive in the establishment of the lesion.

Histopathological and immunohistochemical study of the hepatic lesions experimentally induced by Entamoeba dispar

The sequence of hepatic necrotic-inflammatory events produced by Entamoeba dispar are originally described in this work. For the first time the experimental lesions produced by E. dispar were described in details, as well as the distribution of the trophozoites detected by the immunohistochemistry. Animals experimentally infected with E. dispar presented necrosis, thrombosis and chronic granulomatous inflammation. Immunoreactive products derived from trofozoites were observed close or associated with trophozoites, epithelioid cells, leucocytes and hepatocytes. Few are the articles on the literature about virulence of E. dispar, which is approximately 9 times more frequent than to Entamoeba histolytica (E. histolytica). Variation in the virulence is therefore expected and signalizing the need of the continuity of studies with E. dispar strains from different places in the world. Taking into account that E. dispar is a closely related species to E. histolytica, these studies could determine new elements involved with E. histolytica pathogenesis, helping us to better understand the disease.

Entamoeba histolytica and E. dispar trophozoites in the liver of hamsters: in vivo binding of antibodies and complement

BACKGROUND

Human amoebiasis is caused by the parasitic protozoan Entamoeba histolytica that lives in the large intestine of hosts, where can produce asymptomatic colonization until severe invasive infections with blood diarrhea and spreading to other organs. The amoebic abscesses in liver are the most frequent form of amoebiasis outside intestine and still there are doubts about the pathogenic mechanisms involved in their formation. In this study we evaluated the in situ binding of antibodies, C3 and C9 complement components on trophozoites, in livers of hamsters infected with E. histolytica or E. dispar. These parameters were correlated with the extension of the hepatic lesions observed in these animals and with trophozoites survivor.

METHODS

Hamsters were inoculated intra-hepatically with 100,000 trophozoites of E. histolytica or E. dispar strain and necropsied 12, 24, 48, 72, 144 and 192 h after inoculation. Antibodies, C3 and C9 binding to trophozoites were detected by immunohistochemistry. The estimation of the necrosis area and the number of labeled trophozoites was performed using digital morphometry analysis.

RESULTS

In the liver sections of animals inoculated with the amoebas, the binding of antibodies to E. histolytica trophozoites was significantly lower than to E. dispar trophozoites. Trophozoites of E. dispar were also more frequently vacuolated and high labeled cellular debris observed in the lesions. Positive diffuse reaction to C3 complement component was more intense in livers of animals inoculated with E. histolytica after 24 and 72 h of infection. C3(+) and C9(+) trophozoites were detected in the vascular lumen, granulomas and inside and in the border of necrotic areas of both infected group animals. C3(+) and C9(+) trophozoite debris immunostaining was higher in livers of E. dispar than in livers of E. histolytica. A positive correlation between necrotic areas and number of C9(+) trophozoites was observed in animals inoculated with E. dispar.

CONCLUSION

Morphological and immunohistochemical results suggest that antibodies and complement are able to bind and destroy some trophozoites in the liver of experimentally infected hamsters, perhaps selecting the more resistant parasites which are responsible by progression of amoebic abscesses. The findings indicate that E. histolytica possesses an enhanced ability in vivo to evade the immune responses compared to E. dispar, although it also causes experimental hepatic lesions.

An alternative method for DNA extraction and PCR identification of Entamoeba histolytica and E. dispar in fecal samples

Since it is known that Entamoeba dispar is non-pathogenic and morphologically similar to E. histolytica, there are many targets used in PCR for differentiating these species. However, obtaining high quality DNA from fecal samples is fundamental for PCR. Most methods are laborious or use kits that make diagnosis expensive. In the present work, a new simple, fast and cheap technique of DNA extraction from fecal samples was combined with a PCR for an episomal target in order to identify E. histolytica and E. dispar in feces.

Morbidity due to Schistosoma mansoni--Entamoeba histolytica coinfection in hamsters (Mesocricetus auratus)

Data on Schistosoma mansoni-Entamoeba histolytica coinfection are scarce in the literature. In the present study, hamsters that had been infected for 70 days with Schistosoma mansoni (LE strain) were inoculated via the portal vein with two strains of trophozoites of Entamoeba histolytica: ICB-EGG (highly virulent) and ICB-RPS (non-virulent). The most evident result of coinfection was increased morbidity and mortality, in comparison with either of the infections alone. Histologically, there were no evident signs of interaction between these two infections. The morphological findings of schistosomal granuloma and amoebic abscesses in the liver were similar to those seen in the respective single-infection controls. However, there was severe wasting of the animals with both infections and greater numbers of amoebic lesions in their livers. The results obtained indicated that schistosomiasis aggravates the course of amoebiasis in hamsters.

Pathogenicity of Entamoeba dispar under xenic and monoxenic cultivation compared to a virulent E. histolytica

Two xenic isolates and cloned cultures of Entamoeba dispar were submitted to monoxenization using Crithidia fasciculata as the associated organism. Growth in monoxenic cultivation and ability of xenic and monoxenic trophozoites to destroy VERO cells and produce lesions in hamster livers were compared to those of a virulent E. histolytica. Parental and cloned E. dispar under monoxenic cultivation showed a remarkable lower growth than the monoxenic E. histolytica and were avirulent in both in vivo and in vitro tests. When xenically cultured, trophozoites of E. dispar showed a moderate lytic activity against VERO cells (1.5 to 41.8% of destruction) but caused severe hepatic lesions in hamsters as those caused by the virulent E. histolytica (29 to 100% in prevalence and 0.86 to 4.00 in lesion degree). Although E. dispar has not been associated with invasive disease in men, the ability of xenic trophozoites to produce prominent tissue damage in experimental conditions has indicated that some strains have a considerable pathogenic potential when in presence of bacteria.

RAPD in the analysis of isolates of Entamoeba histolytica

Genetic variability in Entamoeba histolytica was analyzed by random amplified polymorphic DNA (RAPD) using ten arbitrary primers. Due to intrinsic characteristics of the RAPD technique only axenic samples were analyzed. since the presence of any microorganism in the cultures interfered in the DNA profile by generating RAPDs not pertaining to E. histolytica. The RAPD profiles of E. histolytica samples isolated from patients with different clinical manifestations from different regions of the Americas shared about 70% of the bands produced. These profiles were compared to those obtained for E. moshkorskii, and E. invadens. The combined data for the ten primers were used in the phenetic analysis of all the isolates studied by using the Dice similarity coefficient as the genetic distance measure between the samples. Three distinct groups could be separated by phenon line: one including E. moshkovskii samples, which shared > 90% of the RAPDs produced by the different primers; one consisting solely of E. invadens; and a third comprising samples of E. histolytica, which showed considerable intraspecific variability.