Submitted by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2013-10-15T17:14:57Z No. of bitstreams: 1 Gustavo Santos. Padronização de condições experimentais.2011.pdf: 3612850 bytes, checksum: 6681f5cbe674b715c7de996edc26d29d (MD5) / Made available in DSpace on 2013-10-15T17:14:57Z (GMT). No. of bitstreams: 1 Gustavo Santos. Padronização de condições experimentais.2011.pdf: 3612850 bytes, checksum: 6681f5cbe674b715c7de996edc26d29d (MD5) Previous issue date: 2011 / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / O protozoário, Entamoeba histolytica, constitui a etiologia de milhares de óbitos anuais e, em muitos casos, a falta de saneamento, o grau de instrução e a falta de higiene da população podem favorecer a transmissão e a manutenção desses patógenos em uma comunidade. Por causar tantas mortes e problemas na saúde pública trabalhos que facilitem o estudo deste parasito fazem-se importantes. Uma vez que a padronização de cultivo de E. histolytica em placas de poços vai Existem indicações que mostram que este parasito pode se tornar resistente ao medicamento utilizado no tratamento desta protozoose, por isso, a busca por novas substâncias que possam atuar como tratamento alternativo é de suma importância. Portanto, o objetivo do presente trabalho foi otimizar e padronizar o cultivo e a contagem deste parasito in vitro, além de identificar substâncias com potencial amebicida, que possam ser utilizadas no futuro como fármacos no tratamento da amebíase, sugerindo também uma via possível de ação das substâncias que apresentaram os melhores efeitos. Para tanto, os trofozoítos foram cultivados em placas de 24 poços sobre diferentes condições, quatro métodos de contagem de células foram comparados e 74 (setenta e quatro) substâncias foram testadas. Destas 13 (treze) apresentaram uma inibição na proliferação axênica dos trofozoítos de cerca de 70%. Destas, três compostos foram estudados em mais detalhes, os mesoiônicos derivados da piperina (as MII, MVI e MIX). Estas substâncias pertencem ao grupo dos compostos mesoiônicos, substâncias formadas por um anel heteroatômico composto por nitrogênio, carbono e enxofre, capazes de atravessar membranas e interagir com biomoléculas. Além disso, alguns mesoiônicos são doadores de radicais NO e tais grupamentos são capazes de induzir uma morte celular semelhante à apoptose em E. histolytica, como sugerido pela expressão de fosfatidil-serina revelada por anexina-V. Confirmando os resultados descritos na literatura, estas substâncias foram capazes de induzir uma morte programada, porém observações da ultra-estrutura, tais como figuras de mielina, das células tratadas apontaram para autofagia que também foi evidenciada por testes com MDC gerando apoptose tipo II, que pode ser iniciada pela presença de ROS, que neste caso foram por DCFDA. / The protozoan parasite, Entamoeba histolytica, is the etiology of thousands of deaths annually and in many cases lack of sanitation, education level and poor hygiene of the population may facilitate the transmission and maintenance of these pathogens in a community. There are indications showing that this parasite may become resistant to the drug used in treatment of protozoal disease, so the search for new substances that can act as an alternative treatment is of paramount importance. Therefore, the aim of this study was to optimize and standardize the cultivation and enumeration of this parasite in vitro, and identify substances with potential amebicidal, which can be used in future as drugs for the treatment of amoebiasis, suggesting a possible route of action of the compounds that showed the greatest effects. For this purpose, trophozoites were cultured in 24-well plates under different conditions, four methods of cell count were compared and 74 (seventy four) substances were tested. Of these thirteen (13) showed an inhibition in the proliferation of axenic trophozoites of about 70%. Of these, three compounds were studied in more detail, the mesoionic derivatives of piperine (the MII, MVI and MIX). These substances belong to the group of mesoionic compounds, formed by a heteroatomic ring composed of nitrogen, carbon and sulfur, able to traverse membranes and interact with biomolecules. Moreover, some donors are mesoionic radicals NO and such groups are able to induce a cell death similar to apoptosis in E. histolytica, as suggested by the expression of phosphatidyl-serine revealed by annexin-V. Confirming the results described in the literature, these substances were capable to inducing a programmed death, but observations of the ultra-structure, such as myelin figures, treated cells pointed out that autophagy was also evidenced by tests with MDC generating apoptosis type II can be initiated by the presence of ROS, which in this case were by DCFDA.

MSc (Microbiology) / Department of Microbiology

Universiẗat, Diss., 2005--Würzburg.

PhD (Microbiology) / Department of Microbiology / Background: Diarrheal diseases have a major effect on human health, Globally; it is second only to pneumonia as a leading cause of death among children under five. They are due to a variety of infectious and non-infectious agents; including Entamoeba spp. Entamoeba histolytica is an invasive enteric protozoan parasite that causes amebiasis. Amebiasis is frequent in communities without clean water and poor sanitation, which include low-income South African populations in Giyani and Pretoria. In these populations, the amount of diarrhea caused by Entamoeba histolytica inclusive of all ages, sexes and HIV status is uncertain. Diagnosis of the parasite is usually by microscopy. However, microscopy lacks sensitivity and specificity, therefore it is not reliable. Fortunately, molecular diagnostic tests have been developed to detect different Entamoeba species in humans. It is known that the parasite E. histolytica causes asymptomatic and symptomatic diseases. However, the transition from colonization to disease is still unclear. While parasite and host factors, as well as environmental conditions influence the infection outcome, there is currently no clear explanation of wide variation in the presentation of the disease. This could suggest that there are other factors affecting the disease outcome. A better understanding of these factors as well as their role in disease remains target objectives of modern scientists and it will definitely help in the fight against the disease. In spite of the emerging evidence that the host microbiome, parasite burden and the inflammatory response contribute to the virulence of E. histolytica, their roles have never been defined in developing regions such as Giyani and Pretoria. In addition, the present study hypothesized that co-infections with E. histolytica and secretion of extracellular vesicles/exosomes have a significant impact on the virulence of E. histolytica. Little has been explored or elucidated about responses triggered by other enteropathogens/ameba interplay that could be important in the induction of tissue invasion and disease and also how E. histolytica/enteropathogens interplay in these infections has not been determined. Therefore, the knowledge of this interplay could help in understanding how this modifies disease manifestations by modulating pathogen virulence and the host response. The use of secretion systems is an essential biological process exploited by pathogenic microorganisms to promote survival and spread of the pathogen, which in turn exacerbate the infection. The study of extracellular vesicles (EVs) released by pathogens is a new and exciting field that may realistically contribute to a better understanding of the pathogenic process of E. histolytica and provide alternate control strategies. Aim and objective of the study: The overall aim of the study was to determine the impact of enteric pathogens and secreted extracellular vesicles on amebic virulence and the outcome of infection. This aim was addressed in through a series of six primary objectives, which were: a. To investigate the distribution and prevalence of protozoan parasites in South Africa. b. To investigate novel species of Entamoeba circulating in the South African population. ix c. To elucidate the impact of gut microbiota and immune response during amebic infection. d. To determine the role of Entamoeba histolytica macrophage inhibitory factor (EhMIF) during amebic infection. e. To investigate the impact of co-infections on the outcome of amebiasis. f. To determine the presence of secreted extracellular vesicles/exosomes in Entamoeba histolytica. Brief methodology and results: A modified and validated Taqman qPCR assay (with taqman probes and genus specific primers) was used for amplification and target detection. This assay was used to investigate the distribution and prevalence of protozoan parasites (Cryptosporidium spp and Giardia lamblia) in South Africa, the assay was considered superior for this project because it is more sensitive than conventional PCR and it can be used to detect multiple infection targets. This assay allows fast, accurate, and quantitative detection of a broad spectrum of enteropathogens and is well suited for surveillance or clinical purposes. A total of 484 stool samples collected from diarrheal and non-diarrheal patients from rural and urban communities of South Africa were studied. The overall prevalence of parasites (Giardia lamblia and Cryptosporidium spp) in rural and urban patients were found to be 49% (112/227) and 21% (54/257) respectively (p= < 0.0001). The distribution of specific pathogens in rural areas was Cryptosporidium spp (20%) and Giardia lamblia (14%). Our findings showed no significant difference in parasitic infections between gender and the age of the participants (Chapter 3). The discovery of novel species is of great importance to human health. We have recently discovered stools positive for Entamoeba organisms by microscopy but PCR negative for known Entamoeba species. This led to the hypothesis that novel species of Entamoeba are present in the South African population. A comprehensive assay was used which included probes to identify Entamoeba bangladeshi from diarrheal and non-diarrheal participants. A sensitive qPCR assays and amplicon sequencing was used to detect Entamoeba spp, Prevotella copri and Enterobacteriaceae. Interestingly, E. bangladeshi was identified in the South African population. Entamoeba was present in 27% (E. histolytica 8.5% (41/484), E. dispar 8% (38/484), and E. bangladeshi 4.75% (23/484) E. moshkovskii was not detected in the present study. We were also able to observe changes in the host microbiome and the parasite burden associated with E. histolytica infections in S. African diarrhea cases versus asymptomatic controls but not with E. bangladeshi or E. dispar. In E. histolytica positive samples the level of both parasite and P. copri were lower in non-diarrheal samples (p=0.0034) (Chapter 4). There is accumulating evidence that the inflammatory response contributes to injury. Little is known about the key parasite mediators of host mucosal immunopathology. This study hypothesized that migration inhibitory factor (MIF) mediates the destructive host inflammatory response seen in amebic colitis. To determine the role of EhMIF during amebic infection, we used a genetic approach to test the effect of EhMIF on mucosal inflammation. We found that EhMIF induces IL-8 secretion from intestinal epithelial cells. Mice treated with antibodies that specifically block EhMIF had reduced chemokine expression and neutrophil infiltration in the mucosa. In addition to antibody-mediated neutralization, mice infected with parasites overexpressing EhMIF had increased chemokine expression, neutrophil influx and mucosal damage. We also found that the concentration of EhMIF correlated with the level of intestinal inflammation in persons with intestinal amebiasis. Together, our results reveal a novel parasite mediator of mucosal inflammation and support MIF homologs as potential immunomodulatory targets (Chapter 5). To investigate the impact of co-infections on the outcome of amebiasis, we analyzed the co-occurence of E. histolytica with other enteropathogens known to cause diarrheal infections, such as Shigella/EIEC (IpaH), Campylobacter (cadf), Enterotoxigenic E. coli (STh), Norovirus GII and Adenovirus (Hexon). The results were compared with those obtained with E. histolytica that were not interacted with enteropathogens and with E. histolytica interacted with enteropathogens. The impact of multiple infections on the outcome of the infection was compared between nondiarrheal and diarrheal stool samples. It was found that co-infections with two pathogens were associated with diarrhea compared to single infections. Moreover, Norovirus GII, Campylobacter (Cadf) and co-infections were associated with diarrhea in the study population. This study did not show any significant impact of pathogens co-infecting with E. histolytica on the outcome of amebic infection (Chapter 6). The presence of secreted extracellular vesicles/Exosomes in Entamoeba histolytica was determined by using the Pathogenic ameba strains (HM-1:IMSS or HM-1:IMSS (Sub-strain-US) from petri’s lab to purify exosomes using the commercially available kit to isolate exosomes (total exosomes isolation kit). Our study for the first time revealed that E. histolytica does secrete Evs. This finding increases the appreciation that all organisms are likely to secrete these EVs (Chapter 7). However, the impact of these EVs on the pathogenesis of E. histolytica needs further investigations. Conclusion: This study has contributed significantly to our knowledge on infectious diarrhea and the diversity of Entamoeba species by providing new data on the rate and prevalence of Entamoeba diarrheal infections and their distribution in the South African population. Our study describes for the first time the presence of E. bangladeshi in the South African population. Furthermore, our results reveal a novel parasite mediator of mucosal inflammation and support MIF homologs as potential immunomodulatory targets. This study also, for the first time revealed that E. histolytica does secrete EVs. The results from this work will undoubtedly open an exciting research to establish a deeper understanding of the function and role of these vesicles in amebic infection. We encourage public health interventions like health education programs and improvement of sanitation and hygiene in these populations. Molecular diagnostics should be used for specific diagnostic in clinical settings. / NRF

Saposin-ähnliche Proteine (SAPLIPs) sind membraninteragierende Proteine, die sich durch die konservierte Position von drei Disulfidbrücken, einer typischen alpha-helikalen Proteinfaltung und der Fähigkeit mit Lipiden zu interagieren, auszeichnen. Ihre zellulären Funktionen sind äußerst vielfältig. Bis zum Beginn des Genomsequenzierungsprojektes waren die Amoebapores die einzigen bekannten und charakterisierten SAPLIPs von Entamoeba histolytica, dem Erreger der humanen Amöbenruhr. Aufgrund ihrer antimikrobiellen Aktivität stellen sie für diesen parasitischen Einzeller, der sich von phagozytierten Bakterien ernährt, wichtige Effektormoleküle dar. Sie können aber auch cytolytisch auf Wirtszellen wirken und werden deshalb als bedeutender Pathogenitätsfaktor angesehen. Die theoretische computergestützte Datenbankanalyse nach Abschluss der Genomsequenzierung ergab, dass es 16 weitere Gene kodierend für SAPLIPs zusätzlich zu den drei Amoebapore-Genen gibt. Die Sequenzen der neuen SAPLIPs sind abgesehen von dem Cysteinmotiv divers und auch die Größe der Proteine ist sehr unterschiedlich (77 - 1009 Aminosäuren). Alle besitzen sie jedoch eine einzige, C-terminal gelegene SAPLIP Domäne. Außer der SAPLIP-Domäne konnten keine weiteren bekannten funktionellen oder strukturellen Domänen in den relevanten Datenbanken identifiziert werden, die auf mögliche Funktionen hätten hinweisen können. Alle SAPLIP-Gene werden gleichzeitig in axenisch kultivierten Trophozoiten transkribiert wie durch reverse Transkriptions-PCR gezeigt wurde. Die vergleichende transkriptionelle Analyse im Mikroarray ergab, dass nach Kontakt mit menschlichen Kolonzellen keine Hochregulierung dieser Gene mit Ausnahme des Amoebapore A Gens stattfindet. Für die parallele Klonierung der verschiedenen SAPLIP-Domänen wurde ein ”Expressionsscreening” in E.coli mit dem grün fluoreszierenden Protein als Reporterprotein etabliert, das die erfolgreiche Klonierung und Expression eines Fragments aufgrund der Fluoreszenz der Bakterienkolonie bereits auf der Ebene der Transformation anzeigt. Die rekombinant exprimierte und bis zur Homogenität gereinigte SAPLIP-Domäne von SAPLIP 12 wies Amoebapore-ähnliche Aktivitäten auf. Unter Verwendung von Liposomen konnte porenbildende Aktivität nachgewiesen werden, wobei diese Aktivität stark an einen sauren pH-Wert gebunden ist. Die SAPLIP-Domäne 12 ist aber auch antibakteriell und dieses sogar mit vergleichbarer Selektivität wie Amoebapore A, nämlich Zelllyse von gram-positiven B. megaterium war nachweisbar, jedoch nicht von gram-negativen E. coli. Strukturell unterscheiden sich die SAPLIP-Domäne 12 und Amoebapore A bezüglich der Exposition positiver Ladungsansammlungen auf der Proteinoberfläche und des Fehlens des für den Mechanismus der Amoebapores essentiellen Histidinrestes an entsprechender Position in der Sequenz. Darüber hinaus übt die SAPLIP-Domäne 12 eine im Vergleich zum Amoebapore A geringere spezifische Aktivität aus. Diese Eigenschaften weisen darauf hin, dass es sich um einen anderen Wirkungsmechanismus handeln könnte. Für die SAPLIP-Domäne 12 wäre eine über die positiven Ladungen der Proteinoberfläche vermittelte Interaktion mit den negativ geladenen Phospholipidköpfen von Membranen denkbar, die bei Erreichen einer bestimmten Konzentration in einer Störung der Lipidordnung und letztendlich in der Auflösung der Membranstruktur resultieren könnte. SAPLIP 3 ähnelt den Amoebapores in der Größe und molekularen Architektur und kann somit als funktionelle Einheit angesehen werden, es unterscheidet sich aber durch eine hohe negative Nettoladung von den Amoebapores. Außerdem ist das rekombinante SAPLIP 3 nicht antibakteriell und die Membraninteraktionen dieses SAPLIPs unterscheiden sich grundlegend von denjenigen, die für die Amoebapores beschrieben sind. SAPLIP 3 zerstört nicht einfach die Liposomenstruktur wie von den porenbildenden Amoebapores bekannt, sondern es vermittelt die Fusion von multilamellaren Liposomen unter Freisetzung des Liposomeninhalts. Diese Aktivität ist abhängig von der Anwesenheit anionischer Lipide und von einem sauren pH-Wert. Die Fähigkeit zur Vesikelfusion sowie die Verteilung der negativen Ladungen von SAPLIP 3 auf der Proteinoberfläche ähneln Merkmalen des humanen Saposin C. Neben der Funktion als Cofaktor von Exohydrolasen, die im Sphingolipid Katabolismus involviert sind, wird angenommen, dass die Fähigkeit von Saposin C, Vesikel zu fusionieren, wichtig für die Reorganisation der humanen lysosomalen Kompartimente ist. Die Saposin C-ähnlichen Charakteristika von SAPLIP 3 geben Grund zu der Annahme, dass es bereits in einem so basalen Organismus wie der Amöbe ein Protein mit Saposin-ähnlichen membranfusionierenden Aktivitäten gibt und dass dieses SAPLIP entsprechende Funktionen während endo- und exozytotischer Transportprozesse in der Amöbe übernehmen könnte. / Saposin-like proteins (SAPLIPs) are membrane-interacting proteins that are characterized by the conserved position of three disulphide bonds, a typical alpha-helical fold and the ability to interact with lipids. Their cellular functions are extremely diverse. Until the beginning of the genome-sequencing project, the amoebapores were the only known and characterized SAPLIPs of Entamoeba histolytica, which is the causative agent of human amoebiasis. Due to their antimicrobial activity, these proteins are important effector molecules of this unicellular parasite, which feeds on phagocytozed bacteria. However, they also exert cytolytic activity against host cells and therefore, they are considered to be a major pathogenicity factor of the amoeba. The theoretical computer-based data base analysis after the completion of genome sequencing revealed 16 genes coding for SAPLIPs in addition to the three amoebapore genes. The sequences of the novel SAPLIPs are diverse apart from the cysteine motif and furthermore, the sizes of the proteins are highly different (77 – 1009 amino acid residues). They all contain a single, C-terminally located SAPLIP domain. Beside the SAPLIP domain, no other functional or structural domains were identified in the relevant databases that would have pointed to possible functions. All SAPLIP-genes are transcribed in axenically cultured trophozoites at the same time as shown by reverse transcription PCR. The comparative transcriptional analysis using microarrays revealed that after six hours of contact with human cells and their phagocytosis none of these genes, with the exception of the amoebapore A gene, was upregulated. In order to clone the different fragments in parallel, an expression screening in E. coli with the green fluorescent protein as reporter protein was established, which indicates the successful cloning and expression of a fragment by the fluorescence of the bacterial colony already at the level of transformation. The SAPLIP domain 12, which has been recombinantly expressed and purified to homogeneity, exerts amoebapore-like activities. Using liposomes, pore-forming activity was detected, which is strongly dependent on acidic pH. Furthermore, the SAPLIP domain 12 is antibacterial even with similar selectivity as amoebapore A in that cell lysis of gram-positive B. megaterium was detectable but not of gram-negative E. coli. Structurally, the SAPLIP domain 12 differs from the amoebapores by exposing patches of positive charges on the protein surface und by lacking a histidine residue at a corresponding position in its sequence, which has been shown to be essential for the mechanism of amoebapore A. Moreover, the SAPLIP domain 12 displays a lower specific activity. These features indicate that this SAPLIP domain may act by means of another mechanism. It may interact with the negatively charged phospholipid head groups of membranes by its positively charged protein surface and after reaching a certain threshold concentration, possibly resulting in a disturbance of the lipid order and finally in the disintegration of the membrane structure. SAPLIP 3 resembles the amoebapores in size and molecular architecture and could therefore be considered as a functional unit, but it differs from the amoebapores by a highly negative net charge. Besides, the recombinant protein is not antibacterial and the membrane interactions of this SAPLIP are completely different from those described for the amoebapores. SAPLIP 3 does not simply destroy the liposome structure as known from the pore-forming amoebapores but induces leaky fusion of multilamellar liposomes. This activity is dependent on the presence of negatively charged lipids and on acidic pH. The capability of vesicle fusion as well as the negative charge distribution of SAPLIP 3 resembles features of the human saposin C. Beside its function as a cofactor of exohydrolases, which are involved in the sphingolipid catabolism, saposin C is considered to be involved in the reorganization of human lysosomal compartments due to its fusogenic activity. The saposin C-like characteristics of SAPLIP 3 suggest that a protein with saposin-like membrane fusogenic activity already exists in such a basal organism like an amoeba and that this SAPLIP fulfils corresponding functions during endo- and exocytotic transport processes in the amoeba.

A crude extract of axenically grown amoebae was used as antigen in order to develop an AB microELISA for the detection and quantitation of E. histolytica-specific IgG antibodies. This ELISA was used to screen individual sera of patients suffering from invasive amoebiasis (n=47)and control individuals(n=33). Significant titers of E-histolytica- specific IgG antibodies were present only in sera of patients suffering from invasive amoebiasis. The AB-microELISA had a sensitivity of 98% and a specificity of 97%. Immunoblot analysis of the crude E. histolytica extract indicated the presence of several antigenic proteins. One of the common antigenic proteins recognized by the individual patients' sera had a molecular weight of 160.170 kDa Sera of five patienta with high titers of E. histotytica-specific IgG antibodies were used to prepare a serum pool. This pooled serum was used for immunoscreening of an E. histolyitca cDNA expression library prepared in the phage vector l ZAP-II. A strongly immunoreactive phage done was identified, from which he recombinant phagemid was released by in vivo excision for characterization of the cDNA insert.

Invasive amebiasis, caused by the protozoan parasite Entamoeba histolytica, is one of the leading parasitic causes of mortality worldwide, and there are no vaccines available to control the disease. The heavy subunit of the E. histolytica Gal-lectin is regarded as a potential subunit vaccine candidate. A Th1 (cell-mediated) immune response is protective against invasive amebiasis, and DNA vaccination is a strategy to induce such a response against specific antigens. The objective of this study was to construct and test a Gal-lectin-based DNA vaccine against E. histolytica. DNA encoding as 894--1081 of the Gal-lectin heavy subunit was resynthesized using a gerbil codon frequency bias and inserted in a mammalian expression vector to generate the DNA vaccine pCISToGL6. Balb/c mice vaccinated intradermally developed a Gal-lectin-specific cellular immune response, as well as an anti-Gal-lectin humoral immune response. Serum antibodies recognized a recombinant portion of the Gal-lectin heavy subunit by immunoblot and ELISA, and bound to native Gal-lectin on the surface of live trophozoites, inhibiting adherence to target cells. The Gal-lectin-specific serum antibodies were of the IgG2a isotype, indicating that a Th1 response was stimulated by the vaccine. We were also interested in using DNA encoding IL-12, IL-18 or GM-CSF as genetic adjuvants co-injected with pCISToGL6 to potentiate the immune response. Since the DNA vaccine was destined to confer protection in the gerbil model of invasive amebiasis, we cloned gerbil IL-12 (p35 and p40), IL-18 and its convertase caspase-1, and GM-CSF. The proteins were expressed in mammalian cells and showed bioactivity in vitro. Taken together, these results have laid the foundation to optimize and test a working Gal-lectin with co-stimulatory molecules to elicit a Th1 immune response for protective immunity against invasive amebiasis.

Isoenzyme characterisation of Entamoeba histolytica into pathogenic and non-pathogenic zymodemes substantiated previously held views that this parasite con5titutes two distinct strains or even sub-species that are morphologically identical but vary in their pathogenicity. A reappraisal of the epidemiology of amoebiasis and investigation of the patho-physiological relationships between these pathogenic and non-pathogenic zymodemes and their host was therefore indicated. Only pathogenic zymodemes were isolated from hospitalised patients with amoebic liver abscess (ALA) and amoebic dysentery (AD). In the amoebiasis endemic peri-urban population of Durban, I. histolytica occurred at an overall prevalence of 10%. Carriers of non-pathogenic zymodemes constituted 9% of the population. A key observation was that asymptomatic infections with pathogenic zymodemes occurred at a prevalence of 1%. Higher prevalence of E. histolytica occurred in association with poor sanitary conditions. Furthermore., both pathogenic and non-pathogenic zymodemes tended to cluster into family units suggesting person-to-person transmission of the parasite by the faecal-oral route. Although invasive amoebiasis occurs far more frequently in males than females (8:1) both pathogenic and non-pathogenic zymodemes are equally distributed in male and female E. histolytica cyst passers. Ninety percent of carriers of pathogenic zymodemes spontaneously cleared their infections and remained asymptomatic throughout the study period of 2 years while 10% developed AD which required treatment with metronidazole. No spontaneous changes in zymodemes from the non-pathogenicto the pathogenic type was observed in a longitudinal study. The serological response of asymptomatic carriers of pathogenic zymodemes (100% seropositive) was identical to that of patients with ALA or AD with a high proportion (94-100%) of them being strongly seropositive. The prevalence of seropositivity amongst subjects who were not infected by E. histolytica (13% seropositive) was not statistically different (p>0,5) from that of the random population of this endemic area (19% seropositive) and carriers of non-pathogenic zymodemes (21% positive); the prevalence of strongly seropositive reactions among this group was only between 2-4%. It is concluded that a positive serological response is directly due to past or present contact with pathogenic zymodemes. This is further substantiated by the observation that the proportion of seropositive subjects was found to increase dramatically in a population near Cape Town where an outbreak of invasive amoebiasis (ALA and AD) occurred indicating a high prevalence of pathogenic zymodemes in this community. Another community in northern Transvaal (Gazankulu) where ALA and AD does not occur was, as expected, uniformly seronegative. Axenic growth of pathogenic zymodemes was possible but could not be accomplished with the non-pathogenic zymodemes. Even though monaxenic growth together with Trypanosoma cruzi was possible with both strains, the pathogenic zymodemes tended to grow more prolificly. No zymodeme changes from non-pathogenic to pathogenic and vice versa were observed with such changes in culture conditions. Cyst production by the pathogenic zymodemes in vivo was confirmed experimentally, thereby demonstrating the ability of pathogenic E. histolytica to independently complete their life-cycle thus giving it the ability to propagate itself successfully as a species. / Thesis (M.D.)-University of Natal, Durban, 1989.

Entamoeba histolytica, etiological agent of amebiasis, continues to be a significant threat to human health worldwide. The disease affects 10% of the world's population and leads to an estimated 100, 000 deaths a year. The parasite's surface Gal-lectin is an immunodominant protein that also mediates colonization and pathogenicity. The Gal-lectin is the most promising vaccine candidate against amebiasis. However, the immune mechanisms involved in protection against disease remain unclear. The objective of this study was to characterize the immunological basis of the host defense mechanisms using a Gal-lectin based vaccine. Exposure of the Gal-lectin with immature dendritic cells increased cell maturation and activation and upregulated co-stimulatory molecules and pro-inflammatory cytokines production. Dendritic cell activation was dependent on NF-kappaB and MAPK activation. In vaccination studies, the adjuvant effect of CpG-ODN, a synthetic oligodeoxynucleotide capable of stimulating Th1 immune responses enhanced the immune response to the Gal-lectin when administered systemically or mucosally. Protected animals had elevated anti-Gal-lectin serum and stool IgA antibodies capable of blocking parasite adherence in vitro. Analysis of cytokine responses in vaccinated and protected animals revealed increased IFN-gamma production compared to controls. Finally, E. histolytica DNA was shown to activate macrophages in a TLR9 and MYD88-dependent manner. Immunized gerbils with Gal-lectin and E. histolytica DNA induced protective immunity against a challenge infection. Taken together, these findings underscore the importance of multivalent subunit vaccines in Th1 mediated immune responses in host defense against amebiasis.

The enteric protozoan parasite Entamoeba histolytica is the etiologic agent of the disease amebiasis which is characterized by colitis or hepatic lesions. Amebae colonize the colon by binding to mucous glycoproteins (mucins). Secretory mucins provide the gel nature to mucus and are a vital component of epithelial barrier function. Mucins prevent contact-dependent cytolysis of colonic cells by E. histolytica. To possibly circumvent this barrier, the parasite secretes a potent yet unidentified mucin secretagogue, which could deplete the stored mucin pool and render the mucous layer less protective. The objective of this study was to investigate the molecular mechanisms by which E. histolytica modulates colonic mucin exocytosis. We showed that E. histolytica converts exogenous arachidonic acid to prostaglandin E2 (PGE2), a known mucin secretagogue and potential mechanism by which the parasite evokes mucin secretion. Conversion was via a novel cyclooxygenase-like activity and was inhibitable with the known cyclooxygenase inhibitor aspirin. To study E. histolytica-mucin interactions, we developed an in vitro model of LS174T human colonic epithelial cells that secrete mucin constitutively and in response to mucin agonists. Highly purified mucins isolated from LS174T cells markedly inhibited amebic adherence to target cells and the mucous barrier protected the LS174T monolayers from amebic cytolysis. We have identified that Gal and GalNAc residues (O-linked sugars) of mucins are the protective moiety as O- but not N-linked glycosylation inhibitors decreased their protective effect. To understand how mucins are regulated during intestinal amebiasis and in the inflamed gut, we determined that PGE2 binds the EP4 receptor on LS174T cells and in rat colon to stimulate cyclic adenosine monophosphate-dependent mucin exocytosis. Taken together, these studies delineate how E. histolytica modulates host responses during infection to allow the parasite to survive and persist in th