BB30052

Scientific Communication

The pathophysiology of
Junho Jung
Acanthamoeba
Keratitis
30th April 2007

Introduction

What is Acanthamoeba?

One of the most common protozoa in soil,

and also frequently found in fresh water
Most species are free-living bacterivores
some are opportunists that can cause
infections in humans and other animal
Relatively rare disease. However in 2002,
between 17 and 21 Acanthamoeba
infection cases per million contact-lens
wearers reported in UK.

Acanthamoeba as a
human pathogen

Acanthamoeba causes amoebic keratitis

and encephalitis
Eye infection has been associated with
contact lens use
Also enter the skin through a wound or
nostrils. Amoebas can travel to the lungs
and through the bloodstream to central
nerve system, cause fatal infection called
granulomatous amebic encephalitis (GAE).

Symptoms of
Acanthamoeba infection

A corneal ulcer may result from

exposures. This could be sightthreatening without proper treatment.
Acanthamoeba spp. can cause skin
lesions and a systemic (whole body)
infection.
GAE Patients may suffer with
headaches, stiff neck, nausea,
vomiting, tiredness, confusion, lack of
attention, loss of balance and bodily
control, seizures, and hallucinations.

The pathogenic cascade

of Acanthamoeba keratitis

Attachment
Destruction of epithelium and
upregulation of MMPs
Breachment of Bowmans
membrane
Degradation of stroma
Radialneuritis

Treatment for infection

with Acanthamoeba

Eye and skin infections are generally

treatable. Treatment is most effective
when the diagnosis is made promptly.
Because the cyst may form, and can be
highly resistant to therapy, a
combination of agents is generally used.
Although most cases of brain (CNS)
infection with Acanthamoeba have been
fatal, a few have recovered from the
infection with proper treatment.

Acanthamoeba and MRSA

Recent findings from the University

of Bath demonstrate that MRSA
can infect and replicate inside of
Acanthamoeba polyphaga;
Since A. polyphaga can form cysts,
cysts infected with MRSA can act
as a mode of airborne dispersal for
MRSA.

Concluding remarks

A better understanding of the pathogenic

cascade of Acanthamoeba keratitis could
lead to improved clinical treatment of this
and other amebic infections.
Might be possible to develop Multivalent
mucosal vaccines that induce multiple
secretory IgA antibodies that target the
lectin-binding molecules on the surface of
the amoeba and the proteases that are
released during invasion of the mucosal
surface.