Immune markers characteristic for asymptomatically infected and diseased Entamoeba histolytica individuals and their relation to sex

Bernin, Hannah; Marggraff, Claudia; Jacobs, Thomas; Brattig, Norbert W.; An, Lê Văn; Blessmann, Jörg; Lotter, Hannelore

doi:10.1186/s12879-014-0621-1

Cited by 30 publications

(33 citation statements)

References 49 publications

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“…Also, in this study, preliminary results of repeated cytokine analyses using stocked samples from one patient (case AA42) showed high serum levels of interleukin-4 (IL-4), a marker of asymptomatic E. histolytica infection (20), at 3.5 months before the onset of acute appendicitis, and the level decreased immediately after treatment of amoebic appendicitis (data not shown). Unfortunately, no control data were available for serum IL-4 levels in the HIV-1-infected individual who did not have E.…”

Section: Discussionmentioning

confidence: 70%

Underestimated Amoebic Appendicitis among HIV-1-Infected Individuals in Japan

et al. 2017

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Entamoeba histolytica is not a common causative agent of acute appendicitis. However, amoebic appendicitis can sometimes be severe and life threatening, mainly due to a lack of awareness. Also, its frequency, clinical features, and pathogenesis remain unclear. The study subjects were HIV-1-infected individuals who presented with acute appendicitis and later underwent appendectomy at our hospital between 1996 and 2014. Formalin-fixed paraffin-embedded preserved appendix specimens were reexamined by periodic acid-Schiff (PAS) staining and PCR to identify undiagnosed amoebic appendicitis. Appendectomies were performed in 57 patients with acute appendicitis. The seroprevalence of E. histolytica was 33% (14/43) from the available stored sera. Based on the medical records, only 3 cases were clinically diagnosed as amoebic appendicitis, including 2 diagnosed at the time of appendectomy and 1 case diagnosed by rereview of the appendix after the development of postoperative complications. Retrospective analyses using PAS staining and PCR identified 3 and 3 more cases, respectively. Thus, E. histolytica infection was confirmed in 9 cases (15.8%) in the present study. Apart from a significantly higher leukocyte count in E. histolytica-positive patients than in negative patients (median, 13,760 versus 10,385 cells/μl, respectively, P = 0.02), there were no other differences in the clinical features of the PCR-positive and -negative groups. In conclusion, E. histolytica infection was confirmed in 9 (15.8%) of the appendicitis cases. However, only 3, including one diagnosed after intestinal perforation, were diagnosed before the present analyses. These results strongly suggest there is frequently a failure to detect trophozoites in routine examination, resulting in an underestimation of the incidence of amoebic appendicitis.

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Section: Discussionmentioning

confidence: 70%

Underestimated Amoebic Appendicitis among HIV-1-Infected Individuals in Japan

et al. 2017

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“…Ultimately, the progression to symptomatic disease is dependent on a multitude of factors including gut microbiome composition, dysbiosis, hosts' age, hosts' genetic composition, immunogenicity (i.e., reduced cellmediated immunity), and the unique interaction between host-immunity and parasitic virulence. These have been shown to be a predictor of disease severity [9,[52][53][54][55], and are discussed in Fig. 1 below.…”

Section: Pathogenesis Of Entamoeba Histolyticamentioning

confidence: 98%

“…ALA generally affects men between 18 and 50 years of age, with the greatest prevalence occurring between the 4th and 5th decades of life [18,42]. The prevalence is also estimated to be 7-10 times greater in males compared with females [52,53]. Singh et al (2019) demonstrated that amongst 115 ALA cases in India, 93% were reported in males.…”

Section: Male Sexmentioning

confidence: 99%

Entamoeba histolytica and amoebic liver abscess in northern Sri Lanka: a public health problem

et al. 2020

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Entamoeba histolytica (E. histolytica) is a facultative protozoan parasite implicated in amoebic liver abscesses (ALA), the most common extraintestinal manifestation of this infection. E. histolytica is endemic to subtropical and tropical countries and has been a major public health concern in northern Sri Lanka (SLK) for the last three decades. This has been attributed to a multitude of factors such as poor sanitation, hygiene, male sex, middle age, overcrowding, unsanitary practices in the production of indigenous alcoholic beverages, and alcohol consumption. Additionally, while rates of E. histolytica have declined substantially throughout the rest of the island, largely due to better infrastructure, it remains pervasive in the northern peninsula, which is generally less developed. Infection arises primarily from fecal-oral transmission through the consumption of contaminated drinking water containing cysts. Upon ingestion, cysts multiply into trophozoites and colonize the host colonic mucosa using lectin and cysteine proteases as virulence factors, leading to host invasion. Symptoms occur along a spectrum, from asymptomatology, to pyrexia, abdominal cramping, and amoebic dysentery. Colonization of the colon results in the formation of distinct flask-shaped ulcers along the epithelium, and eventual penetration of the lamina propria via the production of matrix metalloproteinases. ALA then develops through trophozoite migration via the mesenteric hepatic portal circulation, where microabscesses coalesce to form a single, large right-lobe abscess, commonly on the posterior aspect. The progression of infection to invasive disease is contingent on the unique interplay between host and pathogen factors, such as the strength of host-immunity to overcome infection and inherent pathogenicity of the Entamoeba species. As a preventable illness, E. histolytica complications such as ALA impose a significant burden on the healthcare system. This mini-review highlights epidemiological trends, risk factors, diagnostic modalities, treatment approaches, and opportunities for prevention of E. histolytica-induced ALA, to help address this endemic problem on the island of SLK.

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“…In case series from endemic countries, the cited male to female ratio is between 3.2:1 and 13:1. [20][21][22][23] There are several explanations for this male predominance. Gupta presented a case series from India of 100 ALA cases, 88 males and 12 females.…”

mentioning

confidence: 99%

“…25 An immunologic assumption for the male predominance was given by Bernin and others who studied blood samples from Vietnamese ALA patients compared with asymptomatic amebiasis carriers and concluded that asymptomatic female carriers had significantly higher immunologic reaction markers and therefore developed less invasive disease than males. 20 An alternative explanation is given in an Indian case series that reported that among 220 ALA patients the majority were young or middle aged males belonging to the lower socioeconomic group and 85% gave a history of drinking toddy (fermented palm juice). Furthermore, the highest incidence of the disease occurred during the peak toddy season; therefore, they conclude that the male predominance is due to a behavioral explanation.…”

mentioning

confidence: 99%

Amebic Liver Abscess in Israeli Travelers: A Retrospective Study

Lachish

Wieder‐Finesod

Schwartz

2016

The American Journal of Tropical Medicine and Hygiene

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Abstract. Amebic liver abscess (ALA) is endemic in developing countries. The epidemiology and clinical characteristics of the disease in developing countries are well described. Travelers from nonendemic countries can serve as a model for the natural history of ALA. Currently, the available literature on travelers is limited. This is a retrospective observational study on Israeli travelers diagnosed with ALA. Data regarding travel history, clinical presentation, imaging, and treatment were collected and analyzed. Among 6,867 ill returning Israeli travelers, amebiasis was diagnosed in 53 travelers (0.77%), of whom 14 were with ALA (0.2%). Twelve ALA cases (86%) had an exposure in the Indian subcontinent. The male to female ratio was 1:1, with no significant clinical differences between the sexes. The average lag period between exposure and onset of symptoms was 17.1 months. The lack of male predominance and the prolonged lag period may imply that behavioral factors are pivotal in the development of ALA. Larger case series of travelers are required.

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Immune markers characteristic for asymptomatically infected and diseased Entamoeba histolytica individuals and their relation to sex

Cited by 30 publications

References 49 publications

Underestimated Amoebic Appendicitis among HIV-1-Infected Individuals in Japan

Underestimated Amoebic Appendicitis among HIV-1-Infected Individuals in Japan

Entamoeba histolytica and amoebic liver abscess in northern Sri Lanka: a public health problem

Amebic Liver Abscess in Israeli Travelers: A Retrospective Study

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