The importance of amebiasis to the proctologist.
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In order to gain better knowledge about pathomechanisms of amebiasis, histological and histochemical studies were performed on large and small intestine of guinea pigs infected by PS-2 Entamoeba histolytica strain. Results of these studies showed that the presence of E. histolytica in large intestine caused also pathomorphological changes of small intestine: partial atrophy of villi, epithelium destruction, epithelial metaplasia, lacteral dilation, infiltration of mucous membrane by lymphocytes, plasmocytes and macrophages. Influence of this parasite on lowering of investigated enzyme reactions and reduction of mucus secretion in large intestine as well as in small intestine of infected animals were also shown. These results suggest influence of E. histolytica cytotoxins (studied earlier by others authors) on the enzymes activity in host tissues and next on the weakness of intracellular metabolism and on cells destruction. For induction of these changes the adhesion host cell-amoeba is not necessary.
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Axenically cultivated Entamoeba histolytica, trophozoites, strains HM-1:IMSS and HM-38, were suspended in solutions of NaCl, 330 mOsm, of varying pH and ammonium concentrations. Short-term viability was inversely proportional to the ammonia concentration of the medium and was independent of the ammonium concentration and pH. The NH3-induced ameba killing was associated with a cellular alkalosis and cell swelling. While short-term trophozoite viability was unaffected by changes in the medium pH over the range 5.5-8.0, long-term viability was reduced by high pH, and of three pH values tested (6.27, 7.27, and 8.27), trophozoite growth was greatest at the lower value. Chemotaxis was observed in media over the pH range 5.5-8.0, and attenuated chemotaxis was observed in trophozoites in media containing NH3 (0.1 mM). The cecal content total ammonia concentration and pH and the in vivo mucosal microclimate pH were measured in young adult male rats, hamsters, and gerbils. Ceca of the three rodent species were also inoculated with HM-38 trophozoites and 7 days later the cecal contents were studied for signs of amebic infection. Infections were absent in the rat, the species with highest luminal total ammonia concentration and mucosal microclimate pH. All gerbils were infected. This species had the lowest mucosal microclimate pH. The hamster, with the intermediate microclimate pH, had a low infection rate (1 of 5). It is proposed that when ammonium diffuses from the large intestinal lumen into a more basic mucosal microclimate, it is converted to ammonia, and the combination of this ammonia and the high microclimate pH threatens Entamoeba trophozoite viability and reduces the probability of a given ameba penetrating the mucus blanket and invading the mucosal epithelium.
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The use of in vivo animal models in amebiasis has contributed significantly to the knowledge of this common human parasitic disease. Although there is no animal model that mimics the whole cycle of the human disease, the use of different susceptible and resistant laboratory animals and the availability for many years of techniques for the axenic culture of trophozoites of Entamoeba histolytica have allowed a better understanding of the parasite and the host-parasite relationship. The recent introduction of frontier methodologies in biology has increased our comprehension of this parasite. New information on the cellular and molecular biology and genetics of this organism has been extensively reported, and much of this has clearly required the more frequent use of animal models to verify specific facts. Based on experimental animals characterized previously, the introduction of new animal models with genetic or surgical modifications, especially in mice, has allowed a more adequate analysis of the mechanisms of pathogenesis. Multiple factors have been considered in the promotion of the invasiveness and virulence of E. histolytica. Additionally, the immunological and physiological responses of the host, depending on the environmental conditions, lead to the establishment or the rejection of the parasite. The role of inflammatory reaction to amebic infection constitutes one of the controversies that has been studied by several authors. In susceptible animals (hamsters and gerbils), inflammatory cell damage seems to be related to target cell lysis, while in resistant animals (mice), inflammatory cells appear to protect the host by lysing the parasite. Presently, the involvement of various substances in the development of lesions including lectins, proteases, amebapores, promoters of apoptosis, cytokines, nitric oxide, etc., is being examined using different in vivo models.
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