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1.
J Assoc Physicians India ; 67(4): 79-81, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31299848

RESUMO

Acute fulminant necrotizing amebic colitis rarely presents with massive lifethreatening lower gastrointestinal bleeding without diarrhea. Diagnosis is difficult as colonoscopy is suboptimal due to active bleeding, stool testing is often negative and a positive serology cannot confirm the diagnosis. We herein report a case of a 39-year-old male who presented with profuse bleeding per rectum, without associated significant antecedent history of fever or diarrhea. Colonoscopy was inconclusive as active bleeding obscured the vision. Computed tomography of abdomen revealed non-specific thickening of the caecum. Emergency laparotomy with right hemicolectomy and temporary ileostomy was performed. Microscopic examination of colonic mucosa revealed Entamoeba histolytica trophozoites with erythrophagocytosis suggestive of fulminant amebic colitis. Intravenous metronidazole was given subsequently and patient recovered completely. Ileocolonic anastomosis was done after closing the ileostomy three months later. This case highlights this exceedingly rare presentation of fulminant amebic colitis which poses a diagnostic challenge and can be life threatening without early surgical intervention.


Assuntos
Disenteria Amebiana/diagnóstico , Hemorragia Gastrointestinal/diagnóstico , Adulto , Colo , Colonoscopia , Diarreia , Disenteria Amebiana/terapia , Hemorragia Gastrointestinal/microbiologia , Hemorragia Gastrointestinal/terapia , Humanos , Masculino
2.
Parasit Vectors ; 12(1): 101, 2019 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-30867040

RESUMO

BACKGROUND: Despite similarities in morphology, gene and protein profiles, Entamoeba histolytica and E. moshkovskii show profound differences in pathogenicity. Entamoeba histolytica infection might result in amoebic dysentery and liver abscess, while E. moshkovskii causes only mild diarrhea. Extensive studies focus on roles of host immune responses to the pathogenic E. histolytica; however, evidence for E. moshkovskii remains scarce. METHODS: To study differences in host-antibody response profiles between E. histolytica and E. moshkovskii, mice were immunized intraperitoneally with different sets of Entamoeba trophozoites as single species, mixed species and combinations. RESULTS: Mice prime-immunized with E. histolytica and E. moshkovskii combination, followed by individual species, exhibited higher IgG level than the single species immunization. Mice immunized with E. moshkovskii induced significantly higher levels and long-lasting antibody responses than those challenged with E. histolytica alone. Interestingly, E. histolytica-specific anti-sera promoted the cytopathic ability of E. histolytica toward Chinese hamster ovarian (CHO) cells, but showed no effect on cell adhesion. There was no significant effect of immunized sera on cytopathic activity and adhesion of E. moshkovskii toward both CHO and human epithelial human colonic (Caco-2) cell lines. Monoclonal-antibody (mAb) characterization demonstrated that 89% of E. histolytica-specific mAbs produced from mice targeted cytoplasmic and cytoskeletal proteins, whereas 73% of E. moshkovskii-specific mAbs targeted plasma membrane proteins. CONCLUSIONS: The present findings suggest that infection with mixed Entamoeba species or E. moshkovskii effectively induces an antibody response in mice. It also sheds light on roles of host antibody response in the pathogenic difference of E. histolytica and E. moshkovskii trophozoites, and cell surface protein modifications of the amoebic parasites to escape from host immune system.


Assuntos
Anticorpos Antiprotozoários/imunologia , Disenteria Amebiana/parasitologia , Entamoeba/patogenicidade , Entamebíase/parasitologia , Abscesso Hepático Amebiano/parasitologia , Animais , Células CACO-2 , Diarreia/imunologia , Diarreia/parasitologia , Modelos Animais de Doenças , Disenteria Amebiana/imunologia , Entamoeba/imunologia , Entamoeba histolytica/imunologia , Entamoeba histolytica/patogenicidade , Entamebíase/imunologia , Humanos , Abscesso Hepático Amebiano/imunologia , Camundongos , Camundongos Endogâmicos BALB C
3.
Rev. bras. med. fam. comunidade ; 14(41): e1917, 02/2019. ilus
Artigo em Português | LILACS, Coleciona SUS | ID: biblio-996064

RESUMO

A diarreia crônica, caracterizada pela presença de mais de três dejeções de consistência pastosa durante pelo menos quatro semanas, é frequentemente encontrada na prática clínica. Na diarreia crônica, a probabilidade de uma etiologia infecciosa é baixa, sendo as causas funcionais, inflamatórias, osmóticas ou secretórias mais comuns. A amebíase intestinal é uma causa de diarreia crônica, causada pelo protozoário Entamoeba histolytica, sendo comum e prevalente em países em desenvolvimento. Pode ter várias formas de apresentação, sendo na maioria dos casos assintomática. Apresenta-se o caso clínico de um paciente de 27 anos, sexo masculino, raça caucasiana, homem que pratica sexo com homens (HSH), com diarreia crônica com início há cerca de seis anos. O exame objetivo não revelava alterações. Realizou exame parasitológico de fezes, com isolamento de quistos de Entamoeba histolytica. Foi medicado com metronidazol e paromomicina com resolução clínica do quadro. É importante para o Médico de Família equacionar esta etiologia na investigação de pacientes com diarreia, para um correto e atempado diagnóstico e tratamento, de modo a evitar exames desnecessários, possíveis complicações, a transmissão do agente e um grave problema de saúde pública.


Chronic diarrhea, characterized by the presence of more than three loose stools for at least four weeks, is often found in clinical practice. In chronic diarrhea, the probability of an infectious etiology is low, having usually a functional, inflammatory, osmotic or secretory origin. Intestinal amebiasis is a cause of chronic diarrhea, caused by the protozoan Entamoeba histolytica, common and prevalent in developing countries. It can have different presentations but most patients are asymptomatic. We present a 27-year-old Caucasian male, man who have sex with men (MSM), with chronic diarrhea starting six years ago. The physical exam was normal. A parasitological stool examination was performed with isolation of cysts of Entamoeba histolytica. He was treated with metronidazole and paromomycin with clinical resolution. It is important for General Practice to address this etiology in the investigation of patients with diarrhea for a correct and timely diagnosis and treatment, to avoid unnecessary testing, possible complications, transmission of the agent and a serious public health problem.


La diarrea crónica, caracterizada por la presencia de más de tres heces de consistencia blanda durante al menos cuatro semanas, es frecuentemente encontrada en la práctica clínica. En la diarrea crónica, la probabilidad de una etiología infecciosa es baja, siendo las causas funcionales, inflamatorias, osmóticas o secretoras más comunes. La amebiasis intestinal es una causa de diarrea crónica, causada por el protozoario Entamoeba histolytica, siendo común y prevalente en los países en desarrollo. Puede tener varias formas de presentación, siendo en la mayoría de los casos asintomática. Presentamos un paciente de 27 años, sexo masculino, caucásico, hombre que tiene sexo con hombres (HSH), con diarrea crónica con inicio hace cerca de seis años. El examen objetivo no reveló alteraciones. Realizó un examen parasitológico de heces, con aislamiento de quistes de Entamoeba histolytica. Fue medicado con metronidazol y paromomicina con resolución clínica del cuadro. Es importante para el médico de familia considerar esta etiología en la investigación de pacientes con diarrea, para un correcto y oportuno diagnóstico y tratamiento, de modo a evitar, exámenes innecesarios, posibles complicaciones, la transmisión del agente y un grave problema de salud pública.


Assuntos
Humanos , Masculino , Adulto , Saúde Pública , Diarreia , Disenteria Amebiana , Entamoeba histolytica
4.
Cochrane Database Syst Rev ; 1: CD006085, 2019 01 09.
Artigo em Inglês | MEDLINE | ID: mdl-30624763

RESUMO

BACKGROUND: Infection with the protozoan Entamoeba histolytica is common in low- and middle-income countries, and up to 100,000 people with severe disease die every year. Adequate therapy for amoebic colitis is necessary to reduce illness, prevent development of complicated disease and extraintestinal spread, and decrease transmission. OBJECTIVES: To evaluate antiamoebic drugs for treating amoebic colitis. SEARCH METHODS: We searched the available literature up to 22 March 2018. We searched the Cochrane Infectious Diseases Group Specialised Register, CENTRAL, MEDLINE, Embase, LILACS, mRCT, and conference proceedings. We contacted individual researchers, organizations, and pharmaceutical companies, and we checked reference lists. SELECTION CRITERIA: Randomized controlled trials of antiamoebic drugs given alone or in combination, compared with placebo or another antiamoebic drug, for treating adults and children with a diagnosis of amoebic colitis. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed the eligibility and methodological quality of trials and extracted and analysed the data. We calculated clinical and parasitological failure rates and rates of relapse and adverse events as risk ratios (RRs) with 95% confidence intervals (CIs), using a random-effects model. We determined statistical heterogeneity and explored possible sources of heterogeneity using subgroup analyses. We carried out sensitivity analysis by using trial quality to assess the robustness of reported results. MAIN RESULTS: In total, 41 trials (4999 participants) met the inclusion criteria of this review. In this update, we added four trials to the 37 trials included in the first published review version. Thirty trials were published over 20 years ago. Only one trial used adequate methods of randomization and allocation concealment, was blinded, and analysed all randomized participants. Only one trial used an E histolytica stool antigen test, and two trials used amoebic culture.Tinidazole may be more effective than metronidazole for reducing clinical failure (RR 0.28, 95% CI 0.15 to 0.51; 477 participants, eight trials; low-certainty evidence) and is probably associated with fewer adverse events (RR 0.65, 95% CI 0.46 to 0.92; 477 participants, 8 trials; moderate-certainty evidence). Compared with metronidazole, combination therapy may result in fewer parasitological failures (RR 0.36, 95% CI 0.15 to 0.86; 720 participants, 3 trials; low-certainty evidence), but we are uncertain which combination is more effective than another. Evidence is insufficient to allow conclusions regarding the efficacy of other antiamoebic drugs. AUTHORS' CONCLUSIONS: Compared with metronidazole, tinidazole may be more effective in reducing clinical failure and may be associated with fewer adverse events. Combination drug therapy may be more effective for reducing parasitological failure compared with metronidazole alone. However, these results are based mostly on small trials conducted over 20 years ago with a variety of poorly defined outcomes. Tests that detect E histolytica more accurately are needed, particularly in countries where concomitant infection with other bacteria and parasites is common.


Assuntos
Amebicidas/uso terapêutico , Disenteria Amebiana/tratamento farmacológico , Entamoeba histolytica , Amebicidas/efeitos adversos , Animais , Quimioterapia Combinada , Disenteria Amebiana/parasitologia , Humanos , Metronidazol/efeitos adversos , Metronidazol/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Tinidazol/efeitos adversos , Tinidazol/uso terapêutico
5.
Niger J Clin Pract ; 21(6): 812-815, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29888733

RESUMO

Type II enteropathy-associated T-cell lymphoma (Type II EATL) is a rare peripheral T-cell lymphoma of the gastrointestinal tract. Here, we report a case of Type II EATL, in which the patient with repeated diarrhea was diagnosed as ulcerative colitis and amebic infection at the beginning, but her symptom had no improvement after therapy. The diagnosis of Type II EATL was confirmed by the repeated biopsies and immunohistochemistry. This case suggests that Type II EATL is difficult to diagnose due to lack of specific symptoms and endoscopic features. It reminds us that for patients with increased intraepithelial lymphocytes and thickened bowel wall, lymphoma should be highly suspected and biopsy should be repeated if necessary.


Assuntos
Linfoma de Células T Associado a Enteropatia/patologia , Neoplasias Gastrointestinais/patologia , Biópsia , Colite Ulcerativa/diagnóstico , Diagnóstico Diferencial , Diarreia/complicações , Diarreia/diagnóstico , Disenteria Amebiana/diagnóstico , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade
6.
Intern Med ; 57(13): 1855-1860, 2018 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-29491283

RESUMO

We herein report a case of simultaneous amebic colitis and cytomegalovirus (CMV) enteritis in an HIV-infected patient. The patient was a 40-year-old man who developed bloody stool and diarrhea. We diagnosed him with severe amebic colitis associated with HIV infection and administered metronidazole. While his symptoms began to improve, the patient then developed CMV enteritis. We administered ganciclovir, and his symptoms improved. However, despite control of the infection, stenosis of the descending colon caused intestinal obstruction, and colostomy was performed. This case shows the importance of considering the possibility of simultaneous infection when gastrointestinal symptoms appear in people infected with HIV.


Assuntos
Antivirais/uso terapêutico , Colite/cirurgia , Infecções por Citomegalovirus/tratamento farmacológico , Disenteria Amebiana/tratamento farmacológico , Enterite/cirurgia , Ganciclovir/uso terapêutico , Infecções por HIV/complicações , Adulto , Colite/complicações , Colite/diagnóstico , Colite/tratamento farmacológico , Colostomia , Infecções por Citomegalovirus/complicações , Disenteria Amebiana/complicações , Enterite/complicações , Enterite/tratamento farmacológico , Humanos , Masculino , Resultado do Tratamento
7.
Can J Gastroenterol Hepatol ; 2018: 4601420, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30631758

RESUMO

Entamoeba histolytica is the responsible parasite of amoebiasis and remains one of the top three parasitic causes of mortality worldwide. With increased travel and emigration to developed countries, infection is becoming more common in nonendemic areas. Although the majority of individuals infected with E. histolytica remain asymptomatic, some present with amoebic colitis and disseminated disease. As more is learned about its pathogenesis and the host's immune response, the potential for developing a vaccine holds promise. This narrative review outlines the current knowledge regarding E. histolytica and E. dispar and insight in the development of a vaccine.


Assuntos
Antiprotozoários/uso terapêutico , Entamoeba histolytica , Entamebíase , Vacinas Protozoárias/uso terapêutico , Disenteria Amebiana/parasitologia , Entamoeba histolytica/imunologia , Entamebíase/parasitologia , Entamebíase/patologia , Entamebíase/prevenção & controle , Humanos , Viagem
8.
BMJ Case Rep ; 20172017 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-29196305

RESUMO

Multiple concurrent infectious processes have previously been reported in the context of advanced HIV with significant immunosuppression. Here we report a case of multiple infections in a 56-year-old man with well-controlled HIV diagnosed 5 years earlier. Soon after returning to Australia following 12 years living in Thailand, he became unwell with fevers, night sweats, arthralgia and myalgia. There were no localising symptoms and examination was unremarkable. Investigations revealed positive syphilis (Treponema pallidum) serology with an RPR of 16, a positive urine culture (Klebsiella pneumoniae), a pulmonary nodule, a liver abscess and colitis (Entamoeba histolytica). Recovery was only complete when all the individual infections were treated.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Síndrome de Imunodeficiência Adquirida/diagnóstico , Coinfecção/diagnóstico , Disenteria Amebiana/diagnóstico , Febre/diagnóstico , Infecções por HIV/diagnóstico , Sífilis/diagnóstico , Síndrome de Imunodeficiência Adquirida/virologia , Assistência ao Convalescente , Antirretrovirais , Antiprotozoários/uso terapêutico , Austrália/epidemiologia , Colonoscopia/métodos , Disenteria Amebiana/diagnóstico por imagem , Disenteria Amebiana/tratamento farmacológico , Entamoeba histolytica/parasitologia , Febre/etiologia , Infecções por HIV/tratamento farmacológico , HIV-1/isolamento & purificação , Humanos , Masculino , Metronidazol/administração & dosagem , Metronidazol/uso terapêutico , Pessoa de Meia-Idade , Sífilis/sangue , Sífilis/tratamento farmacológico , Tailândia/epidemiologia , Resultado do Tratamento , Treponema pallidum/imunologia
9.
Parasitol Int ; 66(6): 817-823, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28927906

RESUMO

Amebiasis is an infectious disease caused by Entamoeba histolytica, an anaerobic protozoan parasite, and is a major public health problem worldwide, particularly in areas with inadequate sanitation and poor hygiene. Th1 responses, represented by interferon gamma (IFN-γ), play a protective role by clearing the amebae from the gut, whereas Th2 responses are responsible for chronic infection. Th17 responses preconditioned by vaccination or by modulating the intestinal microbiome protect mice from the settlement of E. histolytica. However, the role of interleukin-17A (IL-17A), which is upregulated during the natural course of intestinal amebiasis, has not been clarified. The aim of this study was to investigate the role of IL-17A during intestinal amebiasis in a mouse model. IL-17A knockout and wild-type CBA/J mice were challenged intracecally with 2×106E. histolytica trophozoites, and their infection, pathology, and immune responses were monitored. Neither the initial settlement of E. histolytica nor the inflammation of the cecum was affected by the absence of IL-17A for week 1, but the infection rate and parasite burden declined in a late stage of infection, accompanied by an increased IFN-γ/IL-4 ratio. Therefore, IL-17A contributes to the persistence of E. histolytica and modulates the immune response, including the IFN-γ/IL-4 ratio, which may be responsible for the reduction of the parasite burden in the IL-17A knockout mice during the chronic phase of intestinal amebiasis.


Assuntos
Disenteria Amebiana/imunologia , Entamebíase/imunologia , Interleucina-17/genética , Animais , Disenteria Amebiana/parasitologia , Entamoeba histolytica , Entamebíase/parasitologia , Interleucina-17/metabolismo , Camundongos , Camundongos Endogâmicos CBA , Camundongos Knockout
10.
Infez Med ; 25(3): 281-284, 2017 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-28956549

RESUMO

A case of amoebic colitis and liver abscess is described in a previously fit 59-year old man who had been given the incorrect diagnosis of ulcerative colitis. His symptoms were so severe that a colectomy was being considered. The patient had a significant travel history including trips to Morocco, the Gambia and Cape Verde, putting him at risk of acquiring amoebic disease. However, this history was not ascertained until much later on in the disease process. The case highlighted crucial learning points including the importance of taking a lifelong travel history, the difficulties in telling ulcerative colitis and amoebic colitis apart both clinically and histopathologically, and the importance of sending multiple stool samples for parasitological microscopy analysis in patients being investigated for inflammatory bowel disease.


Assuntos
Colite Ulcerativa/diagnóstico , Erros de Diagnóstico , Disenteria Amebiana/diagnóstico , Entamebíase/diagnóstico , Abscesso Hepático Amebiano/diagnóstico , Terapia Combinada , Diagnóstico Tardio , Diagnóstico Diferencial , Drenagem , Disenteria Amebiana/tratamento farmacológico , Disenteria Amebiana/parasitologia , Disenteria Amebiana/patologia , Entamoeba histolytica/isolamento & purificação , Entamebíase/tratamento farmacológico , Entamebíase/parasitologia , Entamebíase/cirurgia , Fezes/parasitologia , Humanos , Abscesso Hepático Amebiano/tratamento farmacológico , Abscesso Hepático Amebiano/cirurgia , Masculino , Anamnese , Metronidazol/uso terapêutico , Pessoa de Meia-Idade , Nutrição Parenteral Total , Paromomicina/uso terapêutico , Doença Relacionada a Viagens
12.
PLoS Pathog ; 13(8): e1006513, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28817707

RESUMO

The disease severity of Entamoeba histolytica infection ranges from asymptomatic to life-threatening. Recent human and animal data implicate the gut microbiome as a modifier of E. histolytica virulence. Here we have explored the association of the microbiome with susceptibility to amebiasis in infants and in the mouse model of amebic colitis. Dysbiosis occurred symptomatic E. histolytica infection in children, as evidenced by a lower Shannon diversity index of the gut microbiota. To test if dysbiosis was a cause of susceptibility, wild type C57BL/6 mice (which are innately resistant to E. histiolytica infection) were treated with antibiotics prior to cecal challenge with E. histolytica. Compared with untreated mice, antibiotic pre-treated mice had more severe colitis and delayed clearance of E. histolytica. Gut IL-25 and mucus protein Muc2, both shown to provide innate immunity in the mouse model of amebic colitis, were lower in antibiotic pre-treated mice. Moreover, dysbiotic mice had fewer cecal neutrophils and myeloperoxidase activity. Paradoxically, the neutrophil chemoattractant chemokines CXCL1 and CXCL2, as well as IL-1ß, were higher in the colon of mice with antibiotic-induced dysbiosis. Neutrophils from antibiotic pre-treated mice had diminished surface expression of the chemokine receptor CXCR2, potentially explaining their inability to migrate to the site of infection. Blockade of CXCR2 increased susceptibility of control non-antibiotic treated mice to amebiasis. In conclusion, dysbiosis increased the severity of amebic colitis due to decreased neutrophil recruitment to the gut, which was due in part to decreased surface expression on neutrophils of CXCR2.


Assuntos
Disenteria Amebiana/microbiologia , Microbiota/imunologia , Infiltração de Neutrófilos/imunologia , Animais , Pré-Escolar , Modelos Animais de Doenças , Disenteria Amebiana/imunologia , Entamoeba histolytica , Fezes/microbiologia , Citometria de Fluxo , Humanos , Lactente , Camundongos , Camundongos Endogâmicos C57BL , Reação em Cadeia da Polimerase em Tempo Real , Receptores de Interleucina-8B/imunologia
14.
Pathog Glob Health ; 111(3): 128-136, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28335696

RESUMO

Entamoeba histolytica infection remains a public health concern in developing countries. Early diagnosis of amoebiasis can avoid disease complications, thus this study was aimed at developing a test that can rapidly detect the parasite antigens in stool samples. Rabbits were individually immunized with recombinant pyruvate phosphate dikinase (rPPDK) and E. histolytica excretory-secretory antigens to produce polyclonal antibodies. A rapid dipstick test was produced using anti-rPPDK PAb lined on the dipstick as capture reagent and anti-EhESA PAb conjugated to colloidal gold as the detector reagent. Using E. histolytica-spiked in stool sample of a healthy individual, the detection limit of the dipstick test was found to be 1000 cells ml-1. Meanwhile when rPPDK was spiked in the stool sample, the minimum concentration detected by the dipstick test was 0.1 µg ml-1. The performances of the dipstick, commercial Techlab E. histolytica II enzyme-linked immunosorbent assays (ELISA) and real-time PCR were compared using 70 stool samples from patients infected with Entamoeba species (n = 45) and other intestinal pathogens (n = 25). When compared to real-time PCR, the diagnostic sensitivity of the dipstick for detection of E. histolytica was 65.4% (n = 17/26); while the diagnostic specificity when tested with stool samples containing other intestinal pathogens was 92% (23/25). In contrast, Techlab E. histolytica II ELISA detected 19.2% (5/26) of the E. histolytica-positive samples as compared to real-time PCR. The lateral flow dipstick test produced in this study enabled rapid detection of E. histolytica, thus it showed good potential to be further developed into a diagnostic tool for intestinal amoebiasis.


Assuntos
Anticorpos Antiprotozoários/imunologia , Antígenos de Protozoários/imunologia , Disenteria Amebiana/diagnóstico , Entamoeba histolytica/imunologia , Piruvato Ortofosfato Diquinase/imunologia , Animais , Disenteria Amebiana/parasitologia , Entamoeba histolytica/enzimologia , Entamoeba histolytica/isolamento & purificação , Ensaio de Imunoadsorção Enzimática , Fezes/parasitologia , Feminino , Humanos , Limite de Detecção , Piruvato Ortofosfato Diquinase/genética , Piruvato Ortofosfato Diquinase/metabolismo , Coelhos , Fitas Reagentes , Reação em Cadeia da Polimerase em Tempo Real , Proteínas Recombinantes , Sensibilidade e Especificidade , Testes Sorológicos
15.
MBio ; 8(1)2017 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-28246365

RESUMO

The parasite Entamoeba histolytica is a cause of diarrhea in infants in low-income countries. Previously, it was shown that tumor necrosis factor alpha (TNF-α) production was associated with increased risk of E. histolytica diarrhea in children. Interleukin-25 (IL-25) is a cytokine that is produced by intestinal epithelial cells that has a role in maintenance of gut barrier function and inhibition of TNF-α production. IL-25 expression was decreased in humans and in the mouse model of amebic colitis. Repletion of IL-25 blocked E. histolytica infection and barrier disruption in mice, increased gut eosinophils, and suppressed colonic TNF-α. Depletion of eosinophils with anti-Siglec-F antibody prevented IL-25-mediated protection. In contrast, depletion of TNF-α resulted in resistance to amebic infection. We concluded that IL-25 provides protection from amebiasis, which is dependent upon intestinal eosinophils and suppression of TNF-α.IMPORTANCE The intestinal epithelial barrier is important for protection from intestinal amebiasis. We discovered that the intestinal epithelial cytokine IL-25 was suppressed during amebic colitis in humans and that protection could be restored in the mouse model by IL-25 administration. IL-25 acted via eosinophils and suppressed TNF-α. This work illustrates a previously unrecognized pathway of innate mucosal immune response.


Assuntos
Disenteria Amebiana/imunologia , Entamoeba histolytica/imunologia , Eosinófilos/imunologia , Interleucina-17/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Animais , Modelos Animais de Doenças , Humanos , Interleucinas/metabolismo , Camundongos
16.
J Infect Dis ; 215(8): 1294-1302, 2017 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-28186296

RESUMO

Understanding the mechanisms by which Entamoeba histolytica drives gut inflammation is critical for the development of improved preventive and therapeutic strategies. E. histolytica encodes a homolog of the human cytokine macrophage migration inhibitory factor (MIF). Here, we investigated the role of E. histolytica MIF (EhMIF) during infection. We found that the concentration of fecal EhMIF correlated with the level of intestinal inflammation in persons with intestinal amebiasis. Mice treated with antibodies that specifically block EhMIF had reduced chemokine expression and neutrophil infiltration in the mucosa. In addition to antibody-mediated neutralization, we used a genetic approach to test the effect of EhMIF on mucosal inflammation. Mice infected with parasites overexpressing EhMIF had increased chemokine expression, neutrophil influx, and mucosal damage. Together, these results uncover a specific parasite protein that increases mucosal inflammation, expands our knowledge of host-parasite interaction during amebic colitis, and highlights a potential immunomodulatory target.


Assuntos
Disenteria Amebiana/patologia , Fatores Inibidores da Migração de Macrófagos/imunologia , Neutrófilos/imunologia , Proteínas de Protozoários/imunologia , Animais , Anticorpos Bloqueadores/farmacologia , Células CACO-2 , Técnicas de Cultura de Células , Pré-Escolar , Disenteria Amebiana/tratamento farmacológico , Entamoeba histolytica/efeitos dos fármacos , Fezes/química , Interações Hospedeiro-Parasita , Humanos , Mucosa Intestinal/parasitologia , Mucosa Intestinal/patologia , Fatores Inibidores da Migração de Macrófagos/genética , Masculino , Camundongos , Camundongos Endogâmicos CBA , Infiltração de Neutrófilos/efeitos dos fármacos , Proteínas de Protozoários/genética
17.
Cir Cir ; 85 Suppl 1: 6-12, 2017 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-28126184

RESUMO

In the fourth century, during the Chinese Dong Jin dynasty, the doctor Ge Hong described good results after the oral administration of a suspension prepared from human faeces in patients with severe diarrhoea or food poisoning. Faecal microbiota transplantation has been used for five years in order to treat different diseases in addition to the severe diarrhoea caused by Clostridium difficile1. This paper aims to confirm that intestinal microbiota transplantation succeeds in reducing the negative impact of diseases such as severe diarrhoea, irritable bowel syndrome, anxiety, allergies, metabolic syndrome and others and that it is not only indicated for severe diarrhoea caused by C. difficile. This preliminary study included six patients who underwent faecal microbiota transplantation, aged 83, 76, 66, 37 and 36 years (four men and two women). An improvement in symptoms of 70% was observed. The methodology and criteria to be followed with donors are described and the results are listed in three tables. The methodology followed for the microbiota transplant is the same as that reported by other researchers for the treatment of C. difficile diarrhoea and other diseases. The discussion addresses the issues raised in other parts of the world in handling different pathologic entities, as well as genetic advances. The conclusions show encouraging results.


Assuntos
Ansiedade/terapia , Diarreia/terapia , Transplante de Microbiota Fecal , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/etiologia , Doença Celíaca/complicações , Colo/microbiologia , Comorbidade , Contraindicações de Medicamentos , Diarreia/etiologia , Diarreia/psicologia , Diverticulose Cólica/complicações , Disenteria Amebiana/tratamento farmacológico , Disenteria Amebiana/terapia , Esofagite/complicações , Feminino , Microbioma Gastrointestinal , Hérnia Hiatal/complicações , Humanos , Síndrome do Intestino Irritável/complicações , Jejuno/microbiologia , Síndromes de Malabsorção/complicações , Masculino , Metronidazol , Projetos Piloto , Quinolinas/uso terapêutico
18.
Parasitology ; 144(1): 48-58, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-26741568

RESUMO

The archaeological evidence for parasites in the Roman era is presented in order to demonstrate the species present at that time, and highlight the health consequences for people living under Roman rule. Despite their large multi-seat public latrines with washing facilities, sewer systems, sanitation legislation, fountains and piped drinking water from aqueducts, we see the widespread presence of whipworm (Trichuris trichiura), roundworm (Ascaris lumbricoides) and Entamoeba histolytica that causes dysentery. This would suggest that the public sanitation measures were insufficient to protect the population from parasites spread by fecal contamination. Ectoparasites such as fleas, head lice, body lice, pubic lice and bed bugs were also present, and delousing combs have been found. The evidence fails to demonstrate that the Roman culture of regular bathing in the public baths reduced the prevalence of these parasites. Fish tapeworm was noted to be widely present, and was more common than in Bronze and Iron Age Europe. It is possible that the Roman enthusiasm for fermented, uncooked fish sauce (garum) may have facilitated the spread of this helminth. Roman medical practitioners such as Galen were aware of intestinal worms, explaining their existence and planning treatment using the humoural theory of the period.


Assuntos
Doenças Parasitárias/história , Mundo Romano , Animais , Disenteria Amebiana/epidemiologia , Disenteria Amebiana/história , Disenteria Amebiana/parasitologia , Ectoparasitoses/epidemiologia , Ectoparasitoses/história , Ectoparasitoses/parasitologia , Entamoeba histolytica/isolamento & purificação , Europa (Continente)/epidemiologia , Fezes/parasitologia , Helmintíase/epidemiologia , Helmintíase/história , Helmintíase/parasitologia , Helmintos/isolamento & purificação , História Antiga , Humanos , Doenças Parasitárias/epidemiologia , Prevalência , Saneamento , Tricuríase/epidemiologia , Tricuríase/história , Tricuríase/parasitologia , Trichuris/isolamento & purificação
20.
In. Noya Chaveco, María Elena; Moya González, Noel Lorenzo. Roca Goderich. Temas de Medicina Interna. Tomo III. Quinta edición. La Habana, ECIMED, 5 ed; 2017. , tab.
Monografia em Espanhol | CUMED | ID: cum-68035
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