The immune response to Naegleria fowleri amebae and pathogenesis of infection

The genus Naegleria is comprised of a group of free-living ameboflagellates found in diverse habitats worldwide. Over 30 species have been isolated from soil and water but only Naegleria fowleri (N. fowleri) has been associated with human disease. Naegleria fowleri causes primary amebic meningoencephalitis (PAM), a fatal disease of the central nervous system. The pathogenesis of PAM and the role of host immunity to N. fowleri are poorly understood. Strategies for combating infection are limited because disease progression is rapid and N. fowleri has developed strategies to evade the immune system. The medical significance of these free-living ameboflagellates should not be underestimated, not only because they are agents of human disease, but also because they can serve as reservoirs of pathogenic bacteria.     

Light and Electron Microsopic Observations on the Pathogenesis of Naegleria fowleri in Mouse Brain and Tissue Culture

Two strains of pathogenic Naegleria were employed to infect mice and monkey kidney (Vero line) cell cultures. Mice were infected intranasally. Moribund mice were sacrificed and their brains processed for light and electron microscopy. The normal architecture of the infected brain was completely destroyed; the olfactory lobes and the cerebral cortex showed the heaviest damage. The inflammatory response was mainly in the form of neutrophil polymorphs (PMN) and was confined to the olfactory lobes and the superficial regions of cerebral cortex. Numerous amebas were seen interspersed with the degenerating neurons, glial processes, and PMN. Most conspicuous were the food vacuoles which contained host tissue in various stages of digestion. Amebas in the brain tissue also produced many micropinocytotic vesicles from the surface of the plasma membrane. These vesicles are interpreted as vehicles of transport of nutritive materials from the host tissue. The infected cell culture showed the characteristic cytopathic effect (CPE). The CPE was chiefly in the form of cell shrinkage, nuclear pycnosis and discontinuity of cell sheet. Amebas were often seen in an intracellular location. The Vero cells produced many fuzzy pinocytotic vesicles at these loci where the ameba plasma membrane and Vero cell membrane were in close apposition; the probable significance of this is discussed. Most impressive, however, were the pseudopodial formation and capturing of the host material which indicated the great phagocytic activity of the amebas. This was confirmed further by the presence of large numbers of food vacuoles containing host material in various stages of digestion. These observations show that the amebas invade and destroy the brain tissue by active phagocytosis.     

Diagnosis of the primary amoebic meningoencephalitis due to Naegleria fowleri

Trophozoites of the free-living amoeba, Naegleria fowleri, were isolated from the cerebrospinal fluid of meningoencephalitis patient. The infecting agent was identified as N. fowleri based on morphologic, serologic and molecular techniques carried out on the isolated organisms.     

Identification of Naegleria fowleri and other Naegleria spp. (free-living amoebae) using cellulose acetate membrane electrophoresis of glucose phosphate isomerase

Abstract A simple isoenzyme cellulose acetate membrane electrophoresis method with respect to glucose phosphate isomerase (GPI) was developed for the differentiation of the human pathogenic free-living amoeba Naegleria fowleri from other Naegleria spp. A single GPI band was detected in all the species tested, the relative mobility of which could be used to identify N. fowleri . Of the other Naegleria spp., only N. italica and N. jadini shared a common GPI mobility. No intraspecies variation in GPI profile was detected, regardless of whether the strains were cultured in monoxenic or axenic media. The technique is proposed as a useful means of identifying N. fowleri soon after isolation from the environment.     

Comparative Study of Six Strains of Naegleria with Special Reference to Nonpathogenic Variants of Naegleria fowleri*

SYNOPSIS. Naegleria fowleri strains HB-1 and KUL, pathogenic for humans, Naegleria gruberi strain 1518/1e, and 3 strains (Vm1, LvH₁, and LvH₂) of Naegleria isolated from a body of water polluted with thermal effluents were compared in an attempt at specific identifications of the latter strains. The 3 environmental isolates were morphologically almost identical with N. fowleri and had almost the same temperature tolerance, although at 37 and 42 C the growth rates of LvH₁ and LvH₂ were higher than those of the human pathogen, N. fowleri, and of isolate Vm1, which was pathogenic for mice. Serologic examinations by indirect fluorescent antibody method revealed a very close relationship of the new isolates with the human pathogens. While Vm1 was indistinguishable from N. fowleri, LvH₁ and LvH₂ were not, when cross-absorbed antisera were used. Of all the strains examined, only the 2 LvH isolates were not inhibited by amphotericin B, while only N. gruberi was not inhibited by fumagillin. The cytopathic effect in Vero cell cultures suggested that the LvH strains could have a certain degree of virulence, although this was not confirmed by intranasal and intracerebral inoculations of mice. The cytopathic effects of the human pathogens and of the isolate pathogenic for mice were related to their virulence for mice. It is concluded that there exists an intermediate form between N. gruberi and N. fowleri, with a strong relationship to the latter species. We refer to such strains as nonpathogenic variants of N. fowleri. Further research is needed to reveal their place in the taxonomy.     

Balamuthia Mandrillaris, N. G., N. Sp., Agent of Amebic Meningoencephalitis In Humans and Other Animals

ABSTRACT. We recently reported the isolation of a leptomyxid ameba from the brain of a mandrill baboon that died of meningo-encephalitis. Based on light and electron microscopic studies, animal pathogenicity tests, and immunofluorescence patterns, we conclude that our isolate differs fundamentally from the other two amebas ( Leptomyxa and Gephyramoeba ) included in the Order Leptomyxida. We therefore created a new genus, Balamuthia , to accommodate our isolate and described it as Balamuthia mandrillaris to reflect the origin of the type species. Briefly, B. mandrillaris is a pathogenic ameba that causes amebic encephalitis in humans and animals. It has trophic and cyst stages in its life cycle, and is uninucleate with a large vesicular nucleus and a central nucleolus. Mature cysts have a tripartite wall consisting of an outer loose ectocyst, an inner endocyst and a middle mesocyst. Unlike Acanthamoeba and Naegleria , the other two amebas that cause amebic encephalitis in humans, Balamuthia will not grow on agar plates seeded with enteric bacteria. However, Balamuthia grows on a variety of mammalian cell cultures and kills mice following intranasal or intraperitoneal inoculation. Based on immunofluorescence testing, 35 cases of amebic encephalitis in humans and three in other animals have been identified worldwide as being caused by Balamuthia .     

In-vitro activity of miltefosine and voriconazole on clinical isolates of free-living amebas: Balamuthia mandrillaris, Acanthamoeba spp., and Naegleria fowleri

The anticancer agent miltefosine and the antifungal drug voriconazole were tested in vitro against Balamuthia mandrillaris, Acanthamoeba spp., and Naegleria fowleri. All three amebas are etiologic agents of chronic (Balamuthia, Acanthamoeba) or fulminant (Naegleria) encephalitides in humans and animals and, in the case of Acanthamoeba, amebic keratitis. Balamuthia exposed to <40 microm concentrations of miltefosine survived, while concentrations of >or=40 microM were generally amebacidal, with variation in sensitivity between strains. At amebastatic drug concentrations, recovery from drug effects could take as long as 2 weeks. Acanthamoeba spp. recovered from exposure to 40 microM, but not 80 microM miltefosin. Attempts to define more narrowly the minimal inhibitory (MIC) and minimal amebacidal concentrations (MAC) for Balamuthia and Acanthamoeba were difficult due to persistence of non-proliferating trophic amebas in the medium. For N. fowleri, 40 and 55 microM were the MIC and MAC, respectively, with no trophic amebas seen at the MAC. Voriconazole had little or no inhibitory effect on Balamuthia at concentrations up to 40 microg/ml, but had a strong inhibitory effect upon Acanthamoeba spp. and N. fowleri at all drug concentrations through 40 microg/ml. Following transfer to drug-free medium, Acanthamoeba polyphaga recovered within a period of 2 weeks; N. fowleri amebas recovered from exposure to 1 microg/ml, but not from higher concentrations. All testing was done on trophic amebas; drug sensitivities of cysts were not examined. Miltefosine and voriconazole are potentially useful drugs for treatment of free-living amebic infections, though sensitivities differ between genera, species, and strains.     

Starch Gel Electrophoresis: An Effective Method for Separation of Pathogenic and Nonpathogenic Naegleria Strains*

SYNOPSIS. Isoenzyme electrophoresis of 7 different enzyme systems was used to compare 24 strains of Naegleria fowleri and 6 strains of N. gruberi. The 30 strains could be grouped into 4 distinct categories based upon zymogram patterns. No interstrain band variation in all enzyme systems was demonstrated in pathogenic strains of N. fowleri. Three nonpathogenic high temperature-tolerant strains of Naegleria had similar zymograms. Four of the 5 remaining nonpathogenic Naegleria strains had no interstrain band variation. Based upon zymograms, the 22 pathogenic strains constitute a homogenous species. Similarly the high temperature-tolerant nonpathogenic strains formed a cohesive group. The remaining nonpathogenic strains could be separated into 2 groups.     

Differentiation of Naegleria fowleri and other naegleriae by polymerase chain reaction and hybridization methods

Abstract In order to detect and identify Naegleria fowleri strains an assay based on the Polymerase Chain Reaction (PCR) was evaluated. The amplified DNA fragments were detected by gel electrophoresis and ethidium bromide staining, followed by Southern blot hybridization with an internal digoxigenin-labeled probe. A set of primers (B1B2) which flank a 678-bp region within a virulence-associated gene, allowed for the highly specific identification of N. fowleri , since Naegleriae ( N. lovaniensis, N. australiensis, N. gruberi, N. andersoni and N. jadini ) and other Protozoa did not react. These primers did not detect amplification products from various organisms: Gram-positive bacteria, algae, y, yeasts and human DNA. Whereas a second set of primers (A1A2), which flank a different sequence, detected various Naegleriae and Acanthamoebae strains. After 40 amplification cycles, the limit of detection was a single cell (cyst or trophozoite). Thus, the PCR appears to be a rapid and powerful tool for identification and detection of N. fowleri .     

Detection of Naegleria fowleri cysts in environmental samples by using a DNA probe

Abstract In this study we tried to detect DNA Naegleria fowleri in artificially contaminated environmental samples, with or without sediments, containing 10⁴ cysts of this pathogenic amoeba. We used two assays to extract DNA from samples: first, direct DNA extraction, which gave positive results only for water samples without sediment; second, DNA extraction after sample incubation on agar plates, which allowed us to remove amoeba growing out of the sediments, and which gave positive results for all samples, even those initially with sediments (5, 500 or 500 mg). Thus, this molecular identification appears as a powerful tool to investigate N. fowleri growth in environmental samples.     

Successful Demonstration of an Elusive Cell Coat in Amebae*

SYNOPSIS. Cell coats were cytochemically demonstrated for the first time in myxamebae of Fuligo septica, Didymium iridis, Dictyostelium discoideum, Cavostelium apophysatum, and amebae of Naegleria gruberi. The stain enhances the cell coats of Physarum polycephalum plasmodia, Ceratiomyxa fruticulosa myxamebae, and Acanthamoeba sp. Cell coats usually unstained by cationic dyes stain intensely with the aid of the new cytochemical protocol utilizing 0.5% Alcian blue in the primary fixative and 0.05% ruthenium red in the secondary fixative.     

Cessation of Nuclear DNA Synthesis in Differentiating Naegleria*

SYNOPSIS. DNA synthesis during growth and differentiation in Naegleria gruberi strain NEG populations has been studied. Autoradiography of cells labeled with [³H]thymidine revealed that grains are concentrated over the nuclei in logarithmically growing populations of cells, whereas in differentiating cells, grains are scattered over the cytoplasm; i.e. no significant nuclear labeling is detectable. It was established by MAK chromatographic analysis that [³H]thymidine is incorporated into double-stranded DNA in Naegleria and that the actual amount of incorporation in the logarithmically growing populations of cells is 20 times greater than that in differentiating cells. These results suggest that nuclear DNA synthesis is reduced markedly soon after the initiation of differentiation, while cytoplasmic DNA synthesis continues. It was established from cell cycle analysis that the approximate intervals of G₁, S, G₂, and M phases were 180, 183, 90, and 28 min, respectively. Hence, the reduction in the nuclear DNA synthesis in differentiating cells is not due to the inhibition of initiation of DNA replication, but rather to the termination of the DNA replicating process. Thus DNA synthesis is curtailed in the presence of RNA and protein synthesis which are required for differentiation.     

Cellular and Environmental Variables Determining Numbers of Flagella in Temperature-shocked Naegleria*

SYNOPSIS Naegleria gruberi amebae normally transform into biflagellated cells. When subjected to high temperatures during flagellate differentiation, populations develop an average of 4–5 flagella/flagellate. Attempts to maximize this phenomenon by altering cellular and environmental variables revealed that: (a) few Naegleria isolates become multiflagellated: strain NB-1 gives the greatest response to heat shocks: (b) temperature is the most critical variable: highest numbers of flagella are obtained only if cells are temperature-shocked at precisely 38.2 ± 0.1 C, then returned to 19–22 C to complete differentiation; (c) although pH alone does not affect numbers of flagella. a pH optimum of 5.5–7.0 exists for temperature-shocked cells; and (d) single cells in microdrops become multiflagellated, but the population response is density-dependent. Optimal conditions are described for growing, washing, and transforming amebae to generate reproducibly highest numbers of flagella.     

An Infectious Agent Associated with Amebas of the Genus Naegleria*

A study of amebas of the genera Naegleria, Acanthamoeba, Polysphondylium, and Didymium shows that a cytopathogenic agent that is filterable and passageable is present only in the strains of the Naegleria whether they are obtained free-living from soil samples (N. gruberi) or as pathogens from humans (N. fowleri). The agents obtained from the different Naegleria strains are similar in amount and in their cytopathogenic interaction with chick cultures. The agent has characteristics that distinguish it from the known viruses.     

A Simplified Overlay Plaque Technic for Evaluating Responses of Small Free-Living Amebae in Grassland Soils*

SYNOPSIS. The responses of amebae and bacteria in a grassland soil were investigated by an overlay plaque technic developed in this laboratory. This procedure, using Aerobacter aerogenes as the food source, allowed convenient assay of significant changes in ameba populations which resulted from additions of nutrient and water. In comparison with controls, when water was added an initial increase occurred in bacterial counts followed by an increase in the numbers of amebae. Upon addition of glucose, ameba populations increased initially and then decreased with time, while populations of bacteria remained constant. The addition of hay resulted in significant increases in populations of bacteria and amebae. Plaque appearance on enumeration plates was most rapid with inocula from nutrient-treated soils. Predominant amebae recovered by this technic were species of Acanthamoeba and Hartmannella. They were estimated to be present in untreated soils at 3.2 × 10³/gram. Ameba feeding experiments were used to evaluate the possible suitability of other bacteria as food. The results indicated that nonpigmented laboratory strains of bacteria were preferred, while pigmented grassland isolates were more rapidly utilized. Small soil amebae appear to be sensitive to minor soil perturbations, and the enumeration procedure developed in this study should aid in following their responses to environmental stresses.     

Preparation and Properties of Mitochondria from Naegleria gruberi*

Whole cell respiration rates were measured polarographically for Naegleria gruberi during growth in agitated cultures. Log growth phase amebae consumed 80 ng atoms O/min/mg cell protein. At stationary phase, respiration rate decreased 4–fold. Intact mitochondria were isolated from N. gruberi and their oxidative and phosphorylative capacities were studied polarographically. As with the mammalian system, the mitochondria oxidized succinate and NAD-linked substrates, but unlike rat liver mitochondria, those from the protozoan rapidly oxidized citrate and NADH. The rates of substrate oxidation were ADP-dependent, with ADP:O ratios equalling ? 2.8 for NAD-linked substrates and ? 2.2 for succinate. The respiratory control ratios. 2 to 4 for 11 substrates, were dependent on Pi, Mg²⁺, and serum albumin. Potassium cyanide, azide, malonale, and rotenone inhibited electron transport the same way as that of the mammalian system: however, amytal inhibited both glutamate and succinate respiration. Pentachlorophenol, DNP, and bilirubin uncoupled oxidation from phosphorylation. Difference spectra of oxidized and dithionite-reduced mitochondria had distinct absorption bands of flavins and of c-, b-, and α-type cytochromes.     

Isolation,Enumeration and Identification of Amebae from a Nebraska Lake*

A plaque technic was evaluated and used for the isolation and enumeration of small, free-living amebae in lake-bottom samples which were collected each month for one year from a Nebraska lake. Several culture media were evaluated, and a simple glucose-salts medium was chosen. The most frequent ameba in the lake-bottom samples was Acanthamoeba polyhaga which underwent marked increases and decreases in population densities during the collection period. This pattern was not correlated with water temperature, bacterial counts, and nitrate or phosphate levels. Other species of amebae of the genera Hartmannella, Vahlkampfia, Naegleria, Paratetramitus and Echinamoeba were isolated. Most of these were either found infrequently or remained at relatively low, constant densities throughout the year. In addition, 4 species of Acrasieae of the genera Dictyostelium and Polysphondylium were isolated from the lake-bottom samples.     

Naegleria fowleri: functional expression of the Nfa1 protein in transfected Naegleria gruberi by promoter modification

To establish a transient transfection system in a Naegleria, we constructed three nfa1-pEGFP-N1 vectors by the promoter replacement and insertion of a nfa1 gene and transfected the DNAs into Naegleria gruberi using a lipid reagent. The transfection efficiency and usefulness of the three modified vectors were estimated by identifying the expressions of the EGFP and Nfa1 protein from N. gruberi. After transfection, the Nfa1 protein was functionally expressed on pseudopodia of N. gruberi. The strong GFP fluorescence was observed in N. gruberi transfected with the actin-nfa1-pEGFP-N1 vector, of which the CMV promoter region in the expression vector was replaced with the actin 5' UTR region. Additionally, when transgenic N. gruberi trophozoites were co-cultured with CHO target cells, the Nfa1 protein was also located on cytoplasm and pseudopodia, especially on a food cup that was formed in contact with target cells as it shown in pathogenic N. fowleri.     

斜带髭鲷外周血嗜中性粒细胞核内包涵体的超微结构

目的在对斜带髭鲷（Hapalogenys nitens）外周血细胞结构进行透射电镜观察时发现嗜中性粒细胞存在大量的核内包涵体,系统研究了这些核内包涵体的超微结构,以探讨其来源和形成过程。方法应用电镜技术对这些核内包涵体的超微结构进行研究。结果斜带髭鲷外周血嗜中性粒细胞的核内包涵体可分为假包涵体和真包涵体两种类型,包涵体中的内含物来自胞质。胞核首先是以核膜内陷的方式将胞质及其各种有形成分包绕进核内而在核质外层形成具有双层膜包裹的典型假包涵体,随后假包涵体双层膜降解消失而转化成无被膜包裹的真包涵体,即核内糖原包涵体。结论假包涵体是形成真包涵体的开始阶段。随着假包涵体向真包涵体的转变,包涵体内含物的组成及其超微结构也出现了显著变化。