Host-parasite interactions and mechanisms of infection in amebiasis

Main Article Content

Suriptiastuti Suriptiastuti


Amebiasis is caused by E. histolytica, which is the only species pathogenic in humans, while the pathogeneicity of E. dispar and E. moshkovskii is still unclear. The disease is endemic in the developing countries, mainly due to poor sanitation and lack of clean water supplies. Infection occurs by ingestion of E. histolytica cysts in fecally contaminated food or water. Excystation in the small intestine releases motile invasive trophozoites which migrate to the large intestine, adhere to the colonic epithelium by means of galactose and an amebic surface antigen, N-acetyl-D-galactosamine-specific lectin. This results in killing of epithelial cells, neutrophils, and lymphocytes by the trophozoites, presumably through secretion of the pore-forming proteins called amebapores and activation of caspase 3. The trophozoite virulence factor, cysteine proteinase, induces an inflammatory response, resulting in neutrophil-mediated damage. Hematogenous spread of trophozoites causes extraintestinal amebiasis, particularly amebic liver abscess (ALA), in the formation of which caspase 3 presumably also plays a role. The trophozoites in the liver induce tissue destruction, cellular necrosis and formation of microabcesses that coalesce into a large solitary abscess in 65-75% of cases. Results from pediatric studies reveal that partial immunity is acquired after infection with E.histolytica, the immunity however declining with age.

Article Details

How to Cite
Suriptiastuti, S. (2010). Host-parasite interactions and mechanisms of infection in amebiasis. Universa Medicina, 29(2), 104–113.
Review Article


Ravdin JL, Stauffer WM. Entamoeba histolytica (amebiasis). In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas, and Bennett’s Priciple and Practice of Infectious Diseases. 6th ed. Philadelphia, PA: Churchill Livingstone; 2005:3097-111.

WHO/PAHO/UNESCO report: a consultation with experts on amoebiasis: Mexico City, Mexico 28-29 January 1997. Epidemiol Bull 1997;18:13-4.

Petri WA Jr, Haque R, Lyerly D, Vines RR. Estimating the impact of amebiasis on health. Parasitol Today 2006;16:320-1.

Parija SC, Khairnar K. Entamoeba moshkovskii and Entamoeba dispar-associated infections in Pondicherry, India. J Health Pop Nutr 2005;23: 292-5.

Tanyuksel M, Ulukanligil M, Guclu Z, Araz E, Koru U, Petri WA Jr. Two cases of rarely recognized infection with Entamoeba moshkovskii. Am J Trop Med Hyg 2007;76:723-4.

Fotedar R, Stark D, Beebe N, Marriott D, Ellis J, Harkness J. Laboratory diagnosis techniques for Entamoeba species. Clin Microbiol Rev 2007;20:511-32.

Haque R, Petri WA. Diagnosis of amoebiasis in Bagladesh. Arch Med Res 2006;37:273-7.

Blessmann J, Van Linh P, Nu PA, Thi HD, Muller-Mihsok B, Buss H, et al. Epidemiology of amebiasis in a region of high incidence of amebic liver abscess in central Vietnam. Am J Trop Med Hyg 2002;66:578-83.

Stanley SL Jr. Amoebiasis. Lancet 2003;361: 1025-34.

Stanley SL Jr. Protective immunity to amebiasis: new insight and new challanges. J Infect Dis 2001;184:504-6.

Ali IKM, Hossain MB, Roy S, Ayeh-Kumi PF, Petri WA Jr, Haque R, et al. Entamoeba moshkovskii infections in children, Bangladesh. Emerg Infect Dis 2003;9:580-4.

Fotedar R, Stark D, Marriott D, Ellis J, Harkness J. Entamoeba moshkovskii infections in Sydney, Australia. Eur J Clin Microbiol Infect Dis 2008; 27:133-7.

Hamzah Z, Petmitr S, Mungthin M, Leelayoova S, Chavalitshewinkoon-Petmitr P. Differential detection of Entamoeba histolytica, Entamoeba dispar, and Entamoeba moshkovskii by a single-round PCR assay. J Clin Microbiol 2006;44: 3196–200.

Blessmann J, Ali IKM, Nu PA, Dinh BT, Viet TQ, Van AL, et al. Longitudinal study of intestinal Entamoeba histolytica infections in asymptomatic adult carriers. J Clin Microbiol 2003;41:4745-50.

Haque R, Mondal D, Kirkpatrick BD, Akhter S, Farr BM, Sack RB, et al. Epidemiologic and clinical characteristics of acute diarrhea with emphasis on Entamoeba histolytica infections in preschool children in urban slums of Dhaka, Bangladesh. Am J Trop Med Hyg 2003;69:398-405.

Acuno-Soto R, Maguire JH, Wirth DF. Gender distribution in asymptomatic and invasive amebiasis. Am J Gastrointerol 2000;95:1277-83.

Freedman DO, Weld LH, Kozarsky PE, Fisk T, Robins R, von Sonnenburg F, et al. Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med 2006;119-30.

Haque R, Huston CD, Hughes M, Houpt E, Petri WA Jr. Current concept: amebiasis. N Engl J Med 2003;346:1565-73.

Pritt BS, Graham C. Amebiasis. Mayo Clin Proc 2008;83:1154-60.

Blessmann J, Van AL, Tannich E. Epidemiology and treatment of amebiasis in Hue, Vietnam. Arch Med Reas 2006;37:270-2.

Haque R, Ali IM, Sack RB, Farr BM, Ramakrishnan G, Petri WA. Amebiasis and mucosal IgA antibody against the Entamoeba histolytica adherence lectin in Bangladesh children. J Infect Dis 2001;183:1787-93.

Petri WA Jr, Mann BJ, Haque R. The bittersweet interface of parasite and host: lectin-carbohydrate interactions during human invasion by the parasite Entamoeba histolytica. Annu Rev Microbiol 2001;56:39-64.

CDC.Amebiasis. Available at: http://www.dpd. Accessed June 22, 2010.

Yan L, Stanley SL Jr. Blockade of caspase inhibits amebic liver abscess formation in a mouse model of disease. Infect Immun 2001;69:7911-4.

Santi-Rocca J, Rigothier M-C, Guillen N. Host-microbe interactions and defense mechanisms in the development of amoebic liver abscesses. Clin Microbiol Rev 2009;22:65-75.

Lotter H, Jacobs T, Gaworski I, Tannich E. Sexual dimorphism in the control of amebic liver abscess in a mouse model of disease. Infect Immun 2006;74:118–24.

Maldonado-Bernal C, Kirschning CJ, Rosenstein Y, Rocha LM, Rios-Sarabia N, Espinosa-Cantellano M, et al. The innate immune response to Entamoeba histolytica lipopeptidophos- phoglycan is mediated by Toll-like receptors 2 and 4. Parasite Immunol 2005;27:127–37.

Ivory CP, Chadee K. Activation of dendritic cells by the Gal-lectin of Entamoeba histolytica drives Th1 responses in vitro and in vivo. Eur J Immunol 2007; 37:385–94.

Salles JM, Moraes LA, Salles MC. Hepatic amebiasis. Braz J Infect Dis. 2003;7:96-110.

Gill GV, Beeching NJ. Tropical Medicine. 5th ed. Oxford, UK: Blackwell Publishing; 2004.

Muzzafar J, Madan K, Sharma MP, Kar P. Randomized, single-blind, placebo-controlled multicenter trial to compare the efficacy and safety of metronidazole and satranidazole in patients with amebic liver abscess. Dig Dis Sci 2006;51:2270-3.

Lotter H, Jacobs T, Gaworski I, Tannich E. Sexual dimorphism in the control of amebic liver abscess in a mouse model of disease. Infect Immun 2006; 74:118-24.