title: An update on Acanthamoeba keratitis: diagnosis, pathogenesis and treatment.
abstract: Free-living amoebae of the genus Acanthamoeba are causal agents of a severe sight-threatening infection of the cornea known as Acanthamoeba keratitis. Moreover, the number of reported cases worldwide is increasing year after year, mostly in contact lens wearers, although cases have also been reported in non-contact lens wearers. Interestingly, Acanthamoeba keratitis has remained significant, despite our advances in antimicrobial chemotherapy and supportive care. In part, this is due to an incomplete understanding of the pathogenesis and pathophysiology of the disease, diagnostic delays and problems associated with chemotherapeutic interventions. In view of the devastating nature of this disease, here we present our current understanding of Acanthamoeba keratitis and molecular mechanisms associated with the disease, as well as virulence traits of Acanthamoeba that may be potential targets for improved diagnosis, therapeutic interventions and/or for the development of preventative measures. Novel molecular approaches such as proteomics, RNAi and a consensus in the diagnostic approaches for a suspected case of Acanthamoeba keratitis are proposed and reviewed based on data which have been compiled after years of working on this amoebic organism using many different techniques and listening to many experts in this field at conferences, workshops and international meetings. Altogether, this review may serve as the milestone for developing an effective solution for the prevention, control and treatment of Acanthamoeba infections.
authors: University Institute of Tropical Diseases and Public Health of the Canary Islands, University of La Laguna, Avda. Astrofísico Fco. Sánchez, S/N, 38203 La Laguna, Tenerife, Canary Islands, Spain.
authors: Jacob
authors: J
authors: Lorenzo-Morales
authors: Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan.
authors: Naveed A
authors: NA
authors: Khan
authors: Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria.
authors: Julia
authors: J
authors: Walochnik
mesh_terms: D000048:Acanthamoeba / Q000201:enzymology / Q000235:genetics / Q000254:growth & development / Q000302:isolation & purification; D015823:Acanthamoeba Keratitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000563:Amebicides / Q000627:therapeutic use; D000818:Animals; D001681:Biological Assay; D002710:Chlorhexidine / Q000627:therapeutic use; D016039:Corneal Transplantation; D003432:Cross-Linking Reagents / Q000627:therapeutic use; D003941:Diagnostic Techniques, Ophthalmological; D006790:Host-Parasite Interactions; D006801:Humans; D006902:Hydroxymercuribenzoates / Q000627:therapeutic use; D051379:Mice; D010274:Parasitology / Q000379:methods; D010587:Phagocytosis; D015800:Protozoan Proteins / Q000502:physiology; D013048:Specimen Handling; D014774:Virulence
chemical_list: D000305:Adrenal Cortex Hormones; D000563:Amebicides; D003432:Cross-Linking Reagents; D006902:Hydroxymercuribenzoates; D015800:Protozoan Proteins; C030601:4-hydroxymercuribenzoate; D002710:Chlorhexidine