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Original Research |
Nidia León-Sicairos, DSc; Departamento de Biología Celular, Centro de Investigación y de Estudios, Avanzados del I.P.N. Apdo. 14-740, México, D. F. 07000, México; Hospital Pediátrico de Sinaloa, Depto. Investigación, Blvd. Constitución s/n, Col. Almada, Culiacán, Sinaloa 80200, México
Fernando López-Soto, MSc; Departamento de Biología Celular, Centro de Investigación y de Estudios, Avanzados del I.P.N. Apdo. 14-740, México, D. F. 07000, México
Magda Reyes-López, BSc; Departamento de Biología Celular, Centro de Investigación y de Estudios, Avanzados del I.P.N. Apdo. 14-740, México, D. F. 07000, México
Delfino Godínez-Vargas, MSc; Departamento de Biología Celular, Centro de Investigación y de Estudios, Avanzados del I.P.N. Apdo. 14-740,México, D. F. 07000, México
Cynthia Ordaz-Pichardo, DSc; Unidad Académica Multidisciplinaria Reynosa-Aztlán, Universidad Autónoma de Tamaulipas, Calle 16 y Lago de Chapala, Col. Aztlán, Reynosa, Tamps. 88710, México
Mireya de la Garza, DSc; Departamento de Biología Celular, Centro de Investigación y de Estudios, Avanzados del I.P.N. Apdo. 14-740, México, D. F. 07000, México
Reprint Requests: Mireya de la Garza, DSc, Departamento de Biología Celular, Centro de Investigación y de Estudios Avanzados del I.P.N., Apdo. 14-740, México, D.F. 07000, México, Tel: 52-55-50613987, Fax: 52-55-50613393, Email: mireya{at}cell.cinvestav.mx
Received: November 14, 2005.
Revised: February 14, 2006.
Accepted: March 30, 2006.
| Abstract |
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Design: Investigation in axenic cultures of Entamoeba histolytica trophozoites.
Methods: Amoebas were treated with 5%20% of human, bovine and swine milk, with 10% of human milk fractions (i.e., casein, proteins except casein and fat) or with 1 mg/ml of human milk apo-lactoferrin, human secretory immunoglobulin type A (sIgA) and chicken egg-white lysozyme (i.e., purified proteins). Milk proteins were detected using immunoblot. Confocal microscopy was used to define the interaction of milk proteins (100 µM each) and amoebas. Experiments were done at least three times in triplicate, and mean and standard deviations were calculated.
Results: Human and bovine milk were amoebicidal showing a concentration-dependent effect. The amoebicidal effect was increased in the absence of iron. Milk protein fractions, with the exception of casein, were the components responsible for the amoebicidal activity found. Apo-lactoferrin, sIgA and lysozyme were identified in the amoebicidal milk protein fraction. Apo-lactoferrin showed the major amoebicidal effect. These proteins, either alone or in combination, showed a killing effect on the trophozoites. They bound to the amoebic membrane causing cell rounding, lipid disruption and damage.
Conclusions: Milk proteins such as apo-lactoferrin, sIgA and lysozyme are able to kill Entamoeba histolytica trophozoites. This study confirms the importance of feeding breast milk to newborns.
Key Words: Amoebicidal Apo-lactoferrin Entamoeba histolytica Lysozyme Milk sIgA
Milk is a widely recognized, healthy, and nutritious source of energy, proteins, vitamins and minerals. In addition to the nutritional value of milk, there has been a growing interest in its capacity to kill microbes, and this knowledge can be applied to feeding recommendations for babies (e.g., breast milk) and also to the production of functional foods for people.13 Many compounds found in milk exhibit antimicrobial activity.49 For example, immunoglobulins are protective proteins important in the transfer of passive immunity from the mother to the neonate.1012 In addition to immunoglobulins, other proteins found in milk such as lactoferrin, lactoperoxidase, lysozyme and N-acetyl-ß-D-glucosaminidase are thought to have antimicrobial activity.13,14
Entamoeba histolytica is a pathogenic, parasitic protozoan that can infect the large intestine and cause amoebiasis, an illness responsible for at least 100,000 deaths annually worldwide. The capacity of human milk to kill amoebas6,15 and the amoebicidal action of secretory immunoglobulin type A (sIgA)16 have been reported. However, it is unknown which other components of milk are amoebicides. As milk contains several microbicidal components, we fractionated milk and tested each fraction against trophozoites in axenic cultures to describe any amoebicidal effects of other components of human and bovine milk such as lactoferrin, lysozyme and sIgA. We also sought to identify any combined effect among these molecules.
| Materials and Methods |
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Milk samples and fractions
Fresh human milk was donated by two healthy women at 40 days postpartum. Bovine and porcine milk were also used in some experiments. The samples were used either immediately or after storage at 70°C. Human milk samples were centrifuged at 4000 x g for 30 minutes at 4°C to remove fat and then again at 30000 x g for 6 hours at 4°C to separate the casein pellet.20,21
Susceptibility to anti-amoebic compounds
Protozoa suspended in BI-S-33 medium were adjusted to a cell density of 1x106 cells/ml. Experiments were performed following the addition of either milk, milk fractions or purified proteins each with and without iron. Milk samples (i.e., human, bovine and porcine milk) were tested at 5%, 10%, 15% and 20% after a 1 to 3 hour incubation period. Porcine milk was also tested with human and bovine apo-lactoferrin (Morinaga Milk Co., Japan). Human milk fractions were tested at 10% after 3, 6, 9 and 12 hour incubation periods. Purified proteins (i.e., human milk apo-lactoferrin, human colostrum sIgA and chicken egg-white lysozyme (Sigma-Aldrich, St. Louis, MO)) were added at 1.0 mg/ml and tested after a 3 hour incubation period. Tubes were mixed carefully by inversion and then incubated at 37°C for the times indicated. Lastly, the tubes were chilled on ice baths for 15 minutes. The number of living amoebas was determined by microscopic visualization using the criterion of exclusion of trypan blue dye in a Neubauer hemocytometer or by exclusion of propidium iodide measured by flow cytometry. Dead trophozoites, when they were not destroyed, could be easily recognized by staining with the dyes. Survival was expressed as the average percentage of living organisms in treated cultures in relation to the untreated ones. In flow cytometry assays, the amoebic fluorescence was quantified. Negative controls included media lacking milk, BI-S-33 and low-iron diluted with PBS in order to test the notion that the amoebicidal effect is due to the milk and not to the dilution itself. Each experiment was repeated three to five times in triplicate.
Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblot
Protein concentration was measured,22 and then 20 µg protein/well was loaded and run in a 10% SDS-PAGE by using the method of Laemmli.23 To detect the proteins of at 37°C and then cells were washed and stained with interest, the gel was electroblotted to a polyvinylidene difluoride membrane using a transfer apparatus according to the method described by Towbin et al.24 After electroblotting, the membrane was blocked at room temperature for 1 hour with 5% skim milk in PBS containing 0.1% Tween 20 (PBS-T) (Sigma-Aldrich). It was washed 3 times in PBS-T and was incubated for 1 hour with the following antibodies: mouse IgG anti-lactoferrin (1:100, Santa Cruz Biotechnology, Santa Cruz, CA), goat IgG anti-IgA (1:100, Zymed Laboratories Inc., San Francisco, CA), and rabbit IgG anti-lysozyme [obtained by us as follows: one rabbit was inoculated with 50 µg of chicken egg-white lysozyme (Sigma-Aldrich) every week; the first inoculation was delivered subcutaneously, and three boosts were delivered intramuscularly. IgG was purified by using the monoRec Ab column (Zymed Laboratories, Inc.), as indicated by the manufacturer]. After 3 washes with PBS-T, the membrane was incubated for 1 hour with horseradish peroxidase-protein A (1:10000 in PBS-T), washed with PBS-T, and incubated with 3,3-diaminobenzidine. Color reaction was developed using H2O2.
Confocal microscopy
Trophozoites were treated for 1 hour with 100 µM each of the following proteins: FITC-apo-lactoferrin, sIgA and lysozyme. They were then washed twice with PBS and fixed with 4% paraformaldehyde for 1 hour at 37°C. Next, amoebas were washed, permeabilized with 2.5% Triton X100 for 5 minutes at 37°C, washed and incubated for 1 hour at 37°C with the polyclonal antibodies anti-IgA and anti-lysozyme. Cells were then washed and incubated for 1 hour with secondary antibodies coupled to Cy5 (1:100, Zymed Laboratories, Inc.) to detect lysozyme and IgA. In order to determine whether these proteins affected the amoebic lipids pattern, parasites were stained with 100 µg/ml Nile red (Sigma-Aldrich) for 30 minutes, washed and their fluorescence intensity was estimated under flow cytometry. Stained trophozoites were then incubated with 1 mg/ml each of the three proteins together and fixed. The fluorescence intensity was measured, and samples were prepared for confocal microscopy.
| Results and Discussion |
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Amoebicidal effect of human milk is due to the protein fraction, with the exception of casein
The assumption that the observed killing effect of milk was produced by its proteins was corroborated by testing milk fractions on E. histolytica cultures. Milk samples were centrifuged in order to separate the casein pellet, lipids and the remaining proteins, and then each of these fractions was added to the medium containing trophozoites. After a 1 hour incubation period, the samples enriched in proteins showed amoebicidal activity, but cultures in which lipids or casein were added maintained viability (figure 2A
). Ten percent milk proteins significantly reduced the trophozoite number (i.e., 26%, 20%, 14%, 14% and 16% viability of amoebas after 1, 3, 6, 9 and 12 hours of incubation, respectively; figure 2A
) compared with 20% whole milk (i.e., 62%, 60%, 56%, 42% and 42% viability at the same times). Again, when iron was removed from the culture medium, the cidal effect displayed by the fraction containing proteins was higher (i.e., 16%, 14%, 8% and 8% after 3, 6, 9 and 12 hours of incubation, respectively; figure 2B
) than that in the iron-containing medium BI-S-33. Interestingly, the amoebicidal effect in all cases was marked in the first hours of interaction. Lipid fraction had low amoebicidal activity (i.e., 12% to 15% inhibition). These results show that proteins of milk, with the exception of casein which had little effect (i.e., approximately 8% to 10% of inhibition), attack the amoeba trophozoites. Casein is an anionic protein involved in the transport of ions, mainly calcium. Also, it has been reported that after digestion with pepsin and trypsin, resulting peptides have an antibacterial action against gram-positive bacteria,31 but other peptides kill gram-negative ones.32 Casein is also a cysteine-protease inhibitor.32 Perhaps casein does not have a direct amoebicidal action because its target sites may not be present in E. histolytica, and the amoebic cysteine-proteases and calcium transport are not affected by casein. Apparently, milk proteins without casein resulted in higher amoebicidal activity than whole milk. These components from the protein fraction are concentrated in comparison with those from whole milk. However, lipids and casein, which are also concentrated in fractions, had no amoebicidal effect.
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Although the sensitivity of E. histolytica toward sIgA, apo-lactoferrin and lysozyme was assayed in vitro, the parasites might also be affected in vivo due to the presence of these proteins in the large intestine, the area where E. histolytica infection occurs. Lactoferrin is a natural component of mothers milk. It is also found in all secretions that bathe the mucous membranes and is released from neutrophiles at infection sites. Lactoferrin is concentrated in oral cavities and comes in direct contact with pathogens killing them through a variety of different mechanisms.25,34,35 Thus, it is a first-line, innate immune defense in the human body.33 Lactoferrin also acts on the immune system. Exactly how it exerts the modulating function is not entirely clear. Specific receptors for lactoferrin are found in many key cells such as lymphocytes, monocytes and macrophages, and it is directly involved in the upregulation of natural killer (NK) cell activity. Most research points to lactoferrin as being more of an immune modulator rather than a simple stimulant of immunity. Thus, lactoferrin appears to be particularly important in the health and function of the intestinal tract. It greatly reduces inflammation in some bowel diseases,36 and lactoferrin concentration has been found to be augmented in the large intestine in patients with colitis or active ulcerative colitis, colon cancer,37 colon disorders and in other pathologies.38 These results indicate the crucial participation of lactoferrin at the large intestine level. Although we do not have data of fecal lactoferrin content during intestinal amoebiasis, it is probably increased by the neutrophiles degranulation, and lactoferrin could be acting against E. histolytica trophozoites.
Perhaps lactoferrin could be effective against intestinal amoebiasis. However, it must be administered in the free-iron state (i.e., apo-lactoferrin) and probably in enteric-coated formulas that permit passage through the site infected by E. histolytica in the colon. In the case of hepatic amoebiasis, the peptides derived from lactoferrin generated in the stomach by the action of pepsin absorbed in the small intestine can act throughout the body and ultimately reach the liver. Importantly, in animal models, the oral supplementation of vitamin A and lactoferrin has influenced growth of the ileum and colon.39 Published studies that have examined the use of lactoferrin as a food supplement and its effects on immunity have been quite promising. Researchers using various animal models have found that the ingestion of lactoferrin has a direct protective effect on the regulation and modulation of the immune system.40,41 Indeed, lactoferrin and its N-amino derived peptide, lactoferricin, are already used in therapy against pathogenic microorganisms and for several types of cancer in animal models and in patients.40 For example, one study that examined the immune response to the bacterial lipopolysaccharide found that feeding lactoferrin to mice dramatically reduced the lethality of this endotoxin and improved the immune response parameters.42 Another study with baby pigs reported that only 17% of the animals died when fed lactoferrin and simultaneously injected with the Escherichia coli endotoxin, as opposed to 74% of pigs dying that were not fed lactoferrin.43 This could be a major finding, as septic shock is the most frequent cause of death for intensive care patients and the thirteenth leading cause of death in the United States. A study using healthy human volunteers found that the ingestion of lactoferrin derived from bovine milk had positive immunoregulatory effects that were specific to the individual, and that lactoferrin may be applied in the clinic to improve the immune status of the patients.44
The main immunoglobulin in human milk is sIgA. E. histolytica contains surface antigens that interact with specific human immune sera; for example, the 260-kDa galactose-inhibitable lectin elicits serum and intestinal sIgA that have in vitro inhibitory activity.45 Furthermore, a known serine-rich protein isoform, a 29 kDa cysteine-rich protein, the
- and ß-elongation factor, and the glutamic acid-peptide are recognized by sIgA antibodies.46 IgA also inhibits amoebic proteolytic activities in vitro.47 In asymptomatic carriers, the recognition of the E. histolytica 115-kDa surface protein by human sIgA has been reported.48 In fact, it has been postulated for use in the vaccination with the E. histolytica Gal/Gal lectin, a molecule implicated in mediate parasite adherence to the colonic surface.49 In this work, we found a reduction of the E. histolytica trophozoite culture viability with human milk. As the milk donors were healthy persons without symptoms of amoebiasis or history of bowel inflammation, the milk used did not have increased anti-amoebic sIgA antibodies. However, these milk donors may have been carrying Entamoeba dispar, the non-pathogenic amoeba, and sIgA antibodies might recognize some antigens shared by E. histolytica and E. dispar. Akisu et al15 had similar results with milk from healthy lactating mothers. Undoubtedly, the presence of induced sIgA antibodies against E. histolytica in milk is important for protection of babies.
Interestingly, non-induced commercial sIgA was strongly bound to the amoebic surface in some sites co-localizing with apo-lactoferrin. This result suggests the presence of a receptor for this protein in the E. histolytica trophozoites, which remains to be determined. The binding of IgA to the amoebic surface could signal cellular death. In E. coli, non-immune binding of human IgA and IgG Fc by distinct sequence segments of a cellular surface has been reported. This immunoglobulin-binding protein is also present in other bacteria.50
Lysozyme is an enzyme present in milk and secretions of some mammalian species, especially in humans.14 Lysozyme concentration is higher in human colostrum and pre-colostral milk than in mature milk, and it acts against a wide number of bacterial species. Lysozyme kills bacteria by hydrolysis of the N-acetylmuramyl-(14)-ß-linkages of the peptidoglycan constituent of the bacterial cell wall.14,51 Since we found that lysozyme acted slightly against the amoeba and since this parasite lacks a cell wall, perhaps the amoebic membrane possesses a similar component to the bacterial peptidoglycan. A candidate could be the lipopeptidophosphoglycan, which was described by Isibasi et al.52 However, lysozyme was not effective against Giardia lamblia, a parasitic protozoan that infects the small intestine.6 Lysozyme usually functions in association with lactoferrin, sIgA and other microbicidal compounds.53 For example, lysozyme is effective against E. coli in concert with sIgA, and it causes lysis of some species of Salmonella in association with ascorbate and peroxide which are both present at low concentrations in milk.51 Lysozyme can limit the migration of neutrophils into damaged tissue and might function as an anti-inflammatory agent.54
To our knowledge this is the first report on the killing activity of milk protein components against the protozoan parasite E. histolytica. The only work concerning the effect of lysozyme and complement-dependent lysis of E. histolytica was reported 20 years ago.55 Although the biological activity of these compounds has been previously demonstrated for viruses, bacteria and yeasts, there is little known about the molecular basis of their killing activities. 6,9,15 In the case of apo-lactoferrin, it has potential as a new therapeutic agent for inflammatory bowel disease.56 It is important to say that apo-lactoferrin affects pathogens such as Salmonella enterica serovar Typhimurium and E. coli without inhibiting the growth of bifidobacteria. These data suggest that lactoferrin may have the potential to be combined with probiotic bacteria in biotherapeutic products, which could help to balance human gut microflora and limit the overgrowth of certain pathogenic microorganisms,57 including parasites. In conclusion, the observed specific effect of physiologically occurring proteins against E. histolytica may open up a new approach for drug development against this protozoan parasite.
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