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Antimicrobial Agents and Chemotherapy, March 2002, p. 695-701, Vol. 46, No. 3
0066-4804/02/$04.00+0     DOI: 10.1128/AAC.46.3.695-701.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Cytotoxic Activities of Alkylphosphocholines against Clinical Isolates of Acanthamoeba spp.

Department of Medical Parasitology, Clinical Institute of Hygiene,¹ Division of Specific Prophylaxis and Tropical Medicine, Department of Pathophysiology, University of Vienna, Vienna, Austria,² Max-Planck-Institute for Biophysical Chemistry, Göttingen, Germany³

Received 16 July 2001/ Returned for modification 20 September 2001/ Accepted 26 November 2001

Free-living amoebae of the genus Acanthamoeba are causing serious chronic conditions such as destructive keratitis in contact lens wearers or granulomatous amoebic encephalitis in individuals with compromised immune systems. Both are characterized by the lack of availability of sufficiently effective and uncomplicated, manageable treatments. Hexadecylphosphocholine (miltefosine) is licensed for use as a topical antineoplastic agent, but it is also active in vitro against several protozoan parasites, and it was applied very successfully for the treatment of human visceral leishmaniasis. The aim of our study was to evaluate the efficacy of hexadecylphosphocholine and other alkylphosphocholines (APCs) against Acanthamoeba spp. The in vitro activities of eight different APCs against three Acanthamoeba strains of various pathogenicities were determined. All substances showed at least amoebostatic effects, and some of them disrupted the amoebae, as shown by the release of cytoplasmic enzyme activity. Hexadecylphosphocholine exhibited the highest degree of cytotoxicity against trophozoites, resulting in complete cell death at a concentration as low as 40 µM, and also displayed significant cysticidal activity. Hexadecylphosphocholine may be a promising new candidate for the topical treatment of Acanthamoeba keratitis and, conceivably, even for the oral treatment of granulomatous amoebic encephalitis.

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