Acanthamoeba keratitis: new hopes for potential interventions for a curable but often refractory disease

ABSTRACT

Introduction

Often associated with contact lens wear, Acanthamoeba keratitis is an extremely painful blinding infection that has remained significant despite advances in drug discovery and chemotherapies. Current treatment is intricate and demands early diagnosis, aggressive and prolonged application, and may result in infection recurrence. The latter is due to the ability of the parasite to undergo cellular differentiation and transform into a resistant cyst form or infective trophozoite form.

Areas covered

Here, we present a review of our current understanding of emerging therapies and priorities tackling Acanthamoeba keratitis. Literature searches were carried out using bibliographic databases and results sifted and reviewed to present recent findings, challenges and novel opportunities in the development of therapeutic interventions and/or preventative measures against Acanthamoeba keratitis.

Expert opinion

Nanomedicine-based theranostics to combine diagnosis and treatment of Acanthamoeba keratitis offer remarkable opportunity in the development of clinical applications in the management of Acanthamoeba keratitis.

KEYWORDS:

• Acanthamoeba
• sight-threatening amoeba
• Eye infection
• free-living amoebae
• emerging therapies

Article highlights

• Acanthamoeba keratitis is a sight-threatening infection that is becoming more prevalent worldwide with the rise of contact lens wearers.

• In this review, current and emerging therapies are discussed.

• Developments of novel contact lens disinfectants using agents such as salicylic-based deep eutectic solvents or cetylpyridinium chloride hold promise for effective prevention.

• Nanomedicine-based theranostics offer promise in the development of clinical applications.

Declaration of interest

R Siddiqui and NA Khan are supported by the Air Force Office of Scientific Research (AFOSR), U.S.A.. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Acknowledgments

The authors wish to thank Sutherland Maciver (University of Edinburgh) for critical discussions.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

R Siddiqui and NA Khan are supported by the Air Force Office of Scientific Research (AFOSR), USA.