A Synthetic View on Acanthamoeba Keratitis Host Immune Response: Potential Factors Influencing the Development of Chronic Inflammation.

Purpose: The purpose of this study was to compile the current knowledge concerning Acanthamoeba keratitis (AK) host immune response to better understand the elements involved in the chronification of inflammation and worse disease outcomes.

Methods: A scoping review of the literature on AK host immune response was written after a systematic literature search was performed on the PubMed, Latin American Caribbean Health Sciences Literature, Cochrane Library, Embase, Web of Science, and Scientific Electronic Library Online databases. Recovered articles were screened according to inclusion and exclusion criteria, and the selected studies were analyzed to compile the review.

Results: The search strategy yielded a total of 768 articles from all searched databases. After the exclusion of duplicate records, 412 studies were screened according to inclusion and exclusion criteria. Finally, a total of 95 articles were selected to compile this review, of which 15 were included as additional bibliography. As for study type, 45 were experimental, 19 were observational, 23 were case reports, and 8 were reviews.

Conclusions: From the literature, both innate and adaptive immune systems seem to play an important role in AK control and resolution. On the other hand, there is also abundant evidence pointing out that the development of chronic and extracorneal inflammation is immune mediated and is influenced by several factors such as individual patient genetic variability, inadequate treatment, and Acanthamoeba strain pathogenicity.