2.1. Epithelial Adhesion and Desquamation
Ancanthamoeba has been observed to adhere to healthy epithelium, without a traumatic entry point [15]. This is facilitated by glycoproteins and glycolipids present on human corneal epithelial cells, which are believed to interact with a 136kDa mannose binding protein that is expressed on Acanthamoeba cells membranes [16]. The amoebae are able to burrow under epithelial cells, where they cause rapid desquamation through three mechanisms: direct epithelial cell cytolysis; phagocytosis; induction of apoptosis.