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Applied and Environmental Microbiology, June 2002, p. 3076-3084, Vol. 68, No. 6
0099-2240/02/$04.00+0 DOI: 10.1128/AEM.68.6.3076-3084.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
Crescent Bodies of Parachlamydia acanthamoeba and Its Life Cycle within Acanthamoeba polyphaga: an Electron Micrograph Study
Gilbert Greub and Didier Raoult*
Unité des Rickettsies, Faculté de Médecine, Université de la Méditerranée, Marseille, France
Received 27 September 2001/
Accepted 17 December 2001

ABSTRACT
Parachlamydiaceae are endosymbionts of free-living amoeba first
identified in 1997. Two developmental stages, elementary and
reticulate bodies, were observed; however, their localization
and proportions according to culture condition and duration
remain unknown. The life cycle of
Parachlamydia acanthamoeba within
Acanthamoeba polyphaga was studied by transmission electron
microscopy of 8-, 36-, and 144-h coculture. Morphometry and
quantification were performed using SAMBA software. The elementary
body, the predominant stage within the amoebae, was located
mainly within their vacuoles. The multiplication of
Parachlamydia bacteria by binary fission of reticulate bodies was independently
associated with culture in PYG broth (odds ratio [OR] = 4.4;
95% confidence interval [CI], 1.55 to 12.46) and with the presence
of reticulate bodies within the amoebae (OR = 2.10; 95% CI,
1.53 to 2.89). A third developmental stage was observed, the
crescent body. Its presence outside and inside the amoebae was
associated mainly with prolonged incubation time (OR = 3.98;
95% CI, 1.49 to 10.68, and OR = 5.98; 95% CI, 1.75 to 20.4,
respectively). Elementary and crescent bodies were released
into the extracellular medium within vesicles or after amoebal
lysis. For both, phagocytosis was their mode of entry. This
electron micrograph study revealed another infective developmental
stage, the crescent body, and provided quantitative analysis
of the life cycle of
P. acanthamoeba within
A. polyphaga.

INTRODUCTION
Legionella was the first pathogen demonstrated to multiply and
persist in free-living amoebae (
21), which are common inhabitants
of natural aquatic environments and water systems (
11,
19).
Since then, several other intracellular bacterial pathogens
were shown to infect free-living amoebae, including
Chlamydia pneumoniae (
6),
Mycobacterium avium (
24),
Listeria monocytogenes (
13), an
Ehrlichia-like organism (
15), the Legionella-like amoebal
pathogens (
3,
9),
Afipia species (
12), and
Chlamydia-like endosymbionts
(
1,
4). The latter,
Parachlamydia acanthamoeba, could be pathogenic
for humans (
7a). However, there are only eight strains of
Parachlamydiaceae described to date, including the BN9 endosymbiont (
1) and Hall's
coccus (
4). Amann et al. demonstrated the presence of two developmental
stages, a thin-walled gram-negative stage and a gram-positive
infective stage (
1). These two stages, i.e., reticulate and
elementary bodies (well known for
Chlamydia spp. [
16,
17]),
were also subsequently reported by Horn et al. and by Fritsche
et al. for additional
Parachlamydiaceae strains (
7,
10). However,
the localization of these bodies within free-living amoebae
according to culture condition and duration was not yet studied.
It is unknown how they exit the protozoan host. Fritsche et
al. showed the presence of
Chlamydia-like inclusions in a cyst
of
Acanthamoeba (
7), suggesting that amoebae could also act
as Trojan horses for the
Parachlamydiaceae, since amoebae are
resistant to various disinfecting solutions (
5,
20,
26) and
to extreme temperature, pH, and osmolarity conditions while
encysted (reviewed in reference
18).
In the present paper, we report on a third and as yet unknown developmental stage, the crescent body, and on the life cycle of P. acanthamoeba within Acanthamoeba polyphaga.

MATERIALS AND METHODS
Broth and media.
Broths used for amoebal coculture were obtained by the method
of T. J. Rowbotham (
22), slightly modified: peptone yeast-extract
glucose (PYG), 100 g of proteose peptone (Difco, Sparks, Md.),
10 g of yeast extract (Merck, Darmstadt, Germany), 4.9 g of
MgSO
4 · 7H
2O, 5 g of sodium citrate · 2H
2O, 0.1
g of Fe(NH
4)
2(SO
4)
2 · 6 H
2O, 1.7 g of KH
2PO
4, 1.97 g
of Na
2HPO
4 · 7H
20, 45 g of glucose, and 0.295 g of CaCl
2 in 5 liters of distilled water; Page's modified Neff's amoeba
saline (PAS), 120 mg of NaCl, 4 mg of MgSO
4 · 7H
2O, 4
mg of CaCl
2 · 2H
2O, 142 mg of Na
2HPO
4, and 136 mg of
KH
2PO
4 in 1 liter of distilled water; encystment buffer was
prepared as described by Steinert et al. (
24); nonnutritive
agar, 1.5 g of agar (Research Organics, Cleveland, Ohio) in
100 ml of PAS. All media were autoclaved for 15 min at 121°C,
and broths were also filtered through a 0.22-µm-pore-size
membrane (Corning, Corning N.Y.).
Strains, culture, and fixation.
P. acanthamoeba strain BN9 (ATCC VR 1471) was kindly provided by R. Amann. Parachlamydia sp. "Hall's coccus" and A. polyphaga Linc-AP1 were kindly provided by T. J. Rowbotham. Three days' coculture of bacterial strains with A. polyphaga in PYG, corresponding to about 106 bacteria/ml, was used for inoculation of 5 x 105 A. polyphaga organisms/ml. Cocultures in PAS were incubated at 32°C for 8 and 36 h, while PYG has been used for longer incubation (144 h), as amoebal lysis occurred after 3 to 5 days in PAS in the presence of Parachlamydia strains. Amoebae were washed twice in PAS (two centrifugation steps at 179 x g for 10 min; Heraeus Megafuge 1.0 R; Sepatech, Hanau, Germany) before fixation in 4% glutaraldehyde in monophosphate buffer (pH 7.2). A negative control (uninfected A. polyphaga) was treated similarly after 36 h of incubation.
Encystment procedures.
Ten milliters of a 1-day coculture of Parachlamydia with 5 x 105 A. polyphaga organisms/ml was centrifuged at 179 x g for 10 min, and the supernatant was discarded. The pellets were suspended in (i) 0.3 ml of PAS and inoculated on nonnutrient agar or (ii) suspended in 10 ml of encystment buffer. After 18 h of incubation at room temperature in a laminar flow hood (open petri plates), 4 to 5 ml of distilled water were dispersed on nonnutrient agar to resuspend cysts while swabbing with a sterile loop; this procedure was repeated twice to increase its efficiency. This suspension and the 18-h encystment buffer preparations were washed twice and fixed in 4% glutaraldehyde, as described above. Encystment of uninfected A. polyphaga on dried agar plates was performed similarly (negative control).
Electron microscopy.
Fixed samples were washed overnight in monophosphate buffer (pH 7.2) and then fixed for 1 h at 4°C at room temperature with 1% osmium tetroxide. Dehydration was performed by successive washes in increasing acetone concentrations (25 to 100%). After the preparations were incubated for 1 h in a vol/vol suspension of acetone-epon and overnight in epon, they were embedded in Araldite (Fluka, St Quentin Fallavier, France). Thin sections were cut from embedded blocks by an Ultracut microtome (Reichert-Leica, Marseille, France), deposited on copper grids coated with formvar (Sigma-Aldrich, Taufkirchen, Germany) and stained for 10 min with a solution of methanol-uranyl acetate and lead nitrate with sodium citrate in water. Grids were examined from magnifications of x2,800 to x180,000 with Jeol 1220 (Jeol, Croissy sur Seine, France) and Morgagni 268D (Philips, Eindhoven, The Netherlands) electron microscopes. Both microscopes were calibrated using shadowcast carbon replicas of diffraction parallel line gratings with a spacing of 463 nm (Euromedex, Souffleleweyersheim, France).
Morphometry and quantification.
The SAMBA IPS version 4.06 software (Alcatel TITN Answare, Toulouse, France) was used for morphometry of amoebae (surface of cytoplasm, vacuoles, and nucleus) and for quantification of each developmental stage of Parachlamydia according to their localization (intracytoplasmic, intravacuolar, and in the immediate proximity, but outside of A. polyphaga). For this purpose, 50 pictures (magnification, x3,500; TIFF format) were acquired for each broth culture, including negative controls. Amoebae were selected randomly from the amoebae present at the upper left corner of each square of the grids. Fragments of amoebae without visible nuclei were not eligible for quantification. All round bacterial forms were classified as reticulate or elementary bodies according to their structure; crescent bodies were defined as any crescent form. The proportions of cysts and trophozoites were assessed for the 36- and 144-h cultures as well as for cysts preparation.
Statistical analysis.
Localization of the developmental stages of Parachlamydia and encystment efficiency were compared using the
2 test. Using the Student t test, the mean numbers of developmental bodies were compared according to incubation time and their localization within amoebae. Comparison of median surfaces was performed with the Mann-Whitney test. Logistic regression was used to study the factors associated with the presence of crescent bodies inside and outside amoeba and those associated with multiplication of P. acanthamoeba. These multivariate analyses were adjusted for incubation time, culture broth, strain, and localization of other bacterial developmental stages within amoeba. STATA software (version 7.0; Stata Corporation, College Station, Tex.) was used for analysis.

RESULTS
Samples.
After 144 h of coculture of
P. acanthamoebae strain BN9 (BN9)
in PYG, there were not enough trophozoites (due to amoeba lysis
by BN9) for electron microscopy. The poor quality of the sample
of
Parachlamydia sp. Hall's coccus in encystment buffer prevented
its accurate analysis. Thus, a total of nine preparations were
available for electron microscopy, including five samples of
infected
A. polyphaga trophozoites. Of the 250 trophozoites
(50 per sample) for which complete quantification and morphometry
was performed, 209 (83.6%) were infected by
Parachlamydia and
at least one bacterium was found outside, but in the immediate
proximity of, 88 (35%) of them.
Developmental stages of P. acanthamoeba organisms and their localization.
Three morphological stages were observed: the reticulate body (Fig. 1A), the elementary body (Fig. 1B), and the crescent body (Fig. 1C). The elementary body was the predominant stage within the amoeba. Per amoeba, the mean numbers of elementary, reticulate, and crescent bodies and of reticulate bodies undergoing binary fission were 19.4, 12.7, 1.4, and 0.8, respectively. Elementary bodies were located mainly within vacuoles, and their number increased with incubation time. For instance, for Hall's coccus we found a mean number of 39.72 bodies per amoeba after 144 h of incubation, compared to 0.86 (P < 0.001) and 23.26 (P = 0.005) after 8 and 36 h incubation, respectively (Table 1). The reticulate body was the predominant stage within the cytoplasm, but it was also numerous within vacuoles (Table 1). The crescent body was never found within the cytoplasm of the amoeba, but it was found repeatedly within their vacuoles. Even after adjustment, the presence of intravacuolar crescent bodies was associated with prolonged incubation time (odds ratio [OR] = 5.98; 95% confidence interval [CI], 1.75 to 20.4), the presence of intra-amoebal elementary bodies (OR = 1.74; 95% CI, 1.42 to 2.12 [per 10 bacteria]) and, marginally, of Hall's coccus strain (OR = 2.57; 95% CI, 1.004 to 6.59 [compared to the BN9 endosymbiont]) (Fig. 2A). In a similar model, the presence of a crescent body outside but in immediate proximity to A. polyphaga was associated with a prolonged incubation time (OR = 3.98; 95% CI, 1.49 to 10.68), and the presence of reticulate bodies undergoing binary fission within amoebae (OR = 1.33; 95% CI, 1.04 to 1.72 [per bacterium]) (Fig. 2B). Except for the marginal association of Hall's coccus with the presence of intra-amoebal crescent bodies, these observations remained statistically significant when we further adjusted for amoebal surface. The reticulate bodies were rarely observed outside the amoeba: 4 (1.6%) of 250 amoeba. Conversely, elementary bodies were observed exceptionally within the amoebal cytoplasm, and crescent bodies did not seem to invade it at all. The size of the crescent bodies, about 500 nm, is similar to that of the elementary bodies, while reticulate bodies are slightly larger (600 nm). Intermediate states of the transformation of reticulate forms into elementary forms or into crescent bodies were also observed.
Life cycle of P. acanthamoeba within A. polyphaga.
Entry by phagocytosis of elementary bodies (Fig.
3, A to D)
or crescent bodies (Fig.
3, E to F) revealed their infective
nature. Elementary and crescent bodies could be differentiated
in less than 8 h in reticulate bodies (Table
1). The reticulate
bodies could divide by binary fission (Fig.
4A) and were able
to "invade" the amoebal cytoplasm (Fig.
4B). Multiplication
of
Parachlamydia, assessed by the presence and number of reticulate
bodies in division, occurred mainly in the vacuoles (mean of
0.72 per amoeba;
n = 250) and less frequently within the amoebal
cytoplasm (mean of 0.11 per amoeba;
n = 250). Multiplication
was greater in the 144-h PYG broth (mean of 1.92 division per
amoeba;
n = 50). That observation was confirmed by multivariate
analysis: after adjustment, binary fission of reticulate bodies
remained associated with culture in PYG broth (OR = 4.4; 95%
CI; range, 1.55 to 12.46 [compared to PAS broth]) and with the
presence of reticulate bodies within the amoeba (OR = 2.10;
95% CI; range, 1.53 to 2.89 per 10 bacteria) (Fig.
2C). In the
vacuoles, the reticulate bodies could be condensed in elementary
and/or crescent bodies, which are released after amoebal lysis
or expelled within vesicles (Fig.
5A and B). The amoebal size
increased with infection; thus, the median total surface for
uninfected amoebae (
n = 50) was 118 µm
2, compared to 147.7
µm
2 (
P = 0.038) for
Parachlamydia-infected samples (
n = 250). This increased size was partially due to vacuole formation
and/or dilatation. Indeed, the vacuole surface was 10.0 (
n =
100) and 31.8 (
n = 100) µm
2 after 8 and 36 h of incubation
in PAS broth (
P < 0.001), respectively. However, the cytoplasm
surface also was enlarged significantly with prolonged incubation
(
P < 0.001); it was 62.9 (
n = 100) and 125.2 (
n = 100) µm
2 after 8 and 36 h, respectively. No differences in cytoplasm
or vacuole surfaces were observed between
A. polyphaga infected
with Hall's coccus and the BN9 endosymbiont.
Encystment.
During encystment, some amoebae showed the presence of a few
Parachlamydia organisms within vacuoles (Fig.
6B). However,
no
Parachlamydia organisms were observed in mature cysts (Fig.
6A). The number of cysts was inversely proportional to that
of bacteria: 0 of 565 and 2 of 591 (0.34%) for the heavily infected
BN9 36-h PAS coculture and Hall 144-h PYG coculture, respectively,
compared to 5 of 620 (0.8%) for the Hall 36-h PAS coculture
(
P = 0.055). However, no differences in encystment efficiency
were found between Hall and BN9 with the drying procedure: 11
of 388 (2.8%) and 14 of 452 (3.1%) for BN9 and Hall, respectively.
The drying technique was more efficient than encystment buffer
(
P < 0.001), yet both procedures gave limited encystment:
25 of 840 (2.98%) and 8 of 563 (1.42%), respectively. This low
encystment rate contrasted with the 99.6% cysts obtained with
the dried agar plate procedure for uninfected sample (
P <
0.001 compared to any infected sample). Coalescent cysts were
observed in all preparations obtained with the encystment buffer
or drying technique, but they were never found in cocultures.

DISCUSSION
The present electron micrograph study described a third developmental
stage, the crescent body, and provided a thorough description
and quantitative analysis of the life cycle of P.
acanthamoeba within
A. polyphaga (Fig.
7).
The crescent body, though never described earlier, could be
seen on several previously published electron micrograph pictures
(
1,
7,
10). The presence of crescent bodies is thus not restricted
to the
Parachlamydia species; they can also be found on electron
micrographs of the UWE25 endosymbiont (
7) and of
Neochlamydia hartmanellae (
10). Its absence within
Chlamydophila and
Chlamydia species (
16,
23) suggests that it may be restricted to
Parachlamydiaceae,
and that its presence could be used as a taxonomic tool for
this phylum.
Moreover, our data confirmed the hypothesis of Amann (1) that elementary and reticulate parachlamydial bodies behaved similarly to their homologue chlamydial bodies (23). We could show that the condensed infective gram-positive elementary body could be phagocytosed by the amoeba and then could reorganize within the vacuole, in less than 8 h, into reticulate bodies, which are the metabolically active stage. After division by binary fission, the reticulate body could be condensed in an elementary body. The crescent body, found to be gram-positive (data not shown), thus seems to be another infective stage. It is, however, found mainly outside amoeba or within large vacuoles filled with Parachlamydia bacteria. This suggests that the crescent form might be a further stage, besides the elementary body of Parachlamydia, enabling the bacterium to overcome conditions under which the reticulate body would not survive. The crescent bodies were associated with prolonged incubation, independently of their localization within amoeba and of other cofactors. Though its presence within the amoeba correlated with that of elementary bodies, its presence outside the amoeba was independent of that of elementary bodies. Since these associations remained strong in various models, including one adjusted for amoebal surface, and since amoeba were selected randomly, the risk of selection bias can be appreciably reduced. The main limitation of such quantification is a systematic error in classifying the developmental stage in crescent, elementary, and reticulate bodies. However, the same person (G. Greub) acquired all pictures and doubtful quantifications were reassessed, without significantly modifying the initial results.
Our data demonstrated that the phagocytosis of elementary or crescent bodies takes place in less than 8 h. These bodies then differentiated into reticulate bodies, which divides by binary fission, similar to Chlamydiaceae (17), resulting in an exponential increase of intravacuolar bacteria. The observed increased vacuoles' size with prolonged incubation could explain the mechanism of amoebal lysis in heavily infected cultures, such as the lysis observed with the 144-h BN9 coculture. Though lysis released large numbers of infective Parachlamydia organisms, some amoeba could also expel them within vesicles (Fig. 5), decreasing the risk of amoebal lysis. Such a mechanism had been reported only for Legionella pneumophila (2) and was viewed as a potential additional mode of Legionella transmission to humans (8).
Fritsche demonstrated the presence of Parachlamydia within cysts (7). However, encystment of infected amoebae seems to be exceptional, since the encystment rate decreased from 99.6 to 3% with infection with Parachlamydia and since this 3% of cysts were revealed to be uninfected despite systematic observation of all cysts found on a total of 16 electron microscopy grids. It was already reported for another endosymbiont that infected trophozoites lose their ability to encyst (14). Our data strongly suggest that encystment is prevented, at least partially, by Parachlamydia infection. The survival of Parachlamydia within cysts should be further studied, including after exposure to biocides.
The potential pathogenicity of Parachlamydia is not established (7a). However, the multiplication of Parachlamydia within amoebal vacuoles suggests that this bacterium can survive amoebal lytic enzymes and could possibly also survive those of macrophage phagosomes. As C. pneumoniae, whose pathogenicity is well established, was shown to infect A. castellanii, with vacuoles filled with elementary and reticulate bodies (6), one could hypothesize that Parachlamydia organisms will multiply within macrophages, as already has been shown with Chlamydia (25). Additional studies on macrophage permissivity to Parachlamydia should test this hypothesis.
In conclusion, the present report describes for the first time an additional developmental stage, the crescent body. It gives a comprehensive quantitative description of the life cycle of Parachlamydia within A. polyphaga, demonstrating that expelled vesicles are not restricted to the genus Legionella, and thus opening new views on the vector role of free-living amoeba.

ACKNOWLEDGMENTS
We thank Lina Barrassi, Claude Cataldo, Mireille Vasserot, Claude
Alazia, Bernard La Scola, Gary Burkhart, and Nicolas Aldrovandi
for their help and technical assistance.

FOOTNOTES
* Corresponding author. Mailing address: Unité des Rickettsies, CNRS UPRESA 6020, Faculté de médecine, Université de la Méditerranée, 27 Blvd. Jean Moulin, 13385 Marseille Cedex 05, France. Phone: 00 33 491 32 43 75. Fax: 00 33 491 83 03 90. E-mail:
didier.raoult{at}medecine.univ-mrs.fr.


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Applied and Environmental Microbiology, June 2002, p. 3076-3084, Vol. 68, No. 6
0099-2240/02/$04.00+0 DOI: 10.1128/AEM.68.6.3076-3084.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
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