Fluvastatin and atorvastatin induce programmed cell death in the brain eating amoeba Naegleria fowleri

Naegleria fowleri is the causative agent of a type of encephalitis called Primary Amoebic Encephalitis (PAM). Almost 98 % of PAM cases reported worldwide are fatal and affect mostly immunocompetent children and young adults. The current therapeutic option against PAM cases includes a combination of miltefosine, amphotericin B and other drugs which are unfortunately associated with severe side effects. In a recent study in our group, statins were tested in vitro against Naegleria fowleri trophozoites showing activity against these pathogens at low concentrations causing low toxicity. Consequently, there is an urgent need to develop novel PAM therapeutic options. Therefore, this study was undertaken to evaluate the pathway of cell death induced by two of the previously tested molecules, fluvastatin and atorvastatin. Moreover, these statins were compared to miltefosine and amphotericin B. Furthermore, the induction of Programmed Cell Death (PCD) instead of necrosis in treated amoebae would be the ideal situation since necrosis could lead to non-desired inflammation processes in the infected individual. The obtained results revealed that both statins induced PCD in the treated amoebae after the observation of condensed chromatin, cell membrane damages, mitochondrial membrane potential and ATP levels collapse and ROS generation. In conclusion, both fluvastatin and atorvastatin could be potential new candidates for PAM therapy since they are active at low concentrations, induce low toxicity and cause PCD in the treated amoebae, hence avoiding the activation of inflammation pathways.