Is Toxoplasma gondii a causal agent in migraine?
Koseoglu, E., Yazar, S., Koc, I.
Clinical Investigation , 338: 120 - 122
The association between Toxoplasma gondii infection and hypertensive disorders in T2DM patients: a case-control study in the Han Chinese population
Han, Y. J., Nie, L. H., Ye, X. H., Zhou, Z. X., Huang, S. Q., Zeng, C. L., Guo, C. C., Ou, M. L., Xiao, D., Zhang, B. H., Huang, C. C., Ye, X. G., Jing, C. X., Yang, G.
Parasitology Research 2018; 117: 689-695
Click for abstract
Type 2 diabetes mellitus (T2DM) is a major global health problem. The rate of infection with Toxoplasma gondii (T. gondii) is more than one-third of the total world population. The effects of T. gondii infection on the risk of diabetic complications and comorbidities are unclear. This study aims to determine the relationship between T. gondii infection and complications of T2DM in the Han Chinese population. We collected 1580 blood samples from T2DM patients and measured the levels of specific IgG antibodies against T. gondii in the sera of these patients using an ELISA assay. A logistic regression analysis was performed to estimate the effect of T. gondii infection on the complications of T2DM, while adjusting for age, gender, and triglyceride level (TG). We applied the multifactor dimensionality reduction (MDR) method to detect the interactions between T. gondii infections, demographic indexes and biochemical indicators among the different complications. Gender (the odds ratio (OR) = 0.63, 95%CI =0.45-0.89, P = 0.008) and TG level (OR = 0.64, 95%CI =0.45-0.89, P = 0.009) were influencing factors in T. gondii infections. T2DM patients who were infected with T. gondii had a 2.34 times risk of developing hypertension than those patients without T. gondii infection (OR = 2.34, 95%CI = 1.12-4.88, P = 0.024). The multiplicative interaction analysis and the additive interaction analysis did not reveal any evidence of interactive effects on diabetic complications and comorbidities. T. gondii might be a factor associated with hypertension in T2DM patients.
Toxoplasma gondii as a possible causative pathogen of type-1 diabetes mellitus: Evidence from case-control and experimental studies
Beshay, E. V. N., El-Refai, S. A., Helwa, M. A., Atia, A. F., Dawoud, M. M.
Experimental Parasitology 2018; 188: 93-101
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Toxoplasma gondii is the causative parasite of an important worldwide disease. This obligate intracellular parasite can infect and replicate inside any nucleated cells including those of pancreas. Insulin is a hormone secreted by the pancreas and is responsible for controlling blood glucose concentration. Deficiency of insulin production accounts for the occurrence of type-1 diabetes mellitus (T1D). Thus, theoretically, toxoplasmosis could play a possible role in the development of T1D. However, the studies on this theory are still insufficient; therefore, this work was designed. Interestingly, in the case-control study, seropositivity of anti-Toxoplasma IgG was significantly higher among T1D (86.37%) in comparison with T2D (66.67%) and the control group (60%). Moreover, the odd ratio of chronic toxoplasmosis was 4.2 folds higher among T1D patients than among controls. The experimental study included acute and chronic Me49 T gondii infected mice groups in addition to a control group. Pathological examination revealed the presence of T gondii zoites adjacent to the islets of Langerhans and in pancreatic parenchyma of acutely infected mice. With chronic infection, there was a significant reduction of islets number and sizes in association with grade-1 insulitis. Additionally, the immunohistochemical study showed significant infiltration of the islets of chronically infected mice by CD8(+) and CD45(+) immune cells. In contrary to the control group, the islets of the chronic group showed significantly higher expression of the apoptotic marker caspase-3 and a significantly lower expression of the proliferation marker Ki69. Finally, a significant reduction of insulin expression in the islets of chronic infection group was detected in association with a significant increase in serum glucose concentrations; however, the establishment of diabetes did not occur throughout this work. Thus, this study presents an evidence for the probable role of chronic toxoplasmosis in the development of T1D which should be considered in further studies
Seroprevalance Anti-Toxoplasma gondii antibodies in children and adolescents with tourette syndrome/chronic motor or vocal tic disorder: A case-control study
Akaltun, I., Kara, T., Kara, S. S., Ayaydin, H.
Psychiatry Research 2018; 263: 154-157
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Toxoplasma gondii infection may be associated with psychiatric disorders due to its neurological effects. The purpose of this study was to investigate the relation between tic disorders in children and adolescents and Anti-Toxoplasma IgG. 43 children diagnosed with Tourette's syndrome(TS) and 87 with chronic motor or vocal tic disorder(CMVTD), and 130 healthy volunteers, all aged 7-18, were enrolled. Anti-Toxoplasma IgG antibody levels obtained from blood specimens were investigated. Toxoplasma IgG positivity was determined in 16(37.2%) of the patients with TS, in 27(31%) of those with CMVTD and in 12(9.2%) members of the control group. Anti-Toxoplasma gondii antibody positivity was 5.827-fold higher in subjects with TS and 4.425-fold higher in subjects with CMVTD compared to the control group. Correlation was determined between a diagnosis of TS or CMVTD and Anti-Toxoplasma gondii antibodies. We think that it will be useful for the neuropsychiatric process associated with Anti-Toxoplasma gondii antibodies to be clarified.
Prevalence of Toxoplasma gondii infection in diabetic patients in Makkah AL Mukarramah, Saudi Arabia
Khalil, M., Baothman, M., Alserhan, F., Almunyif, A., Alsharbe, G., Samaren, H., Deqnah, N., Al Malki, A., Al Harbi, W.
Tropical Biomedicine 2018; 3: 464-471
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Toxoplasmosis is a parasitic and zoonotic disease caused by Toxoplasma gondii. The disease has worldwide distribution and all people maybe under the risk of getting infected by the parasite. The overall aim of this research was to detect the prevalence rate of anti-Toxoplasma gondii IgM and IgG among diabetic patients in Makkah, Saudi Arabia. Blood samples were collected from diabetic patients. Toxo IgM and IgG combo rapid test cassette were used to screen the samples, and the results were confirmed by using Enzyme-Linked Immunosorbent Assay (ELISA) to detect anti-IgM and anti-IgG antibodies on the plasma of 90 diabetic patients who attended the mobile clinic or AL Noor hospital in Makkah area. The subject was asked to complete a structured questionnaire. The questionnaire data and serological results were analyzed by using SPSS 20. Chi-square was used to compare different variables. Out of 90 samples, 39 (43.3%) were positive to anti-Toxoplasma gondii IgG wherein 33 (36.6%) of them were male and 6 (6.7%) were female. The age ranged between 13-85 years with the mean of 49.9 years. The study found that there were statistical differences between the age groups with higher prevalence in the 50-65 years age group. Detection of IgM against T. gondii gave negative results. The results of the study indicate that latent T. gondii in diabetic patient are relatively high especially among the 50-65 age group. There were significant associated between direct contact with a cat and infection by T. gondii (p<0.05).
Toxoplasmosis seroprevalence in rheumatoid arthritis patients: A systematic review and meta-analysis
Hosseininejad, Z., Sharif, M., Sarvi, S., Amouei, A., Hosseini, S. A., Chegeni, T. N., Anvari, D., Saberi, R., Gohardehi, S., Mizani, A., Sadeghi, M., Daryani, A.
Plos Neglected Tropical Diseases 2018; 12
Click for abstract
Background
Toxoplasmosis is a cosmopolitan infection caused by an intracellular obligatory protozoan, Toxoplasma gondii. Infection to this parasite in immunocompetent patients is usually asymptomatic, but today it is believed that the infection can be a risk factor for a variety of diseases, including rheumatoid arthritis (RA). RA is an autoimmune disease and the most common type of inflammatory arthritis that is a major cause of disability. The aim of this systematic review and meta-analysis was to address the association between RA and toxoplasmosis in light of the available research.
Methods
Based on the keywords, a systematic search of eight databases was conducted to retrieve the relevant English-language articles. Then, the studies were screened based on the inclusion and exclusion criteria. The random effect model was used to calculate the odds ratio (OR) using forest plot with 95% confidence interval (CI).
Results
Overall, 4168 Individual, extracted from 9 articles were included for systematic review evaluation, with 1369 RA patients (46% positive toxoplasmosis) and 2799 individuals as controls (21% positive toxoplasmosis). Then, eight articles (10 datasets) were used for meta-analysis (1244 rheumatoid arthritis patients and 2799 controls). By random effect model, the combined OR was 3.30 (95% CI: 2.05 to 5.30) with P < 0.0001.
Conclusion
Although toxoplasmosis could be considered as a potential risk factor for rheumatoid arthritis, more and better quality studies are needed to determine the effect of T. gondii infection on induction or exacerbation of RA. Our study was registered at the International Prospective Register of Systematic Reviews.
Is Toxoplasma gondii playing a positive role in multiple sclerosis risk? A systematic review and meta-analysis
Saberi, R., Sharif, M., Sarvi, S., Aghayan, S. A., Hosseini, S. A., Anvari, D., Chegeni, T. N., Hosseininejad, Z., Daryani, A.
Journal of Neuroimmunology 2018;322: 57-62
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Toxoplasmosis is a parasitic disease caused by Toxoplasma gondii with a globally widespread distribution. The aim of this systematic review and meta-analysis was to characterize the association between T. gondii infection and multiple sclerosis (MS). The data were systematically collected from the English electronic databases up to April 2017. The research process resulted in the identification of five studies related to the subject of interest entailing 669 MS patients and 770 controls. The pooled prevalence rates of T. gondii infection in the MS patients and controls were estimated as 32.4% (95% CI: 27.4-38.6) and 39.1% (95% CI: 29.1-50.5), respectively. By random effect model, the combined odds ratio was 0.72 (95% CI: 0.49-1.06) with P = .0961. Although this meta-analysis study showed a lower seroprevalence of T. gondii in the MS patients as compared with that in the control group, no significant association was found between toxoplasmosis and MS disease. Further investigations are recommended to determine the detailed association between MS patients and T. gondii infection.
Viral and parasitic pathogen burden and the association with stroke in a population-based cohort
Pearce, B. D.,Bracher, A. , Jones, J. L., Kruszon-Moran, D.
International Journal of Stroke 2018; 13_: 481-495
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Background Higher cumulative burden of viral and bacterial pathogens may increase the risk of stroke, but the contribution of parasitic infections in relation to cumulative pathogen burden and risk of stroke has rarely been examined. Aim To estimate the association of multiple persistent viral and parasitic infections with stroke in a representative sample of adults in the United States. Methods Serological evidence of prior infection was categorized as positive for 0-1, 2, 3, or 4-5 infections based on immunoglobulin G seropositivity to cytomegalovirus, hepatitis A virus, hepatitis B virus, Toxoplasma gondii, and Toxocara spp. in 13,904 respondents from the National Health and Nutrition Examination Survey III. Regression analysis was used to estimate the cross-sectional association between serological evidence of prior infection and history of stroke adjusting for demographic risk factors, and potential mediators of stroke. Results Age-adjusted models that included serological evidence of prior infection to cytomegalovirus, hepatitis A virus, hepatitis B virus, Toxoplasma gondii, and Toxocara spp. showed that adults in the highest serological evidence of prior infection category (4-5 infections) had a higher prevalence of stroke (5.50%, 95% confidence interval 2.44-10.46%) than those in the lowest serological evidence of prior infection categories (1.49%, 95% confidence interval 1.01-2.11%), and a trend test suggested a graded association between serological evidence of prior infection and stroke (p=0.02). In multivariable logistic regression models, the positive association of serological evidence of prior infection with stroke prevalence remained significant after adjustment for other significant risk factors (odds ratio=1.4, p=0.01) but was only significant among those aged 20-59 (odds ratio=2.0, p=0.005) and not among those aged 60-69 (p=0.78) or 70 and older (p=0.43). Conclusion We found support for a connection between serological evidence of prior infection to cytomegalovirus, hepatitis A virus, hepatitis B virus, Toxoplasma gondii, and Toxocara spp. and stroke among those aged 20-59. There may be a need to consider common parasitic infections in addition to viral and bacterial pathogens when calculating serological evidence of prior infection in relation to cerebrovascular disease.
Is Toxoplasma gondii infection correlated with nonalcoholic fatty liver disease?- a population-based study
Huang, J. F. , Zhang, H. Y., Liu, S. Y. ,Wang, M. F. .Wan, B. , Velani, B. ., Zhu , Y. Y., Lin, S.
BMC Infectious Diseases 2018; 18: DOI: 10.1186/s12879-018-3547-1
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BackgroundPrevious studies have suggested that Toxoplasma gondii (T. gondii) infection might be associated with fatty liver disease. However, the relationship between non-alcoholic fatty liver disease (NAFLD) and T. gondii infection has not been investigated in a large population. We aimed to study the relationship between those two diseases using a population-based dataset from the United States.MethodsThe data were collected from the third National Health and Nutrition Examination Survey (NHANES III) between 1988 and 1994. Statistical analysis was applied to compare the prevalence of NAFLD in anti-T. gondii antibody-positive participants with antibody-negative ones.ResultsA total of 9465 persons with a mean age of 44.3316.21years, 46.9% of which were males, were included in the final analysis. Their mean BMI was 27.60 +/- 5.96kg/m(2). A total of 2520 participants (26.62%) were positive for the T. gondii antibody. There was an increasing trend of seroprevalence of T. gondii with age (P for trend <0.001). The incidence of NAFLD in the seropositive group was higher than that in the seronegative group (27.10% vs 23.40%, p<0.001). In addition to this, metabolic biomarkers, including serum lipid, fasting blood-glucose, and uric acid were also significantly higher in the seropositive group. However, multivariate analysis revealed that T. gondii infection was not an independent risk factor for NAFLD. Age was independently correlated with both the prevalence of T. gondii and NAFLD.Conclusions Patients with T. gondii infection may have a higher prevalence of NAFLD. Age may have an effect on the increase of NAFLD in the T. gondii seropositive population.
Seroprevalence of Toxoplasma gondii infection in children with central nervous system disorders in Mansoura, Egypt: a case-control study
El-Beshbishi,S. N. , El-Tantawy,N. L, Elzeky, S. M., Abdalaziz , K. F. ,Atia, R. A.
Transactions of the Royal Society of Tropical Medicine and Hygiene 2018;112: 555-560
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Background: Toxoplasma gondii is a global infection with a crucial role in the development of neurological diseases. Data concerning the association between T. gondii and neurological illnesses in Egyptian children is scarce. Methods: A case-control study was conducted on 60 patients divided into children suffering from central nervous system manifestations without apparent chromosomal anomalies (n=30) and children with Down syndrome (n=30) recruited from Mansoura University Children's Hospital, Mansoura, Egypt. A total of 30 healthy children were included as controls. Demographics and clinical data were collected from all cases and Toxoplasma immunoglobulin (Ig) M and G antibodies were assessed by enzyme-linked immunosorbent assay. Results: Anti-T. gondii IgG was the most frequent antibody detected and the highest seropositivity rates were ranked for the neurologically disabled non-syndromic children, followed by Down syndrome, compared with controls (p <= 0.001). Statistically significant (p=0.05) associations were found between Toxoplasma IgG seropositivity and hydrocephalus and between Toxoplasma IgM and a history of contact with farm animals, soil and cats in children with Down syndrome. Conclusions: The association between Toxoplasma infection and neurological disorders in children should be kept in mind by paediatricians and assessment of T. gondii antibodies in early childhood is needed for timely management of afflicted patients.
Anti-Toxoplasma antibodies in Egyptian rheumatoid arthritis patients
El-Henawy, A. A., Hafez, E. A. R., Nabih,N., Shalaby, N. M., Mashaly, M.
Rheumatology International 2017;37:785-790
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To assess seroprevalence of anti-Toxoplasma gondii antibodies; both IgG and IgM in Egyptian rheumatoid arthritis (RA) patients versus a non-RA group and to compare anti-Toxoplasma antibodies seroprevalence among RA patients receiving traditional treatment and RA patients treated with biologic drug. 60 RA patients and 60 healthy controls were enrolled in the study. Patients were categorized into two groups: one group included 30 patients receiving disease modifying anti-rheumatic drugs (DMARDs), while the other group included 30 patients receiving biologic agent, infliximab, a TNF-alpha antagonist. Serum samples of all investigated persons were examined for anti-Toxoplasma antibodies. RA activity markers including rheumatoid factor, anti-cyclic citrullinated protein antibodies, C reactive protein, ESR in addition to disease activity score 28 (DAS28) of RA patients were also evaluated to explore their association with Toxoplasma seropositivity. Anti-Toxoplasma IgG antibodies were detected among 46/60 RA patients (76.7%) versus 29/60 controls (48.3%), (p = 0.001). Anti-Toxoplasma IgG titre was higher among RA group [median, (range) = 232.940 (8.949-653.242) IU/ml] than among controls [median, (range) = 68.820 (2.450-318.945) IU/ml], (p < 0.001). No difference was detected among RA patients either on traditional or biologic treatment regarding anti-Toxoplasma IgG antibodies. No positive anti-Toxoplasma IgM was detected. A positive correlation was detected between anti-Toxoplasma IgG titre and disease activity markers. Higher seroprevalence of anti-Toxoplasma IgG antibodies among RA patients compared to controls reflects an association between latent Toxoplasma infection and RA. Our findings support previous studies and necessitate future large-scale studies to elucidate the exact role of Toxoplasma whether a trigger of autoimmunity in RA or an effect of immunosuppression.
Is Toxoplasma gondii infection protective against multiple sclerosis risk?
Koskderelloglu, A., Afsar, I., Pektas, B., Gedizlioglu, M.
Multiple Sclerosis and Related Disorders 2017;15:7-10
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Background: Parasitic infections may play a protective role in neurodegenative diseases. Objective: To determine the association between Toxoplasma gondii (T. gondii) infection and Multiple Sclerosis (MS). Methods: One hundred fifteen patients with MS were included in the study. Sixty age and gender-matched healthy subjects were recruited as controls. Subjects were assessed for clinical and demographic parameters. The presence of specific IgG antibodies against T. gondii microorganism was searched by using an enzyme immunoassay test in the sera of the subjects. Results: T. gondii seropositivity was found to be lower in MS patients than in healthy controls (33.9% vs. 55%, p = 0.007). Mean age and disease duration of the patients were 41.15 +/- 11.20 (18-74) and 1.90 +/- 1.44 (0-6) years, respectively. MS patients with a high IgG titer had lower expanded disability status scale (EDSS) scores (p = 0.001) and lower annualized relapse rates (ARR) (p = 0.005). There was no significant association between T. gondii seropositivity and disease duration (p = 0.598). Female MS patients tended to have higher T. gondii seropositivity than males although the difference did not reach statistical significance (p = 0.192). We found a negative correlation between T. gondii seropositivity and both EDSS scores (r= - 0.322, p < 0.001) and ARR (r = - 0.263, p = 0.004). Conclusion: We found a negative association between T. gondii infection and the presence of MS. Furthermore, parasite infected MS patients had experienced fewer relapses with lower disability scores supporting the hypothesis of immunomodulatory effects of parasitic infections in autoimmune diseases. Further studies are required to establish the protective role of parasitic infections in MS
Seroprevalence of Bartonella species, Coxiella burnetii and Toxoplasma gondii among patients with hematological malignancies: A pilot study in Romania
Messinger, C. J., Gurzau, E. S., Breitschwerdt, E. B., Tomuleasa, C. I., Trufan, S. J., Flonta, M. M., Maggi, R. G., Berindan-Neagoe, I., Rabinowitz, P. M.
Zoonoses and Public Health 2017;64:485-490
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Patients receiving immunosuppressive cancer treatments in settings where there is a high degree of human-animal interaction may be at increased risk for opportunistic zoonotic infections or reactivation of latent infections. We sought to determine the seroprevalence of selected zoonotic pathogens among patients - diagnosed with haematologic malignancies and undergoing chemotherapeutic treatments in Romania, where much of the general population lives and/or works in contact with livestock. A convenience sample of 51 patients with haematologic cancer undergoing chemotherapy at a referral clinic in Cluj-Napoca, Romania, was surveyed regarding animal exposures. Blood samples were obtained and tested for evidence of infection with Bartonella species, Coxiella burnetii and Toxoplasma gondii, which are important opportunistic zoonotic agents in immunocompromised individuals. 58.8% of participants reported living or working on a farm, and living or working on a farm was associated with contact with livestock and other animals. 37.5% of participants were IgG seroreactive against one or more of five Bartonella antigens, and seroreactivity was statistically associated with living on farms. Farm dwellers were 3.6 times more likely to test IgG seroreactive to Bartonella antibodies than non-farm dwellers. 47.1% of the participants tested T. gondii IgG positive and 13.7% tested C. burnetii IgG positive, indicating past or latent infection. C. burnetii IgM antibodies were detected in four participants (7.8%), indicating possible recent infection. These results indicate that a large proportion of patients with haematologic cancer in Romania may be at risk for zoonotic infections or for reactivation of latent zoonotic infections, particularly with respect to Bartonella species. Special attention should be paid to cancer patients' exposure to livestock and companion animals in areas where much of the population lives in rural settings.
Physical and mental health status in Toxoplasma-infected women before and three years after they learn about their infection: Manipulation or side-effects of impaired health?
Šebánková, B., Flegr, J.
Frontiers in Ecology and Evolution 2017; 5:144
Fetomaternal and pediatric toxoplasmosis
Oz, H. S.
Journal of Pediatric Infectious Diseases 2017; 12: 202-208
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Toxoplasmosis is one of the most important causes of foodborne illnesses and inflammatory complications, as well as congenital disorders. Promiscuous Toxoplasma is transmitted by contaminated food and animal produce, water, vegetations, fruits, and sexually through semen. Toxoplasma infects nucleated cells with a unique tropism formuscles and central nervous system and amind bugging malicious effect. Pregnant women with acute or reactivated toxoplasmosis can transmit Toxoplasma via transplacental transmission to the fetus. The severity of congenital toxoplasmosis depends on the gestation period, as infection in early pregnancy causes more severe consequences. Congenital toxoplasmosis complications include miscarriage, encephalitis, neurological retardation, mental illnesses, auditory, and visual inflammatory disorders, cardiovascular abnormalities, and pains. Current therapies are inefficient for congenital and chronic toxoplasmosis or have severe side effects with life-threatening complications. There is an urgent need for effective and safe therapeutic modalities to treat complications of toxoplasmosis and effective vaccines to eliminate the infectious agent. This investigation will discuss the pathogenesis of fetomaternal, congenital, and pediatric toxoplasmosis, the currently available therapies in practice, and explore those therapeutic modalities in experimental stages for promising future trials.
Serologic evidence of Toxoplasma gondii infection among cancer patients. A prospective study from Qassim region, Saudi Arabia
Al-Mendalawi M.D.
Saudi Medical Journal 2017; 38: 669-669
Serologic evidence of Toxoplasma gondii infection among cancer patients. A prospective study from Qassim region, Saudi Arabia
Imam, A., Al-Anzi, F. G., Al-Ghasham, M. A., Al-Suraikh, M. A., Al-Yahya, A. O., Rasheed, Z.
Saudi Medical Journal 2017; 38: 319-321
Click for abstract
Objectives: To determine the frequency of antibody seropositivity of Toxoplasma gondii infection in a cancer patient population. We also explored on association of Toxoplasma gondii seropositivity with selected variables.
Methods: This is a prospective cross-sectional study conducted at Prince Faisal bin Bandar cancer center, Qassim, Saudi Arabia, from November 2014 to March 2015. One hundred thirty seven patients were involved in the study. Demographic data was collected using structured questionnaire, and clinical information was retrieved from the patient's medical reports. Enzyme-linked immunosorbent assay technique was used for antibody assay.
Results: The frequency of seropositivity for Toxoplasma gondii infection was 30.6%. The patient's age range from 1.5-84 years with a geometric mean of 42.7 years. The seropositivity was significantly higher (p< 0.05) among the 40-80 years age group (71.4%) as compared to 0-39 years one (28.6%).
Conclusion: The prevalence of Toxoplasma gondii increases with increasing age among cancer patients in this region of central Saudi Arabia. More research is advisable for better understanding of ageing in pathogenesis of toxoplasmosis among patients with malignancies.
A critical assessment of the association between postnatal toxoplasmosis and epilepsy in immune-competent patients
Uzorka, J.W., Arend ,S.M.
European Journal of Clinical Microbiology and Infectious Diseases 2017; 36: 1111-1117
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While postnatal toxoplasmosis in immune-competent patients is generally considered a self-limiting and mild illness, it has been associated with a variety of more severe clinical manifestations. The causal relation with some manifestations, e.g. myocarditis, has been microbiologically proven, but this is not unequivocally so for other reported associations, such as with epilepsy. We aimed to systematically assess causality between postnatal toxoplasmosis and epilepsy in immune-competent patients. A literature search was performed. The Bradford Hill criteria for causality were used to score selected articles for each component of causality. Using an arbitrary but defined scoring system, the maximal score was 15 points (13 for case reports). Of 704 articles, five case reports or series and five case-control studies were selected. The strongest evidence for a causal relation was provided by two case reports and one case-control study, with a maximal causality score of, respectively, 9/13, 10/13 and 10/15. The remaining studies had a median causality score of 7 (range 5-9). No selection bias was identified, but 6/10 studies contained potential confounders (it was unsure whether the infection was pre- or postnatal acquired, or immunodeficiency was not specifically excluded). Based on the evaluation of the available literature, although scanty and of limited quality, a causal relationship between postnatal toxoplasmosis and epilepsy seems possible. More definite proof requires further research, e.g. by performing Toxoplasma serology in all de novo epilepsy cases.
Toxoplasma modulates signature pathways of human epilepsy, neurodegeneration & cancer
Ngo, H. M., Zhou, Y., Lorenzi, H., Wang, K., Kim, T. K., Zhou, Y., El Bissati, K., Mui, E., Fraczek, L., Rajagopala, S. V., Roberts, C. W., Henriquez, F. L., Montpetit, A., Blackwell, J. M., Jamieson, S. E., Wheeler, K., Begeman, I. J., Naranjo-Galvis, C., Alliey-Rodriguez, N., Davis, R. G., Soroceanu, L., Cobbs, C., Steindler, D. A., Boyer, K., Noble, A. G., Swisher, C. N., Heydemann, P. T., Rabiah, P., Withers, S., Soteropoulos, P., Hood, L., McLeod, R.
Scientific Reports 2017; 7: doi:10.1038/s41598-017-10675-6
Click for abstract
One third of humans are infected lifelong with the brain-dwelling, protozoan parasite, Toxoplasma gondii. Approximately fifteen million of these have congenital toxoplasmosis. Although neurobehavioral disease is associated with seropositivity, causality is unproven. To better understand what this parasite does to human brains, we performed a comprehensive systems analysis of the infected brain: We identified susceptibility genes for congenital toxoplasmosis in our cohort of infected humans and found these genes are expressed in human brain. Transcriptomic and quantitative proteomic analyses of infected human, primary, neuronal stem and monocytic cells revealed effects on neurodevelopment and plasticity in neural, immune, and endocrine networks. These findings were supported by identification of protein and miRNA biomarkers in sera of ill children reflecting brain damage and T. gondii infection. These data were deconvoluted using three systems biology approaches: "Orbital-deconvolution" elucidated upstream, regulatory pathways interconnecting human susceptibility genes, biomarkers, proteomes, and transcriptomes. "Cluster-deconvolution" revealed visual protein-protein interaction clusters involved in processes affecting brain functions and circuitry, including lipid metabolism, leukocyte migration and olfaction. Finally, "disease-deconvolution" identified associations between the parasite-brain interactions and epilepsy, movement disorders, Alzheimer's disease, and cancer. This "reconstruction-deconvolution" logic provides templates of progenitor cells' potentiating effects, and components affecting human brain parasitism and diseases.
Central nervous system infections in immunocompromised patients
Sonneville, R., Magalhaes, E., Meyfroidt, G.
Current Opinion in Critical Care 2017; 23: 128-133
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Purpose of review
Although rare, central nervous system (CNS) infections are increasingly being recognized in immunocompromised patients. The goal of the present review is to provide a practical diagnostic approach for the intensivist, and to briefly discuss some of the most prevalent conditions
Recent findings
Immunocompromised patients presenting with new neurological symptoms should always be suspected of a CNS infection. These infections carry a poor prognosis, especially if intracranial hypertension, severely altered mental status or seizures are present. Clinical examination and serum blood tests should be followed by brain imaging, and when no contra-indications are present, a lumbar puncture including cerebrospinal fluid PCR to identify causative organisms. Empirical therapy depends on the type of immunodeficiency. In HIV-infected patients, the most common CNS infection is cerebral toxoplasmosis, whereas in other immunocompromised patients, aspergillosis, cryptococcal meningitis and tuberculous meningitis are more prevalent. Multiple pathogens can be detected in up to 15% of patients. The diagnostic value of fast multiplex PCR has yet to be evaluated in this setting.
Summary
CNS infections represent a rare but severe complication in immunocompromised patients. A systematic approach including early diagnosis, appropriate antimicrobial treatment, early ICU admission and aggressive measures to reduce intracranial pressure may improve outcome.
Toxoplasma gondii in the food supply
Hussain, M.A., Stitt, V., Szabo, E.A., Nelan, B.
Pathogens 2017; 6: 10.3390/pathogens6020021
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Toxoplasmosis is caused by infection with the protozoan parasite Toxoplasma gondii. Infections are usually either asymptomatic or develop mild symptoms that are self-limited, but infections in immunosuppressed persons can be severe. Infections in pregnant women can cause serious health problems in the child such as mental retardation and blindness. Infection with T. gondii in immunocompetent adults can lead to impaired eyesight. Toxoplasmosis has ranked very highly in two studies of death and disability attributable to foodborne pathogens. The consumption of raw or undercooked meat containing T. gondii tissue cysts and the consumption of raw vegetables or water contaminated with T. gondii oocysts from cat feces is most frequently associated with human illness. The risk of acquiring a Toxoplasma infection via food varies with cultural and eating habits in different human populations.
Ocular lesions in congenital toxoplasmosis in Santa Isabel do Ivai, Parana, Brazil
Sanders, A.P., dos Santos, T., Felipe, C.K.K., Estevao, M.L., Cicero, C., Evangelista, F., Manrique, C.A., Mizutani, A.S., Falavigna-Guilherme, A.L.
Pediatric Infectious Disease Journal 2017; 36: 817-820
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We verified clinical and psychopedagogic aspects of congenital cases with ocular sequelae, 13 years after toxoplasmosis outbreak in Santa Isabel do Ivai, and current seroprevalence of this zoonosis in pregnant women. Audiologic and ophthalmologic evaluations were performed in congenital cases, in addition to collection of clinical and psychopedagogic data. In pregnant women, current seroprevalence was observed. Among affected teenagers, 2 of 5 are behind in school grade, and 4 of 5 reported learning difficulties, requiring psychopedagogic monitoring, as well as ocular complaints. We observed predominance of small, scarred, dispersed, type II chorioretinal lesions (hypopigmented halo and hyperpigmented central area), and 1 case of ocular relapse. All patients presented normal audiologic assessment. Among 131 pregnant women, 62 (47.3%) were seronegative and 39 (29.8%) were IgG reactive. Only 1 reported acquiring infection during the outbreak. This is one of the few studies in Brazil showing the outcome of congenital toxoplasmosis, a decade after infection, in one of the world's largest outbreaks.
Sleep onset insomnia, daytime sleepiness and sleep duration in relationship to Toxoplasma gondii IgG seropositivity and serointensity
Ahmad, Z., Moustafa, Y,W., Stiller, J.W., Pavlovich, M.A., Raheja, U.K., Gragnoli, C., Snitker, S., Nazem, S., Dagdag, A., Fang, B., Fuchs, D., Lowry, C.A., Postolache, T.T.
Pteridines 2017; 28: 195-204
Click for abstract
Toxoplasma gondii (T. gondii) infects central nervous tissue and is kept in relative dormancy by a healthy immune system. Sleep disturbances have been found to precipitate mental illness, suicidal behavior and car accidents, which have been previously linked to T. gondii as well. We speculated that if sleep disruption, particularly insomnia, would mediate, at least partly, the link between T. gondii infection and related behavioral dysregulation, then we would be able to identify significant associations between sleep disruption and T. gondii. The mechanisms for such an association may involve dopamine (DA) production by T. gondii, or collateral effects of immune activation necessary to keep T. gondii in check. Sleep questionnaires from 2031 Old Order Amish were analyzed in relationship to T. gondii-IgG antibodies measured by enzyme-linked immunosorbent assay (ELISA). Toxoplasma gondii seropositivity and serointensity were not associated with any of the sleep latency variables or Epworth Sleepiness Scale (ESS). A secondary analysis identified, after adjustment for age group, a statistical trend toward shorter sleep duration in seropositive men (p = 0.07). In conclusion, it is unlikely that sleep disruption mediates links between T. gondii and mental illness or behavioral dysregulation. Trending gender differences in associations between T. gondii and shorter sleep need further investigation.
Toxoplasmosis, leptospirosis, and brucellosis seroepidemiology in veterinary medical students and their relation with unique health
Clazer, M., Rodrigues, G. V., Ferreira, B. P. M., Zaniolo, M. M., Correa, N. A. B., Fortes, M. S., Navarro, I. T., Chiderolli, R. T., de Freitas, J. C., Goncalves, D. D.
Semina-Ciencias Agrarias, 2017, 38: 1347-1359
Click for abstract
Toxoplasmosis, leptospirosis, and brucellosis are global zoonoses, with humans as accidental participants in their transmission cycles. The can also be considered occupational diseases, because certain professionals are at greater risk of contact and infection by such zoonoses. These three diseases have different epidemiological characteristics because of the distinct environmental, social, cultural, and economic conditions where these pathogens circulate. Because of the importance of these diseases and their associations with specific occupations, we performed a seroepidemiological survey of Toxoplasma, Leptospira, and Brucella antibodies, with an analysis of the association between positive serum and certain occupational and environmental variables, in students of a veterinary medicine course (1st, 2nd, 3rd, 4th, and 5th year) in a university in the northwestern region in the state of Parana, Brazil. From May to November 2014, blood samples were collected from 157 volunteers by professionals trained in nursing and biomedicine from the same university as the veterinary students. At the time of blood collection, the students did not present any clinical signs of the three diseases of interest. To detect anti-Toxoplasma gondii, anti-Leptospira spp., and anti-Brucella antibodies, indirect immunofluorescence test (IIF), microscopic agglutination test (MAT), fast agglutination test (a screening test), and enzyme-linked immunosorbent assay (ELISA) were performed. To determine variables associated with these infections, the students were interviewed to complete an epidemiological questionnaire with environmental, behavioral, and occupational information. The associations between these variables and infections were assess by chi-square or Fischer's exact tests, with a 5% significance level (a). Of the 157 serum samples analyzed, 29.29% reacted to Toxoplasma antigens, with titers ranging from 16 to 4096 by IIF, 1.27% to Leptospira antigens, with titers ranging from 100 to 800 by MAT using Hardjo and Wolffi serovars, and 0.63% to Brucella antigens by ELISA; however, no variables were found to be associated with infection with any of these pathogens. The results of this study show that one-third of the students in the veterinary medicine course were exposed to Toxoplasma gondii, Leptospira spp., and Brucella spp. at some stage in their lives; however, it is not possible to determine whether these infections were acquired at the university, because no associations between occupational risk variables and these infections were found. An understanding of the transmission of each etiological agent and methods to prevent infection is important to maintain low prevalence levels of these zoonotic diseases during the veterinary medicine course and extra-curricular internships, when there is increased exposure to these pathogens.
Seropositivity of Toxoplasma gondii and Toxocara spp. in children with cryptogenic epilepsy, Benha, Egypt
Eraky, M.A., Abdel-Hady, S., Abdallah, K.F.
Korean Journal of Parasitology 2016; 54: 335-338.
Click for abstract
The present study aimed to investigate the possible association of Toxoplasma gondii and Toxocara spp. infections with cryptogenic epilepsy in children. The study was carried out between June 2014 and March 2015. Total 90 children (40 with cryptogenic epilepsy, 30 with non-cryptogenic epilepsy, and 20 healthy control children) were evaluated to determine the anti-Toxocara and anti-T. gondii IgG seropositivity using ELISA kits. Epileptic cases were selected from those attending the pediatrics outpatient clinic of Benha University Hospital, Pediatrics Neurology Unit, and from Benha Specialized Hospital of children. The results showed that the level of anti-T. gondii IgG seropositivity was significantly higher among children with cryptogenic epilepsy (20%) than among children with non-cryptogenic children (0%). In healthy controls (10%), there was no association between toxocariasis seropositivity and cryptogenic epilepsy (only 5.7%; 4 out of 70 cases) among cases and 10% (2 out of 20) among controls. Among toxocariasis IgG positive cases, 3 (7.5%) were cryptogenic, and only 1 (3.3%) was non-cryptogenic. These statistically significant results support the association between T. gondii infection and cryptogenic epilepsy while deny this association with toxocariasis.
What Is Your Neurologic Diagnosis? Toxoplasmosis
Hu, H. Z., Jeffery, N. D., Donnelly, J., Severs, M., Lindquist, T., Gilmour, L., Flaherty, H. A., Barker, A. K.
Javma-Journal of the American Veterinary Medical Association 2016; 249: 1007-1010.
Is Toxoplasma gondii infection a risk factor for leukemia? An evidence-based meta-analysis
Huang, Y., Chang, A. S., Wang, J. S., Zeng, X. Q.,
Medical Science Monitor 2016; 22.
Click for abstract
Background: Possible associations of parasite infection with cancer risk have recently attracted much attention. Published studies concerning the association between Toxoplasma gondii (T. gondii) infection and leukemia risk have generated inconsistent results. In the present study, we aimed to address this topic by conducting a quantitative meta-analysis.
Material/Methods: Relevant publications were searched in electronic databases and eligible studies were rigorously screened and selected. Essential information was extracted and the data were pooled. Subgroup analysis on source of controls and detection target was also performed.
Results: A total of 6 studies that met the inclusion criteria were selected. The overall data show that T. gondii infection might have an association with increased leukemia risk (OR=3.05; 95% CI=1.83-5.08). Similar results were shown in the subgroups regarding source of controls and detection target.
Conclusions: Our results suggest that T. gondii infection might be a risk factor for leukemia, providing new insight into the etiology of leukemia. Future studies with large sample sizes in different geographic areas are needed to confirm this conclusion.
Is chronic toxoplasmosis a risk factor for diabetes mellitus? A systematic review and meta-analysis of case-control studies
Majidiani, H., Datuand, S., Daryani, A., Galuan-Ramirez, M. D., Foroutan-Rad, M.
Brazilian Journal of Infectious Diseases 2016; 20: 605-609.
Click for abstract
INTRODUCTION: The global protozoan parasite, Toxoplasma gondii, infects many warm-blooded animals and humans by employing different transmission routes. There have been some recent studies on the probable relevance of infectious agents and diabetes. Therefore, we conducted a systematic review and meta-analysis to identify the possible association between chronic toxoplasmosis and diabetes mellitus. METHODS: This study was conducted following the general methodology recommended for systematic reviews and meta-analysis. Nine English literature databases (Google scholar, PubMed, Scopus, Web of science, Science Direct, Ovid, ProQuest, IngentaConnect, and Wiley Online Library) were searched, up to January 2016. Random effects model was used to determine odds ratios and their 95% confidence intervals. RESULTS: Our review resulted in a total of seven publications meeting the inclusion criteria. Because of significant heterogeneity, we estimated a common OR by a random effects model at 1.10 (95% CI=0.13-9.57) with p=0.929 and 2.39 (95% CI=1.20-4.75) with p=0.013 for type 1 and type 2 diabetes mellitus, respectively. CONCLUSION: Despite the limitations such as low number of studies, this meta-analysis suggests chronic toxoplasmosis as a possible risk factor for type 2 DM. However, based on random effects model no statistically significant association was observed between T. gondii and type 1 DM. It is highly recommended for researchers to carry out more accurate studies aiming to better understand this association.
Infection and characterization of Toxoplasma gondii in human induced neurons from patients with brain disorders and healthy controls
Passeri E, Jones-Brando, L Bordon, C Sengupta, S Wilson, AM Primerano, A Rapoport, JL Ishizuka, K Kano, S Yolken, RH Sawa, A
Microbes and Infection 2016; 18: 153-158
Click for abstract
Toxoplasma gondii is a protozoan parasite capable of establishing persistent infection within the brain. Serological studies in humans have linked exposure to Toxoplasma to neuropsychiatric disorders. However, serological studies have not elucidated the related molecular mechanisms within neuronal cells. To address this question, we used human induced neuronal cells derived from peripheral fibroblasts of healthy individuals and patients with genetically-defined brain disorders (i.e. childhood-onset schizophrenia with disease-associated copy number variations). Parasite infection was characterized by differential detection of tachyzoites and tissue cysts in induced neuronal cells. This approach may aid study of molecular mechanisms underlying individual predisposition to Toxoplasma infection linked to neuropathology of brain disorders
Toxoplasmosis: an overlooked infection in cancer patients
Wassef, R. M., Malek, R. R. A., Rizk, E. M.,
Annals of Oncology 2016; 27
Impaired health status and increased incidence of diseases in Toxoplasma-seropositive subjects – An explorative cross-sectional study
Flegr, J. Escudero, D. Q.
Parasitology, 143, 1974-1989, doi:10.1017/S0031182016001785, 2016
Click for abstract
parasites in tissue cysts located mainly in immunoprivileged organs was long considered asymptomatic. Recently, many
studies have shown that latent
Toxoplasma
infections could have serious impacts on human health. Here we ran a
cross-sectional study in a population of 1486 volunteers. The results showed that 333 infected subjects scored
worse than 1153 controls in 28 of 29 health-related variables. Similarly, they reported higher rates of 77 of a list of 134
disorders reported by at least 10 participants of the study. Toxoplasmosis was associated most strongly with musculoskel-
etal (
Ï„
= 0·107,
P
< 0·0005), followed by neurological (
Ï„
= 0·088,
P
< 0·0005), immune (
Ï„
= 0·085,
p
< 0·0005), metabolic
(
Ï„
= 0·079,
P
< 0·0005), respiratory (
Ï„
= 0·068,
P
= 0·0001), allergic (
Ï„
= 0·053,
P
= 0·004), digestive system (
Ï„
= 0·052,
P
= 0·004) and mental health disorders (
Ï„
= 0·050,
P
= 0·008). Results of the present cohort study, along with the previous
data from many case-control studies or ecological studies suggest that latent toxoplasmosis represents a large and so far
underrated public health problem
Do differences in Toxoplasma gondii prevalence influence global variation in secondary sex ratio? Preliminary ecological regression study
Dama, S.M., Martinec Nováková, L., Flegr, J.
Parasitology 2016; 143, 1193–1203 doi:10.1017/S0031182016000597
Click for abstract
Sex of the fetus is genetically determined such that an equal number of sons and daughters are born in large populations.
However, the ratio of female to male births across human populations varies signi
fi
cantly. Many factors have been impli-
cated in this. The theory that natural selection should favour female o
ff
spring under suboptimal environmental conditions
implies that pathogens may a
ff
ect secondary sex ratio (ratio of male to female births). Using regression models containing
13 potential confounding factors, we have found that variation of the secondary sex ratio can be predicted by seropreva-
lence of
Toxoplasma
across 94 populations distributed across African, American, Asian and European continents.
Toxoplasma
seroprevalence was the third strongest predictor of secondary sex ratio,
β
=
−
0·097,
P
< 0·01, after son pref-
erence,
β
= 0·261,
P
< 0·05, and fertility,
β
=
−
0·145,
P
< 0·001. Our preliminary results suggest that
Toxoplasma gondii
in-
fection could be one of the most important environmental factors in
fl
uencing the global variation of o
ff
spring sex ratio in
humans. The e
ff
ect of latent toxoplasmosis on public health could be much more serious than it is usually supposed to be.
Influence of Toxoplasma gondii infection on symptoms and signs of premenstrual syndrome: A cross-sectional study.
Alvarado-Esquivel, C., Sanchez-Anguiano, L. F., Hernandez-Tinoco, J., Perez-Alamos, A. R., Rico-Almochantaf, Y. D., Estrada-Martinez, S., Vaquera-Enriquez, R., Diaz-Herrera, A., Ramos-Nevarez, A., Sandoval-Carrillo, A. A., Salas-Pacheco, J. M., Cerrillo-Soto, S. M., Antuna-Salcido, E. I., Liesenfeld, O., Guido-Arreola, C. A.
European Journal of Microbiology and Immunology 2016; 6: 298-305
Click for abstract
Infection with Toxoplasma gondii in brain may cause some symptoms that resemble those in women with premenstrual syndrome. To determine the association of T. gondii infection with symptoms and signs of premenstrual syndrome, we examined 489 women aged 30-40 years old. Sera of participants were analyzed for the presence of anti-Toxoplasma IgG and IgM antibodies using enzyme-linked immunoassays (EIA) and T. gondii DNA by polymerase chain reaction (PCR).
Anti-T. gondii IgG antibodies were found in 38 (7.8%) of the women studied. Anti-T. gondii IgM antibodies were found in 13 (34.2%) of the 38 IgG seropositive women. Logistic regression showed two variables associated with seropositivity to T. gondii: presence of diarrhea (odds ratio [OR] = 6.10; 95% confidence interval [CI]: 1.37-27.85; P = 0.01) and weight gain (OR = 2.89; 95% CI: 1.37-6.07; P = 0.005), and two variables associated with high (>150 IU/ml) levels of IgG against T. gondii: presence of diarrhea (OR = 7.40; 95% CI: 1.79-30.46; P = 0.006) and abdominal inflammation (OR = 3.38; 95% CI: 1.13-10.10; P = 0.02). Positivity to EIA IgG and PCR was positively associated with obesity and negatively associated with joint pain by bivariate analysis.
Our study for the first time reveals a potential association of T. gondii infection with clinical manifestations of premenstrual syndrome.
The role of infection in miscarriage
Giakoumelou, S., Wheelhouse, N., Cuschieri, K., Entrican, G., Howie, S.E.M., Horne, A.W.
Human Reproductive Update 2016; 22: 116-133
Click for abstract
BACKGROUND: Miscarriage is the spontaneous loss of a pregnancy before 12 weeks (early miscarriage) or from 12 to 24 weeks (late miscarriage) of gestation. Miscarriage occurs in one in five pregnancies and can have considerable physiological and psychological implications for the patient. It is also associated with significant health care costs. There is evidence that potentially preventable infections may account for up to 15% of early miscarriages and up to 66% of late miscarriages. However, the provision of associated screening and management algorithms is inconsistent for newly pregnant women. Here, we review recent population-based studies on infections that have been shown to be associated with miscarriage.
METHODS: Our aim was to examine where the current scientific focus lies with regards to the role of infection in miscarriage. Papers dating from June 2009 with key words 'miscarriage' and 'infection' or 'infections' were identified in PubMed (292 and 327 papers, respectively, on 2 June 2014). Relevant human studies (meta-analyses, case-control studies, cohort studies or case series) were included. Single case reports were excluded. The studies were scored based on the Newcastle - Ottawa Quality Assessment Scale.
RESULTS: The association of systemic infections with malaria, brucellosis, cytomegalovirus and human immunodeficiency virus, dengue fever, influenza virus and of vaginal infection with bacterial vaginosis, with increased risk of miscarriage has been demonstrated. Q fever, adeno-associated virus, Bocavirus, Hepatitis C and Mycoplasma genitalium infections do not appear to affect pregnancy outcome. The effects of Chlamydia trachomatis, Toxoplasma gondii, human papillomavirus, herpes simplex virus, parvovirus B19, Hepatitis B and polyomavirus BK infections remain controversial, as some studies indicate increased miscarriage risk and others show no increased risk. The latest data on rubella and syphilis indicate increased antenatal screening worldwide and a decrease in the frequency of their reported associations with pregnancy failure. Though various pathogens have been associated with miscarriage, the mechanism(s) of infection-induced miscarriage are not yet fully elucidated.
CONCLUSIONS: Further research is required to clarify whether certain infections do increase miscarriage risk and whether screening of newly pregnant women for treatable infections would improve reproductive outcomes.
Cerebral toxoplasmosis in a diffuse large B cell lymphoma patient
Savsek, L., Opaskar, T.R.
Radiology and Onkology 2016; 50: 87-93
Click for abstract
Background. Toxoplasmosis is an opportunistic protozoal infection that has, until now, probably been an underestimated cause of encephalitis in patients with hematological malignancies, independent of stem cell or bone marrow transplant. T and B cell depleting regimens are probably an important risk factor for reactivation of a latent toxoplasma infection in these patients.
Case report. We describe a 62-year-old HIV-negative right-handed Caucasian female with systemic diffuse large B cell lymphoma who presented with sudden onset of high fever, headache, altered mental status, ataxia and findings of pancytopenia, a few days after receiving her final, 8th cycle of rituximab, cyclophosphamide, vincristine, doxorubicin, prednisolone (R-CHOP) chemotherapy regimen. A progression of lymphoma to the central nervous system was suspected. MRI of the head revealed multiple on T2 and fluid attenuated inversion recovery (FLAIR) hyperintense parenchymal lesions with mild surrounding edema, located in both cerebral and cerebellar hemispheres that demonstrated moderate gadolinium enhancement. The polymerase chain reaction on cerebrospinal fluid (CSF PCR) was positive for Toxoplasma gondii. The patient was diagnosed with toxoplasmic encephalitis and successfully treated with sulfadiazine, pyrimethamine and folic acid. Due to the need for maintenance therapy with rituximab for lymphoma remission, the patient now continues with secondary prophylaxis of toxoplasmosis.
Conclusions. With this case report, we wish to emphasize the need to consider cerebral toxoplasmosis in patients with hematological malignancies on immunosuppressive therapy when presenting with new neurologic deficits. In such patients, there are numerous differential diagnoses for cerebral toxoplasmosis, and the CNS lymphoma is the most difficult among all to distinguish it from. If left untreated, cerebral toxoplasmosis has a high mortality rate; therefore early recognition and treatment are of essential importance.
Relationship of Toxoplasma Gondii Exposure with Multiple Sclerosis
Oruc, S.
European Journal of General Medicine, 2016, 13: 58-63
Click for abstract
Objective: Toxoplasma gondii infection is a very common parasitic disease in human. In Turkey, the rate of seropositivity was reported as 23.1% to 36%. Because of the high affinity of parasite into Central Nervous System (CNS), chronic toxoplasma infection has been found correlated with many neuropsychiatric disorders, including altered mental status, obsessive-compulsive disorder, cognitive impairment, epilepsy, headache and schizophrenia. In this study, we aimed to investigate whether T. gondii has any role in Multiple Sclerosis (MS) by measuring anti-T. gondii IgG antibodies. Methods: Fifty-two MS patients followed up and 45 controls with similar age and socioeconomic status were included in the study. Anti-T. gondii IgL antibodies of the patients and controls were studied in blood with micro-enzyme-linked immunosorbent assay (ELISA) technique. Results: Of 52 MS patients included in the study, 37 had RRMS, 10 PPMS and 5 SPMS. Mean age of onset of the disease was 31.7 +/- 10.4 (min; 14 and max; 53). Twenty three of 52 (44.2%) cases with MS and 11 of 45 (24.4%) healthy controls were positive for anti-T. gondii IgG antibodies. There was a statistically significant difference between the rates of positivity between the MS patient group and control group (p=0.042). Conclusion: This study shows a relation of chronic T. Gondii infection with MS. According to this study, experienced T. gondii infection may be one of the several environmental risk factors for MS.
Autoimmune diseases, gastrointestinal disorders and the microbiome in schizophrenia: more than a gut feeling
Severance, E. G., Yolken, R. H., Eaton, W. W.
Schizophrenia Research, 2016, 176 :23-35
Click for abstract
Autoimmunity, gastrointestinal (GI) disorders and schizophrenia have been associated with one another for a long time. This paper reviews these connections and provides a context by which multiple risk factors for schizophrenia may be related. Epidemiological studies strongly link schizophrenia with autoimmune disorders including enteropathic celiac disease. Exposure to wheat gluten and bovine milk casein also contribute to non-celiac food sensitivities in susceptible individuals. Co-morbid GI inflammation accompanies humoral immunity to food antigens, occurs early during the course of schizophrenia and appears to be independent from antipsychotic-generated motility effects. This inflammation impacts endothelial barrier permeability and can precipitate translocation of gut bacteria into systemic circulation. Infection by the neurotropic gut pathogen, Toxoplasma gondii, will elicit an inflammatory GI environment. Such processes trigger innate immunity, including activation of complement C1q, which also functions at synapses in the brain. The emerging field of microbiome research lies at the center of these interactions with evidence that the abundance and diversity of resident gut microbiota contribute to digestion, inflammation, gut permeability and behavior. Dietary modifications of core bacterial compositions may explain inefficient gluten digestion and how immigrant status in certain situations is a risk factor for schizophrenia. Gut microbiome research in schizophrenia is in its infancy, but data in related fields suggest disease-associated altered phylogenetic compositions. In summary, this review surveys associative and experimental data linking autoimmunity, GI activity and schizophrenia, and proposes that understanding of disrupted biological pathways outside of the brain can lend valuable information regarding pathogeneses of complex, polygenic brain disorders. (C) 2014 Elsevier B.V. All rights reserved.
Toxoplasma gondii infection in interstate truck drivers: a case-control seroprevalence study
Alvarado-Esquivel, C., Pacheco-Vega, S. J., Hernandez-Tinoco, J., Salcedo-Jaquez, M., Sanchez-Anguiano, L. F., Berumen-Segovia, L. O., Rabago-Sanchez, E., Liesenfeld, O.
Parasites & Vectors 2015; 8
Click for abstract
Background: Infection with Toxoplasma gondii can be acquired via the ingestion of undercooked or raw meat containing tissue cysts, or via ingestion of water contaminated with oocysts. Professional long distance truck driving may have epidemiological importance for food-borne infections since drivers eat out of home and in places where hygiene and cooking practices are uncertain. We aimed to determine whether interstate truck drivers in Durango, Mexico have an increased risk of infection with T. gondii as indicated by seropositivity; and to determine the socio-demographic, work, clinical, and behavioral characteristics associated with T. gondii seropositivity in interstate truck drivers.
Methods: Through a case-control study design, 192 truck drivers and 192 controls from the general population of the same region matched by gender and age were examined with enzyme-linked immunoassays for the presence of anti-Toxoplasma IgG and IgM antibodies. Socio-demographic, work, clinical and behavioral characteristics from the truck drivers were obtained.
Results: Anti-T. gondii IgG antibodies were found in 23 (12.0%) of 192 truck drivers and in 13 (6.8%) of 192 controls (OR = 21.0; 95% CI: 1.23-358.38; P = 0.002). Anti-T. gondii IgM antibodies were found in 7 (3.6%) cases and in 7 (3.6%) controls (P = 1.00). The seroprevalence of T. gondii infection was higher in drivers with reflex impairment than in those without this impairment (4/13, 30.8% vs 19/179, 10.6%, respectively; P = 0.05), and in drivers with hearing impairment than in those without this impairment (3/7, 42.9% vs 20/185, 10.8%, respectively; P = 0.03). Multivariate analysis of work and behavioral characteristics of truck drives showed positive associations of T. gondii exposure with trips to the south of Mexico (OR = 3.11; 95% CI: 1.02-9.44; P = 0.04) and consumption of horse meat (OR = 5.18; 95% CI: 1.62-16.55; P = 0.005).
Conclusions: Results suggest that interstate truck drivers may have an increased risk for T. gondii infection, and that T. gondii exposure may be impacting neurological functions in truck drivers. Contributing factors for T. gondii exposure should be taken into account for the design of optimal prevention measures against T. gondii infection.
The link between toxoplasmosis and diabetes: modifications of pancreatic beta cells TC-6 infected by Toxoplasma gondii tachyzoites
Carmen, M. G. D., Calvo, L. C., Avila, S. V., Cortes, Mdjh, Montalvo, E. A. G., Sanchez, M. E.
Tropical Medicine and International Health 2015; 20: 299-299
The prevalence of anti-Toxoplasma gondii antibodies in stutterers is higher than in the control group
Celik, T., Gokcen, C., Aytas, O., Ozcelik, A., Celik, M., Coban, N.
Folia Parasitologica 2015; 62
Click for abstract
The purpose of this study was to investigate the possible relationship between Toxoplasma gondii (Nicolle et Manceaux, 1908) and stuttering. We investigated the seropositivity rate for anti-T. gondii IgG and antibodies by enzyme-linked immunosorbent assay (ELISA) in stuttering children to ascertain a possible relationship between T. gondii infection and stuttering. We selected 65 stuttering children and 65 control children (non-stutterers) to investigate the seropositivity rate of anti-T. gondii antibodies by ELISA. Cranial magnetic resonance imaging (MRI) and scalp electroencephalography (EEG) were also performed in stuttering children. The seropositivity rate of anti-T. gondii IgG antibodies among stuttering children (28%) was significantly higher than in control group (5%; p = 0.001). No abnormality was detected in cranial MRI's of stutttering children and their EEG recordings were also normal. There was no significant difference in seropositivity rate regarding age, genders and residence area. The association between seroprevalence of infection with T. gondii and stuttering may be due to hyperdopaminergic state in brains of patients who are T. gondii-seropositive. Thus, there might be a causal relationship between toxoplasmosis and stuttering.