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Toxoplasma gondii & Human Phenotype

Compendium of Known Effects and Ongoing Research

antibodies

Cognitive deterioration among bipolar disorder patients infected by Toxoplasma gondii is correlated to interleukin 6 levels

October 6, 2015 85 Comments
Hamdani, N., Daban-Huard, C., Lajnef, M., Gadel, R., Le Corvoisier, P., Delavest, M., Carde, S., Lepine, J. P., Jamain, S., Houenou, J., Galeh, B., Richard, J. R., Aoki, M., Charron, D., Krishnamoorthy, R., Yolken, R., Dickerson, F., Tamouza, R., Leboyer, M.
Journal of Affective Disorders 2015; 179: 161-166
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Background: Cognitive deficits are present in a large majority of Bipolar Disorder (BD) patients and known to be a marker of bad prognosis. Because, these deficits encompass several domains and no specific medical treatment seems to be effective, it is important to better understand the mechanisms underlying cognitive deterioration. As Toxoplasma gondii is known to induce the synthesis of pro-inflammatory cytokines such as IL-6, we will explore here the possible role of T. gondii in the cognitive decline observed in BD. Methods: 42 euthymic BD patients and 36 controls were assessed for episodic verbal memory using the CVLT and for working memory and verbal ability using the WAIS Ill. Patients and controls were also screened for seropositivity to I gondii and evaluated for the levels of IL-fl transcripts. Results: The seropositivity for I gondii was significantly higher in BD patients as compared to controls (p-0.005). The cognitive deterioration index (Dl) was higher in BD patients (p=5.10 ') and correlated to high IL-6 mRNA expression only among those infected by T gondii (rho-0.43, p-0.01). Among deteriorated patients (defined by scores above 0.10 according to Weschler's definition), the IL-6 mRNA expression was twice greater (p=0.01). Limitations: Our results are to be interpreted with caution because of our small sample size and the cross-sectional design. Conclusions: A long-term exposure to inflammation, measured here with IL-6 mRNA expression in T. gonciii infected BD may alter cognitive functioning. IL-6 could thus be a useful predictive marker of cognitive deterioration in BD and may help to design personalized treatment.

Tagged: antibodies, association, bipolar disorder, cognitive deterioration, exposure, il-6, impairment, individuals, Major depression, risk, Schizophrenia, simplex-virus type-1, t. gondii, traffic accidents

Cognitive functionsMental health

Is there any role of latent toxoplasmosis in schizophrenia disease?

October 6, 2015 29 Comments
Karabulut, N., Bilgic, S., Gurok, M. G., Karaboga, F.
Journal of the Chinese Medical Association 2015; 78: 533-537
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Background: A large number of studies have hypothesized that Toxoplasma gondii is a potentially relevant etiological factor in some cases of schizophrenia. By contrast, some studies have disproved this association. The aim of this study was to investigate whether latent toxoplasmosis has any role in schizophrenia disease. Additionally, the association between T. gondii and subtypes of schizophrenia, and the impacts of toxoplasmosis on psychopathology were examined in the study. Methods: A total of 85 patients with schizophrenia and 60 healthy volunteers were included in this prospective study. Immunoglobulin G (IgG) antibody to T. gondii was examined by enzyme-linked immune-sorbent assay method. Results: Seropositivity rates were 43.5% for the patients with schizophrenia and 43.3% for the healthy controls (odds ratio: 1.008, 95% confidence interval: 0.517-1.964, p = 0.981). There was no significant difference in T gondii IgG positivity between the schizophrenia and control groups with respect to sex and age. The difference in seroprevalence of T gondii IgG antibodies among the schizophrenia subtypes was not statistically significant (p = 0.934). No significant difference was found in Positive and Negative Syndrome Subscales between Toxoplasma-infected and Toxoplasma-free patients. Conclusion: In the study area with a high prevalence of T gondii, no association between toxoplasmosis and schizophrenia was detected. These findings showed that toxoplasmosis has no role in the risk of schizophrenia disease.

Tagged: antibodies, gondii, Schizophrenia, Toxoplasma gondii, toxoplasmosis

Mental health

The relationship between pediatric obsessive compulsive disorder and Toxoplasma gondii

October 6, 2015 46 Comments
Memik, N. C., Tamer, G. S., Unver, H., Gundogdu, O. Y.
Journal of Obsessive-Compulsive and Related Disorders 2015; 7: 24-28
Tagged: antibodies, children, compulsion, diagnosis, Epidemiology, infection, mental-disorders, obsession, obsessive-compulsive disorder, reliability, Schizophrenia, seropositivity, Toxoplasma gondii, united-states

Mental health

Toxoplasma gondii seropositivity is negatively associated with multiple sclerosis

October 6, 2015 Leave a Comment
Stascheit, F., Paul, F., Harms, L., Rosche, B.
Journal of Neuroimmunology 2015; 285: 119-124
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Background: Toxoplasma (T.) gondii is a ubiquitous intracellular parasitic protozoan that was recently associated with various autoimmune diseases. Objectives: We aimed to investigate the prevalence of T. gondii IgG and IgM antibodies between MS patients and healthy controls. Methods: Sera from 163 MS, 91 clinically isolated syndrome cases and 178 age and gender matched controls were evaluated for the prevalence of T. gondii IgG antibodies utilizing chemiluminescent immunoassay (ARCHITECT). Results: MS-patients showed a significantly lower prevalence for T. gondii IgG antibodies compared to controls (333% vs. 47.9%; p = 0.011, OR = 1.8 (95% CI 12-3.2)). Conclusion: The results demonstrate a negative association between an infection with the parasite T. gondii and the presence of MS.

Tagged: antibodies, case-control studies, cigarette-smoking, environmental risk-factors, hygiene hypothesis, infection, multiple sclerosis, parasitic infections, Toxoplasma gondii

Physical health

Immune alterations in acute bipolar depression

May 28, 2015
Dickerson, F., Katsafanas, E., Schweinfurth, L. A. B., Savage, C. L. G., Stallings, C., Origoni, A., Khushalani, S., Lillehoj, E., Yolken, R.
Acta Psychiatrica Scandinavica 2015; 132: 204-210
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Objective immunologic abnormalities have been found in bipolar disorder and acute mania. However, there have been fewer studies of patients with acute bipolar depression. MethodBlood samples were obtained from individuals with acute bipolar depression, acute mania, and controls. These samples were evaluated for antibodies to human herpesviruses, gliadin, Toxoplasma gondii, and endogenous retroviruses as well as for C-reactive protein (CRP) and pentraxin-3 using immunoassay methods. Linear regression models were used to compare the levels of the markers controlling for demographic and clinical variables. A subset of the bipolar depressed group was evaluated at a 6-month follow-up. ResultsThe sample consisted of 82 individuals with acute bipolar depression, 147 with acute mania, and 280 controls. The levels of CRP and IgG antibodies to an endogenous retrovirus, Mason-Pfizer monkey virus (MPMV), were significantly elevated in the bipolar depressed group. Levels of pentraxin-3 were reduced in both psychiatric groups. An evaluation of 32 individuals 6months after hospitalization for bipolar depression showed a significant decrease in the levels of MPMV antibodies, but not a change in the other markers. ConclusionIndividuals with acute bipolar depression show immune alterations. Some of the alterations are similar to those found in acute mania.

Tagged: antibodies, bipolar disorder, c-reactive protein, cognitive deficits, depression, disease, disorder, individuals, mania, metaanalysis, neuroimmunology, Schizophrenia, Toxoplasma gondii

Mental health

An observational study of inflammation in the central nervous system in patients with bipolar disorder

January 5, 2015
Stich, O., Andres, T. A., Gross, C. M., Gerber, S. I., Rauer, S., Langosch, J. M.
Bipolar Disorders 2015; 17: 291-302
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ObjectivesThe potential influence of infections and immunological changes on the aetiology and pathogenesis of bipolar disorder (BD) has been discussed. Our aim was to detect intrathecal specific antibody synthesis against the neurotropic infectious agents that have previously been linked to BD. MethodsPaired cerebrospinal fluid (CSF) and serum samples from 40 patients with BD were analysed using the enzyme-linked immunosorbent assay to detect the concentration of antibodies against the following neurotropic infectious pathogens: Toxoplasma gondii (T.gondii), herpes simplex virus (HSV) types 1 and 2, cytomegalovirus (CMV), and Epstein-Barr virus (EBV). The specific antibody index (AI) was calculated, and an AI>1.4 was considered to be evidence of intrathecal specific antibody synthesis. Twenty-six patients with pseudotumour cerebri served as controls. ResultsEight out of 40 patients with BD displayed specific intrathecal antibody synthesis against at least one of the tested neurotropic agents compared to only one patient in the control group (p=0.061, not significant). Of these eight patients with BD, no significant prevalence of any particular neurotropic pathogen was evident. Five out of 40 patients with BD showed oligoclonal bands in the CSF, suggestive of a chronic immune reaction in the central nervous system (CNS). ConclusionsWe found evidence for increased production of antibody in the CSF of individuals with BD. However, the trend for polyspecific intrathecal antibody synthesis, as well as the presence of oligoclonal bands, might indicate activation of the intrathecal humoral immune system in a subgroup of patients with BD, as it is known to be associated with autoimmune disorders of the CNS.

Tagged: agents, antibodies, antibody index, autoimmunity, bipolar disorder, cerebrospinal fluid, cognitive deficits, cytomegalovirus, disease, epstein-barr-virus, herpes-simplex, herpesviridae, infection, intrathecal synthesis, networks, neurotropic agents, psychosis, Schizophrenia, simplex-virus type-1, Toxoplasma gondii, toxoplasma gondii infection

Mental health

The effect of artemether on psychotic symptoms and cognitive impairment in first-episode, antipsychotic drug-naive persons with schizophrenia seropositive to Toxoplasma gondii

October 10, 2014 206 Comments
Wang, H. L., Xiang, Y. T., Li, Q. Y., Wang, X. P., Liu, Z. C., Hao, S. S., Liu, X., Liu, L. L., Wang, G. H., Wang, D. G., Zhang, P. A., Bao, A. Y., Chiu, H. F. K., Ungvari, G. S., Lai, K. Y. C., Buchanan, R. W.
Journal of Psychiatric Research 2014; 53: 119-124
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The objective was to evaluate the efficacy and safety of add-on artemether in first-episode, untreated people with schizophrenia, who were Toxoplasma gondii seropositive, and explore the change in T gondii antibodies during treatment. In this eight-week, double-blind, randomized, placebo-controlled trial, 100 T. gondii seropositive participants with schizophrenia were randomized to either the artemether or placebo group. Participants in the artemether group received 80 mg artemether once per day during the second week (days 8-14) and the fourth week (days 22-28). Participants in the placebo group received identical looking placebo capsules. Psychopathology, adverse side effects and cognitive function were measured using standardized instruments. The group x time interaction effects for the scores of the Positive and Negative Syndrome Scale (PANSS) subscales and performances on all cognitive components were not significant, only the main effect of group was significant. Compared to the placebo group, artemether group participants showed significantly greater reduction in the PANSS negative symptom scale (F-(1,F-46) = 4.7, p = 0.03) and the Clinical Global Impressions Scale (F-(1,F-96) = 6.2, p = 0.01) scores, but there were no significant differences in the PANSS positive symptom and general psychopathology scales (p > 0.05). There were also no significant differences between the two groups in performance on any of the Brief Assessment of Cognition in Schizophrenia (BACS) cognitive domains. The artemether risperidone combination is safe and well tolerated, but artemether as an adjunct to risperidone does not appear to alleviate cognitive deficits of schizophrenia. Trial Registration Chinese Clinical Trial Register (ChiCTR) TRC-13003145 (C) 2014 Elsevier Ltd. All rights reserved.

Tagged: acetylcholine-receptors, antibodies, artemether, artemisinin, cognition, derivatives, exposure, growth, inhibition, metaanalysis, progressive brain changes, psychopathology, rodents, Schizophrenia, Toxoplasma gondii

Mental health

Inflammatory molecular signature associated with infectious agents in psychosis

October 9, 2014 32 Comments
Hayes, L. N., Severance, E. G., Leek, J. T., Gressitt, K. L., Rohleder, C., Coughlin, J. M., Leweke, F. M., Yolken, R. H., Sawa, A.
Schizophrenia Bulletin 2014; 40: 963-972
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Schizophrenia (SZ) is a devastating mental condition with onset in young adulthood. The identification of molecular biomarkers that reflect illness pathology is crucial. Recent evidence suggested immune and inflammatory cascades in conjunction with infection may play a role in the pathology. To address this question, we investigated molecular changes in cerebrospinal fluid (CSF) from antipsychoticnaive patients with SZ and at risk mental status for psychosis (ARMS), in comparison with healthy controls (HCs). We measured 90 analytes using a broad multiplex platform focusing on immune and inflammatory cascades then selected 35 with our quality reporting criteria for further analysis. We also examined Toxoplasma gondii (TG) and herpes simplex virus 1 antibody levels in CSF. We report that expression of 15 molecules was significantly altered in the patient groups (SZ and ARMS) compared with HCs. The majority of these molecular changes (alpha-2-macroglobulin [alpha 2M], fibrinogen, interleukin-6 receptor [IL-6R], stem cell factor [SCF], transforming growth factor alpha [TGF alpha], tumor necrosis factor receptor 2 [TNFR2], IL-8, monocyte chemotactic protein 2 [MCP-2/CCL8], testosterone [for males], angiotensin converting enzyme [ACE], and epidermal growth factor receptor) were consistent between SZ and ARMS patients, suggesting these may represent trait changes associated with psychotic conditions in general. Interestingly, many of these analytes (alpha 2M, fibrinogen, IL-6R, SCF, TGF alpha, TNFR2, IL-8, MCP-2/CCL8, and testosterone [for males]) were exacerbated in subjects with ARMS compared with subjects with SZ. Although further studies are needed, we optimistically propose that these molecules may be good candidates for predictive markers for psychosis from an early stage. Lastly, reduction of IL-6R, TGF alpha, and ACE was correlated with positivity of TG antibody in the CSF, suggesting possible involvement of TG infection in the pathology.

Tagged: antibodies, at risk mental status, biomarker, cerebrospinal fluid, exposure, immune activation, inflammation, metaanalysis, pathways, prenatal infection, recent-onset schizophrenia, risk factors, Schizophrenia, simplex-virus 1, Toxoplasma gondii

Mental health

Association between latent toxoplasmosis and major depression, generalised anxiety disorder and panic disorder in human adults

October 9, 2014 Leave a Comment
Gale, S. D., Brown, B. L., Berrett, A., Erickson, L. D., Hedges, D. W.
Folia Parasitologica 2014; 61: 285-292.
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Latent infection with the apicomplexan Toxoplasma gondii (Nicolle et Manceaux, 1908) has been associated with schizophrenia, bipolar disorder and self-harm behaviour. However, the potential relationship between T. gondii immunoglobulin G antibody (IgG) seropositivity and generalised-anxiety disorder (GAD) and panic disorder (PD) has not been investigated. The associations between serum reactivity to T. gondii and major depressive disorder (MDD), GAD and PD were evaluated in a total sample of 1846 adult participants between the ages of 20 and 39 years from the United States Center for Disease Control's National Health and Nutrition Examination Survey (NHANES). Approximately 16% of the overall sample was seropositive for T. gondii and 7% of the sample met criteria for MDD, 2% for GAD and 2% for PD. There were no significant associations between T gondii IgG seroprevalence and MDD (OR = 0.484, 95% CI = 0.186-1.258), GAD (OR = 0.737, 95% CI = 0.218-2.490) or PD (OR = 0.683, 95% CI = 0.206-2.270) controlling for sex, ethnicity, poverty-to-income ratio and educational attainment. However, limited evidence suggested a possible association between absolute antibody titres for T. gondii and GAD and PD but not MDD. Toxoplasma gondii seroprevalence was not associated with MDD, GAD or PD within the context of the limitations of this study, although there may be an association of T. gondii serointensity with and GAD and PD, which requires further study.

Tagged: antibodies, behavior, behaviour, bipolar disorder, brain, gondii infection, mood, mood disorders, national health and nutrition examination survey (nhanes), psychiatric, risk factors, Schizophrenia, seroprevalence, Toxoplasma gondii, united-states

Mental health

Relationship between Toxoplasma gondii infection and bipolar disorder in a French sample

October 11, 2013 86 Comments
Hamdani, N., Daban-Huard, C., Lajnef, M., Richard, J. R., Delavest, M., Godin, O., Le Guen, E., Vederine, F. E., Lepine, J. P., Jamain, S., Houenou, J., Le Corvoisier, P., Aoki, M., Moins-Teisserenc, H., Charron, D., Krishnamoorthy, R., Yolken, R., Dickerson, F., Tamouza, R., Leboyer, M.
Journal of Affective Disorders 2013; 148: 444-448
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Background: Prenatal exposure to viruses or parasites with tropism for the central nervous system is one of the risk factors for psychotic disorders. However, the relationship between past exposure to Toxoplasma gondii (T. gondii) and incidence of bipolar disorders (BD) is poorly documented across populations. Methods: We explored the potential association between T. gondii exposure and BD in France, a country of high prevalence of Toxoplasmosis, comparing the prevalence of serological markers (IgG/IgM class antibodies) for T. gondii infection in 110 BD patients and 106 healthy controls all living in France. In a subgroup of 42 patients and 42 controls we also evaluated the levels of interleukin 6 (IL-6) transcripts, an adjunct marker of inflammation. Results: We found that the sero-positive group for IgG antibodies to T. gondii had a 2.7 fold odds of having BD as compared to the sero-negative group (OR = 2.17 CI 95% = 1.09-4.36, p = 0.028). Despite the fact that BD patients had significantly higher levels of IL-6 than the non-patient controls, no notable association between T. gondii status and IL-6 transcript levels was found. We did not find any clinical or demographic correlates of Toxoplasma exposure in the study population. Limitations: Our results are to be interpreted with caution because of our small sample size. Results: We confirm the association between seropositive status to T. gondii and bipolar disorders reported in other populations and extend it to French patients. Our data strengthen the importance of early detection of T. gondii infected patients in order to propose specific and adequate treatments.

Tagged: antibodies, bipolar disorder, Epidemiology, health, il-6, neuro-immunology, pathophysiology, pregnant women, prevalence, Schizophrenia, seropositivity, Toxoplasma gondii

Mental health

Prevalence of Toxoplasma gondii infection among individuals with severe mental illness in Nigeria: a case control study

October 11, 2013 118 Comments
James, B. O., Agbonile, I. O., Okolo, M., Lawani, A. O., Omoaregba, J. O.
Pathogens and Global Health 2013; 107: 189-193
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Background: While the aetiology for most psychotic disorders is unknown, a strong association has been observed between Toxoplasma gondii infection and psychosis. The proportion of individuals with psychotic disorders who have current or past infection with toxoplasma has been varied. Reports from the African continent have however been scanty. Methods: A case control study of patients with a psychotic disorder presenting for the first time to a regional psychiatric facility was undertaken and compared to age and sex-matched healthy controls. In addition to socio-demographic and clinical characteristics, seroprevalence (IgG and IgM) of T. gondii was undertaken using an immunoassay test kit. Results: IgG seropositivity was significantly higher among cases (30.7% vs 17.85%, OR=2.04, 95% CI=1.12-3.74, P<0.02). In contrast, IgM seropositivity was significantly lower among the cases (7.14% vs 8.57%, OR=0.82, 95% CI=0.31-2.16, P=0.82). Cases who were IgG seropositive to T. gondii were more likely to be older (P<0.001) and female (P<0.001). There was no statistically significant difference in terms of T. gondii infection and, eaten poorly cooked meat (0.88), and diagnostic group (P=0.53). Though there was a trend towards exposure to cats, this failed to reach significance (P=0.08). Conclusion: T. gondii (IgG) infection is common among individuals with severe mental illness sampled and significantly higher compared to controls.

Tagged: agents, antibodies, behavior, nigeria, posttraumatic-stress-disorder, risk factors, Schizophrenia, severe mental illness, Toxoplasma gondii

Mental health

Differences in some developmental features between Toxoplasma gondii-seropositive and seronegative school children

October 9, 2013 33 Comments
Mizgajska-Wiktor, H., Jarosz, W., Andrzejewska, I., Krzykala, M., Janowski, J., Kozlowska, M.
Folia Parasitologica 2013; 60: 416-424
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Knowledge about the influence of latent toxoplasmosis on development and general biological condition of children is scant and thus the aim of the present study was to investigate these aspects in some detail. We compare school children in rural area seropositive and seronegative to the apicomplexan parasite Toxoplasma gondii (Nicolle et Manceaux, 1908) in terms of their developmental age, body mass and body height, physical fitness and end-of-term grades. Additionally, we evaluated the risk factors of infection with T gondii such as the presence of cats in the household and eating raw meat products. With IFAT and ELISA tests, the prevalence of anti-Toxoplasma antibodies was 41% (190 children examined) and the rate of infection was higher in girls (44%) than in boys (36%). No significant differences were observed in morphological features and physical fitness of examined children. In girls the level of developmental age measured with electrophoretical mobility of nuclei method was significantly higher and school performance significantly lower for those infected with Toxoplasma than for uninfected; this finding was particularly intriguing. Only boys who ate raw meat products were more likely to be seropositive. The study provides some new information on gender differences in reaction to Toxoplasma infection.

Tagged: animals, antibodies, areas, behavior, children development, developmental age, infection, latent toxoplasmosis, physical fitness, risk, risk factors, Schizophrenia, seroprevalence, toxoplasmosis

Cognitive functions

Prevalence of Toxoplasma gondii parasite infection among people who died due to sudden death in the capital city of Warsaw and its vicinity

September 4, 2013
Samojlowicz, D., Borowska-Solonynko, A., Golab, E.
Przegled Epidemiologicny 2013; 67: 29-33
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BACKGROUND: It has recently been shown that the behavioural effects resulting from latent T. gondii infection in immunocompetent people could pose as a threat to their welfare. AIM. The aim of the study was to evaluate the prevalence of T. gondii infection in a group of people who died suddenly in Warsaw and its vicinity. MATERIAL AND METHODS: The studied group (n = 169 people) included 42 road traffic accident victims who were driving a vehicle (bicycle (n = 6), a motorbike (n = 3), a motorcycle (n = 13), a car (n = 20)) prior to sudden death and 41 people whose death resulted from suicide. Blood samples were collected post-mortem and examined for the presence of T. gondii, IgG antibodies and ethyl alcohol. RESULTS: Of the 169 people tested, T. gondii IgG antibodies were found in the serum of 93 (55%) of which 25 (59.5%) were drivers and 26 (63.4%) people who died as a result of suicide. With respect to the prevalence of T. gondii infection no statistically significant differences were found between the study (61.4%) and control group (49.4%); (p = 0.09). A statistically significant result was recorded in the 38-58 age group between suicide and control groups (71.4% vs. 44.4%; p < 0.05). Positive test results for the presence of ethyl alcohol in the blood were reported among 49.7% of the studied population: 25.7% among drivers, 67.6% among suicides and 51.8% in the control group. To a statisctically siginificant degree, IgG T. gondii antibodies were found to occur more frequently in people with positive blood alcohol test results among suicides (72% vs. 50%; p < 0.05) and among the control group (60% vs. 40%; p < 0.05) than in their equivalents with negative test results. CONCLUSIONS: Our work confirmed the usefulness of serologically testing samples collected post-mortem for epidemiological purposes. The small size of the study group made it impossible to evaluate the potential associations between exposure to T. gondii infection and the probability of sudden death. The significance of Toxoplasma gondii infection as a risk factor for self-destructive behaviour merits further study.

Tagged: adult, antibodies, biomarkers/blood, causality, cause of death, comorbidity, female, humans, male, middle aged, Poland/epidemiology, prevalence, protozoan/*blood, risk factors, suicide/*statistics & numerical data, toxoplasmosis/*diagnosis/*epidemiology/immunology, urban population/statistics & numerical data, young adult

Mental health

High seroprevalence of Toxoplasma gondii infection in a subset of Mexican patients with work accidents and low socioeconomic status

October 16, 2012
Alvarado-Esquivel, C., Torres-Castorena, A., Liesenfeld, O., Estrada-Martinez, S., Urbina-Alvarez, J. D.
Parasites & Vectors 2012;5: Artn 13 10.1186/1756-3305-5-13
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BACKGROUND: Toxoplasma gondii has been associated with reflex impairment and traffic accidents. It is unknown whether Toxoplasma infection might be associated with work accidents. Therefore, using a case-control seroprevalence study design, 133 patients with a recent work accident and 266 control subjects of the general population from the same region were examined with enzyme-linked immunoassays for the presence and levels of anti-Toxoplasma IgG antibodies and anti-Toxoplasma IgM antibodies. Socio-demographic, work, clinical and behavioral characteristics from each worker were obtained. RESULTS: Eleven (8.3%) of 133 patients, and 14 (5.3%) of 266 controls had anti-T. gondii IgG antibodies. Anti-T. gondii IgG levels were higher than 150 IU/ml in 8 (6%) patients and 10 (3.8%) controls. Anti-T. gondii IgM antibodies were found in one (0.8%) of the workers, and in 6 (2.3%) of the controls. No statistically significant differences in the IgG seroprevalences, frequencies of high IgG levels, and IgM seroprevalences among patients and controls were found. In contrast, a low socio-economic level in patients with work accidents was associated with Toxoplasma seropositivity (P = 0.01). Patients with work accidents and low socioeconomic status showed a significantly (OR = 3.38; 95% CI: 0.84-16.06; P = 0.04) higher seroprevalence of T. gondii infection than controls of the same socioeconomic status (15.1% vs. 5%, respectively). Multivariate analysis showed a positive association of T. gondii infection with boar meat consumption (OR = 3.04; 95% CI: 1.03-8.94; P = 0.04). In contrast, a negative association between T. gondii infection and national trips (OR = 0.40; 95% CI: 0.17-0.96; P = 0.04), sausage consumption (OR = 0.20; 95% CI: 0.05-0.68; P = 0.01), and ham consumption (OR = 0.16; 95% CI: 0.05-0.51; P = 0.002) was found. CONCLUSIONS: In the study described here seropositivity to T. gondii was associated to work accidents in a subset of patients with low socioeconomic status. This is the first report of an association of T. gondii infection and work accidents. Further studies to confirm our results are needed. Results may help in designing optimal prevention strategies to avoid T. gondii infection.

Tagged: accidents, adolescent, adult, aged, antibodies, case-control studies, enzyme-linked immunosorbent assay, female, humans, immunoglobulin G/blood, Immunoglobulin M/blood, male, Mexico/epidemiology, middle aged, multivariate analysis, occupational, protozoan/blood, risk factors, seroepidemiologic studies, social class, Toxoplasma/*immunology, toxoplasmosis/*epidemiology/parasitology, young adult

Behavior

Seroprevalence of anti-Toxoplasma gondii IgG antibody in patients with schizophrenia

October 16, 2012
Emelia, O., Amal, R. N., Ruzanna, Z. Z., Shahida, H., Azzubair, Z., Tan, K. S., Aadila, S. N., Siti, N. A. M., Aisah, M. Y.
Tropical Biomedicine 2012; 29: 151-159
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Schizophrenia is a pervasive neuropsychiatric disease of unknown cause. Previous studies have reported that toxoplasmosis may be a possible cause of schizophrenia. To ascertain possible relationship between Toxoplasma gondii and schizophrenia, a cross sectional study, employing an enzyme-linked immunosorbent assay (ELISA) was performed to study the seroprevalence of anti-T. gondii IgG antibody in schizophrenic patients. Furthermore, demographic data analysis from schizophrenic patients were analysed to associate toxoplasmosis with schizophrenia. A total of 288 serum samples from schizophrenic patients (n=144) and psychiatrically healthy volunteers (n=144) were recruited in this study. Interestingly, a significant result in the serointensity rate of anti-T. gondii IgG antibody (> 60 IU/mL) in schizophrenic patients (61.1%) was demonstrated as compared to psychiatrically healthy volunteers (40.8%) (X(2) = 4.236, p < 0.050). However, there was no significant difference between the seropositivity rate of anti-T. gondii IgG antibody between the two groups. Analysis from demographic data revealed that the seropositivity rate of anti-T. gondii IgG antibody in schizophrenic patients was significantly associated with age group of more than 40 years old (p=0.007) and between ethnic (p=0.046). Nevertheless, no significant association between seropositivity rate of anti-T. gondii IgG antibody with gender (p=0.897), duration of illness (p=0.344) and family history of schizophrenia (p=0.282) in these patients. Thus, this finding is essential as a preliminary data in Malaysia to establish the association between T. gondii and schizophrenia.

Tagged: adult, age factors, animals, antibodies, cross-sectional studies, enzyme-linked immunosorbent assay, ethnic groups, female, humans, immunoglobulin G/blood, Malaysia/epidemiology, male middle aged, protozoan/blood, risk factors, schizophrenia/*complications, seroepidemiologic studies, Toxoplasma/*immunology, toxoplasmosis/*epidemiology

Mental health

Does Toxoplasma gondii infection affect cognitive function? A case control study

October 16, 2012
Guenter, W., Bielinski, M., Deptula, A., Zalas-Wiecek, P., Piskunowicz, M., Szwed, K., Bucinski, A., Gospodarek, E., Borkowska, A.
Folia Parasitologica 2012; 59: 93-98.
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According to studies, latent Toxoplasma gondii infection may affect several functions of the human brain. Here we search for the association between latent toxoplasmosis and cognitive performance. We tested 70 individuals for latent T. gondii infection. There were 26 Toxoplasma-infected subjects and 44 Toxoplasma-free subjects. Within these two groups we assessed cognitive performance using a set of standardized, widely recognized neuropsychological tests: Trail Making Test, Stroop Test, Verbal Fluency Test, Digit Span Test and N-back test. The relationship between chronic toxoplasmosis and cognitive performance was assessed, with adjustment for age and sex. Patients with latent toxoplasmosis performed worse on one neuropsychological test, N-back Test--percentage of correct answers (beta -8.08; 95% CI - 15.64 to -0.53; p < 0.05) compared to seronegative patients. However, after adjustment for age and sex, no statistically significant associations between latent toxoplasmosis and the scores on any cognitive tests were noticed. As statistically significant relationship was not observed, this study does not confirm that chronic latent T. gondii infection affects cognition.

Tagged: adult, antibodies, case-control studies, chronic disease, cognition disorders/*parasitology, female, humans, immunoglobulin G/blood, male, middle aged *Toxoplasma, protozoan/blood, toxoplasmosis/*complications, young adult

Cognitive functions

Does Toxoplasma gondii play a role in obsessive-compulsive disorder?

October 11, 2012 Leave a Comment
Taboas W, McKay D, Taylor S.
Psychiatry Research 2012; 198: 176-177
Tagged: antibodies, area, birth, Epidemiology, infection, onset, season, seroprevalence, united-states

Mental health

Incidence of adult brain cancers is higher in countries where the protozoan parasite Toxoplasma gondii is common

October 11, 2012 13 Comments
Thomas, F., Lafferty, K. D., Brodeur, J., Elguero, E., Gauthier-Clerc, M., Misse, D.
Biology Letters 2012; 8: 101-103
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We explored associations between the common protozoan parasite Toxoplasma gondii and brain cancers in human populations. We predicted that T. gondii could increase the risk of brain cancer because it is a long-lived parasite that encysts in the brain, where it provokes inflammation and inhibits apoptosis. We used a medical geography approach based on the national incidence of brain cancers and seroprevalence of T. gondii. We corrected reports of incidence for national gross domestic product because wealth probably increases the ability to detect cancer. We also included gender, cell phone use and latitude as variables in our initial models. Prevalence of T. gondii explained 19 per cent of the residual variance in brain cancer incidence after controlling for the positive effects of gross domestic product and latitude among nations. Infection with T. gondii was associated with a 1.8-fold increase in the risk of brain cancers across the range of T. gondii prevalence in our dataset (4-67%). These results, though correlational, suggest that T. gondii should be investigated further as a possible oncogenic pathogen of humans

Tagged: antibodies, brain cancer, Epidemiology, infection, inflammation, medical geography, neoplasms, Toxoplasma gondii, tumors

Physical health

Toxoplasma gondii and other risk factors for schizophrenia: An update

October 11, 2012 Leave a Comment
Torrey, E.F., Bartko, J.J., Yolken, R.H.
Schizophrenia Bulletin 2012; 38: 642-647
Click for abstract
The failure to find genes of major effect in schizophrenia has refocused attention on nongenetic, including infectious factors. In a previous study, antibodies to Toxoplasma gondii were found to be elevated in 23 studies of schizophrenia (OR 2.73; 95% CI 2.10-3.60). The current study replicates this finding with 15 additional studies (OR 2.71; 95% CI 1.93-3.80) and compares this with other identified schizophrenia risk factors. The highest risk factors are having an affected mother (relative risks [RR] 9.31; 95% CI 7.24-11.96), father (RR 7.20; 95% CI 5.10-10.16), or sibling (RR 6.99; 95% CI 5.38-9.08) or being the offspring of immigrants from selected countries (RR 4.5; 95% CI 1.5-13.1). Intermediate risk factors, in addition to infection with T. gondii, include being an immigrant from and to selected countries (RR 2.7; 95% CI 2.3-3.2), being born in (RR 2.24; 95% CI 1.92-2.61) or raised in (RR 2.75; 95% CI 2.31-3.28) an urban area, cannabis use (OR 2.10-2.93; 95% CI 1.08-6.13), having minor physical anomalies (OR 2.23; 95% CI 1.42-3.58), or having a father 55 or older (OR 2.21-5.92; 95% CI 1.46-17.02). Low-risk factors include a history of traumatic brain injury (OR 1.65; 95% CI 1.17-2.32), sex abuse in childhood (OR 1.46; 95% CI 0.84-2.52), obstetrical complications (OR 1.29-1.38; 95% CI 1.00-1.84), having a father 45 or older (OR 1.21-1.66; 95% CI 1.09-2.01), specific genetic polymorphisms (OR 1.09-1.24; 95% CI 1.06-1.45), birth seasonality (OR 1.07-1.95; 95% CI 1.05-2.91), maternal exposure to influenza (RR 1.05; 95% CI 0.98-1.12), or prenatal stress (RR 0.98-1.00; 95% CI 0.85-1.16).

Tagged: 1st-episode, antibodies, birth, cannabis use, complication, infection, metaanalysis, psychosis, risk factors, s individuals, Schizophrenia, season, Toxoplasma gondii

Mental health

Toxoplasma infection in schizophrenia patients: A comparative study with control group

October 19, 2011
Alipour, A., Shojaee, S., Mohebali, M., Tehranidoost, M., Masoleh, F. A., Keshavarz, H.
Iranian Journal of Parasitology 2011; 6: 31-37
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Background: Schizophrenia is a serious, chronic, and often debilitating neuropsychiatric disorder. Its causes are still poorly understood. Besides genetic and non-genetic (environmental) factors are thought to be important as the cause of the structural and functional deficits that characterize schizophrenia. This study aimed to compare Toxoplasma gondii infection between schizophrenia patients and non-schizophrenia individuals as control group. Methods: A case-control study was designed in Tehran, Iran during 2009-2010. Sixty-two patients with schizophrenia and 62 non-schizophrenia volunteers were selected. To ascertain a possible relationship between T. gondii infection and schizophrenia, anti-Toxoplasma IgG antibodies were detected by indirect-ELISA. Data were statistically analyzed by chi- square at a confidence level of 99%. Results: The sero-positivity rate among patients with schizophrenia (67.7%) was significantly higher than control group (37.1) (P <0.01). Conclusion: A significant correlation between Toxoplasma infection and schizophrenia might be expected.

Tagged: antibodies, behavior, bipolar disorder, brain, elisa, episode schizophrenia, gondii infection, individuals, Iran, metaanalysis, personality, recent-onset schizophrenia, Schizophrenia, Toxoplasma gondii

Mental health

Toxoplasma gondii infection and liver disease: a case-control study in a Northern Mexican population

October 19, 2011
Alvarado-Esquivel, C., Torres-Berumen, J. L., Estrada-Martinez, S., Liesenfeld, O., Mercado-Suarez, M. F.
Parasites & Vectors 2011; 4
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Background: Infection with the protozoan parasite Toxoplasma gondii may cause liver disease. However, the impact of the infection in patients suffering from liver disease is unknown. Therefore, through a case-control study design, 75 adult liver disease patients attending a public hospital in Durango City, Mexico, and 150 controls from the general population of the same region matched by gender, age, and residence were examined with enzyme-linked immunoassays for the presence of anti-Toxoplasma IgG and anti-Toxoplasma IgM antibodies. Socio-demographic, clinical and behavioral characteristics from the study subjects were obtained. Results: Seroprevalence of anti-Toxoplasma IgG antibodies and IgG titers did not differ significantly in patients (10/75; 13.3%) and controls (16/150; 10.7%). Two (2.7%) patients and 5 (3.3%) controls had anti-Toxoplasma IgM antibodies (P = 0.57). Seropositivity to Toxoplasma did not show any association with the diagnosis of liver disease. In contrast, seropositivity to Toxoplasma in patients was associated with consumption of venison and quail meat. Toxoplasma seropositivity was more frequent in patients with reflex impairment (27.8%) than in patients without this impairment (8.8%) (P = 0.05). Multivariate analysis showed that Toxoplasma seropositivity in patients was associated with consumption of sheep meat (OR = 8.69; 95% CI: 1.02-73.71; P = 0.04) and rabbit meat (OR = 4.61; 95% CI: 1.06-19.98; P = 0.04). Conclusions: Seropositivity to Toxoplasma was comparable among liver disease patients and controls. Further studies with larger sample sizes are needed to elucidate the association of Toxoplasma with liver disease. Consumption of venison, and rabbit, sheep, and quail meats may warrant further investigation.

Tagged: acquired ocular toxoplasmosis, antibodies, deer, immunocompetent patient, prevalence, quail, rabbits oryctolagus-cuniculus, seroepidemiology, spain, virginianus

Physical health

Toxoplasma gondii infection and schizophrenia: A case control study in a low Toxoplasma seroprevalence Mexican population

October 19, 2011
Alvarado-Esquivel, C., Urbina-Alvarez, J. D., Estrada-Martinez, S., Torres-Castorena, A., Molotla-de-Leon, G., Liesenfeld, O., Dubey, J. P.
Parasitology International 2011; 60: 151-155
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There are conflicting reports concerning the association of Toxoplasma gondii infection and schizophrenia in humans. Therefore, we determined such association in a Mexican population of Mestizo ethnicity. Through a case-control study design, 50 schizophrenic patients and 150 control subjects matched by gender, age, residence place, and ethnicity were examined with enzyme-linked immunoassays for the presence and levels of T. gondii IgG antibodies and for the presence of T. gondii IgM antibodies. Schizophrenic patients attended a public psychiatric hospital in Durango City, Mexico, and the control group consisted of individuals of the general population of the same city. Socio-demographic, clinical and behavioral characteristics from the study subjects were also obtained. Both the seroprevalence and the level of T. gondii IgG antibodies were higher in schizophrenic patients (10/50; 20%) than in control subjects (8/150; 5.3%) (OR=4.44; 95% CI: 1.49-13.37; P=0.003). The IgG T. gondii levels higher than 150 IU/ml were more frequently observed in patients than in controls (10% versus 2%, respectively; P=0.02). One (50%) of the two patients with recently diagnosed schizophrenia and none of the controls had T. gondii IgM antibodies (P=0.01). T. gondii seropositivity was significantly higher in patients with a history of cleaning cat excrement (P=0.005), and suffering from simple schizophrenia (ICD-10 classification: F20.6) (P=0.03) than patients without these characteristics. Toxoplasma seroprevalence was also significantly higher in patients with simple schizophrenia (F20.6) than in those with paranoid schizophrenia (F20.0) (P=0.02). This study provides elements to clarify the controversial information on the association of T. gondii infection and schizophrenia. Published by Elsevier Ireland Ltd.

Tagged: antibodies, case-control study, durango, Epidemiology, individuals, Schizophrenia, seroepidemiology, seroprevalence, Toxoplasma gondii

Mental health

Could Toxoplasma gondii have any role in Alzheimer disease?

October 19, 2011
Kusbeci, O. Y., Miman, O., Yaman, M., Aktepe, O. C., Yazar, S.
Alzheimer Disease and Associated Disorders 2011; 25: 1-3
Tagged: activated microglia, alzheimer disease, antibodies, brain, infection, inflammation, interferon-gamma, mechanism, neurodegeneration, neuroinflammation, parkinson's disease, pathogenesis, Schizophrenia, Toxoplasma gondii, toxoplasmosis

Mental health

Seroprevalence of Toxoplasma gondii infection in female sterility patients in China

October 19, 2011
Alvarado-Esquivel, C., Torres-Berumen, J. L., Estrada-Martinez, S., Liesenfeld, O., Mercado-Suarez, M. F.
Journal of Parasitology 2011; 97: 529-530
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Toxoplasmosis is an important parasitic disease worldwide and is related to certain psychiatric disorders and sterility. In the present study, serum samples from 882 female sterility patients and 107 pregnant-puerperant women were assayed for anti-T. gondii IgG antibodies using ELISA. The overall T gondii seroprevalence was 14.8%. In the female sterility patients, 15.9% (140/882) were seropositive and, in the pregnant-puerperant women, 5.6% (6/107) were positive for anti-T. gondii IgG antibodies. There was a significant difference between the 2 groups (P < 0.05). The samples were further divided into 5 groups based on age, but no significant difference was found among the 5 groups (P > 0.05). Results of the present study argue for more attention to prevention of T. gondii infection in the female population and, in particular, women of childbearing age.

Tagged: antibodies, diagnosis, pregnancy, reproductive failure, seroepidemiology

Reproduction

Serum antibodies to Toxoplasma gondii and Herpesvidae family viruses in individuals with schizophrenia and bipolar disorder: a case-control study

October 16, 2011
Tedla, Y., Shibre, T., Ali, O., Tadele, G., Woldeamanuel, Y., Asrat, D., Aseffa, A., Mihret, W., Abebe, M., Alem, A., Medhin, G., Habte, A.
Ethiopian Medical Journal 2011; 49: 211-220
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BACKGROUND: Recent etiological studies for schizophrenia and bipolar disorder have focused on the protozoan Toxoplasma gondii and Herpesvirdae family viruses. OBJECTIVE: To determine the magnitude of T. gondii, cytomegalovirus (CMV), herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) infection in individuals with schizophrenia, bipolar disorder and healthy controls by using serologic diagnostic methods. MATERIAL AND METHODS: Serologic diagnostic method was used to determine the prevalence and level of antibodies to T gondii, CMV HSV-1 and HSV-2 in individuals with schizophrenia, bipolar disorder, and unaffected controls recruited from Butajira, Ethiopia. The study was conducted from March to May 2009. A total of 495 serum samples were analysed for the presence and level of immunoglobulin G (IgG) to T. gondii, CMV HSV-1, and HSV-2. RESULTS: The seroprevalence of T gondii infection was higher in individuals with schizophrenia [adjusted odds ratio = 4.7; 95% CI (1.5, 15.1)] and bipolar disorder [adjusted odds ratio = 3.0; 95% CI (1.1, 8.6)] than in unaffected controls. The level of IgG to CMV was also significantly higher in individuals with schizophrenia and bipoar disorder than in unaffected controls. Younger individuals with schizophrenia (< 25 years old) also had a significantly higher level of IgG to CMV than matched unaffected controls. CONCLUSION: This study provides additional evidence that infection with 7T gondii and CMV may be associated with some cases of schizophrenia and bipolar disorder. Additional studies should focus on antibodies to these agents in the sera and CSF of individuals with recent-onset psychosis.

Tagged: *ctomegalovirus infections/diagnosis/epidemiology, *herpes simplex/diagnosis/epidemiology, *toxoplasmosis/diagnosis/epidemiology, adolescent, adult, antibodies, bipolar disorder/epidemiology/*parasitology/virology, case-control studies, cytomegalovirus/immunology/isolation & purification, Ethiopia/epidemiology, female, herpesviridae/immunology/isolation & purification, herpesvirus 1, herpesvirus 2, human/immunology/isolation & purification, humans, immunoglobulin G/blood, male, middle aged, prevalence, protozoan/blood, risk factors, schizophrenia/epidemiology/*parasitology/*virology, seroepidemiologic studies, Toxoplasma/immunology/isolation & purification, viral/blood, young adult

Mental health

Potential immunomodulatory effects of latent toxoplasmosis in humans

January 9, 2011
Flegr, J., Striz, I.
Bmc Infectious Diseases 2011; 11: Artn 274 10.1186/1471-2334-11-274
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Background: About 30% of the population worldwide are infected with the protozoan parasite Toxoplasma gondii. Latent toxoplasmosis has many specific behavioral and physiological effects on the human organism. Modified reactivity of the immune system has been suggested to play a key role in many of these effects. For example, the immunosuppression hypothesis explains the higher probability of the birth of male offspring observed in Toxoplasma-positive humans and mice by the protection of the (more immunogenic) male embryos against abortion. Methods: Here we searched for indices of immunosuppression in Toxoplasma-positive subjects by comparing clinical records of immunology outpatients. Results: Our cohort study showed that the male patients with latent toxoplasmosis had decreased and the Toxoplasma-positive women had increased leukocyte, NK-cell and monocyte counts in comparison with controls. The B-cell counts were reduced in both Toxoplasma-positive men and women. The difference between Toxoplasma-positive and Toxoplasma-negative subjects diminished with the decline of the specific Toxoplasma antibody titre (a proxy for the length of infection), which is consistent with the observed decreasing strength of the effect of latent toxoplasmosis on human reproduction. The prevalence of toxoplasmosis in 128 male patients was unusually low (10.9%) which contrasted with normal prevalence in 312 female patients (23.7%) and in general population Prague (20-30%). Conclusions: Latent toxoplasmosis has immunomodulatory effects in human and probably protects men against some classes of immunopathological diseases. The main limitation of the present study was the absence of the data on the immunoreactivity of immune cells subpopulations. Therefore further studies are needed to search for indices of immunosuppression in human using more specific markers.

Tagged: antibodies, behavioral-changes, communication, gender differences, gondii, hypothesis, mice, sex ratio, testosterone concentration, traffic accidents

Physical health

Toxoplasma infection and later development of schizophrenia in mothers

January 5, 2011
Pedersen, M. G., Stevens, H., Pedersen, C. B., Norgaard-Pedersen, B., Mortensen, P. B
American Journal of Psychiatry 2011;168: 814-821
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Objective: Several studies based on clinical samples have found an association between Toxoplasma gondii infection and schizophrenia, and a case-control study among U. S. military personnel with specimens available from both before and after diagnosis found a positive association between T. gondii immunoglobulin G (IgG) antibody level and schizophrenia. These findings have never been replicated in a prospective cohort study. The purpose of this study was to determine whether mothers infected with T. gondii have an elevated risk of schizophrenia or related disorders and whether the risk depends on IgG antibody level. Method: In a register-based prospective cohort study of 45,609 women born in Denmark, the level of T. gondii-specific IgG antibodies was measured in connection with childbirth between 1992 and 1995. Women were followed up from the date of delivery until 2008. Results: A significant positive association between T. gondii IgG antibody level and schizophrenia spectrum disorders was found. Mothers with the highest IgG level had a relative risk of 1.73 (95% confidence interval [CI]=1.12-2.62) compared with mothers with the lowest IgG level. For schizophrenia, the relative risk was 1.68 (95% CI=0.77-3.46). When the mothers were classified according to IgG level, only those with the highest IgG levels had a significantly higher risk of schizophrenia spectrum disorders. Conclusions: Women with high levels of T. gondii-specific IgG antibodies have a significantly elevated risk of developing schizophrenia spectrum disorders.

Tagged: acid, agents, antibodies, brain, disease, gondii infection, molecular mimicry, systém

Mental health

Seroepidemiology of Toxoplasma gondii infection in patients with vision and hearing impairments, cancer, HIV, or undergoing hemodialysis in Durango, Mexico.

October 19, 2010
Alvarado-Esquivel, C., Liesenfeld, O., Torres-Castorena, A., Estrada-Martinez, S., Urbina-Alvarez, J. D., Ramos-de la Rocha, M., Marquez-Conde, J. A., Dubey, J. P.
Journal of Parasitology 2010; 96: 505-508.
Click for abstract
Toxoplasma gondii infection may cause a variety of symptoms involving virtually all organs. Little is known of the epidemiology of T. gondii infection in different patient groups in Mexico. We sought to determine the prevalence of T. gondii infection and associated epidemiological characteristics in 472 patients in Durango, Mexico. Participants were tested for T. gondii IgG and IgM antibodies. In addition, sociodemographic, clinical, and behavioral characteristics from each participant were obtained. Seroprevalences of T. gondii IgG antibodies were found in 7 (8.2%) of 85 patients with hearing impairment, 5 (10.0%) of 50 patients with hemodialysis, 28 (12.0%) of 234 patients with visual impairment, and 7 (6.8%) of 103 at risk of immunosuppression. In total, 47(10%) of 472 subjects had IgG T. gondii antibodies; 6 (1.3%) of them also had IgM anti T. gondii antibodies. Patients born in Durango State had a significantly lower prevalence of T. gondii infection than patients born in other Mexican states (9.0% vs. 21.4%, respectively: P < 0.05). Multivariate analysis showed that T. gondii infection was significantly associated with consumption of undercooked meat (adjusted odds ratio [OR] = 2.95; 95% confidence interval [CI]: 1.18-7.35) or raw cow's milk (adjusted OR = 2.52; 95% CI: 1.28-4.96), presence of cats at home (adjusted OR = 2.01; 95% CI: 1.06-3.78), raising animals (adjusted OR = 2.44; 95% CI: 1.06-5.63), or eating away from home (adjusted OR = 2.70; 95% CI: 1.03-7.11). In the group of patients with visual impairment, those with reflex impairment had a significantly higher frequency of T. gondii infection than those with normal reflexes (19% vs. 9.4%, respectively: P = 0.04). Results of the present study are the first step in the design of prevention programs to avoid the sequelae of toxoplasmosis.

Tagged: antibodies, risk, traffic accidents, turkey

Physical healthSensory functions

Serological survey of Toxoplasma gondii in schizophrenia patients referred to Psychiatric Hospital, Sari City, Iran

October 19, 2010
Daryani, A., Sharif, M., Hosseini, S. H., Karimi, S. A., Gholami, S.
Tropical Biomedicine 2010; 27: 476-482
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Schizophrenia is a severe neuropsychiatric disorder of unknown etiology. As there is little information about the association between Toxoplasma gondii infection and schizophrenia in Iran, we investigated the seroprevalence of T. gondii in these patients and compared with that obtained in control individuals in Sari City, Iran, 2009. Eighty schizophrenia patients and 99 healthy people were examined for the presence of IgG and IgM antibodies to T. gondii by enzyme linked immunosorbent assay (ELISA). Overall prevalence rates of anti-T. gondii antibodies (IgG/IgM) in case and control groups were 72.5% and 61.6%, respectively (P>0.05). IgG antibodies indicating chronic form of toxoplasmosis were found in 28 (35%) and 25 (25.3%) of case and control groups, respectively (P>0.05). IgM antibodies (acute form) were also seen in 9 (11.2%) and 11 (11.1%) of case and control individuals, respectively (P>0.05). The highest 10(th) percentile of IgG titers in schizophrenia individuals (18.8%) was significantly higher than control group (6.1%, P=0.02). As prevalence rate of T. gondii antibodies in patients with schizophrenia was high, it seems that designing a cohort study will determine the causative relationship between Toxoplasma infection and schizophrenia.

Tagged: antibodies, astrocytes, cells, host, individuals, infection, neurons, parasites, primary culture, recent-onset schizophrenia

Mental health

Toxoplasmosis as a cause for behaviour disorders – overview of evidence and mechanisms

October 19, 2010
Fekadu A, Shibre T, Cleare AJ.
Folia Parasitologica 2010; 57: 105-113
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Background - There is growing interest in the role of microbial agents in the causation of psychiatric disorders. The neurotropic protozoan parasite Toxoplasma gondii is one of the main candidates and has been associated with various psychiatric conditions, including schizophrenia. Methods - A narrative review of the literature from the main medical databases (Medline, PubMed, PsycINFO), Google Scholar and Google using combinations of applicable terms. Results - T. gondii affects the brain in both the acute and the latent stages of infection causing apparent brain pathologies in infected rodents and both immuno-compromised and immuno-competent humans. In immuno-competent individuals, behavioural disorders are primarily related to the latent stages of the illness. Behavioural/mental disorders that include schizophrenia, mood disorders, personality changes and cognitive impairments may be related to infection with T gondii. Evidence for a behavioural effect of T gondii comes from observational reports in animal models and controlled behavioural analysis in humans. Indirect clues of infection also come from raised seroprevalence or serotitres of antitoxoplasma antibodies among those with mental disorders. The pathophysiologic mechanism through which T gondii may exert its effect is not clear, but direct impact on the brain and changes in neuroimmunomodulation, neurotransmission and some gene-environment interactions are postulated. Conclusion - There is evidence supporting a potential role of T gondii infection in the onset of some behavioural disorders. Confirmation of such a role would prove a significant breakthrough in the search for the aetiology, treatment and prevention of behavioural disorders, such as schizophrenia. However, the associations remain preliminary.

Tagged: 1st-episode schizophrenia, agents, antibodies, behavioural disorder, decreased level, gondii infection, individuals, mental-health surveys, mood, mood disorders, novelty seeking, personality changes, review, risk, Schizophrenia, Toxoplasma gondii, toxoplasmosis

Mental healthReviews

The association of infectious agents and schizophrenia

October 19, 2010
Krause, D., Matz, J., Weidinger, E., Wagner, J., Wildenauer, A., Obermeier, M., Riedel, M., Muller, N.
World Journal of Biological Psychiatry 2010; 11: 739-743
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Objectives. The influence of infectious agents on the pathogenesis of psychiatric disorders has been discussed for decades. Pre- and postnatal infections are risk factors for schizophrenia. This may be explained by chronic infections or an altered immune status. However most of the studies have only focused on one single pathogen and not on the impact of different infectious agents. We investigated the association between schizophrenia and various neurotophic infectious agents. Methods. A total of 31 schizophrenic patients and 30 healthy matched individuals were included. Antibody titres of cytomegalovirus, herpes simplex virus, Epstein-Barr virus, mycoplasma, chlamydia and toxoplasma were evaluated. For statistical analysis we used Fisher's exact and Wilcoxon test. Results. Significantly elevated positive antibody titres within schizophrenic patients were found only for Chlamydia trachomatis (P=0.005) and a trend to significance for herpes simplex virus (P=0.055). Combining the different agents, schizophrenics had a significantly higher rate of positive titres to infectious agents as compared to controls (P=0.04). Conclusions. The higher prevalence of antibodies within schizophrenic patients emphasizes a possible role of infectious agents in the pathogenesis of schizophrenia. Our data indicates that not one specific agent might be responsible for schizophrenic symptoms but the resulting immune response in the central nervous system.

Tagged: antibodies, childhood, chlamydia, etiology, herpes-simplex, immune system, individuals, infection, influenza, maternal exposure, psychosis, risk, Schizophrenia, virus

Mental health

The probable relation between Toxoplasma gondii and Parkinson’s disease

October 19, 2010
Miman, O., Kusbeci, O. Y., Aktepe, O. C., Cetinkaya, Z.
Neuroscience Letters 2010; 475: 129-131
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Parkinson's disease (PD), a chronic progressive neurodegenerative disorder, has a mainly unknown multifactorial etiology. Neuroinflammatory mechanisms might contribute to the cascade of events leading to neuronal degeneration. Toxoplasmosis can be associated with various neuropsychiatric disorders. The most commonly affected central nervous system (CNS) region in toxoplasmosis is the cerebral hemisphere, followed by the basal ganglia, cerebellum and brain stem. Therefore, in this study, we aimed to investigate the possible association between Toxoplasma infection and PD by evaluating the serum anti-Toxoplasma gondii IgG antibodies. There were no difference between the socioeconomic status of the patients and control subjects and magnetic resonance images of the patients were normal. Serum anti-T. gondii IgG levels were measured using ELISA. There was no statistically significant differences among the patients and control subjects with respect to age (66.01 +/- 12.14 years, 62.42 +/- 5.93 years, p = 0.089; respectively) and gender. The sero-positivity rate for anti-T. gondii IgG antibodies in PD patients and control groups were 42.3 and 22.5%, respectively, and they were statistically significant (p = 0.006). These results suggest that Toxoplasma infection may be involved in the pathogenetic mechanisms of PD. If confirmed, this hypothesis would represent a valuable advancement in care of patients with Parkinson's disease. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

Tagged: antibodies, brain, cryptogenic epilepsy, encephalitis, host, infection, metaanalysis, mice, neurodegeneration, neuroinflammation, neurons, parkinson's disease, Schizophrenia, Toxoplasma gondii, toxoplasmosis

Mental health

Possible role of toxoplasmosis in patients with first-episode schizophrenia

October 19, 2010
Tanyuksel, M., Uzun, O., Araz, E., Koru, O., Babur, C.
Turkish Journal of Medical Sciences 2010; 40: 399-404
Click for abstract
Aim: To determine the possible relationship between toxoplasmosis and patients with first-episode schizophrenia (FES) Materials and methods: Seventy-three subjects with FES (15-54 years old; mean. 23.4 years) and 40 healthy individuals (20-54 years old, mean: 30.3 years) were enrolled in the study Most of the FES patients (90.4%) and the control individuals (95 0%) were male Specific IgG and IgM antibodies to Toxoplasma gondii were investigated by enzyme-linked immunosorbent assay (ELISA), and the total amount of antibodies was investigated with the Sabin-Feldman dye test (SFDT) Results: Compared to the control individuals, study subjects had significantly more toxoplasmosis-like symptoms and more cats in the household; they were less likely to live in apartments and more likely to live in ground-floor houses They did consume more uncooked meat, unpasteurized goat's milk, and chicken eggs; had more contact with soil; and were living less often in urban areas and more often in rural areas. Serum samples from 32 (43 8%) and 25 (34.2%) of 73 patients with FES were seropositive for T gondii when tested by ELISA IgG and SFDT, respectively Out of 40 serum samples from control subjects, 13 (32 5%) and 15 (37.5%) were found positive for T gondii by ELISA IgG and SFDT, respectively In patients with FES, 17 (68%) out of 25 who were SFDT-positive were also positive by ELISA IgG test, while 15 out of 48 (31 3%) SFDT-negative serums were positive by ELISA IgG In the control group, 11 out of 15 SFDT-positive serum samples (73 3%) were also positive by ELISA IgG test, while 2 out of 25 SFDT-negative serum samples were positive by ELISA IgG Conclusion: The present study shows that toxoplasmosis might be associated with first-episode schizophrenia. More studies are needed to prove the association between T gondii infection and patients suffering from schizophrenia

Tagged: antibodies, antibody, area, assay, cat, cats, chicken, contact, control, egg, eggs, elisae, enzyme-linked immunosorbent assay, Fe, gondii, gondii infection, group, house, igg, igm, IgM antibodies, individual, individuals, infection, Ireland, male, meat, method, methods, milk, old, patient, patients, positive, psychosis, relationship, Sabin Feldman dye test sample, samples, Schizophrenia, sera, serum, serum sample, soil, symptoms, t test, Toxoplasma gondii, toxoplasmosis, year

Mental health

The role of latent toxoplasmosis in the aetiopathogenesis of schizophrenia – the risk factor or an indication of a contact with cat?

October 19, 2010
Yuksel, P., Alpay, N., Babur, C., Bayar, R., Saribas, S., Karakose, A. R., Aksoy, C., Aslan, M., Mehmetali, S., Kilic, S., Balcioglu, I., Hamanca, O., Dirican, A., Kucukbasmaci, O., Oner, A., Torun, M. M., Kocazeybek, B.
Folia Parasitologica 2010; 57: 121-128
Click for abstract
We assessed IgG antibody to Toxoplasma gondii in 300 inpatients with schizophrenia (SG), 150 outpatients with anxiety and depressive disorders (PCG), and 150 healthy blood donors (HCG). Seropositivity rates were 60.7% for SG, 36.7% for PCG, and 45.3% for HCG (p<0.001). The seropositivity rate for anti-Toxoplasma IgG antibodies in SG was significantly higher that in PCG (X(2) = 23.11, OR = 2.66, p = 0.001) and HCG (X(2) = 9.52, OR = 1.86, p = 0.002). Among SG, 85% of those who reported close cat contact had IgG antibodies to T gondii. Close cat contacts were reported by 59% of SG, 6% of PCG, and 9% of HCG (p<0.001). There was a nonsignificant positive association between toxoplasmosis and schizophrenia for people with a contact with a cat (OR = 2.221, p = 0.127, CI(95) = 0.796-6.192), and significant negative association between toxoplasmosis and schizophrenia for people without contact with a cat (OR = 0.532, p = 0.009, CI(95) = 0.332-0.854). Close cat contact (OR = 2.679, p<0.001), 51-65-year age group (OR = 1.703, p<0.001) and education [illiterate+primary (OR = 6.146, p<0.001) and high school (OR = 1.974, p = 0.023)] were detected as independent risk factors in multivariate logistic regression. The effect of toxoplasmosis on risk of schizophrenia disappeared in the complex model analyzed with multivariate logistic regression. In conclusion, our data suggest that the toxoplasmosis has no direct effect on the risk of schizophrenia in Turkey but is just an indication of previous contacts with a cat

Tagged: antibodies, behavioral-changes, brain, Dopamine, gondii infection, individuals, latent toxoplasmosis, mice, pregnant women, Schizophrenia, seroprevalence, Toxoplasma gondii, turkey, viral encephalitis

Mental health

Toxoplasma gondii infection in first-episode and inpatient individuals with schizophrenia

January 9, 2010
Hamidinejat, H., Ghorbanpoor, M., Hosseini, H., Alavi, S. M., Nabavi, L., Jalali, M. H., Borojeni, M. P., Jafari, H., Mohammadaligol, S.
International Journal of Infectious Diseases 2010; 14: E978-E981
Click for abstract
Background: A high seroprevalence of Toxoplasma gondii infection has been detected in psychiatric patients, particularly in schizophrenia cases. Methods: In the present study 98 patients suffering from schizophrenia (58 inpatients and 40 first-episode patients) and 96 control patients (50 healthy volunteers and 46 with a depressive disorder) were examined for the presence of both IgG and IgM antibodies against T. gondii by enzyme-linked immunosorbent assay (ELISA). We applied the Bradford Hill criteria to identify the weight of causal inference. Results: The positivity rate of anti-T. gondii IgG antibodies among individuals with schizophrenia (57.1%) was significantly higher than in healthy controls (29.2%). There were no associations between immune status ratio (ISR) values and the risk of schizophrenia. The weight of evidence approach using the Bradford Hill criteria revealed a 92% probability of a causal association. Conclusion: Our results show that exposure to T. gondii may lead to schizophrenia. (C) 2010 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Tagged: agents, antibodies, behavior, depressive disorder, disorders, mice, rats, Schizophrenia, Toxoplasma gondii

Mental health

Toxoplasma gondii antibody titers and history of suicide attempts in patients with recurrent mood disorders

October 30, 2009
Arling, T. A., Yolken, R. H., Lapidus, M., Langenberg, P., Dickerson, F. B., Zimmerman, S. A., Balis, T., Cabassa, J. A., Scrandis, D. A., Tonelli, L. H., Postolache, T. T.
The Journal of Nervous and Mental Disease 2009; 3:905-908
Click for abstract
Toxoplasma gondii (T.gondii) is an obligate intracellular protozoan parasite infecting one-third of the world population, residing relatively silently in the brain of the immunocompetent host. We hypothesized that T.gondii seropositivity and serointensity are associated with having a history of attempting suicide and, in those attempting suicide, a greater number of attempts. T.gondii seropositivity and antibody titers were compared between (a) patients with recurrent mood disorders with history of suicide attempt (99 individuals) versus (b) patients with recurrent mood disorders without history of suicide attempt (119 individuals), and (c) healthy controls (39 individuals). Diagnosis was made using the Structured Clinical Interview for DSM-IV. Statistical methods included chi square, analysis of variance, and linear and logistic regression analyses. Suicide attempters had higher T.gondii antibody titers than nonsuicide attempters (p = 0.004). The logistic regression analysis revealed a predictive association between titers of anti- T.gondii antibodies and history of suicide attempt with OR = 1.55 (1.14-2.12), p = 0.006. No significant relationship was found between T.gondii seropositivity and suicide attempt status, number of prior suicide attempts, and recurrent mood disorder diagnosis. Although preliminary and bearing replication, this is the first report, to our knowledge, of an association between attempting suicide and T. gondii.

Tagged: adult, antibodies, attempted, Bipolar Disorder/*parasitology Depressive Disorder, Cerebral/immunology/*psychology, female, humans, Major/*parasitology, male, Mood Disorders/*parasitology, protozoan/*blood, sex factors, suicide, Toxoplasma/immunology, toxoplasmosis

BehaviorMental health

Schizophrenia and toxoplasmosis

October 26, 2009
Dion, S., Barbe, P. G., Leman, S., Camus, V., Dimier-Poisson, I.
M S-Medecine Sciences 2009; 25: 687-691.
Click for abstract
Schizophrenia and toxoplasmosis Schizophrenia is one of the most severe and disabling psychiatric disease that affects about 1% of the adult worldwide population. Aetiology of schizophrenia is still unknown but genetic and environmental factors are suspected to play a major role in its onset. Recent epidemiologic studies indicate that infectious agents may contribute to some cases of schizophrenia. In particular, several epidemiological, behavioural and neurochemical studies suggested the existence of an association between schizophrenia and post history of primo-infection by the Toxoplasma gondii. However, they are some limitations for this hypothesis among which the lack of correlation between the geographic distribution of both diseases and of direct evidence for the presence of the parasite in schizophrenic patients. Nevertheless the identification of physiopathological mechanisms related to the parasite could provide a better comprehension to the outcome of schizophrenia. Studies on the link between toxoplasmosis and schizophrenic may provide interesting data for the diagnosis and the development of new treatments for this disorder.

Tagged: 1st-episode, antibodies, Dopamine, Epidemiology, gondii, high-risk, infection, mental-disorders, metaanalysis, psychosis

Mental health

A possible relationship between Toxoplasma gondii and schizophrenia: A seroprevalence study

October 26, 2009
Dogruman-Al, F., Aslan, S., Yalcin, S., Kustimur, S., Turk, S.
International Journal of Psychiatry in Clinical Practice 2009; 13: 82-87.
Click for abstract
Objective. Schizophrenia is a pervasive neuropsychiatric disease of uncertain etiology. We aimed to investigate a possible association between Toxoplasma gondii infection and schizophrenia in this study. Method. We selected individuals with schizophrenia (n=88) and tested them with commercially available enzyme-linked immunosorbent assay (ELISA) for anti-Toxoplasma IgG and IgM antibodies and compared these seropositivity rate to those of controls without psychiatric disease (n=88). Results. The rate of IgG antibody in the schizophrenia patients (47.7%) was higher than the control groups (20.4%) (P0.001). We did not find any anti-Toxoplasma IgM seropositivity in both schizophrenia patients and control group. In schizophrenic patients with and without anti-Toxoplasma IgG groups statistical analysis did not reveal any correlation between demographic variables and Toxoplasma infection. Conclusion. Our findings supported previous studies indicate that T.gondii may play a role in etiopathogenesis in some cases of schizophrenia.

Tagged: 1st-episode schizophrenia, anti-toxoplasma igg, anti-toxoplasma igm, antibodies, association, behavior, bipolar disorder, brain, exposure, individuals, infection, necrosis-factor-alpha, Schizophrenia, Toxoplasma gondii

Mental health

Higher prevalence of toxoplasmosis in victims of traffic accidents suggest increased risk of traffic accident in Toxoplasma-infected inhabitants of Istanbul and its suburbs.

October 26, 2009
Kocazeybek, B., Oner, Y. A., Turksoy, R., Babur, C., Cakan, H., Sahip, N., Unal, A., Ozaslan, A., Kilic, S., Saribas, S., Asian, M., Taylan, A., Koc, S., Dirican, A., Uner, H. B., Oz, V., Ertekin, C., Kucukbasmaci, O., Torun, M. M.
Forensic Science International 2009; 187: 103-108
Click for abstract
Reflexes of drivers who have toxoplasmosis have been shown to deteriorate from the actions of the parasitic cysts. The cysts can change the level of the neurotransmitters such as dopamine in the brain and by doing so extend the muscle response time and change personality profiles. In this Study, we aimed to determine the frequency of the latent toxoplasmosis (LT) in the driver population who were either injured or died in traffic accidents reported in Istanbul and its suburbs. We compared the results with a control group and discussed the relationship between the LT and the traffic accidents. We included 218 (89.7%) non-fatal, 25 (10.3%) fatal cases in our study as study groups. A total 243 subjects, 234 (96%) male, 9 (4%) female (who were alcohol negative) compared with 191 (95.5%) male and 9 (4.5%) female Subjects (control group) who had a traffic accident before but no history of toxoplasmosis were studied. Serologic tests, enzyme immunoassay (EIA) for IgG and IgM, and microimmunoflorescence (MIF) for IgG were used as the reference test, the Sabin-Feldman Dye test (SFDT) was used. According to serologic test results, LT seroprevalence in the study groups was 130 (53.5%) and in the control group 56 (28%) (p < 0.0001). A LT was present in 126 out of 234 (53.8%) males in the study groups, and 54 out of 191 (28.3%) males in the control group (p < 0.0001). In the 31-44 year age group, there was a significant difference with regard to toxoplasmosis between the study subjects and control groups (p < 0.0001). This difference was statistically very significant in (recent and former) cases with middle-aged men (31 44 years old). The results of this retrospective study Suggest that LT in drivers, especially those who are between 31 and 44 years might increase the risk for getting involved in a car accident. In a prospective study, Toxoplasma positive and negative subjects can be monitored before they are involved in a traffic accident to clarify the cause and result relationship. (C) 2009 Elsevier Ireland Ltd. All rights reserved.

Tagged: antibodies, behavior, decreased level, Dopamine, forensic science, gondii, latent toxoplasmosis, mice, novelty seeking, personality, pregnant women, Schizophrenia, traffic accidents

Behavior

Selected infectious agents and risk of schizophrenia among U.S. military personnel

October 29, 2008
Niebuhr, D. W., Millikan, A. M., Cowan, D. N., Yolken, R., Li, Y., Weber, N. S.
The American Journal of Psychiatry 2008;1 65: 99-106
Click for abstract
OBJECTIVE: A number of studies have reported associations between Toxoplasma gondii (T. gondii) infection and the risk of schizophrenia. Most existing studies have used small populations and postdiagnosis specimens. As part of a larger research program, the authors conducted a hypothesis-generating case control study of T. gondii antibodies among individuals discharged from the U.S. military with a diagnosis of schizophrenia and serum specimens available from both before and after diagnosis. METHOD: The patients (N=180) were military members who had been hospitalized and discharged from military service with a diagnosis of schizophrenia. Healthy comparison subjects (3:1 matched on several factors) were members of the military who were not discharged. The U.S. military routinely collects and stores serum specimens of military service members. The authors used microplate-enzyme immunoassay to measure immunoglobulin G (IgG) antibody levels to T. gondii, six herpes viruses, and influenza A and B viruses and immunoglobulin M (IgM) antibody levels to T. gondii in pre- and postdiagnosis serum specimens. RESULTS: A significant positive association between the T. gondii IgG antibody and schizophrenia was found; the overall hazard ratio was 1.24. The association between IgG and schizophrenia varied by the time between the serum specimen collection and onset of illness. CONCLUSION: The authors found significant associations between increased levels of scaled T. gondii IgG antibodies and schizophrenia for antibodies measured both prior to and after diagnosis.

Tagged: adolescent, adult, animals, antibodies, female, Herpesviridae/immunology, humans, Immunoenzyme Techniques/statistics & numerical data, Immunoglobulin G/blood/immunology, male, Military Personnel/*statistics & numerical data, Protozoan/*analysis/blood/immunology, risk factors, Schizophrenia/epidemiology/*etiology/immunology, Toxoplasma/*immunology, Toxoplasmosis/*complications/epidemiology/immunology, United States/epidemiology, Viral/analysis/immunology

Mental health
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