suicide attempts – Toxoplasma gondii & Human Phenotype

Lower performance of Toxoplasma-infected, Rh-negative subjects in the weight holding and hand-grip tests

September 3, 2018
Flegr, J., Sebankova, B., Priplatova, L., Chvatalova, V., Kankova, S.
PLoS ONE 2018; 13

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Latent toxoplasma infection in real-world schizophrenia: Results from the national FACE-SZ cohort

February 12, 2018
Fond,G., Boyer, L. ,Schurhoff, F. ., Berna,F. , Godin, O., Bulzacka, E., Andrianarisoa, M. Brunel, ,L. ,Aouizerate, B. , Capdevielle, D.,Chereau, I. , Coulon, N., D'Amato, T. , Dubertret,C. , Dubreucq, J.,Faget, C.,. Lancon, Leignier,S., Mallet,J., Misdrahi, D., Passerieux, C., Rey,R., Schandrin,A., Urbach,M., Vidailhet,P., Llorca, P. M., Leboyer, M., Grp,F.S.
Schizophrenia Research 2018; 201: 373-380

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Objective: Latent Toxoplasma infection has been associated with widespread brain immune activation, increased blood brain barrier permeability, neural disruption, increased dopamine release in dopaminergic neurons, with NMDA activation and with schizophrenia (SZ) onset risk. Toxoplasma has been suggested to be a source of chronic low-grade inflammation and this inflammation has been associated with cognitive impairment in SZ. The objective of the present study were (i) to determine if latent Toxoplasma infection was associated with specific clinical features in stabilized SZ subjects, with cognitive impairment and with increased low-grade peripheral inflammation and (ii) to determine if Treatments with Anti-Toxoplasmic Activity (TATA) were associated with improved outcomes in subjects with latent Toxoplasma infection. Methods: A comprehensive 2 daylong clinical and neuropsychological battery was administered in 250 SZ subjects included between 2015 and 2017 in the national FondaMental Expert Center (FACE-SZ) Cohort. Solid phase-enzyme microplate immunoassay methods were used to measure IgG class of antibodies to T. gondii in blood sample. Latent Toxoplasma infection was defined by T. gondii IgG ratio >= 0.8, equivalent to >= 10 international units. Chronic peripheral inflammation was defined by highly sensitive Creactive protein blood level >= 3 mg/L. Results: Latent Toxoplasma infection has been found in 184 (73.6%) of this national multicentric sample. In the multivariate analyses, latent Toxoplasma infection has been significantly associated with higher PANSS negative (aOR = 1.1 [1.1-1.1], p = 0.04) and excitement subscores (aOR = 1.3 [1.1-1.6], p = 0.01), with two specific symptoms (i.e., reference delusion (aOR = 3.6 [1.2-10.6] p = 0.01) and alogia (aOR = 16.7 [2.0-134.7], p = 0.008)) and with chronic low-grade peripheral inflammation (27.2% vs. 7.6%, aOR = 3.8 [1.4-10.3], p = 0.004). Extrapyramidal symptoms remained significantly associated with latent Toxoplasma infection. On the opposite, no significant association of latent Toxoplasma infection with age, gender, age at SZ onset, suicide behavior or cognitive deficits has been found in these models (all p > 0.05). TATA were associated with lower depressive symptoms (aOR = 0.8[0.7-0.9], p = 0.01), and with lower rates of chronic peripheral inflammation (20.9% vs. 48.6%, aOR = 3.5 [1.5-7.9], p = 0.003) but not with higher cognitive scores (p > 0.05). Conclusion: The present findings suggest that Toxoplasma is almost 3 times more frequent in SZ population compared to general population in France. The potential cerebral underpinnings of the association of latent Toxoplasma infection and the above-mentioned outcomes have been discussed. Future studies should confirm that TATA may be effective to reduce Toxoplasma-associated depressive symptoms and low-grade peripheral inflammation.

Toxoplasmosis, the insidious parasitic infection: dangers of asymptomatic carrier state

December 8, 2017
Bognar, L., Izso, T., Szakos, D., Kasza, G.
Magyar Allatorvosok Lapja 2017;139:479-487

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Background: The highly prevalent parasitic infection of humans, toxoplasmosis, can have serious consequences even during an asymptomatic course of the disease. The causative agente of infection is Toxoplasma gondii, which proliferates in the intestine of cats. Risk of infection by direct contact with cats is low, but the infection can occur due to contaminated soil, water, unwashed vegetables and fruits, as well as insufficiently heat-treated meat. Objectives: The aim of this study was to synthesize the current knowledge about infection caused by Toxoplasma gondii in a brief review focusing on latent toxoplasmosis in humans. Materials and Methods: More than hundred articles, studies and reports from scientific journals were considered to summarize the infection's characteristics such as prevalence and symptoms in humans. Results and Discussion: The symptoms of acute toxoplasmosis are either featureless, or non-existent, although, for people with immunosuppression it can be fatal, and for expectants it can result in foetal harm. The detection of the infection is conducted with serology methods, however, only in a few European countries are general screenings present. The asymptomatic carrier state is dangerous as well, because the cysts subsist in the brain of the host, which affects behaviour, the regulation of emotions, and also the level of several hormones. The latent toxoplasmosis can be connected to aggression, anxiety, schizophrenia, bipolar personality disorder, suicidal inclination, depression, and the reduction in intelligence quotient. For the reason of the deterioration of reaction time, the disease increases the risk of traffic accidents. The latent toxoplasmosis also influences personality traits; for women and men the alteration of the personality change differs. There is no data on the current epidemiological situation in Hungary, and not even in Europe. A research regarding the extent of asymptomatic carrier state and about the psychological changes in the Hungarian population has not been conducted so far.

Bipolar disorder with psychotic features and ocular toxoplasmosis

January 3, 2017
Del Grande, C., Contini, C., Schiavi, E., Rutigliano, G., Maritati, M., Seraceni, S., Pinto, B., Dell'Osso, L., Bruschi, F.
Journal of Nervous and Mental Disease 2017; 205: 192-195

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Toxoplasma gondii infection: Relationship with aggression in psychiatric subjects

October 6, 2016
Coccaro, E. F., Lee, R., Groer, M. W., Can, A., Coussons-Read, M., Postolache, T. T.,
Journal of Clinical Psychiatry 2016; 77: 334-341.

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Latent toxoplasmosis is associated with neurocognitive impairment in young adults with and without chronic HIV infection

October 6, 2016
Ene, L., Marcotte, T. D., Umlauf, A., Grancea, C., Temereanca, A., Bharti, A., Achim, C. L., Letendre, S., Ruta, S. M.,
Journal of Neuroimmunology 2016; 299: 1-7.

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No association between current depression and latent toxoplasmosis in adults

October 6, 2016
Gale, S. D., Berrett, A. N., Brown, B., Erickson, L. D., Hedges, D. W.
Folia Parasitologica 2016; 63: DOI 10.14411/fp.2016.032

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Changes in behaviour and cognition have been associated with latent infection from the apicomplexan protozoan Toxoplasma gondii (Nicolle et Manceaux, 1908) in both animal and human studies. Further, neuropsychiatric disorders such as schizophrenia have also been associated with latent toxoplasmosis. Previously, we found no association between T. gondii immunoglobulin G antibody (IgG) seropositivity and depression in human adults between the ages of 20 and 39 years (n = 1 846) in a sample representative of the United States collected by the Centers for Disease Control as part of a National Health and Nutrition Examination Survey (NHANES) from three datasets collected between 1999-2004. In the present study, we used NHANES data collected between 2009 and 2012 that included subjects aged 20 to 80 years (n = 5 487) and used the Patient Health Questionnaire 9 (PHQ-9) to assess depression with the overall aim of testing the stability of the results of the prior study. In the current study, the seroprevalence of T. gondii was 13%. The percentage of subjects reporting clinical levels of depression assessed with the PHQ-9 was 8%. As before, we found no association between T. gondii IgG seroprevalence and depression (OR = 1.01, 95% CI = 0.81-1.25; p = 0.944) while controlling for sex, educational attainment, race-ethnicity, age, poverty-to-income ratio and cigarette smoking. We also found no positive associations between anti-T. gondii antibody titre and depression (OR = 1.00, 95% CI = 0.96-1.06; p = 0.868). Moreover, we found no association between T. gondii seroprevalence or antibody titre and suicidal ideation (seroprevalence: OR = 1.22, 95% CI =.85-1.75; p = 0.277, titre: OR = 1.05, 95% CI = 0.98-1.14; p = 0.177). Defining depression to also include subjects currently taking antidepressant medication even with non-elevated questionnaires did not find evidence of a positive association between latent toxoplasmosis and depression. In the present study, neither T. gondii seroprevalence nor anti-T. gondii antibody titre was positively associated with depression or suicidal ideation among subjects aged 20 to 80 years.

Toxoplasma gondii infection in interstate truck drivers: a case-control seroprevalence study

October 9, 2015
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

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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.

Treatment with anti-toxoplasmic activity (TATA) for Toxoplasma positive patients with bipolar disorders or schizophrenia: A cross-sectional study

October 9, 2015
Fond, G., Boyer, L., Gaman, A., Laouamri, H., Attiba, D., Richard, J. R., Delavest, M., Houenou, J., Le Corvoisier, P., Charron, D., Krishnamoorthy, R., Oliveira, J., Tamouza, R., Yolken, R., Dickerson, F., Leboyer, M., Hamdani, N.
Journal of Psychiatric Research 2015; 63: 58-64.

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Objective: The association between Toxoplasma gondii seropositivity and respectively Bipolar Disorder (BD) and Schizophrenia/Schizoaffective disorder (SZ) is one of the most studied link between one pathogen and psychiatric disorders. The aim of the present study was thus to retrospectively determine if the administration of an antipsychotic and/or a mood stabilizer having known in vitro Anti-Toxoplasmic Activity (TATA+) was associated with a better clinical outcome in a population of 152 BD or 114 SZ patients and seropositive for T gondii infection compared to patients receiving a treatment without anti-toxoplasmic activity (TATA-). Methods: This multicenter study was conducted in an academic public hospital during a 3-years period between 2009 and 2011. All consecutive inpatients and outpatients with SZ or BD diagnosis with a stable treatment for more than 4 weeks were recruited. socio-demographic and clinical characteristics measured with validated scales as well as a serological status for toxoplasmic infection were included. Treatments were classified according to their in vitro antitoxoplasmic activity. A multivariate model was used to determine the clinical characteristics that were significantly different between patients receiving a treatment with no antitoxoplasmic activity compared to others. Results: BD patients with positive serum antibodies against T gondii presented more lifetime depressive episodes (p = 0.048) after adjustment forage, sex and sociodemographic characteristics when treated by drug having no anti-toxo activity, compared to patients having received drugs with anti-toxo activity. A significant difference was not found in BD toxonegative patients and in SZ toxopositive or toxonegative patients. Conclusions: It seems to be of importance to consider prescribing a drug with a clear anti-toxoplasmic activity (TATA+) for BD patients seropositive to T. gondii, in particular valproate that was found as the mood stabilizer with the highest antitoxoplasmic activity. Prospective randomized controlled trials are warranted to confirm this preliminary data.

High seroprevalence of Toxoplasma gondii infection in female sex workers: a case-control study

May 25, 2015
Alvarado-Esquivel, C., Sanchez-Anguiano, L. F., Hernandez-Tinoco, J., Arreola-Chaidez, E., Lopez, J., Salcido-Meraz, K. I., Estrada-Martinez, S., Navarrete-Flores, J. A., Perez-Alamos, A. R., Hernandez-Ochoa, M., Rabago-Sanchez, E., Liesenfeld, O.
European Journal of Microbiology and Immunology 2015; 5: 285-292

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Antibodies to Toxoplasma gondii in individuals with mania

October 10, 2014
Dickerson, F., Stallings, C., Origoni, A., Vaughan, C., Katsafanas, E., Khushalani, S., Yolken, R.
Bipolar Disorders 2014; 16: 129-136

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Are there any relationships between latent Toxoplasma gondii infection, testosterone evelatin, and risk of autism spectrum disorder?

October 9, 2014
Abdoli A, Dalimi A.
Frontiers in Behavioral Neuroscience 2014; 8

Toxoplasma gondii infection and suicide attempts a case-control study in psychiatric outpatients

October 10, 2013
Alvarado-Esquivel, C., Sanchez-Anguiano, L. F., Arnaud-Gil, C. A., Lopez-Longoria, J. C., Molina-Espinoza, L. F., Estrada-Martinez, S. Liesenfeld, O. Hernandez-Tinoco, J. Sifuentes-Alvarez, A. Salas-Martinez, C.
Journal of Nervous and Mental Disease 2013; 201: 948-952.

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Latent Toxoplasmosis gondii: Emerging Evidence for Influences on Neuropsychiatric Disorders

October 16, 2012
Hurley, R. A., Taber, K. H.
Journal of Neuropsychiatry and Clinical Neurosciences 2012; 24: 376-383

Neonatal antibodies to infectious agents and risk of bipolar disorder: a population-based case-control study

October 16, 2011
Mortensen, P. B., Pedersen, C. B., McGrath, J. J., Hougaard, D. M., Norgaard-Petersen, B., Mors, O., Borglum, A. D., Yolken, R. H.
Bipolar Disorders 2011; 13: 624-629