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Toxoplasma gondii & Human Phenotype

Compendium of Known Effects and Ongoing Research

toxoplasma gondii infection

Host-parasite interaction associated with major mental illness

January 29, 2020
Kano, S., Hodgkinson, C. A., Jones-Brando, L., Eastwood, S., Ishizuka, K., Niwa, M., Choi, E. Y., Chang, D. J., Chen, Y., Velivela, S. D., Leister, F., Wood, J., Chowdari,K., Ducci, F., Caycedo, D. A., Heinz, E., Newman, E. R., Cascella, N., Mortensen, P. B., Zandi, P. P., Dickerson, F., Nimgaonkar, V., Goldman, D., Harrison, P. J., Yolken, R. H., Sawa, A.
Molecular Psychiatry 2020, 25: 194 - 205
Click for abstract
Clinical studies frequently report that patients with major mental illness such as schizophrenia and bipolar disorder have comorbid physical conditions, suggesting that systemic alterations affecting both brain and peripheral tissues might underlie the disorders. Numerous studies have reported elevated levels of anti-Toxoplasma gondii (T. gondii) antibodies in patients with major mental illnesses, but the underlying mechanism was unclear. Using multidisciplinary epidemiological, cell biological, and gene expression profiling approaches, we report here multiple lines of evidence suggesting that a major mental illness-related susceptibility factor, Disrupted in schizophrenia (DISC1), is involved in host immune responses against T. gondii infection. Specifically, our cell biology and gene expression studies have revealed that DISC1 Leu607Phe variation, which changes DISC1 interaction with activating transcription factor 4 (ATF4), modifies gene expression patterns upon T. gondii infection. Our epidemiological data have also shown that DISC1 607 Phe/Phe genotype was associated with higher T. gondii antibody levels in sera. Although further studies are required, our study provides mechanistic insight into one of the few well-replicated serological observations in major mental illness.

Tagged: bipolar disorder, brain, catechol-o-methyltransferase, genetic, olfactory cells, risk faktor, Schizophrenia, toxoplasma gondii infection

Mental health

Economic holobiont: Influence of parasites, microbiota and chemosignals on economic behavior

September 3, 2018
Houdek, P.
Frontiers in Behavioral Neuroscience 2018; 12
Click for abstract
The article is a perspective on utilization of microorganisms and chemosignals in studying human economic behavior. Research in biological roots of economic development has already confirmed that parasitic pressure influenced the creation and development of cultural norms and institutions. However, other effects of microorganisms on human groups and individual decision-making and behavior are heavily understudied. The perspective discusses how parasitic infections, sexually transmitted organisms and microbiota (i.e., "human holobiont") could causally influence risk-seeking behavior, impulsivity, social dominance, empathy, political views and gender differences. As a case study, the parasite Toxoplasma gondii and its influence on economic preferences, personal characteristics and human appearance are examined. I also briefly review how chemosignals influence decision-making, particularly in the social preferences domain. I mention some predictions that arise from the paradigm of economic holobiont for the economic science. The conclusion summarizes limitations of the discussed findings and the stated speculations.

Tagged: chemosignaling, decreased level, economics, family ties, fatal attraction, gender differences, gut-brain axis, latent toxoplasmosis, master possible influence, microbiota, novelty seeking, parasites, personality-traits, risk preferences, social preferences, time preferences, Toxoplasma gondii, toxoplasma gondii infection

Behavior

Differences in cognitive functions between cytomegalovirus-infected and cytomegalovirus-free university students: a case control study

May 3, 2018
Chvatalova, V., Sebankova, B., Hrbackova, H., Turecek, P., Flegr, J
Scientific Reports 2018; 8: Artn 5322 10.1038/S41598-018-23637-3
Click for abstract
Cytomegalovirus (CMV) is the herpetic virus, which infects 45-100% people worldwide. Many reports suggest that CMV could impair cognitive functions of infected subjects. Here we searched for indices of effects of CMV on infected subjects' intelligence and knowledge. The Intelligence Structure Test I-S-T 2000 R was used to compare IQ of 148 CMV-infected and 135 CMV-free university students. Infected students expressed higher intelligence. Paradoxically, their IQ decreased with decreasing concentration of anti-CMV antibodies, which can be used, statistically, as a proxy of the time passed from the moment of infection in young subjects when the age of subjects is statistically controlled. The paradox of seemingly higher intelligence of CMV infected subjects could be explained by the presence of the subpopulation of about 5-10% CMV-positive individuals in the population of "CMV-negative students". These false negative subjects had probably not only the oldest infections and therefore the lowest concentration of anamnestic antibodies, but also the lowest intelligence among the infected students. Prevalence of CMV infection in all countries is very high, approaching sometimes 90%. Therefore, the total impact of CMV on human intelligence may be large.

Tagged: blood-donors, decreased level, host beahavior, latent toxoplasmosis, novelty seeiking, persistent infection, personality profile, simplex-virus 1, toxoplasma gondii infection, Whitehall II cohort

Cognitive functions

Latent Toxoplasma gondii infection is associated with decreased serum triglyceride to high-density lipoprotein cholesterol ratio in male patients with schizophrenia

May 3, 2018
Sagud, M. Vlatkovic, S. Strac, D.S. Sviben, M. Zivkovic, M. Vilibic, M. Vuksan-Cusa, B. Mihaljevic-Peles, A. Pivac, N.
Compr. Psychiat. 2018; 82: 115-120
Click for abstract
Previous studies suggested a complex association between Toxoplasma gondii (TG) infection and host lipid metabolism Both TG infection and metabolic disturbances are very common in patients with schizophrenia, but this relationship is not clear. Methods: In this cross-sectional study, we evaluated the association between TG seropositivity, serum lipid levels, body mass index (BMI) and metabolic syndrome (MetS) in 210 male inpatients with schizophrenia. Results: In our sample of schizophrenia patients, with the mean age of 43.90 +/- 12.70 years, the rate of TG seropositivity was 52.38% and the prevalence of MetS was 17%. Patients with the TG antibodies had lower serum triglyceride levels and body weight compared to TG seronegative patients, despite having more frequently received antipsychotics (clozapine, olanzapine risperidone and quetiapine), which are well known to induce weight gain and metabolic abnormalities. However, the only significant change in metabolic parameters, observed in TG seropositive patients with schizophrenia, was decreased serum triglyceride to high-density lipoprotein cholesterol (HDL-C) ratio. No associations were observed between TG seropositivity and serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and glucose levels, waist circumference, BMI and the rate of MetS. Conclusion: This is the first report of the association between TG infection and decreased serum triglyceride to HDL-C ratio in a sample of carefully selected men with chronic schizophrenia.

Tagged: body mass index, metabolic syndrome, schizophrenia patients, serum lipid indices, toxoplasma gondii infection

Mental health

Viral and parasitic pathogen burden and the association with stroke in a population-based cohort

February 12, 2018
Pearce, B. D.,Bracher, A. , Jones, J. L., Kruszon-Moran, D.
International Journal of Stroke 2018; 13_: 481-495
Click for abstract
Background Higher cumulative burden of viral and bacterial pathogens may increase the risk of stroke, but the contribution of parasitic infections in relation to cumulative pathogen burden and risk of stroke has rarely been examined. Aim To estimate the association of multiple persistent viral and parasitic infections with stroke in a representative sample of adults in the United States. Methods Serological evidence of prior infection was categorized as positive for 0-1, 2, 3, or 4-5 infections based on immunoglobulin G seropositivity to cytomegalovirus, hepatitis A virus, hepatitis B virus, Toxoplasma gondii, and Toxocara spp. in 13,904 respondents from the National Health and Nutrition Examination Survey III. Regression analysis was used to estimate the cross-sectional association between serological evidence of prior infection and history of stroke adjusting for demographic risk factors, and potential mediators of stroke. Results Age-adjusted models that included serological evidence of prior infection to cytomegalovirus, hepatitis A virus, hepatitis B virus, Toxoplasma gondii, and Toxocara spp. showed that adults in the highest serological evidence of prior infection category (4-5 infections) had a higher prevalence of stroke (5.50%, 95% confidence interval 2.44-10.46%) than those in the lowest serological evidence of prior infection categories (1.49%, 95% confidence interval 1.01-2.11%), and a trend test suggested a graded association between serological evidence of prior infection and stroke (p=0.02). In multivariable logistic regression models, the positive association of serological evidence of prior infection with stroke prevalence remained significant after adjustment for other significant risk factors (odds ratio=1.4, p=0.01) but was only significant among those aged 20-59 (odds ratio=2.0, p=0.005) and not among those aged 60-69 (p=0.78) or 70 and older (p=0.43). Conclusion We found support for a connection between serological evidence of prior infection to cytomegalovirus, hepatitis A virus, hepatitis B virus, Toxoplasma gondii, and Toxocara spp. and stroke among those aged 20-59. There may be a need to consider common parasitic infections in addition to viral and bacterial pathogens when calculating serological evidence of prior infection in relation to cerebrovascular disease.

Tagged: b-virus infection, cytomegalovirus, disease, Epidemiology, helicobacter-pylori, hepatitis virus, infection, national-health, prevention, risk, seroprevalence, toxocara, Toxoplasma gondii, toxoplasma gondii infection, united-states

Physical health

The missing link in parasite manipulation of host behaviour

February 12, 2018
Herbison, R. , Lagrue, C. , Poulin, R.
Parasites Vectors 2018; 10.1186/s13071-018-2805-9
Click for abstract
The observation that certain species of parasite my adaptively manipulate its host behaviour is a fascinating phenomenon. As a result, the recently established field of 'host manipulation' has seen rapid expansion over the past few decades with public and scientific interest steadily increasing. However, progress appears to falter when researchers ask how parasites manipulate behaviour, rather than why. A vast majority of the published literature investigating the mechanistic basis underlying behavioural manipulation fails to connect the establishment of the parasite with the reported physiological changes in its host. This has left researchers unable to empirically distinguish/identify adaptive physiological changes enforced by the parasites from pathological side effects of infection, resulting in scientists relying on narratives to explain results, rather than empirical evidence. By contrasting correlative mechanistic evidence for host manipulation against rare cases of causative evidence and drawing from the advanced understanding of physiological systems from other disciplines it is clear we are often skipping over a crucial step in host-manipulation: the production, potential storage, and release of molecules (manipulation factors) that must create the observed physiological changes in hosts if they are adaptive. Identifying these manipulation factors, via associating gene expression shifts in the parasite with behavioural changes in the host and following their effects will provide researchers with a bottom-up approach to unraveling the mechanisms of behavioural manipulation and by extension behaviour itself.

Tagged: behaviour, manipulation factor, manipulation., mechanism, Parasite, toxoplasma gondii infection, us

Behavior

Parkinson’s disease and Toxoplasma gondii infection: Sero-molecular assess the possible link among patients

October 2, 2017
Fallahi, S., Rostami, A., Birjandi, M., Zebardast, N., Kheirandish, F., Spotin, A.
Acta Tropica 2017; 173: 97-101
Click for abstract
We investigated the possible association between Parkinson's disease (PD), the second most common neurode-generative disorder and Toxoplasma gondii infection, the most common neurotropic protozoan parasitic infection, using serological and molecular techniques. One hundred and fifteen patients with confirmed PD and 115 healthy subjects in the same age and sex distribution were enrolled in this study. Blood samples were taken from each participant and the sera was screened for anti-Toxoplasma antibodies (IgG and IgM). PCR assay was performed in duplicate using the primer pair targeting the B1 gene of Toxoplasma. Amplicons were directly sequenced to conduct the phylogenetic analysis. The prevalence of Toxoplasma infection based on IgG titer was 53% in case and 55.6% in the control groups, revealing no statistically significant association between Toxoplasma seropositivity and PD (OR = 0.90; 95% CI = 0.54-1.51; P = 0.691). According to PCR assay, the prevalence of Toxoplasma infections was 19.3% in the case and 10.4% in control groups which the difference was statistically significant (OR = 3.02; 95% CI = 1.46-6.27; P = 0.002). Multiple sequence alignment of Toxoplasma gondii isolates manifested a common haplotype by the identity: 93.6-100% and divergence: 0-6.7%. We concluded that T. gondii infection not only could not be a risk factor to PD, but even it could be concluded that patients with PD are in more risk to acquisition of infection. These results provide fresh insights into the ambiguous association between T. gondii infection and PD.

Tagged: Dopamine, metaanalysis, parkinson's disease, prevalence, Schizophrenia, sero-molecular assessment, toxoplasma gondii infection

Mental health

Curiosity killed the cat: no evidence of an association between cat ownership and psychotic symptoms at ages 13 and 18 years in a UK general population cohort

May 9, 2017
Solmi, F., Hayes, J.F., Lewis, G., Kirkbride, J.B.
Psychological Medicine 2017; 47: 1659-1667
Click for abstract
Background. Congenital or early life infection with Toxoplasma gondii has been implicated in schizophrenia aetiology. Childhood cat ownership has been hypothesized as an intermediary marker of T. gondii infection and, by proxy, as a risk factor for later psychosis. Evidence supporting this hypothesis is, however, limited. Method. We used birth cohort data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to investigate whether cat ownership in pregnancy and childhood (ages 4 and 10 years) was associated with psychotic experiences (PEs) in early (age 13, N = 6705) and late (age 18, N = 4676) adolescence, rated from semi-structured interviews. We used logistic regression to examine associations between cat ownership and PEs, adjusting for several sociodemographic and socioeconomic factors, household characteristics and dog ownership. Missing data were handled via multiple imputation. Results. Cat ownership during pregnancy was not associated with PEs at age 13 years [adjusted odds ratio (OR) 1.15, 95% confidence interval (CI) 0.97-1.35] or 18 years (OR 1.08, 95% CI 0.86-1.35). Initial univariable evidence that cat ownership at ages 4 and 10 years was associated with PEs at age 13 years did not persist after multivariable adjustment (4 years: OR 1.18, 95% CI 0.94-1.48; 10 years: OR 1.12, 95% CI 0.92-1.36). There was no evidence that childhood cat ownership was associated with PEs at age 18 years. Conclusions. While pregnant women should continue to avoid handling soiled cat litter, given possible T. gondii exposure, our study strongly indicates that cat ownership in pregnancy or early childhood does not confer an increased risk of later adolescent PEs.

Tagged: children, risk factors, Schizophrenia, toxoplasma gondii infection

Mental health

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
Click for abstract
Recent evidence suggests the involvement of Toxoplasma gondii infection in the emergence of psychotic and affective disorders. In this report, we describe the case of a young Brazilian woman affected by recurrent ocular toxoplasmosis and presenting with a manic episode with psychotic features in the context of a diagnosis of Bipolar Disorder (BD), type I. We observed a relationship between ocular manifestations and the clinical course of bipolar illness, confirmed by molecular analyses (nested-PCR), as well as by the high level of T. gondii specific IgG. This case report is the first showing the presence of circulating parasite DNA at the time of occurrence of psychiatric symptoms, thus providing further support for a possible role of the parasite in the pathogenesis of some cases of BD.

Tagged: antibodies, bipolar disorder, gondii infection, individuals, metaanalysis, mood disorders, nested pcr, ocular toxoplasmosis, psychosis, rating-scale, retinochoroiditis, Schizophrenia, seropositivity, suicide attempts, toxoplasma gondii infection

Mental health

Suicide attempts and markers of immune response in individuals with serious mental illness

January 3, 2017
Dickerson, F., Wilcox, H. C., Adamos, M., Katsafanas, E., Khushalani, S., Origoni, A., Savage, C., Schweinfurth, L., Stallings, C., Sweeney, K., Yolken, R.
Journal of Psychiatric Research 2017; 87: 37-43
Click for abstract
Previous studies have identified elevations in antibodies to Toxoplasma gondii in individuals with a history of suicide attempts but studies have not measured the association between suicide attempts and a panel of antibody markers. We assessed 162 patients receiving treatment for schizophrenia, bipolar disorder, or major depression on the Columbia Suicide Severity Rating Scale for suicide attempt history and other clinical measures. All participants had a blood sample drawn from which were measured antibodies to Toxoplasma gondii and other neurotropic infectious agents. A total of 72 (44%) of participants had a lifetime suicide attempt; these individuals had elevated levels of IgM class antibodies to Toxoplasma gondii and Cytomegalovirus (CMV). We also found an association between the levels of these antibodies and the number of suicide attempts. There was a particularly strong odds of a suicide attempt history in individuals who had elevated levels of IgM antibodies to both Toxoplasma gondii and to CMV suggesting an additive risk associated with the antibodies. These findings remained significant when adjusting for current cigarette smoking and history of drug/alcohol use which were also associated with suicide attempts. We did not find an association between a suicide attempt history and IgG class antibodies to Toxoplasma gondii, CMV, or IgM or IgG antibodies to the Epstein Barr Virus or other antigens tested. The identification of blood-based antibody markers should provide for more personalized methods for the assessment and treatment, and ultimately prevention, of suicide attempts in individuals with serious mental illnesses. (C) 2016 Elsevier Ltd. All rights reserved.

Tagged: barr-virus infection, biomarkers, bipolar disorder, cytomegalovirus-infection, immunoglobulin-m antibodies, psychological autopsy, rating-scale, risk factors, Schizophrenia, suicide, toll-like receptors, Toxoplasma, toxoplasma gondii infection

Mental health

Infectious and immunogenetic factors in bipolar disorder

January 3, 2017
Oliveira, J., Oliveira-Maia, A. J., Tamouza, R., Brown, A. S., Leboyer, M.
Acta Psychiatrica Scandinavica 2017; 136:409-423
Click for abstract
Objective: Despite the evidence supporting the association between infection and bipolar disorder (BD), the genetic vulnerability that mediates its effects has yet to be clarified. A genetic origin for the immune imbalance observed in BD, possibly involved in the mechanisms of pathogen escape, has, however, been suggested in recent studies. Method: Here, we present a critical review based on a systematic literature search of articles published until December 2016 on the association between BD and infectious/immunogenetic factors. Results: We provide evidence suggesting that infectious insults could act as triggers of maladaptive immune responses in BD and that immunogenetic vulnerability may amplify the effects of such environmental risk factors, increasing susceptibility to subsequent environmental encounters. Quality of evidence was generally impaired by scarce attempt of replication, small sample sizes and lack of high-quality environmental measures. Conclusion: Infection has emerged as a potential preventable cause of morbidity in BD, urging the need to better investigate components of the host-pathogen interaction in patients and at-risk subjects, and thus opening the way to novel therapeutic opportunities.

Tagged: antagonist gene polymorphism, bipolar disorder, borna-disease virus, immunogenetics, infection, inflammation, korean population, manic-depressive disorders, mood disorders, necrosis-factor-alpha, population-based cohort, retrovirus-w family, severe mental illness, toxoplasma gondii infection

Mental health

Hepatitis C virus antibody titers associated with cognitive dysfunction in an asymptomatic community-based sample

May 29, 2016
Ibrahim, I., Salah, H., El Sayed, H., Mansour, H., Eissa, A., Wood, J., Fathi, W., Tobar, S., Gur, R. C., Gur, R. E., Dickerson, F., Yolken, R. H., El Bahaey, W., Nimgaonkar, V.
Journal of Clinical and Experimental Neuropsychology 2016; 38: 861-868
Click for abstract
Background: Hepatitis C virus (HCV) infection is associated with cognitive dysfunction in clinic-based studies. The risk could be attributed to factors such as antiviral medications, substance abuse, or coincidental infection. Aim: The aim was to evaluate cognitive function in relation to HCV antibody titers in a community-based sample of asymptomatic individuals at low risk for substance abuse. Method: Adults were ascertained from a community in Mansoura, Egypt, where HCV is endemic (n = 258). Cognitive performance was evaluated using the Arabic version of the Penn Computerized Neurocognitive Battery. Substance abuse and psychopathology were also assessed. Antibodies to HCV and Toxoplasma gondii (TOX), a common protozoan that can affect cognition, were estimated using serological IgG assays. Results: The prevalence of HCV and TOX infection was 17.6% and 52.9%, respectively. HCV antibody titers were significantly associated with worse function in four cognitive tests for accuracy and three tests for speed, after adjusting for covariates (p <.05, beta coefficients, 2.1-3.2). TOX antibody titers were associated with impaired accuracy in one test. Conclusions: The association between HCV antibody titers and cognitive impairment is not mediated by antiviral treatment or substance abuse in this sample. Whether HCV has a causal role in the cognitive dysfunction should be investigated.

Tagged: cognition, computerized neurocognitive battery, egypt, Epidemiology, hepatitis c virus, impairment, liver-disease, prevalence, psychiatric-disorders, quality of life, risk factors, Toxoplasma, toxoplasma gondii infection, united-states

Cognitive functions

Exposure to perinatal infections and bipolar disorder: A systematic review

May 24, 2016
Barichello, T., Badawy, M., Pitcher, M. R., Saigal, P., Generoso, J. S., Goularte, J. A., Simoes, L. R., Quevedo, J., Carvalho, A. F.
Curr Mol Med 2016; 16: 106-118
Click for abstract
Bipolar disorder (BD) is a debilitating psychiatric disorder and a growing global public health issue. Notwithstanding BD has been conceptualized as a neuroprogressive illness, there are some evidences to suggest a role for neurodevelopmental pathways in the patho-etiology of this disorder. Evidences on the associations between perinatal infections and risk for bipolar disorder have been inconsistent across studies. Here, we performed a systematic review of observational studies on the relationship between exposure to perinatal pathogens and bipolar disorder. A computerized literature search of the PubMed, Embase, and PsyINFO databases till January 31st, 2015 was performed. Twenty-three studies ultimately met inclusion criteria. Studies investigated exposure to several pathogens namely Cytomegalovirus (CMV), Epstein-Barr Virus (EBV), Herpes simplex virus-1 (HSV-1), Herpes simplex virus-2 (HSV-2), Human herpesvirus 6 (HHV-6), Toxoplasma gondii, Influenza, and Varicella zoster virus (VZV). Overall, studies provided mixed evidences. Thus, contrary to schizophrenia, the role of perinatal infections as risk factors for BD remain inconclusive. Larger studies with a prospective design would be necessary to elucidate the role of previous exposure to infectious agents as a potential risk factor for BD.

Tagged: antibodies, bipolar disorder, cerebrospinal fluid, cognitive impairment, cytomegalovirus, herpes, herpes-simplex encephalitis, individuals, influenza, maternal infection, metaanalysis, psychiatric patients, Schizophrenia, systematic review, Toxoplasma gondii, toxoplasma gondii infection

Mental healthReproductionReviews

Inflammatory markers in recent onset psychosis and chronic schizophrenia

March 23, 2016
Dickerson, F., Stallings, C., Origoni, A., Schroeder, J., Katsafanas, E., Schweinfurth, L., Savage, C., Khushalani, S., Yolken, R.
Schizophrenia Bulletin 2016; 42: 134-141
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Background. Immune markers have been associated with schizophrenia, but few studies have examined multiple markers in both recent onset and chronic schizophrenia patients. Methods. The sample of 588 individuals included 79 with recent onset psychosis, 249 with chronic schizophrenia, and 260 controls. A combined inflammation score was calculated by principal components factor analysis of the levels of C-reactive protein, Pentraxin 3, and IgG antibodies to gliadin, casein, and Saccharomyces cerevisiae measured in blood samples. Inflammation scores among groups were compared by multivariate analyses. Results. The chronic schizophrenia group showed significant elevations in the combined inflammation score compared with controls. The recent onset group surprisingly showed a reduction in the combined inflammation score. Consistent with these findings, the chronic schizophrenia group had significantly increased odds of a combined inflammation score greater than the 75th and the 90th percentile of that of the controls. The recent onset group had significantly increased odds of a combined inflammation score less than the 10th and the 25th percentile level of the controls. Conclusions. The recent onset of psychosis may be associated with inherent deficits in innate immunity. Individuals later in the course of disease may have increased levels of innate immunity. The reasons for these changes are not known with certainty but may be related to compensatory increases as the disease progresses. Longitudinal studies are needed to determine the course of immune abnormalities in schizophrenia and their role in the clinical manifestations of the disorder.

Tagged: association, astrocytes, autoimmune diseases, c-reactive protein, dysfunction, immunity, inflammation, innate immunity, population, psychosis, risk, Schizophrenia, systém, toxoplasma gondii infection

Mental health

Infectious disease burden and cognitive function in young to middle-aged adults

January 4, 2016
Gale, S. D., Erickson, L. D., Berrett, A., Brown, B. L., Hedges, D. W.
Brain Behavior and Immunity 2016, 52: 161-168
Click for abstract
Prior research has suggested an association between exposure to infectious disease and neurocognitive function in humans. While most of these studies have explored individual viral, bacterial, and even parasitic sources of infection, few have considered the potential neurocognitive burden associated with multiple infections. In this study, we utilized publically available data from a large dataset produced by the Centers for Disease Control and Prevention that included measures of neurocognitive function, sociodemographic variables, and serum antibody data for several infectious diseases. Specifically, immunoglobulin G antibodies for toxocariasis, toxoplasmosis, hepatitis A, hepatitis B, and hepatitis C, cytomegalovirus, and herpes 1 and 2 were available in 5662 subjects. We calculated an overall index of infectious-disease burden to determine if an aggregate measure of exposure to infectious disease would be associated with neurocognitive function in adults aged 20-59 years. The index predicted processing speed and learning and memory but not reaction time after controlling for age, sex, race-ethnicity, immigration status, education, and the poverty-to-income ratio. Interactions between the infectious-disease index and some sociodemographic variables were also associated with neurocognitive function. In summary, an index aggregating exposure to several infectious diseases was associated with neurocognitive function in young- to middle-aged adults. (C) 2015 Elsevier Inc. All rights reserved.

Tagged: 3rd national-health, chronic hepatitis-c, cytomegalovirus, cytomegalovirus-infection, hepatitis, herpes, infectious disease, latent toxoplasmosis, neurocognitive function, nhanes, northern-manhattan, nutrition examination survey, risk factors, simplex-virus type-1, toxocariasis, toxoplasma gondii infection, toxoplasmosis, united-states

Cognitive functions

Mental Health Disorders Associated with Foodborne Pathogens

January 4, 2016
Bolton, D. J., Robertson, L. J.
Journal of Food Protection 2016, 79: 2005-2017
Click for abstract
Human infections with foodborne pathogenic organisms are relatively well described in terms of their overt physical symptoms, such as diarrhea, abdominal cramps, vomiting, fever, and associated sequelae. Indeed, some of these are key for diagnosis and treatment, although it should be noted that, for some foodborne pathogens, the physical symptoms might be more diffuse, particularly those associated with some of the foodborne parasites. In contrast, the impact of these pathogens on mental health is less well described, and symptoms such as depression, anxiety, and general malaise are usually ignored when foodborne infections are recorded. Despite this, it is generally accepted that there are several psychiatric disorders of unknown etiology that may be associated with microbial pathogens. Depression, autism, hypochondriasis and anxiety, schizophrenia, and Tourette syndrome probably have multiple contributing causes, among which foodborne pathogens may play a decisive or contributory role, possibly sharing pathophysiological pathways with other environmental triggers. This review focuses on foodborne parasites and bacterial pathogens. Some foodborne parasites, such as metacestodes of Taenia soliunz and tissue cysts (bradyzoites) of Toxoplasma gondii, may affect mental health by directly infecting the brain. In contrast, bacterial infections and other parasitic infections may contribute to mental illness via the immune system and/or by influencing neurotransmission pathways. Thus, cytokines, for example, have been associated with depression and schizophrenia. However, infectious disease models for psychiatry require a more complete understanding of the relationship between psychiatric disorders and microbial triggers. This article reviews the current state of knowledge on the role of foodborne parasitic and bacterial pathogens in mental illness and identifies some of the gaps that should be addressed to improve diagnosis and treatment of mental health issues that are not solely related to psychiatric factors.

Tagged: autistic spectrum disorders, bacteria, bipolar disorder, chronic-fatigue-syndrome, foodborne pathogens, gastrointestinal symptoms, induced sickness behavior, intestinal microbiota, irritable-bowel-syndrome, maternal exposure, mental health, mood disorders, parasites, toxoplasma gondii infection

Mental health

Association between prenatal exposure to maternal infection and offspring mood disorders: A review of the literature

May 25, 2015
Simanek, A. M., Meier, H. C. S.
Current Problems in Pediatric and Adolescent Health Care 2015; 45: 325-364
Click for abstract
The purpose of this article is to provide a systematic review of studies that have examined the association between prenatal exposure to maternal infection and development of mood disorders across the life course. Drawing from both human- and animal-based studies, we give an overview of hypothesized biological mechanisms by which exposure to maternal infection during critical periods of gestation may contribute to fetal programming of mood disorders in offspring. We discuss studies examining the association between prenatal exposure to maternal infection with pathogens including influenza as well as other respiratory viruses, herpesviruses, hepatitis viruses, and Toxoplasma gondii and mood disorders in human populations. Moreover, we outline strengths and limitations of the current body of evidence and make recommendations for future research. We also discuss findings in the context of well-documented gender and socioeconomic disparities in the prevalence and severity of mood disorders, particularly major depression, and the role that early exposure to infection may play in explaining the perpetuation of such disparities across generations. Overall, this review of the current knowledge on this topic has important implications for determining future research directions, designing interventions as well as prenatal care guidelines targeted at prevention or treatment of infection during pregnancy, and clinical practice for the identification of individuals that may be at increased risk for mood disorders beginning early in life. Importantly, such efforts may not only lower the overall burden of mood disorders but also serve to address social disparities in these adverse mental health conditions in the U.S.

Tagged: bipolar disorder, comorbidity survey replication, depression-related behaviors, gray-matter volume, herpes-simplex-virus, immune activation, major affective-disorder, nervous system, toxoplasma gondii infection, united-states

Mental healthReproductionReviews

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
Click for abstract
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

Describing the relationship between cat bites and human depression using data from an electronic health record

January 9, 2013
Hanauer, D. A., Ramakrishnan, N., Seyfried, L. S.
Plos One 2013; 8: ARTN e70585 10.1371/journal.pone.0070585
Click for abstract
Data mining approaches have been increasingly applied to the electronic health record and have led to the discovery of numerous clinical associations. Recent data mining studies have suggested a potential association between cat bites and human depression. To explore this possible association in more detail we first used administrative diagnosis codes to identify patients with either depression or bites, drawn from a population of 1.3 million patients. We then conducted a manual chart review in the electronic health record of all patients with a code for a bite to accurately determine which were from cats or dogs. Overall there were 750 patients with cat bites, 1,108 with dog bites, and approximately 117,000 patients with depression. Depression was found in 41.3% of patients with cat bites and 28.7% of those with dog bites. Furthermore, 85.5% of those with both cat bites and depression were women, compared to 64.5% of those with dog bites and depression. The probability of a woman being diagnosed with depression at some point in her life if she presented to our health system with a cat bite was 47.0%, compared to 24.2% of men presenting with a similar bite. The high proportion of depression in patients who had cat bites, especially among women, suggests that screening for depression could be appropriate in patients who present to a clinical provider with a cat bite. Additionally, while no causative link is known to explain this association, there is growing evidence to suggest that the relationship between cats and human mental illness, such as depression, warrants further investigation.

Tagged: adverse-event reports, cardiovascular-disease, clinical associations, companion animals, human social support, pet ownership, primary-care, risk factors, toxoplasma gondii infection, united-states

Mental health

The role of parasites and pathogens in influencing generalised anxiety and predation-related fear in the mammalian central nervous system

October 12, 2012
Kaushik, M., Lamberton, P.H.L., Webster, J.P.
Hormones and Behavior 2012; 62: 191-201
Click for abstract
This article is part of a Special Issue "Neuroendocrine-Immune Axis in Health and Disease." Behavioural and neurophysiological traits and responses associated with anxiety and predation-related fear have been well documented in rodent models. Certain parasites and pathogens which rely on predation for transmission appear able to manipulate these, often innate, traits to increase the likelihood of their life-cycle being completed. This can occur through a range of mechanisms, such as alteration of hormonal and neurotransmitter communication and/or direct interference with the neurons and brain regions that mediate behavioural expression. Whilst some post-infection behavioural changes may reflect 'general sickness' or a pathological by-product of infection, others may have a specific adaptive advantage to the parasite and be indicative of active manipulation of host behaviour. Here we review the key mechanisms by which anxiety and predation-related fears are controlled in mammals, before exploring evidence for how some infectious agents may manipulate these mechanisms. The protozoan Toxoplasma gondii, the causative agent of toxoplasmosis, is focused on as a prime example. Selective pressures appear to have allowed this parasite to evolve strategies to alter the behaviour in its natural intermediate rodent host. Latent infection has also been associated with a range of altered behavioural profiles, from subtle to severe, in other secondary host species including humans. In addition to enhancing our knowledge of the evolution of parasite manipulation in general, to further our understanding of how and when these potential changes to human host behaviour occur, and how we may prevent or manage them, it is imperative to elucidate the associated mechanisms involved

Tagged: altered host behavior, anxiety, bacillus-calmette-guerin, c-reactive protein, central-nervous-system, depressive-like behavior, Dopamine, elevated plus-maze, endogenous kynurenic acid, helminth, male norway rats, mammal, obsessive-compulsive disorder, predation, protozoa, rodent, serotonin, toxocara-canis larvae, Toxoplasma gondii, toxoplasma gondii infection

Mental health

Prevalence of anti-Toxoplasma antibodies in patients with autoimmune diseases

October 11, 2012
Shapira, Y., Agmon-Levin, N., Selmi, C., Petrikova, J., Barzilai, O., Ram, M., Bizzaro, N., Valentini, G., Matucci-Cerinic, M., Anaya, J. M., Katz, B. S. P., Shoenfeld, Y.
Journal of Autoimmunity 2012; 39: 112-116
Click for abstract
The identification of etiological factors in the induction of autoimmunity has remained elusive despite an enormous effort at dissection of the molecular structure of the target antigens and effector mechanisms. One characteristic feature of autoantigens is their repetitive structure as well as their conservation and evolution. Toxoplasma (T.)gondii is a primitive protozoan. We hypothesized that patients with autoimmune disease would have broad reactions against Toxoplasma antigens based on autoantigen conservation. To address this issue, we assessed serologic evidence of reactivity to Toxoplasma gondii along with a large profile of autoantibodies in patients with various autoimmune diseases (AID). We included sera of 1514 patients with 11 different AID collected from referral centers in Europe and Latin America as well as from 437 geographically matched controls, for the prevalence of anti Toxoplasma antibodies (ATxA) IgG and IgM and serum autoantibodies utilizing the BioPlex 2200 system (Bio- Rad Laboratories, USA). Serum ATxA IgG were positive in 42% of patients with AID versus 29% of controls (p < 0.0001). Among Europeans, ATxA IgG were associated with anti-phospholipid syndrome (APS; p < 0.0001), cryoglobulinemia (p < 0.0001), ANCA-associated vasculitides (p < 0.01), autoimmune thyroid diseases (p < 0.0001), systemic sclerosis (SSc; p < 0.0001) and rheumatoid arthritis (RA; p < 0.0001). Of note, Latin American RA sera exhibited similar frequency of ATxA IgG as controls. ATxA IgM were more prevalent in European patients with APS (p < 0.01), SSc (p < 0.05) and inflammatory bowel disease (IBD, p < 0.05) than in controls. Further, in AID patients the presence of ATxA correlated with autoantibodies characteristic of APS (anti-cardiolipin, B2GPI, complex of cardiolipin- B2GPI, prothrombin, phosphatydilethanolamine), and of SSc (anti-centromere, Scl-70). Our findings suggest that T. gondii may contribute to the pathogenesis of AID. This interaction may depend on or explain observed geoepidemiological variance in AID. (C) 2012 Elsevier Ltd. All rights reserved.

Tagged: antiphospholipid syndrome, autoantibodies, autoimmunity, cytomegalovirus, environment, geoepidemiology, inflammatory-bowel-disease, parasites, rheumatic-diseases, systemic sclerosis, systemic-lupus-erythematosus, toxoplasma gondii infection, toxoplasmosis, trichuris-suis therapy

Physical health

Selected infectious agents and risk of schizophrenia among US military personnel

October 26, 2008
Nielbuhr, D.W., Millikan, A. M., Cowan, D. N., Yolken, R., Li, Y. Z., Weber, N. S.
American Journal of Psychiatry 2008; 165: 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: antibodies, association, bipolar disorder, brain, exposure, host, individuals, mice, rats, toxoplasma gondii infection

Mental health

Are some cases of psychosis caused by microbial agents? A review of the evidence

October 26, 2008
Yolken RH, Torrey EF
Molecular Psychiatry 2008; 13: 470-479
Click for abstract
The infectious theory of psychosis, prominent early in the twentieth century, has recently received renewed scientific support. Evidence has accumulated that schizophrenia and bipolar disorder are complex diseases in which many predisposing genes interact with one or more environmental agents to cause symptoms. The protozoan Toxoplasma gondii and cytomegalovirus are discussed as examples of infectious agents that have been linked to schizophrenia and in which genes and infectious agents interact. Such infections may occur early in life and are thus consistent with neurodevelopmental as well as genetic theories of psychosis. The outstanding questions regarding infectious theories concern timing and causality. Attempts are underway to address the former by examining sera of individuals prior to the onset of illness and to address the latter by using antiinfective medications to treat individuals with psychosis. The identification of infectious agents associated with the etiopathogenesis of schizophrenia might lead to new methods for the diagnosis, treatment and prevention of this disorder.

Tagged: bipolar disorder, central-nervous-system, congenital cytomegalovirus-infection, cytomegalovirus, environmental, genetic, genetic polymorphisms, immunodeficiency-virus, infectious, necrosis-factor-alpha, psychiatric-disorders, Schizophrenia, toxoplasma gondii infection, toxoplasmosis, viral-infection, virus-infection

Mental health

Look what the cat dragged in: do parasites contribute to human cultural diversity?

October 30, 2005
Lafferty, K.D.
Behavioural Processes 2005; 68: 279-282
Tagged: behavior, cats, culture, mice, performance, personality, rats, rattus-norvegicus, Toxoplasma gondii, toxoplasma gondii infection

BehaviorPersonality

Toxoplasmosis and mental-retardation -report of a case-control study

January 10, 1993
Caiaffa, W. T., Chiari, C. A., Figueiredo, A. R. P., Orefice, F., Antunes, C. M. F.
Memorias Do Instituto Oswaldo Cruz 1993; 88: 253-261
Click for abstract
A case-control study evaluating the association between mental retardation and toxoplasmosis was conducted among 845 school children in Belo Horizonte, MG, Brazil. Cases (450) were mentally retarded children attending a Public school for special education. Controls (395) were children from the regular public school system. Clinical and anthropometric examinations and interviews were carried out to determine risk factors for toxoplasmosis and mental retardation. Diagnosis of Toxoplasma gondii infection was based upon an indirect immunofluorescent test (IFA); 55% of cases and 29% of controls were positive. The Relative Odds of mental retardation in children with positive serology was 3.0 (95% CI 2.2-4.0). Maternal exposure to cats and contact with soil were associated with an increased risk of mental retardation. Retinochoroiditis was fourfold more prevalent among cases than controls and was only diagnosed in T. gondii IFA positive participants. Congenital toxoplasmosis, in its subclinical form, appears to be an important component in the etiology of mental retardation, especially in high risk (lower socioeconomic) groups. The population attributable risk was estimated as 6.0-9.0%, suggesting the amount of mental retardation associated with this infection.

Tagged: case-control study, children, mental-retardation, toxoplasma gondii infection, toxoplasmosis

Cognitive functionsMental health

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  • Mortality Patterns of Toxoplasmosis and Its Comorbidities in Tanzania: A 10-Year Retrospective Hospital-Based Survey February 6, 2020
  • The role of latent toxoplasmosis in the aetiopathogenesis of schizophrenia–the risk factor or an indication of a contact with cat? February 6, 2020
  • The Association between Toxoplasma gondii Infection and Risk of Parkinson’s Disease: A Systematic Review and Meta-Analysis February 6, 2020

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