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Abdoli A, Ghaffarifar F, Sharifi Z, Taghipour A. Toxoplasma gondii infection and testosterone alteration: A systematic review and meta-analyses. PLoS One 2024; 19:e0297362. [PMID: 38568993 PMCID: PMC10990213 DOI: 10.1371/journal.pone.0297362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 01/03/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Toxoplasma gondii (T. gondii) is a worldwide distributed protozoan parasite which has infected a wide range of warm-blooded animals and humans. The most common form of T. gondii infection is asymptomatic (latent); nevertheless, latent toxoplasmosis can induce various alterations of sex hormones, especially testosterone, in infected humans and animals. On the other hand, testosterone is involved in behavioral traits and reproductive functions in both sexes. Hence, the purpose of this systematic review is to summarize the available evidence regarding the association between T. gondii infection and testosterone alteration. METHODS In the setting of a systematic review, an electronic search (any date to 10 January 2023) without language restrictions was performed using Science Direct, Web of Science, PubMed, Scopus, and Google Scholar. The PRISMA guidelines were followed. Following the initial search, a total of 12,306 titles and abstracts were screened initially; 12,281 were excluded due to the lack of eligibility criteria or duplication. Finally, 24 articles met the included criteria. A mean±standard deviation (SD) was calculated to assess the difference of testosterone between T. gondii positive and T. gondii negative humans. The possibility of publication bias was assessed using Egger's regression. P-value < 0.05 was considered statistically significant. RESULTS This systematic review identified 24 articles (18 studies in humans and six studies in animals). Most human studies (13 out of 19) reported an increased level of testosterone following latent toxoplasmosis in males, while three studies reported decreased levels and two studies reported an insignificant change. Eleven articles (seven datasets in males and seven datasets in females) were eligible to be included in the data synthesis. Based on the random-effects model, the pooled mean± SD of testosterone in T. gondii positive than T. gondii negative was increased by 0.73 and 0.55 units in males and females, respectively. The Egger's regression did not detect a statistically significant publication bias in males and females (p = value = 0.95 and 0.71), respectively. Three studies in male animals (rats, mice, and spotted hyenas) and two studies in female animals (mice and spotted hyenas) reported a decline in testosterone in infected compared with non-infected animals. While, one study in female rats reported no significant changes of testosterone in infected than non-infected animals. Moreover, two studies in male rats reported an increased level of testosterone in infected than non-infected animals. CONCLUSIONS This study provides new insights about the association between T. gondii infection and testosterone alteration and identifies relevant data gaps that can inform and encourage further studies. The consequence of increased testosterone levels following T. gondii infection could partly be associated with increased sexual behavior and sexual transmission of the parasite. On the other hand, declining testosterone levels following T. gondii infection may be associated with male reproductive impairments, which were observed in T. gondii-infected humans and animals. Furthermore, these findings suggest the great need for more epidemiological and experimental investigations in depth to understand the relationship between T. gondii infection and testosterone alteration alongside with future consequences of testosterone alteration.
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Affiliation(s)
- Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Fatemeh Ghaffarifar
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Zohreh Sharifi
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Ali Taghipour
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom, Iran
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Xiao J, Huang J, Yolken RH. Elevated matrix Metalloproteinase-9 associated with reduced cerebellar perineuronal nets in female mice with toxoplasmosis. Brain Behav Immun Health 2024; 36:100728. [PMID: 38323226 PMCID: PMC10844038 DOI: 10.1016/j.bbih.2024.100728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/08/2024] Open
Abstract
Brain infection by the parasite Toxoplasma gondii is thought to impair learning and memory, although the underlying mechanisms remain largely unknown. Recent studies suggest that perineuronal nets (PNNs) and their key regulator, matrix metalloproteinase-9 (MMP-9), have essential roles in synaptic plasticity associated with learning and memory. We investigated their roles in a chronic toxoplasmosis model using female mice. In mice with a high parasite burden of chronic infection, we found that MMP-9 expression was increased in the peripheral circulation and the brain. A correlation was found between the serum levels of MMP-9 and antibodies to the Toxoplasma matrix antigen MAG1, a surrogate marker for Toxoplasma tissue cysts in the brain. MMP-9 elevation was accompanied by increased expression of its endogenous regulators, TIMP-1 and NGAL. An increase in the levels of GSK-3α/β was observed, alongside a decrease in inhibitory GSK-3α/β (Ser-21/Ser-9) phosphorylation. MMP-9 expression was notably associated with the loss of PNNs but increased expression of the synaptic vesicle protein synaptophysin. There was a trend toward a negative correlation between MMP-9 and aggrecan expression, a critical PNN component. Together, these results suggest that chronic Toxoplasma infection can cause an increase in MMP-9 expression, resulting in the degradation of PNNs, which provides a possible mechanism for Toxoplasma-associated deficits in learning and memory.
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Affiliation(s)
- Jianchun Xiao
- Stanley Division of Developmental Neurovirology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
| | - Jing Huang
- Stanley Division of Developmental Neurovirology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
| | - Robert H. Yolken
- Stanley Division of Developmental Neurovirology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
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Sheikhshoaee S, Taheri F, Esmaeilpour K, Firouzeh N, Fard SRN. Aggravation of cognitive impairments in the valproic acid-induced animal model of autism in BALB/c mice infected with Toxoplasma gondii. Int J Dev Neurosci 2024; 84:64-74. [PMID: 37960995 DOI: 10.1002/jdn.10308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/04/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
PURPOSE Toxoplasmosis is a disease caused by infection with a type of coccidial protozoan parasite called Toxoplasma gondii. The relationship between toxoplasmosis and cognitive disorders in neurodegenerative diseases has been proven. There is also evidence that children born to Toxoplasma-infected mothers are more likely to develop autism. METHODS In the present study, Toxoplasma-infected pregnant BALB/c mice were given valproic acid to induce autism in their male offspring, and their social behaviors, learning, and memory were examined. Chronic toxoplasmosis was established in BALB/c mice by intraperitoneal injection of cyst form of T. gondii. To induce autism, 600 mg/kg of valproic acid was injected intraperitoneally into mice on the 12.5th day of pregnancy. The behavioral experiments, such as social interaction, novel object recognition, and passive avoidance tasks, were performed on male offspring at 50 days. RESULTS Toxoplasma and valproic acid during the embryonic period caused social communication deficits and disrupted recognition memory and avoidance memory in offspring. Our findings showed that administering valproic acid to Toxoplasma-infected mothers exacerbates cognitive disorders in their offspring.
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Affiliation(s)
- Saeed Sheikhshoaee
- Department of Pathobiology, School of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Farahnaz Taheri
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Khadijeh Esmaeilpour
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
- Physics and Astronomy department, University of Waterloo, Waterloo, Ontario, Canada
| | - Nima Firouzeh
- Vector-Borne Diseases Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Saeid Reza Nourollahi Fard
- Department of Pathobiology, School of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
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Sager REH, Walker AK, Middleton FA, Robinson K, Webster MJ, Gentile K, Wong ML, Shannon Weickert C. Changes in cytokine and cytokine receptor levels during postnatal development of the human dorsolateral prefrontal cortex. Brain Behav Immun 2023; 111:186-201. [PMID: 36958512 DOI: 10.1016/j.bbi.2023.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 03/09/2023] [Accepted: 03/16/2023] [Indexed: 03/25/2023] Open
Abstract
In addition to their traditional roles in immune cell communication, cytokines regulate brain development. Cytokines are known to influence neural cell generation, differentiation, maturation, and survival. However, most work on the role of cytokines in brain development investigates rodents or focuses on prenatal events. Here, we investigate how mRNA and protein levels of key cytokines and cytokine receptors change during postnatal development of the human prefrontal cortex. We find that most cytokine transcripts investigated (IL1B, IL18, IL6, TNF, IL13) are lowest at birth and increase between 1.5 and 5 years old. After 5 years old, transcriptional patterns proceeded in one of two directions: decreased expression in teens and young adults (IL1B, p = 0.002; and IL18, p = 0.004) or increased mean expression with maturation, particularly in teenagers (IL6, p = 0.004; TNF, p = 0.002; IL13, p < 0.001). In contrast, cytokine proteins tended to remain elevated after peaking significantly around 3 years of age (IL1B, p = 0.012; IL18, p = 0.026; IL6, p = 0.039; TNF, p < 0.001), with TNF protein being highest in teenagers. An mRNA-only analysis of cytokine receptor transcripts found that early developmental increases in cytokines were paralleled by increases in their ligand-binding receptor subunits, such as IL1R1 (p = 0.033) and IL6R (p < 0.001) transcripts. In contrast, cytokine receptor-associated signaling subunits, IL1RAP and IL6ST, did not change significantly between age groups. Of the two TNF receptors, the 'pro-death' TNFRSF1A and 'pro-survival' TNFRSF1B, only TNFRSF1B was significantly changed (p = 0.028), increasing first in toddlers and again in young adults. Finally, the cytokine inhibitor, IL13, was elevated first in toddlers (p = 0.006) and again in young adults (p = 0.053). While the mean expression of interleukin-1 receptor antagonist (IL1RN) was highest in toddlers, this increase was not statistically significant. The fluctuations in cytokine expression reported here support a role for increases in specific cytokines at two different stages of human cortical development. The first is during the toddler/preschool period (IL1B, IL18, and IL13), and the other occurs at adolescence/young adult maturation (IL6, TNF and IL13).
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Affiliation(s)
- Rachel E H Sager
- Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Adam K Walker
- Laboratory of Immunopsychiatry, Neuroscience Research Australia, Sydney, NSW, Australia; Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia; Monash Institute of Pharmaceutical Science, Monash University, Parkville, VIC, Australia
| | - Frank A Middleton
- Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Kate Robinson
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Sydney, NSW, Australia
| | | | - Karen Gentile
- Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Ma-Li Wong
- Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA; Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Cynthia Shannon Weickert
- Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA; Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia; Schizophrenia Research Laboratory, Neuroscience Research Australia, Sydney, NSW, Australia.
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Hassan ZR, Zekry KM, Heikal EA, Ibrahim HF, Khirala SK, Abd El-Hamid SM, Amin DR, Seliem N, El-Aal GNA, Alkherkhisy MM, Elhamid SAA, Mahgoub EA, Hefny MEN, El Nady GH, Badr MS. Toxoplasmosis and cytomegalovirus infection and their role in Egyptian autistic children. Parasitol Res 2023; 122:1177-1187. [PMID: 36917369 PMCID: PMC10097734 DOI: 10.1007/s00436-023-07818-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/03/2023] [Indexed: 03/15/2023]
Abstract
Autism is a neurodevelopmental disorder with a significantly increased incidence rate across the world over the past few years. Toxoplasmosis and cytomegalovirus (CMV) infection are globally prevalent and have been associated with diverse neurological and psychiatric disorders. A few studies have demonstrated the role of toxoplasmosis and CMV as potential etiological factors for autism. Accordingly, this study was performed to estimate the relationship between toxoplasmosis and CMV infection in children with autism as well as to assess their impact on the Childhood Autism Rating Scale (CARS) score. A total of 45 autistic children (6 girls, 39 boys) and 45 (21 girls, 24 boys) healthy control children were enrolled in our study. Their blood samples were collected and tested for the presence of Toxoplasma and CMV (IgG and IgM) antibodies and DNA by ELISA and real-time PCR (RT-PCR), respectively. Toxoplasmosis was detected in 11 (24.4%) autistic children through the ELISA [10 (22.2%) IgG + /IgM - and 1 (2.2%) IgG + /IgM +]; however, RT-PCR assay recorded only 1 positive case (2.2%), while it was detected in 10 (22.2%) control children through ELISA [9 (20%) IgG + /IgM - and 1 (2.2%) IgG + /IgM +] and 1 (2.2%) by RT-PCR. On the other hand, CMV infection was detected in all autistic children with 44 (97.8%) testing positive by ELISA [24 (53.3%) IgG + /IgM - , 18 (40%) IgG + /IgM + and 2 (4.4%) IgG - /IgM +] and 25 (55.6%) testing positive by RT-PCR assay. In addition, ELISA assay recorded 43 (95.6%) [19 (42.2%) IgG + /IgM + and 22 (48.9%) IgG + /IgM - and 2 (4.4%) IgG-/IgM +] and RT-PCR recorded 21 (46.7%) positive samples in control children with CMV. No significant difference was noted between autistic and control children for the overall prevalence of Toxoplasma or/and CMV infection. Similarly, the CARS score indicated a non-significant difference with Toxoplasma or/and CMV infection. Our data does not show an association between autism and toxoplasmosis or/and CMV infection. Nevertheless, considering that autistic children are at a high risk of contracting these infections, further studies with a larger sample size are recommended.
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Affiliation(s)
- Zeinab R Hassan
- Department of Parasitology, Faculty of Medicine for girls, Al-Azhar University, Cairo, Egypt.
| | - Kareman M Zekry
- Department of Parasitology, Faculty of Medicine for girls, Al-Azhar University, Cairo, Egypt
| | - Elham Adel Heikal
- Department of Parasitology, Faculty of Medicine for girls, Al-Azhar University, Cairo, Egypt
| | - Hanan F Ibrahim
- Department of Medical Microbiology and Immunology, Faculty of Medicine for girls and boys, Al-Azhar University, Cairo, Egypt
| | - Seham K Khirala
- Department of Medical Microbiology and Immunology, Faculty of Medicine for girls and boys, Al-Azhar University, Cairo, Egypt
| | - Samar M Abd El-Hamid
- Department of Clinical Pathology, Al-Zahraa University Hospital,Faculty of Medicine for girls, Al-Azhar University, Cairo, Egypt
| | - Doaa R Amin
- Department of Biochemistry, Faculty of Medicine for girls, Al-Azhar University, Cairo, Egypt
| | - Nora Seliem
- Department of Biochemistry, Faculty of Medicine for girls, Al-Azhar University, Cairo, Egypt
| | - Gehad N Abd El-Aal
- Department of Pediatric, Faculty of Medicine for girls, Al-Azhar University, Cairo, Egypt
| | - Mohammad M Alkherkhisy
- Department of Medical Microbiology and Immunology, Faculty of Medicine for girls and boys, Al-Azhar University, Cairo, Egypt
| | - Salwa A Abd Elhamid
- Department of Pediatric, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Emad A Mahgoub
- Department of Psychology, Faculty of Art, Cairo University, Cairo, Egypt
| | - Mahmoud E N Hefny
- Department of Psychological Sciences, Faculty of Education for Early Childhood, Cairo University, Cairo, Egypt
| | - Ghada H El Nady
- Medical Genetic Center, Department of Medical Genetics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed S Badr
- Medical Research Centre, Department of Molecular Biology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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6
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Ginsenoside Rh2 reduces depression in offspring of mice with maternal toxoplasma infection during pregnancy by inhibiting microglial activation via the HMGB1/TLR4/NF-κB signaling pathway. J Ginseng Res 2022; 46:62-70. [PMID: 35035240 PMCID: PMC8753429 DOI: 10.1016/j.jgr.2021.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 04/09/2021] [Accepted: 04/09/2021] [Indexed: 02/08/2023] Open
Abstract
Background Maternal Toxoplasma gondii (T. gondii) infection during pregnancy has been associated with various mental illnesses in the offspring. Ginsenoside Rh2 (GRh2) is a major bioactive compound obtained from ginseng that has an anti-T. gondii effect and attenuates microglial activation through toll-like receptor 4 (TLR4)/nuclear factor-kappa B (NF-κB) signaling pathway. GRh2 also alleviated tumor-associated or lipopolysaccharide-induced depression. However, the effects and potential mechanisms of GRh2 on depression-like behavior in mouse offspring caused by maternal T. gondii infection during pregnancy have not been investigated. Methods We examined GRh2 effects on the depression-like behavior in mouse offspring, caused by maternal T. gondii infection during pregnancy, by measuring depression-like behaviors and assaying parameters at the neuronal and molecular level. Results We showed that GRh2 significantly improved behavioral measures: sucrose consumption, forced swim time and tail suspended immobility time of their offspring. These corresponded with increased tissue concentrations of 5-hydroxytryptamine and dopamine, and attenuated indoleamine 2,3-dioxygenase or enhanced tyrosine hydroxylase expression in the prefrontal cortex. GRh2 ameliorated neuronal damage in the prefrontal cortex. Molecular docking results revealed that GRh2 binds strongly to both TLR4 and high mobility group box 1 (HMGB1). Conclusion This study demonstrated that GRh2 ameliorated the depression-like behavior in mouse offspring of maternal T. gondii infection during pregnancy by attenuating the excessive activation of microglia and neuroinflammation through the HMGB1/TLR4/NF-κB signaling pathway. It suggests that GRh2 could be considered a potential therapy in preventing and treating psychiatric disorders in the offspring mice of mothers with prenatal exposure to T. gondii infection.
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Li D, Xu J, Yang MQ. Gene Regulation Analysis Reveals Perturbations of Autism Spectrum Disorder during Neural System Development. Genes (Basel) 2021; 12:genes12121901. [PMID: 34946850 PMCID: PMC8700980 DOI: 10.3390/genes12121901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/24/2021] [Accepted: 11/24/2021] [Indexed: 01/21/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that impedes patients' cognition, social, speech and communication skills. ASD is highly heterogeneous with a variety of etiologies and clinical manifestations. The prevalence rate of ASD increased steadily in recent years. Presently, molecular mechanisms underlying ASD occurrence and development remain to be elucidated. Here, we integrated multi-layer genomics data to investigate the transcriptome and pathway dysregulations in ASD development. The RNA sequencing (RNA-seq) expression profiles of induced pluripotent stem cells (iPSCs), neural progenitor cells (NPCs) and neuron cells from ASD and normal samples were compared in our study. We found that substantially more genes were differentially expressed in the NPCs than the iPSCs. Consistently, gene set variation analysis revealed that the activity of the known ASD pathways in NPCs and neural cells were significantly different from the iPSCs, suggesting that ASD occurred at the early stage of neural system development. We further constructed comprehensive brain- and neural-specific regulatory networks by incorporating transcription factor (TF) and gene interactions with long 5 non-coding RNA(lncRNA) and protein interactions. We then overlaid the transcriptomes of different cell types on the regulatory networks to infer the regulatory cascades. The variations of the regulatory cascades between ASD and normal samples uncovered a set of novel disease-associated genes and gene interactions, particularly highlighting the functional roles of ELF3 and the interaction between STAT1 and lncRNA ELF3-AS 1 in the disease development. These new findings extend our understanding of ASD and offer putative new therapeutic targets for further studies.
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Affiliation(s)
- Dan Li
- Division of Bioinformatics and Biostatistics, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR 72079, USA;
| | - Joshua Xu
- Division of Bioinformatics and Biostatistics, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR 72079, USA;
- Correspondence: (J.X.); (M.Q.Y.)
| | - Mary Qu Yang
- MidSouth Bioinformatics Center, Joint Bioinformatics Graduate Program of University of Arkansas at Little Rock, University of Arkansas for Medical Sciences, Little Rock, AR 72204, USA
- Correspondence: (J.X.); (M.Q.Y.)
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Spini VBMG, Ferreira FR, Gomes AO, Duarte RMF, Oliveira VHS, Costa NB, Ferreira AFF, Dourado MDPB, Ribeiro-Barbosa ER. Maternal Immune Activation with H1N1 or Toxoplasma gondii Antigens Induces Behavioral Impairments Associated with Mood Disorders in Rodents. Neuropsychobiology 2021; 80:234-241. [PMID: 33070134 DOI: 10.1159/000510791] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 07/23/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Epidemiological studies revealed that maternal exposure to influenza A (H1N1) and Toxoplasma gondii (T. gondii) infection during pregnancy may increase the risk for mood disorders of the offspring. However, the impact of maternal infections in different stages of neural development and the nature of antigens remain to be elucidated. OBJECTIVE This study investigated behavioral impairments induced by maternal immune activation (MIA) due to H1N1 or T. gondii infection during preborn neurodevelopment. METHODS Maternal infection with influenza or toxoplasma was mimicked by administration of influenza vaccine antigens or suspension of soluble T. gondii antigen (STAg) in pregnant Balb/c mice at E6 or E16. Adult male offspring were evaluated for anxiety-like and depressive-like behavior in elevated plus maze (EPM) and forced swimming test (FST). RESULTS In FST, immobility time at E6 and E16 increased when the mothers were treated with both antigen solutions. There was increased immobility in the pups whose mothers were treated with STAg at E16. MIA with influenza antigens reduced the exploration of the open arms of EPM for the pups whose progenitors received treatment at E6 and E16. The animals at E6 exhibited a greater number of stretch-attend postures compared with the saline group. STAg at E6 reduced the time of exploration in the open arms and increased the number of stretch-attend postures compared with the saline group. CONCLUSION These results suggest that immunological responses to H1N1 or T. gondii during pregnancy may impact differently the susceptibility of adult offspring to mood disorder.
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Affiliation(s)
- Vanessa B M G Spini
- Physiology Department, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Brazil,
| | | | - Angelica Oliveira Gomes
- Department of Structural Biology, Federal University of the Triângulo Mineiro, Uberaba, Brazil
| | | | | | | | | | | | - Erika R Ribeiro-Barbosa
- Physiology Department, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Brazil
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Gardner RM, Samuelsson I, Severance EG, Sjöqvist H, Yolken RH, Dalman C, Karlsson H. Maternal antibodies to gliadin and autism spectrum disorders in offspring-A population-based case-control study in Sweden. Autism Res 2021; 14:2002-2016. [PMID: 34213825 DOI: 10.1002/aur.2567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 05/21/2021] [Accepted: 06/04/2021] [Indexed: 11/08/2022]
Abstract
While individuals diagnosed with autism spectrum disorders (ASD) have higher levels of antibodies directed towards gliadin, a component of wheat gluten, no study has examined anti-gliadin antibodies (AGA) in etiologically relevant periods before diagnosis. The objective of this study was to investigate if maternal levels of AGA, during pregnancy and at the time of birth, are associated with ASD in offspring. We analyzed AGA in archived neonatal dried blood spots (NDBS) for 921 ASD cases and 1090 controls, and in paired maternal sera collected earlier in pregnancy for a subset of 547 cases and 428 controls. We examined associations with ASD diagnoses as a group and considering common comorbidities (intellectual disability [ID] and attention-deficit/hyperactivity disorder). We compared 206 cases to their unaffected siblings to examine the potential for confounding by shared familial factors. Odds of ASD tended to be lower among those with the highest levels (≥90th percentile) of AGA compared to those with low levels (<80th percentile; OR 0.78, 95% CI 0.56-1.09, measured in NDBS). This pattern was more apparent for ASD with comorbid ID when measured in NDBS (0.51, 0.30-0.87), with a similar trend in maternal sera (0.55, 0.24-1.29). High levels of AGA were similarly associated with lower odds of ASD in the sibling comparison. In summary, we found little association between maternal antibodies raised against components of gluten and risk of ASD in general. Exposure to high levels of AGA in the pre- and perinatal periods may be protective in terms of risk for ASD with ID. LAY SUMMARY: There is a debate among both scientists and community members as to whether an immune reaction to gluten exposure could be considered a cause of autism. We examined antibodies that are directed against gliadin, a part of gluten, in samples collected from pregnant mothers and their newborn babies. We did not see any major differences in the antibody level among those children diagnosed with ASD or their mothers compared to children who were not diagnosed with ASD. High levels of the antibodies were in fact associated with a somewhat lower risk of ASD with co-occurring intellectual disabilities, though we cannot tell from this study why that might be the case.
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Affiliation(s)
- Renee M Gardner
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Ida Samuelsson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Emily G Severance
- Stanley Division of Developmental Neurovirology, The Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA
| | - Hugo Sjöqvist
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Robert H Yolken
- Stanley Division of Developmental Neurovirology, The Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA
| | - Christina Dalman
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Håkan Karlsson
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Tioleco N, Silberman AE, Stratigos K, Banerjee-Basu S, Spann MN, Whitaker AH, Turner JB. Prenatal maternal infection and risk for autism in offspring: A meta-analysis. Autism Res 2021; 14:1296-1316. [PMID: 33720503 DOI: 10.1002/aur.2499] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 02/13/2021] [Accepted: 02/21/2021] [Indexed: 12/27/2022]
Abstract
While prenatal maternal infection has received attention as a preventable and treatable risk factor for autism, findings have been inconsistent. This paper presents the results of a meta-analysis to determine whether the weight of the evidence supports such an association. Studies with a categorical diagnosis of autism as the outcome and an assessment of its association with prenatal maternal infection or fever (or the data necessary to compute this association) were included. A total of 36 studies met these criteria. Two independent reviewers extracted data on study design, methods of assessment, type of infectious agent, site of infection, trimester of exposure, definition of autism, and effect size. Analyses demonstrated a statistically significant association of maternal infection/fever with autism in offspring (OR = 1.32; 95% CI = 1.20-1.46). Adjustment for evident publication bias slightly weakened this association. There was little variation in effect sizes across agent or site of infection. Small differences across trimester of exposure were not statistically significant. There was some evidence that recall bias associated with status on the outcome variable leads to differential misclassification of exposure status. Nonetheless, the overall association is only modestly reduced when studies potentially contaminated by such bias are removed. Although causality has not been firmly established, these findings suggest maternal infection during pregnancy confers an increase in risk for autism in offspring. Given the prevalence of this risk factor, it is possible that the incidence of autism would be reduced by 12%-17% if maternal infections could be prevented or safely treated in a timely manner. LAY SUMMARY: This study is a meta-analysis of the association of maternal infection during pregnancy and subsequent autism in offspring. In combining the results from 36 studies of this association we find that a significant relationship is present. The association does not vary much across the types of infections or when they occur during pregnancy. We conclude that the incidence of autism could be substantially reduced if maternal infections could be prevented or safely treated in a timely manner.
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Affiliation(s)
- Nina Tioleco
- Division of Child and Adolescent Psychiatry, Columbia University Irving Medical Center, New York, New York, USA.,Division of Child and Adolescent Psychiatry, The New York State Psychiatric Institute, New York, New York, USA
| | - Anna E Silberman
- Division of Child and Adolescent Psychiatry, The New York State Psychiatric Institute, New York, New York, USA
| | - Katharine Stratigos
- Division of Child and Adolescent Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | | | - Marisa N Spann
- Department of Psychiatry and Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Agnes H Whitaker
- Division of Child and Adolescent Psychiatry, Columbia University Irving Medical Center, New York, New York, USA.,Division of Child and Adolescent Psychiatry, The New York State Psychiatric Institute, New York, New York, USA
| | - J Blake Turner
- Division of Child and Adolescent Psychiatry, Columbia University Irving Medical Center, New York, New York, USA.,Division of Child and Adolescent Psychiatry, The New York State Psychiatric Institute, New York, New York, USA
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11
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Al Malki JS, Hussien NA, Al Malki F. Maternal toxoplasmosis and the risk of childhood autism: serological and molecular small-scale studies. BMC Pediatr 2021; 21:133. [PMID: 33731054 PMCID: PMC7968291 DOI: 10.1186/s12887-021-02604-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 03/10/2021] [Indexed: 11/10/2022] Open
Abstract
Background Toxoplasmosis resulting from infection with the Toxoplasma parasite has become an endemic disease worldwide. Recently, a few studies have reported a high prevalence of Toxoplasmosis infections among Saudi Arabian women. This disease could become life threatening for pregnant women and for immunodeficient people. There is evidence that infections during pregnancy, especially in the early stages, are associated with neurodevelopmental disorders. Autism disorder represents one of the most common neurodevelopmental disorders worldwide; it is associated with delayed language development, weak communication interaction, and repetitive behavior. The relationship between prenatal toxoplasmosis and autism in childhood remains unclear. The present study aims to report a link between maternal toxoplasmosis and autistic offspring among Saudi Arabian women. Method Blood samples (36 maternal, 36 from their non-autistic children, and 36 from their autistic children) were collected for serological and molecular evaluation. Results A toxoplasmosis infection was reported for 33.34% of participants using an ELISA assay (5.56% IgG+/IgM+, 11.11% IgG−/IgM+, and 16.67% IgG+/IgM-); however, a nested PCR assay targeting B1 toxoplasmosis specific genes recorded positive tests for 80.56% of the samples. In addition, the present study detected several points of mutation of mtDNA including NADH dehydrogenase (ND1, ND4) and Cyt B genes and the nDNA pyruvate kinase (PK) gene for autistic children infected with toxoplasmosis. Conclusion Considering previous assumptions, we suggest that a maternal toxoplasmosis infection could have a role in the development of childhood autism linked to mtDNA and nDNA impairment.
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Affiliation(s)
- Jamila S Al Malki
- Department of biology, College of Science, Taif University, P.O. Box 11099, Taif, 21944, Saudi Arabia
| | - Nahed Ahmed Hussien
- Department of biology, College of Science, Taif University, P.O. Box 11099, Taif, 21944, Saudi Arabia.
| | - Fuad Al Malki
- Pediatric Department, College of Medicine, Majmaah University, P.O. Box 66, Almajmaah, 11952, Kingdom of Saudi Arabia
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12
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Jafarpour Azami S, Mohammad Rahimi H, Mirjalali H, Zali MR. Unravelling Toxoplasma treatment: conventional drugs toward nanomedicine. World J Microbiol Biotechnol 2021; 37:48. [PMID: 33566198 DOI: 10.1007/s11274-021-03000-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/08/2021] [Indexed: 01/24/2023]
Abstract
Toxoplasma gondii is a worldwide protozoan parasite that infects almost all warm-blooded animals. Although human toxoplasmosis is mostly latent, pregnant women and immunocompromised patients need effective treatment. There are drugs of choice for treatment of toxoplasmosis; however, due to their side effects and/or their disease stage-specificity, prescription of them is limited. During recent years, nanomedicine has been employed to overcome limitations of conventional drugs. Here, we provided a state-of-the-art review of experimental toxoplasmosis treatment using nanotechnology.
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Affiliation(s)
- Sanaz Jafarpour Azami
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hanieh Mohammad Rahimi
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Mirjalali
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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13
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Abdoli A, Taghipour A, Pirestani M, Mofazzal Jahromi MA, Roustazadeh A, Mir H, Ardakani HM, Kenarkoohi A, Falahi S, Karimi M. Infections, inflammation, and risk of neuropsychiatric disorders: the neglected role of "co-infection". Heliyon 2020; 6:e05645. [PMID: 33319101 PMCID: PMC7725732 DOI: 10.1016/j.heliyon.2020.e05645] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/18/2020] [Accepted: 11/30/2020] [Indexed: 02/08/2023] Open
Abstract
Neuropsychiatric disorders (NPDs) have multiple etiological factors, mainly genetic background, environmental conditions and immunological factors. The host immune responses play a pivotal role in various physiological and pathophysiological process. In NPDs, inflammatory immune responses have shown to be involved in diseases severity and treatment outcome. Inflammatory cytokines and chemokines are involved in various neurobiological pathways, such as GABAergic signaling and neurotransmitter synthesis. Infectious agents are among the major amplifier of inflammatory reactions, hence, have an indirect role in the pathogenesis of NPDs. As such, some infections directly affect the central nervous system (CNS) and alter the genes that involved in neurobiological pathways and NPDs. Interestingly, the most of infectious agents that involved in NPDs (e.g., Toxoplasma gondii, cytomegalovirus and herpes simplex virus) is latent (asymptomatic) and co-or-multiple infection of them are common. Nonetheless, the role of co-or-multiple infection in the pathogenesis of NPDs has not deeply investigated. Evidences indicate that co-or-multiple infection synergically augment the level of inflammatory reactions and have more severe outcomes than single infection. Hence, it is plausible that co-or-multiple infections can increase the risk and/or pathogenesis of NPDs. Further understanding about the role of co-or-multiple infections can offer new insights about the etiology, treatment and prevention of NPDs. Likewise, therapy based on anti-infective and anti-inflammatory agents could be a promising therapeutic option as an adjuvant for treatment of NPDs.
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Affiliation(s)
- Amir Abdoli
- Department of Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Ali Taghipour
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Majid Pirestani
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mirza Ali Mofazzal Jahromi
- Department of Advanced Medical Sciences & Technologies, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Department of Laboratory Sciences, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Research Center for Noncommunicable Diseases, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Abazar Roustazadeh
- Department of Advanced Medical Sciences & Technologies, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Research Center for Noncommunicable Diseases, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Department of Clinical Biochemistry, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Hamed Mir
- Research Center for Noncommunicable Diseases, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Department of Clinical Biochemistry, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Hoda Mirzaian Ardakani
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Azra Kenarkoohi
- Department of Microbiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Shahab Falahi
- Zoonotic Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Mahdi Karimi
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Medical Nanotechnology, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran.,Advances Nanobiotechnology and Nanomedicine Research Group (ANNRG), Iran University of Medical Sciences, Tehran, Iran
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14
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Abtibol-Bernardino MR, de Almeida Peixoto LDFA, de Oliveira GA, de Almeida TF, Rodrigues GRI, Otani RH, Soares Chaves BC, de Souza Rodrigues C, de Andrade ABCA, de Fatima Redivo E, Fernandes SS, da Costa Castilho M, Gomes Benzecry S, Bôtto-Menezes C, Martinez-Espinosa FE, Costa Alecrim MDG. Neurological Findings in Children without Congenital Microcephaly Exposed to Zika Virus in Utero: A Case Series Study. Viruses 2020; 12:v12111335. [PMID: 33233769 PMCID: PMC7699969 DOI: 10.3390/v12111335] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/12/2020] [Accepted: 11/16/2020] [Indexed: 02/07/2023] Open
Abstract
The Zika virus can induce a disruptive sequence in the fetal brain and is manifested mainly by microcephaly. Knowledge gaps still exist as to whether the virus can cause minor disorders that are perceived later on during the first years of life in children who are exposed but are asymptomatic at birth. In this case series, we describe the outcomes related to neurodevelopment through the neurological assessment of 26 non-microcephalic children who had intrauterine exposure to Zika virus. Children were submitted for neurological examinations and Bayley Scales-III (cognition, language, and motor performance). The majority (65.4%) obtained satisfactory performance in neurodevelopment. The most impaired domain was language, with 30.7% impairment. Severe neurological disorders occurred in five children (19.2%) and these were spastic hemiparesis, epilepsy associated with congenital macrocephaly (Zika and human immunodeficiency virus), two cases of autism (one exposed to Zika and Toxoplasma gondii) and progressive sensorineural hearing loss (GJB2 mutation). We concluded that non-microcephalic children with intrauterine exposure to Zika virus, in their majority, had achieved satisfactory performance in all neurodevelopmental domains. One third of the cases had some impairment, but the predominant group had mild alterations, with low occurrence of moderate to severe disorders, similar to other studies in Brazil.
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Affiliation(s)
- Marília Rosa Abtibol-Bernardino
- Postgraduate Program in Tropical Medicine, University of Amazonas State, Manaus 69040-000, Brazil; (L.d.F.A.d.A.P.); (B.C.S.C.); (C.d.S.R.); (E.d.F.R.); (S.S.F.); (C.B.-M.); (F.E.M.-E.); (M.d.G.C.A.)
- Correspondence:
| | - Lucíola de Fátima Albuquerque de Almeida Peixoto
- Postgraduate Program in Tropical Medicine, University of Amazonas State, Manaus 69040-000, Brazil; (L.d.F.A.d.A.P.); (B.C.S.C.); (C.d.S.R.); (E.d.F.R.); (S.S.F.); (C.B.-M.); (F.E.M.-E.); (M.d.G.C.A.)
| | - Geruza Alfaia de Oliveira
- Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil; (G.A.d.O.); (G.R.I.R.)
| | | | | | - Rodrigo Haruo Otani
- Department of Medicine, School of Health Sciences, University of Amazonas State, Manaus 69065-001, Brazil; (R.H.O.); (S.G.B.)
| | - Beatriz Caroline Soares Chaves
- Postgraduate Program in Tropical Medicine, University of Amazonas State, Manaus 69040-000, Brazil; (L.d.F.A.d.A.P.); (B.C.S.C.); (C.d.S.R.); (E.d.F.R.); (S.S.F.); (C.B.-M.); (F.E.M.-E.); (M.d.G.C.A.)
| | - Cristina de Souza Rodrigues
- Postgraduate Program in Tropical Medicine, University of Amazonas State, Manaus 69040-000, Brazil; (L.d.F.A.d.A.P.); (B.C.S.C.); (C.d.S.R.); (E.d.F.R.); (S.S.F.); (C.B.-M.); (F.E.M.-E.); (M.d.G.C.A.)
| | - Anny Beatriz Costa Antony de Andrade
- Postgraduate Program in Living Conditions and Health Situations in the Amazon PPGVIDA, Leônidas & Maria Deane Institute, Fiocruz Amazonia, Manaus 69057-070, Brazil;
| | - Elijane de Fatima Redivo
- Postgraduate Program in Tropical Medicine, University of Amazonas State, Manaus 69040-000, Brazil; (L.d.F.A.d.A.P.); (B.C.S.C.); (C.d.S.R.); (E.d.F.R.); (S.S.F.); (C.B.-M.); (F.E.M.-E.); (M.d.G.C.A.)
| | - Salete Sara Fernandes
- Postgraduate Program in Tropical Medicine, University of Amazonas State, Manaus 69040-000, Brazil; (L.d.F.A.d.A.P.); (B.C.S.C.); (C.d.S.R.); (E.d.F.R.); (S.S.F.); (C.B.-M.); (F.E.M.-E.); (M.d.G.C.A.)
| | - Marcia da Costa Castilho
- Department of Virology, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil;
| | - Silvana Gomes Benzecry
- Department of Medicine, School of Health Sciences, University of Amazonas State, Manaus 69065-001, Brazil; (R.H.O.); (S.G.B.)
| | - Camila Bôtto-Menezes
- Postgraduate Program in Tropical Medicine, University of Amazonas State, Manaus 69040-000, Brazil; (L.d.F.A.d.A.P.); (B.C.S.C.); (C.d.S.R.); (E.d.F.R.); (S.S.F.); (C.B.-M.); (F.E.M.-E.); (M.d.G.C.A.)
- Department of Medicine, School of Health Sciences, University of Amazonas State, Manaus 69065-001, Brazil; (R.H.O.); (S.G.B.)
- Department of Malaria, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil
| | - Flor Ernestina Martinez-Espinosa
- Postgraduate Program in Tropical Medicine, University of Amazonas State, Manaus 69040-000, Brazil; (L.d.F.A.d.A.P.); (B.C.S.C.); (C.d.S.R.); (E.d.F.R.); (S.S.F.); (C.B.-M.); (F.E.M.-E.); (M.d.G.C.A.)
- Postgraduate Program in Living Conditions and Health Situations in the Amazon PPGVIDA, Leônidas & Maria Deane Institute, Fiocruz Amazonia, Manaus 69057-070, Brazil;
- Department of Malaria, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil
- Laboratory of Territory, Environment, Health and Sustainability, Leônidas & Maria Deane Institute, Fiocruz Amazonia, Manaus 69057-070, Brazil
| | - Maria das Graças Costa Alecrim
- Postgraduate Program in Tropical Medicine, University of Amazonas State, Manaus 69040-000, Brazil; (L.d.F.A.d.A.P.); (B.C.S.C.); (C.d.S.R.); (E.d.F.R.); (S.S.F.); (C.B.-M.); (F.E.M.-E.); (M.d.G.C.A.)
- Department of Malaria, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus 69040-000, Brazil
- Medical Course Coordination, Manaus Metropolitan College/FAMETRO, Manaus 69050-000, Brazil
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15
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Xu F, Ma X, Zhu Y, Sutterland A, Cheng R, Miao S, Chen J, Qiu L, Zhou Y. Effects of Toxoplasma gondii infection and schizophrenia comorbidity on serum lipid profile: A population retrospective study from Eastern China. Microb Pathog 2020; 149:104587. [PMID: 33091579 DOI: 10.1016/j.micpath.2020.104587] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/10/2020] [Accepted: 10/12/2020] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Toxoplasma gondii (T. gondii), a parasitic protozoa that is associated with various psychiatric disorders. Both T. gondii infection and disturbed host's lipid profile are common in schizophrenia patients. However, the underlying pathophysiological mechanisms remain speculative. Also, the characteristics of serum lipid levels in schizophrenia patients comorbid with T. gondii infection are not clear. Therefore, it is necessary to explore the influence of chronic T. gondii infection on the characteristic physiological indexes of schizophrenia patients so as to provide some insights into finding target therapeutic drugs. METHODS In this study, the effect of chronic T. gondii infection on serum lipid profile was retrospectively analysed in 1719 schizophrenic patients and 1552 healthy subjects from Eastern China. RESULTS The overall prevalence of Immunoglobulin G (IgG) antibodies against T. gondii (17.98%) in schizophrenia patients was significantly higher than healthy controls (7.35%, χ2 = 81.831, P = 0.000). Compared to T. gondii IgG-seronegative schizophrenia patients, IgG-seropositive group had higher high-density lipoprotein (HDL) (P = 0.000) and triglycerides (TG) (P = 0.000) levels, while total cholesterol (TC) (P = 0.000) levels showed an opposite tendency in IgG-seropositive cases. We also found significant correlation between T. gondii seropositivity and increased TG (P = 0.000) and TC levels (P = 0.000) in schizophrenia patients. Binary regression analysis also showed that decreased TC level was more common among schizophrenia patients with T. gondii seropositivity compared to seronegative subjects (OR = 0.617, 95%CI = 0.509-0.749, P = 0.000). CONCLUSION Patients with chronic T. gondii infection and comorbid schizophrenia had higher HDL and TG levels, while cholesterol levels showed an opposite trend. To the best of our knowledge, this is the first report focus on the host's lipid profile of chronic T. gondii infection and comorbid schizophrenia patients.
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Affiliation(s)
- Fei Xu
- Department of Basic Medicine, Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu, 214122, PR China; Key Laboratory of National Health Commission on Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control, Jiangsu Institute of Parasitic Diseases and Public Health Research Center of Jiangnan University, Wuxi, 214064, Jiangsu, China
| | - Xinyu Ma
- Department of Basic Medicine, Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu, 214122, PR China
| | - Yuwei Zhu
- Department of Basic Medicine, Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu, 214122, PR China
| | - Arjen Sutterland
- Department of Psychiatry, Academic Center (AMC), University of Amsterdam, Meibergdreef 5, 1105 AZ, Amsterdam, the Netherlands
| | - Ruitang Cheng
- Department of Basic Medicine, Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu, 214122, PR China
| | - Sunhan Miao
- Department of Basic Medicine, Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu, 214122, PR China
| | - Jialu Chen
- Department of Basic Medicine, Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu, 214122, PR China
| | - Liying Qiu
- Department of Basic Medicine, Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu, 214122, PR China
| | - Yonghua Zhou
- Key Laboratory of National Health Commission on Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control, Jiangsu Institute of Parasitic Diseases and Public Health Research Center of Jiangnan University, Wuxi, 214064, Jiangsu, China.
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16
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Ottaru S, Mirambo MM, Kabyemera R, Kidenya BR, Seugendo M, Msanga DR, Ngoya P, Morona D, Mshana SE. Predictors of Toxoplasma gondii IgG Seropositivity and Cranial Ultrasound Patterns among Children with Hydrocephalus. Int J Pediatr 2020; 2020:8326348. [PMID: 32963556 PMCID: PMC7492872 DOI: 10.1155/2020/8326348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/27/2020] [Accepted: 08/28/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Toxoplasma gondii infection during pregnancy is associated with serious neonatal complications, including hydrocephalus. In many high-income countries, T. gondii screening and treatment during the antenatal period are routinely carried out to prevent associated complications, whereas in most low-income countries, there is no routine screening of T. gondii during pregnancy. Despite the parasite being common in Tanzania, there is a paucity of information on the prevalence of T. gondii and cranial ultrasound patterns among children with hydrocephalus. METHODS An analytical cross-sectional hospital-based study involving 125 infants with hydrocephalus attending the Bugando Medical Centre (BMC) was conducted between May 2017 and February 2018. Sociodemographic and other relevant information was collected using a pretested data collection tool. Venous blood samples were collected, and sera were used for the detection of specific T. gondii antibodies by indirect enzyme-linked immunosorbent assay (ELISA) as per manufacturer's instructions. Data were analysed using STATA version 13 software. RESULTS The mean age of enrolled children was 4.8 ± 3.5 months. Out of 125 infants with hydrocephalus, 29 (23.2%, 95% CI: 21-36) were seropositive for T. gondii-specific IgG antibodies. By multiple generalized linear model analysis, being male (aRR = 1.1, 95% CI: 0.9-1.5, p = 0.049), higher birth order (aRR = 1.2, 95% CI: 1.0-1.5, p = 0.023), consumption of fish meat (aRR = 1.6, 95% CI: 1.2-2.3, p = 0.003), and using other methods of cooking meat than boiling (aRR = 1.7, 95% CI: 1.1-2.5, p = 0.015) were independent risk factors for T. gondii IgG seropositivity. Obstructive hydrocephalus was significantly more common among T. gondii-seronegative infants compared to IgG-seropositive infants (31.3% [30/96] vs. 13.8% [4/29]; p = 0.049). CONCLUSIONS A significant proportion of infants with nonobstructive hydrocephalus are T. gondii IgG seropositive, and this is predicted by male gender, increase of birth order, consuming fish, and using other methods of cooking meat than boiling. These facts highlight the importance of continuing health education for pregnant women regarding T. gondii transmission and the need to follow-up their infants so that appropriate counselling and management can be provided.
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Affiliation(s)
- Sofia Ottaru
- Department of Paediatrics & Child Health, Bugando Medical Centre, P.O. Box 370, Mwanza, Tanzania
| | - Mariam M. Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Rogatus Kabyemera
- Department of Paediatrics & Child Health, Bugando Medical Centre, P.O. Box 370, Mwanza, Tanzania
| | - Benson R. Kidenya
- Department of Biochemistry and Molecular Biology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Mwanaisha Seugendo
- Department of Paediatrics & Child Health, Bugando Medical Centre, P.O. Box 370, Mwanza, Tanzania
| | - Delfina R. Msanga
- Department of Paediatrics & Child Health, Bugando Medical Centre, P.O. Box 370, Mwanza, Tanzania
| | - Patrick Ngoya
- Department of Radiology, Bugando Medical Centre, P.O. Box 370, Mwanza, Tanzania
| | - Domenica Morona
- Department of Medical Parasitology and Entomology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
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17
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Benitez ADN, Gomes JF, Dias MUSS, Navarro IT, Mitsuka-Breganó R, Bresciani KDS. Characterization of prenatal healthcare for implementation of congenital toxoplasmosis surveillance program: cross-sectional study. SAO PAULO MED J 2020; 138:368-376. [PMID: 33111919 PMCID: PMC9673859 DOI: 10.1590/1516-3180.2019.0512.r2.10062020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 06/10/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Prenatal toxoplasmosis remains a neglected disease worldwide and few government programs focusing on its prevention are available. Success in these programs has been extensively reported in the literature, yet the strategies used for their implementation, as a model for such actions in different communities, have not been described. OBJECTIVE To describe the aspects of prenatal care strategies in 13 municipalities within the regional healthcare unit of Araçatuba, in the northwestern region of the state of São Paulo in 2017, focusing on congenital toxoplasmosis. DESIGN AND SETTING Descriptive study on prenatal healthcare within the Brazilian National Health System, in 13 participating municipalities. METHODS Data on serological tests, referral clinics, notifications, healthcare strategies, health education and drugs for infected children were requested through a questionnaire that was sent via e-mail to people responsible for healthcare services in these municipalities. RESULTS Major differences relating to diagnoses, reference outpatient clinics, notifications, health education and healthcare and drugs for infected children were reported among the prenatal strategies of these 13 municipal healthcare services. CONCLUSION The lack of standardized prenatal strategy in the study area may compromise the prevention of infection. However, our identification of each aspect of prenatal care corroborates the need to implement a healthcare surveillance program relating to congenital toxoplasmosis.
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Affiliation(s)
- Aline do Nascimento Benitez
- MSc, PhD. Veterinarian, Specialist in Zoonoses and Public Health and Postdoctoral Student, Postgraduate Program on Child and Adolescent Health, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Jancarlo Ferreira Gomes
- MSc, PhD. Parasitologist, Specialist in Public Health and Professor, Postgraduate Program on Child and Adolescent Health, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Milenne Ura Seixas Santos Dias
- RN. Nurse, Specialist in Occupational Health and Regional Director, Group XI (GVE), “Prof Alexandre Vranjac” Epidemiological Surveillance Center, State Health Department of São Paulo, Araçatuba (SP), Brazil.
| | - Italmar Teodorico Navarro
- MSc, PhD. Parasitologist, Specialist in Zoonoses and Public Health and Professor, Department of Preventive Veterinary Medicine, Universidade Estadual de Londrina (UEL), Londrina (PR), Brazil.
| | - Regina Mitsuka-Breganó
- MSc, PhD. Parasitologist, Specialist in Zoonoses and Public Health and Professor, Department of Preventive Veterinary Medicine, Universidade Estadual de Londrina (UEL), Londrina (PR), Brazil.
| | - Katia Denise Saraiva Bresciani
- MSc, PhD. Parasitologist, Specialist in Zoonoses and Public Health and Professor, Department of Animal Production and Health, School of Veterinary Medicine, Universidade Estadual Paulista (UNESP), Araçatuba (SP), Brazil.
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18
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Nayeri T, Sarvi S, Moosazadeh M, Hosseininejad Z, Sharif M, Amouei A, Daryani A. Relationship between toxoplasmosis and autism: A systematic review and meta-analysis. Microb Pathog 2020; 147:104434. [PMID: 32777351 DOI: 10.1016/j.micpath.2020.104434] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 07/29/2020] [Accepted: 08/02/2020] [Indexed: 12/14/2022]
Abstract
Toxoplasma gondii (T. gondii) is a foodborne parasite that is investigated in many psychiatric diseases, such as autism spectrum disorders (ASD). Therefore, a systematic literature review was conducted searching seven electronic databases on the prevalence of T. gondii antibodies among autism patients. The current study involved sensitivity analysis, meta-regression, subgroup analysis, publication bias test, and quality assessment of studies. On the basis of the findings, the odds ratio (OR) of latent Toxoplasma infection 1.93 (95% confidence intervals (CI): 1.01-3.66) was associated with ASD risk. However, there was no relationship between acute infection and ASD 0.39 (95% CI: 0.18-0.87). The obtained results of Begg's and Egger's tests showed no publication bias (P = 0.851 and P = 0.297, respectively). The sensitivity analysis confirmed robust and stable estimates with a significant level of heterogeneity (I2 = 78.1%, P < 0.000). Of the investigated patients' characteristics, only the gender variable was analyzed, indicating the combined ORs of 2.63 (95% CI: 0.29-23.63) in females and 2.62 (95% CI: 0.94-7.30) in male participants. This study showed that toxoplasmosis plays an important role as a risk factor for autism. However, further prospective investigations are highly recommended to illuminate the developmental pathways to this disorder and provide new strategies for the prevention and treatment of this disease.
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Affiliation(s)
- Tooran Nayeri
- Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran; Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Shahabeddin Sarvi
- Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Zahra Hosseininejad
- Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran; Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Mehdi Sharif
- Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Afsaneh Amouei
- Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Ahmad Daryani
- Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
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19
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Haddad FL, Patel SV, Schmid S. Maternal Immune Activation by Poly I:C as a preclinical Model for Neurodevelopmental Disorders: A focus on Autism and Schizophrenia. Neurosci Biobehav Rev 2020; 113:546-567. [PMID: 32320814 DOI: 10.1016/j.neubiorev.2020.04.012] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 01/28/2020] [Accepted: 04/09/2020] [Indexed: 12/18/2022]
Abstract
Maternal immune activation (MIA) in response to a viral infection during early and mid-gestation has been linked through various epidemiological studies to a higher risk for the child to develop autism or schizophrenia-related symptoms.. This has led to the establishment of the pathogen-free poly I:C-induced MIA animal model for neurodevelopmental disorders, which shows relatively high construct and face validity. Depending on the experimental variables, particularly the timing of poly I:C administration, different behavioural and molecular phenotypes have been described that relate to specific symptoms of neurodevelopmental disorders such as autism spectrum disorder and/or schizophrenia. We here review and summarize epidemiological evidence for the effects of maternal infection and immune activation, as well as major findings in different poly I:C MIA models with a focus on poly I:C exposure timing, behavioural and molecular changes in the offspring, and characteristics of the model that relate it to autism spectrum disorder and schizophrenia.
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Affiliation(s)
- Faraj L Haddad
- Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada.
| | - Salonee V Patel
- Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada.
| | - Susanne Schmid
- Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada.
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20
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Transcriptomic Analysis Reveals Abnormal Expression of Prion Disease Gene Pathway in Brains from Patients with Autism Spectrum Disorders. Brain Sci 2020; 10:brainsci10040200. [PMID: 32235346 PMCID: PMC7226514 DOI: 10.3390/brainsci10040200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 12/22/2022] Open
Abstract
The role of infections in the pathogenesis of autism spectrum disorder (ASD) is still controversial. In this study, we aimed to evaluate markers of infections and immune activation in ASD by performing a meta-analysis of publicly available whole-genome transcriptomic datasets of brain samples from autistic patients and otherwise normal people. Among the differentially expressed genes, no significant enrichment was observed for infectious diseases previously associated with ASD, including herpes simplex virus-1 (HSV-1), cytomegalovirus and Epstein–Barr virus in brain samples, nor was it found in peripheral blood from ASD patients. Interestingly, a significant number of genes belonging to the “prion diseases” pathway were found to be modulated in our ASD brain meta-analysis. Overall, our data do not support an association between infection and ASD. However, the data do provide support for the involvement of pathways related to other neurodegenerative diseases and give input to uncover novel pathogenetic mechanisms underlying ASD.
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21
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Chagas LDS, Sandre PC, Ribeiro e Ribeiro NCA, Marcondes H, Oliveira Silva P, Savino W, Serfaty CA. Environmental Signals on Microglial Function during Brain Development, Neuroplasticity, and Disease. Int J Mol Sci 2020; 21:ijms21062111. [PMID: 32204421 PMCID: PMC7139373 DOI: 10.3390/ijms21062111] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 12/12/2019] [Accepted: 12/13/2019] [Indexed: 12/15/2022] Open
Abstract
Recent discoveries on the neurobiology of the immunocompetent cells of the central nervous system (CNS), microglia, have been recognized as a growing field of investigation on the interactions between the brain and the immune system. Several environmental contexts such as stress, lesions, infectious diseases, and nutritional and hormonal disorders can interfere with CNS homeostasis, directly impacting microglial physiology. Despite many encouraging discoveries in this field, there are still some controversies that raise issues to be discussed, especially regarding the relationship between the microglial phenotype assumed in distinct contexts and respective consequences in different neurobiological processes, such as disorders of brain development and neuroplasticity. Also, there is an increasing interest in discussing microglial–immune system cross-talk in health and in pathological conditions. In this review, we discuss recent literature concerning microglial function during development and homeostasis. In addition, we explore the contribution of microglia to synaptic disorders mediated by different neuroinflammatory outcomes during pre- and postnatal development, with long-term consequences impacting on the risk and vulnerability to the emergence of neurodevelopmental, neurodegenerative, and neuropsychiatric disorders.
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Affiliation(s)
- Luana da Silva Chagas
- Laboratory of Neural Plasticity Neurobiology Department, Biology Institute, Federal Fluminense University, Niteroi 24020-141, Brazil; (L.d.S.C.); (P.C.S.); (N.C.A.R.eR.); (H.M.); (P.O.S.)
| | - Poliana Capucho Sandre
- Laboratory of Neural Plasticity Neurobiology Department, Biology Institute, Federal Fluminense University, Niteroi 24020-141, Brazil; (L.d.S.C.); (P.C.S.); (N.C.A.R.eR.); (H.M.); (P.O.S.)
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
| | - Natalia Cristina Aparecida Ribeiro e Ribeiro
- Laboratory of Neural Plasticity Neurobiology Department, Biology Institute, Federal Fluminense University, Niteroi 24020-141, Brazil; (L.d.S.C.); (P.C.S.); (N.C.A.R.eR.); (H.M.); (P.O.S.)
| | - Henrique Marcondes
- Laboratory of Neural Plasticity Neurobiology Department, Biology Institute, Federal Fluminense University, Niteroi 24020-141, Brazil; (L.d.S.C.); (P.C.S.); (N.C.A.R.eR.); (H.M.); (P.O.S.)
| | - Priscilla Oliveira Silva
- Laboratory of Neural Plasticity Neurobiology Department, Biology Institute, Federal Fluminense University, Niteroi 24020-141, Brazil; (L.d.S.C.); (P.C.S.); (N.C.A.R.eR.); (H.M.); (P.O.S.)
- National Institute of Science and Technology on Neuroimmunomodulation –INCT-NIM, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
| | - Wilson Savino
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
- National Institute of Science and Technology on Neuroimmunomodulation –INCT-NIM, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
- Correspondence: (W.S.); (C.A.S.)
| | - Claudio A. Serfaty
- Laboratory of Neural Plasticity Neurobiology Department, Biology Institute, Federal Fluminense University, Niteroi 24020-141, Brazil; (L.d.S.C.); (P.C.S.); (N.C.A.R.eR.); (H.M.); (P.O.S.)
- National Institute of Science and Technology on Neuroimmunomodulation –INCT-NIM, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
- Correspondence: (W.S.); (C.A.S.)
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22
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Lin CH, Lin WD, Chou IC, Lee IC, Hong SY. Epilepsy and Neurodevelopmental Outcomes in Children With Etiologically Diagnosed Central Nervous System Infections: A Retrospective Cohort Study. Front Neurol 2019; 10:528. [PMID: 31156546 PMCID: PMC6529952 DOI: 10.3389/fneur.2019.00528] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 05/02/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Central nervous system (CNS) infection in childhood can lead to neurological sequelae, including epilepsy, and neurodevelopmental disorders, such as attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). This study investigated the association of etiologically diagnosed childhood brain infections with the subsequent risks of epilepsy and neurodevelopmental disorders. Objectives: We retrospectively analyzed the data of children aged <18 years who had definite brain infections with positive cerebrospinal fluid cultures from January 1, 2005, to December 31, 2017. These patients were followed to evaluate the risks of epilepsy and neurodevelopmental disease (ADHD and ASD) after brain infections (group 1) in comparison with the risks in those without brain infections (group 2). Results: A total of 145 patients with an average age of 41.2 months were included in group 1. Enterovirus accounted for the majority of infections, followed by group B Streptococcus, S. pneumoniae, and herpes simplex virus. A total of 292 patients with an average age of 44.8 months were included in group 2. The 12-year risk of epilepsy in group 1 was 10.7 (95% confidence interval [CI], 2.30-49; p < 0.01). Compared with group 2 (reference), the risk of ASD in the age interval of 2-5 years in group 1 was 21.3 (95% CI, 1.33-341.4; p = 0.03). The incidence of ADHD in group 1 was not significantly higher than that in group 2. Conclusions: This study identified the common etiological causes of brain infections in Taiwanese children. The highest-risk neurodevelopmental sequelae associated with brain infections was epilepsy. Children who had a diagnosis of brain infection (specially Enterovirus) should be followed since they are at greater risk of developing epilepsy and ASD.
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Affiliation(s)
- Chien-Heng Lin
- Division of Pediatrics Pulmonology, China Medical University, Children's Hospital, Taichung, Taiwan.,Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Wei-De Lin
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - I-Ching Chou
- Division of Pediatrics Neurology, China Medical University, Children's Hospital, Taichung, Taiwan.,College of Chinese Medicine, Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Inn-Chi Lee
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan.,School of Medicine, Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Syuan-Yu Hong
- Division of Pediatrics Neurology, China Medical University, Children's Hospital, Taichung, Taiwan
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23
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Haida O, Al Sagheer T, Balbous A, Francheteau M, Matas E, Soria F, Fernagut PO, Jaber M. Sex-dependent behavioral deficits and neuropathology in a maternal immune activation model of autism. Transl Psychiatry 2019; 9:124. [PMID: 30923308 PMCID: PMC6438965 DOI: 10.1038/s41398-019-0457-y] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 02/14/2019] [Accepted: 03/12/2019] [Indexed: 01/29/2023] Open
Abstract
Infections during gestation and the consequent maternal immune activation (MIA) increase the risk of developing neuropsychiatric disorders in infants and throughout life, including autism spectrum disorders (ASD). ASD is a neurodevelopmental disorder that affects three times more males than females and is mainly characterized by deficits in social communication and restricted interests. Consistent findings also indicate that ASD patients suffer from movement disorders, although these symptoms are not yet considered as diagnosis criteria. Here we used the double-stranded RNA analog polyinosinic:polycytidylic acid (poly I:C) MIA animal model of ASD in mice and explored its effects in males and females on social and motor behavior. We then investigated brain areas implicated in controlling and coordinating movements, namely the nigro-striatal pathway, motor cortex and cerebellum. We show that male mice are more affected by this treatment than females as they show reduced social interactions as well as motor development and coordination deficits. Reduced numbers of Purkinje cells in the cerebellum was found more widespread and within distinct lobules in males than in females. Moreover, a reduced number of neurons was found in the motor cortex of males only. These results suggest that females are better protected against developmental insults leading to ASD symptoms in mice. They also point to brain areas that may be targeted to better manage social and motor consequences of ASD.
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Affiliation(s)
- Obelia Haida
- 0000 0001 2160 6368grid.11166.31Université de Poitiers, INSERM, Laboratoire de Neurosciences Expérimentales et Cliniques, Poitiers, France
| | - Tareq Al Sagheer
- 0000 0001 2160 6368grid.11166.31Université de Poitiers, INSERM, Laboratoire de Neurosciences Expérimentales et Cliniques, Poitiers, France
| | - Anais Balbous
- 0000 0001 2160 6368grid.11166.31Université de Poitiers, INSERM, Laboratoire de Neurosciences Expérimentales et Cliniques, Poitiers, France ,0000 0000 9336 4276grid.411162.1CHU Poitiers, Poitiers, France
| | - Maureen Francheteau
- 0000 0001 2160 6368grid.11166.31Université de Poitiers, INSERM, Laboratoire de Neurosciences Expérimentales et Cliniques, Poitiers, France
| | - Emmanuel Matas
- 0000 0001 2160 6368grid.11166.31Université de Poitiers, INSERM, Laboratoire de Neurosciences Expérimentales et Cliniques, Poitiers, France
| | - Federico Soria
- grid.462010.1Université de Bordeaux, CNRS, Institut des Maladies Neurodégénératives, Bordeaux, France
| | - Pierre Olivier Fernagut
- 0000 0001 2160 6368grid.11166.31Université de Poitiers, INSERM, Laboratoire de Neurosciences Expérimentales et Cliniques, Poitiers, France ,grid.462010.1Université de Bordeaux, CNRS, Institut des Maladies Neurodégénératives, Bordeaux, France
| | - Mohamed Jaber
- Université de Poitiers, INSERM, Laboratoire de Neurosciences Expérimentales et Cliniques, Poitiers, France. .,CHU Poitiers, Poitiers, France.
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24
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Carter CJ. Autism genes and the leukocyte transcriptome in autistic toddlers relate to pathogen interactomes, infection and the immune system. A role for excess neurotrophic sAPPα and reduced antimicrobial Aβ. Neurochem Int 2019; 126:36-58. [PMID: 30862493 DOI: 10.1016/j.neuint.2019.03.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 02/22/2019] [Accepted: 03/06/2019] [Indexed: 12/20/2022]
Abstract
Prenatal and early childhood infections have been implicated in autism. Many autism susceptibility genes (206 Autworks genes) are localised in the immune system and are related to immune/infection pathways. They are enriched in the host/pathogen interactomes of 18 separate microbes (bacteria/viruses and fungi) and to the genes regulated by bacterial toxins, mycotoxins and Toll-like receptor ligands. This enrichment was also observed for misregulated genes from a microarray study of leukocytes from autistic toddlers. The upregulated genes from this leukocyte study also matched the expression profiles in response to numerous infectious agents from the Broad Institute molecular signatures database. They also matched genes related to sudden infant death syndrome and autism comorbid conditions (autoimmune disease, systemic lupus erythematosus, diabetes, epilepsy and cardiomyopathy) as well as to estrogen and thyrotropin responses and to those upregulated by different types of stressors including oxidative stress, hypoxia, endoplasmic reticulum stress, ultraviolet radiation or 2,4-dinitrofluorobenzene, a hapten used to develop allergic skin reactions in animal models. The oxidative/integrated stress response is also upregulated in the autism brain and may contribute to myelination problems. There was also a marked similarity between the expression signatures of autism and Alzheimer's disease, and 44 shared autism/Alzheimer's disease genes are almost exclusively expressed in the blood-brain barrier. However, in contrast to Alzheimer's disease, levels of the antimicrobial peptide beta-amyloid are decreased and the levels of the neurotrophic/myelinotrophic soluble APP alpha are increased in autism, together with an increased activity of α-secretase. sAPPα induces an increase in glutamatergic and a decrease in GABA-ergic synapses creating and excitatory/inhibitory imbalance that has also been observed in autism. A literature survey showed that multiple autism genes converge on APP processing and that many are able to increase sAPPalpha at the expense of beta-amyloid production. A genetically programmed tilt of this axis towards an overproduction of neurotrophic/gliotrophic sAPPalpha and underproduction of antimicrobial beta-amyloid may explain the brain overgrowth and myelination dysfunction, as well as the involvement of pathogens in autism.
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Affiliation(s)
- C J Carter
- PolygenicPathways, 41C Marina, Saint Leonard's on Sea, TN38 0BU, East Sussex, UK.
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25
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Wang M, Zhou J, He F, Cai C, Wang H, Wang Y, Lin Y, Rong H, Cheng G, Xu R, Zhou W. Alteration of gut microbiota-associated epitopes in children with autism spectrum disorders. Brain Behav Immun 2019; 75:192-199. [PMID: 30394313 DOI: 10.1016/j.bbi.2018.10.006] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 09/18/2018] [Accepted: 10/23/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) affects 1% of children and has no cure. Gastrointestinal (GI) problems are common in children with ASD, and although gut microbiota is known to play an important role in ASD through the gut-brain axis, the specific mechanism is unknown. Recent evidence suggests that gut microbiota may participate in the pathogenesis of ASD through immune- and inflammation-mediated pathways. Here, we identified potentially immunogenic epitopes derived from gut microbiota in stool samples from ASD children with and without GI problems and typically developing (TD) children. METHODS Candidate gut microbiota-associated epitopes (MEs) were identified by blast shotgun metagenomic sequencing of fecal samples from 43 ASD children (19 with and 24 without GI involvement) and 31 sex- and age-matched typically developing (TD) children. Potentially immunogenic epitopes were screened against a predictive human Immune Epitope Database. The composition and abundance of candidate MEs were compared between the three groups of children. RESULTS MEs identified in ASD children with GI problems were significantly more diverse than those in TD children. ME composition could discriminate between the three groups of children. We identified 34 MEs that were significantly more or less abundant in ASD children than TD children, most (29/34) of the differences in MEs were reduced in ASD and associated with abnormal gut IgA level and altered gut microbiota composition, these MEs were limited effected by clinical factors such as age, gender, and GI problems, of which eleven MEs were pathogenic microorganisms peptides with strong T or B cell response, nine MEs showed high homology to peptides from human self proteins associated with autoimmune disease occurrence, eliciting immune attack against hematopoietic stem cells and inhibition antigen binding. We also found that the abundance of five MEs were increased in ASD, including three human self proteins, gap junction alpha-1 (GJA1), paired box protein Pax-3 (PAX3) and eyes absent homolog 1 isoform 4 (EYA1) which associated with cancer, and a ME with homology to a Listeriolysin O peptide from the pathogenic bacterium Listeria monocytogenes was significantly increased in ASD children compared with TD children. CONCLUSIONS Our findings demonstrate the abnormal of MEs composition in the gut of children with ASD, moreover, the abnormality in MEs composition was associated with abnormal gut IgA levels and altered gut microbiota composition, this abnormality also suggests that there may be abnormalities in intestinal immunity in children with ASD; In all, thirty-four MEs identified were potential biomarker of ASD, and alterations in MEs may contribute to abnormalities in gut immunity and/or homeostasis in ASD children. Further study of the MEs identified here may advance our understanding of the pathogenesis of ASD.
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Affiliation(s)
- Mingbang Wang
- Shanghai Key Laboratory of Birth Defects, Division of Neonatology, Xiamen Branch of Children's Hospital of Fudan University (Xiamen Children's Hospital), Children's Hospital of Fudan University, National Center for Children's Health, Shanghai 201102, China.
| | - Jiaxiu Zhou
- Division of Psychology, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Fusheng He
- Imunobio, Shenzhen, Guangdong 518001, China
| | - Chunquan Cai
- Division of Neurosurgery, Tianjin Children's Hospital, Tianjin 300134, China
| | - Hui Wang
- Xiamen Branch of Children's Hospital of Fudan University (Xiamen Children's Hospital), Xiamen, Fujian 361006, China
| | - Yan Wang
- Imunobio, Shenzhen, Guangdong 518001, China
| | - Yin Lin
- Division of Psychology, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Han Rong
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518020, China
| | - Guoqiang Cheng
- Division of Neonatology, Children's Hospital of Fudan University, National Center for Children's Health, Shanghai 201102, China
| | - Ruihuan Xu
- Clinical Laboratory, Longgang Central Hospital of Shenzhen, Guangdong 518116, China.
| | - Wenhao Zhou
- Shanghai Key Laboratory of Birth Defects, Division of Neonatology, Xiamen Branch of Children's Hospital of Fudan University (Xiamen Children's Hospital), Children's Hospital of Fudan University, National Center for Children's Health, Shanghai 201102, China.
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26
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Guidolin D, Fede C, Tortorella C. Nerve cells developmental processes and the dynamic role of cytokine signaling. Int J Dev Neurosci 2018; 77:3-17. [PMID: 30465872 DOI: 10.1016/j.ijdevneu.2018.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/13/2018] [Accepted: 11/14/2018] [Indexed: 12/14/2022] Open
Abstract
The stunning diversity of neurons and glial cells makes possible the higher functions of the central nervous system (CNS), allowing the organism to sense, interpret and respond appropriately to the external environment. This cellular diversity derives from a single primary progenitor cell type initiating lineage leading to the formation of both differentiated neurons and glial cells. The processes governing the differentiation of the progenitor pool of cells into mature nerve cells will be here briefly reviewed. They involve morphological transformations, specialized modes of cell division, migration, and controlled cell death, and are regulated through cell-cell interactions and cues provided by the extracellular matrix, as well as by humoral factors from the cerebrospinal fluid and the blood system. In this respect, a quite large body of studies have been focused on cytokines, proteins representing the main signaling network that coordinates immune defense and the maintenance of homeostasis. At the same time, they are deeply involved in CNS development as regulatory factors. This dual role in the nervous system appears of particular relevance for CNS pathology, since cytokine dysregulation (occurring as a consequence of maternal infection, exposure to environmental factors or prenatal hypoxia) can profoundly impact on neurodevelopment and likely influence the response of the adult tissue during neuroinflammatory events.
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Affiliation(s)
- Diego Guidolin
- Department of Neuroscience, University of Padova, via Gabelli 65, I-35121, Padova, Italy
| | - Caterina Fede
- Department of Neuroscience, University of Padova, via Gabelli 65, I-35121, Padova, Italy
| | - Cinzia Tortorella
- Department of Neuroscience, University of Padova, via Gabelli 65, I-35121, Padova, Italy
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Cattane N, Richetto J, Cattaneo A. Prenatal exposure to environmental insults and enhanced risk of developing Schizophrenia and Autism Spectrum Disorder: focus on biological pathways and epigenetic mechanisms. Neurosci Biobehav Rev 2018; 117:253-278. [PMID: 29981347 DOI: 10.1016/j.neubiorev.2018.07.001] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 06/11/2018] [Accepted: 07/01/2018] [Indexed: 12/15/2022]
Abstract
When considering neurodevelopmental disorders (NDDs), Schizophrenia (SZ) and Autism Spectrum Disorder (ASD) are considered to be among the most severe in term of prevalence, morbidity and impact on the society. Similar features and overlapping symptoms have been observed at multiple levels, suggesting common pathophysiological bases. Indeed, recent genome-wide association studies (GWAS) and epidemiological data report shared vulnerability genes and environmental triggers across the two disorders. In this review, we will discuss the possible biological mechanisms, including glutamatergic and GABAergic neurotransmissions, inflammatory signals and oxidative stress related systems, which are targeted by adverse environmental exposures and that have been associated with the development of SZ and ASD. We will also discuss the emerging role of the gut microbiome as possible interplay between environment, immune system and brain development. Finally, we will describe the involvement of epigenetic mechanisms in the maintenance of long-lasting effects of adverse environments early in life. This will allow us to better understand the pathophysiology of these NDDs, and also to identify novel targets for future treatment strategies.
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Affiliation(s)
- Nadia Cattane
- Biological Psychiatry Unit, IRCCS Fatebenefratelli San Giovanni di Dio, via Pilastroni 4, Brescia, Italy
| | - Juliet Richetto
- Institute of Pharmacology and Toxicology, University of Zurich-Vetsuisse, Zurich, Switzerland
| | - Annamaria Cattaneo
- Biological Psychiatry Unit, IRCCS Fatebenefratelli San Giovanni di Dio, via Pilastroni 4, Brescia, Italy; Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, 125 Coldharbour Lane, SE5 9NU, London, UK.
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Ellman LM, Murphy SK, Maxwell SD. Pre- and Perinatal Risk Factors for Serious Mental Disorders: Ethical Considerations in Prevention and Prediction Efforts. JOURNAL OF ETHICS IN MENTAL HEALTH 2018; 10:5. [PMID: 35309950 PMCID: PMC8932439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Repeated findings have linked pre- and perinatal risk factors to a variety of mental disorders. Some studies have found large magnitudes of association, suggesting that fetal development represents an important period for understanding neurodevelopmental sequelae. Nevertheless, it remains unclear how best to translate the existing findings into early identification, prevention, and treatment strategies that would be useful for pregnant populations and/or for their offspring. This article will discuss key ethical considerations surrounding the incorporation of findings from studies of the associations between obstetric complications and risk for mental disorders into prevention and prediction efforts.
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Affiliation(s)
- Lauren M Ellman
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Shannon K Murphy
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Seth D Maxwell
- Department of Psychology, Temple University, Philadelphia, PA, USA
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Bilbo SD, Block CL, Bolton JL, Hanamsagar R, Tran PK. Beyond infection - Maternal immune activation by environmental factors, microglial development, and relevance for autism spectrum disorders. Exp Neurol 2017; 299:241-251. [PMID: 28698032 DOI: 10.1016/j.expneurol.2017.07.002] [Citation(s) in RCA: 196] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 06/26/2017] [Accepted: 07/05/2017] [Indexed: 12/17/2022]
Abstract
Immune molecules such as cytokines and chemokines and the cells that produce them within the brain, notably microglia, are critical for normal brain development. This recognition has in recent years led to the working hypothesis that inflammatory events during pregnancy, e.g. in response to infection, may disrupt the normal expression of immune molecules during critical stages of neural development and thereby contribute to the risk for neurodevelopmental disorders such as autism spectrum disorder (ASD). This hypothesis has in large part been shepherded by the work of Dr. Paul Patterson and colleagues, which has elegantly demonstrated that a single viral infection or injection of a viral mimetic to pregnant mice significantly and persistently impacts offspring immune and nervous system function, changes that underlie ASD-like behavioral dysfunction including social and communication deficits. Subsequent studies by many labs - in humans and in non-human animal models - have supported the hypothesis that ongoing disrupted immune molecule expression and/or neuroinflammation contributes to at least a significant subset of ASD. The heterogeneous clinical and biological phenotypes observed in ASD strongly suggest that in genetically susceptible individuals, environmental risk factors combine or synergize to create a tipping or threshold point for dysfunction. Importantly, animal studies showing a link between maternal immune activation (MIA) and ASD-like outcomes in offspring involve different species and diverse environmental factors associated with ASD in humans, beyond infection, including toxin exposures, maternal stress, and maternal obesity, all of which impact inflammatory or immune pathways. The goal of this review is to highlight the broader implications of Dr. Patterson's work for the field of autism, with a focus on the impact that MIA by diverse environmental factors has on fetal brain development, immune system development, and the pathophysiology of ASD.
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Affiliation(s)
- Staci D Bilbo
- Pediatrics and Neuroscience, Harvard Medical School, Lurie Center for Autism, Massachusetts General Hospital for Children, Boston, MA 02126, United States.
| | - Carina L Block
- Psychology and Neuroscience, Duke University, Durham, NC 27708, United States
| | - Jessica L Bolton
- Pediatrics and Anatomy/Neurobiology, University of California-Irvine, Irvine, CA 92697, United States
| | - Richa Hanamsagar
- Pediatrics and Neuroscience, Harvard Medical School, Lurie Center for Autism, Massachusetts General Hospital for Children, Boston, MA 02126, United States
| | - Phuong K Tran
- Pediatrics and Neuroscience, Harvard Medical School, Lurie Center for Autism, Massachusetts General Hospital for Children, Boston, MA 02126, United States
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