1
|
Pollak A. 40 years neonatology : An academic life. Wien Klin Wochenschr 2024:10.1007/s00508-024-02360-2. [PMID: 38634910 DOI: 10.1007/s00508-024-02360-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND A complete review of the development of neonatology in the last 40 years would probably require a compendium with several volumes, to bring to view the remarkable improvements in survival rates and neurodevelopmental outcomes of ill babies in Austria, most industrial countries and to some extent worldwide. The challenge I had to solve here was to integrate my own contributions to the field of neonatology during this period and particularly the contributions of my team from the Division of Neonatology and Pediatric Intensive Care Medicine, Department of Pediatrics and Adolescence Medicine, Medical University Vienna where I was working first as an intern and resident and later had the privilege to become head of department. AIM This very personal review was conceived to showcase the milestones of neonatology where, in my opinion, our department made some meaningful contributions in research and clinical practice during the past 40 years. METHODS A total of 10 areas of interest were selected which most likely influenced survival rates of preterm infants born at increasingly younger gestational ages and ameliorated long-term clinical and neurodevelopmental outcomes, including: 1) Construction and continuous modernization of neonatal intensive care units (NICUs). 2) Installation of the "Regionalization Program for NICUs in Vienna". 3) Treatment of respiratory distress syndrome (RDS) of premature babies. 4) Fine tuning of glucose metabolism for growth and outcome. 5) Neurodevelopmental care. 6) Neonatal hematology. 7) Infection control. 8) The toxoplasma screening program. 9) The newborn screening program. 10) Quality control: the Vermont Oxford Neonatal Network (VONN). RESULTS Over the past four decades advancements in research and technology have allowed a transformative development of neonatal medicine. Survival rates without increased morbidity for very premature infants with gestational ages reaching to what we consider nowadays the border of viability have constantly increased. In my professional life as a neonatologist in Austria I have had the possibility to support and shape some of these developments together with my team. CONCLUSION As we look ahead it is imperative to build upon the progress made, harnessing the power of science and technology to further improve the survival and quality of life for preterm infants in Austria and worldwide. At the same time, neonatology must continue to prioritize ethical reflection and education, fostering a culture of integrity, interdisciplinary collaboration, and the development of guidelines and protocols that uphold ethical standards while addressing the evolving needs and complexities of neonatal medicine.
Collapse
Affiliation(s)
- Arnold Pollak
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care Medicine and Neuropediatrics, Medical University of Vienna, Vienna, Austria.
| |
Collapse
|
2
|
Zhao XY, Lempke SL, Urbán Arroyo JC, Brown IG, Yin B, Magaj MM, Holness NK, Smiley J, Redemann S, Ewald SE. iNOS is necessary for GBP-mediated T. gondii clearance in murine macrophages via vacuole nitration and intravacuolar network collapse. Nat Commun 2024; 15:2698. [PMID: 38538595 PMCID: PMC10973475 DOI: 10.1038/s41467-024-46790-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 03/04/2024] [Indexed: 04/02/2024] Open
Abstract
Toxoplasma gondii is an obligate intracellular parasite of rodents and humans. Interferon-inducible guanylate binding proteins (GBPs) are mediators of T. gondii clearance, however, this mechanism is incomplete. Here, using automated spatially targeted optical micro proteomics we demonstrate that inducible nitric oxide synthetase (iNOS) is highly enriched at GBP2+ parasitophorous vacuoles (PV) in murine macrophages. iNOS expression in macrophages is necessary to limit T. gondii load in vivo and in vitro. Although iNOS activity is dispensable for GBP2 recruitment and PV membrane ruffling; parasites can replicate, egress and shed GBP2 when iNOS is inhibited. T. gondii clearance by iNOS requires nitric oxide, leading to nitration of the PV and collapse of the intravacuolar network of membranes in a chromosome 3 GBP-dependent manner. We conclude that reactive nitrogen species generated by iNOS cooperate with GBPs to target distinct structures in the PV that are necessary for optimal parasite clearance in macrophages.
Collapse
Affiliation(s)
- Xiao-Yu Zhao
- Department of Microbiology, Immunology, and Cancer Biology at the Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Samantha L Lempke
- Department of Microbiology, Immunology, and Cancer Biology at the Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Jan C Urbán Arroyo
- Department of Microbiology, Immunology, and Cancer Biology at the Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Isabel G Brown
- Department of Microbiology, Immunology, and Cancer Biology at the Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Bocheng Yin
- Department of Microbiology, Immunology, and Cancer Biology at the Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Magdalena M Magaj
- Center for Membrane and Cell Physiology, Department of Molecular Physiology and Biological Physics, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Nadia K Holness
- Department of Microbiology, Immunology, and Cancer Biology at the Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Jamison Smiley
- Department of Microbiology, Immunology, and Cancer Biology at the Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Stefanie Redemann
- Center for Membrane and Cell Physiology, Department of Molecular Physiology and Biological Physics, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Sarah E Ewald
- Department of Microbiology, Immunology, and Cancer Biology at the Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, USA.
| |
Collapse
|
3
|
Datta P, Garg P, Rattan D, Bagga R, Rohilla M, Khurana S, Sehgal R. Comparison of B1 and RE 529 gene targets by real time PCR and LAMP assay for diagnosis of toxoplasmosis in pregnant females. Indian J Med Microbiol 2024; 47:100481. [PMID: 37924678 DOI: 10.1016/j.ijmmb.2023.100481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 09/09/2023] [Accepted: 09/12/2023] [Indexed: 11/06/2023]
Abstract
PURPOSE The aim of this study is to accurately diagnose the presence of toxoplasmosis in pregnant women. In this study we evaluated two gene targets B1 and RE-529 using two different molecular methods i.e., real-time PCR and LAMP. PROCEDURE A total of 150 blood samples were collected from pregnant women attending the PGIMER outpatient clinic. The serum and Buffy layer were extracted and various serological (ELISA) and molecular tests (qPCR and LAMP) targeting B1 and RE-529 were carried out. FINDING Out of 150 patients, 32 were seropositive. Amongst which for the RE-529 gene, 18 were LAMP positive and 16 were qPCR positive, while for the B1 gene, 14 were LAMP positive and 13 were qPCR positive. CONCLUSIONS Molecular methods were more sensitive than serological tests to diagnose congenital toxoplasmosis in antenatal females. Few seronegative patients were reported positive using molecular methods. In addition, LAMP targeting the RE-529 gene is more sensitive than qPCR, and LAMP targets the B1 gene.
Collapse
Affiliation(s)
- Priya Datta
- Department of Medical Parasitology, PGIMER, Chandigarh, 160012, India.
| | - Puja Garg
- Department of Medical Parasitology, PGIMER, Chandigarh, 160012, India.
| | - Divya Rattan
- Department of Medical Parasitology, PGIMER, Chandigarh, 160012, India.
| | - Rashmi Bagga
- Department of Obstetrics and Gynaecology, PGIMER, Chandigarh, 160012, India.
| | - Minakshi Rohilla
- Department of Obstetrics and Gynaecology, PGIMER, Chandigarh, 160012, India.
| | - Sumeeta Khurana
- Department of Medical Parasitology, PGIMER, Chandigarh, 160012, India.
| | - Rakesh Sehgal
- Department of Medical Parasitology, PGIMER, Chandigarh, 160012, India.
| |
Collapse
|
4
|
Zhao XY, Lempke SL, Urbán Arroyo JC, Yin B, Holness NK, Smiley J, Ewald SE. Inducible nitric oxide synthase (iNOS) is necessary for GBP-mediated T. gondii restriction in murine macrophages via vacuole nitration and intravacuolar network collapse. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.24.549965. [PMID: 37546987 PMCID: PMC10402109 DOI: 10.1101/2023.07.24.549965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Toxoplasma gondii is an obligate intracellular, protozoan pathogen of rodents and humans. T. gondii's ability to grow within cells and evade cell-autonomous immunity depends on the integrity of the parasitophorous vacuole (PV). Interferon-inducible guanylate binding proteins (GBPs) are central mediators of T. gondii clearance, however, the precise mechanism linking GBP recruitment to the PV and T. gondii restriction is not clear. This knowledge gap is linked to heterogenous GBP-targeting across a population of vacuoles and the lack of tools to selectively purify the intact PV. To identify mediators of parasite clearance associated with GBP2-positive vacuoles, we employed a novel protein discovery tool automated spatially targeted optical micro proteomics (autoSTOMP). This approach identified inducible nitric oxide synthetase (iNOS) enriched at levels similar to the GBPs in infected bone marrow-derived myeloid cells. iNOS expression on myeloid cells was necessary for mice to control T. gondii growth in vivo and survive acute infection. T. gondii infection of IFNγ-primed macrophage was sufficient to robustly induce iNOS expression. iNOS restricted T. gondii infection through nitric oxide synthesis rather than arginine depletion, leading to robust and selective nitration of the PV. Optimal parasite restriction by iNOS and vacuole nitration depended on the chromosome 3 GBPs. Notably, GBP2 recruitment and ruffling of the PV membrane occurred in iNOS knockouts, however, these vacuoles contained dividing parasites. iNOS activity was necessary for the collapse of the intravacuolar network of nanotubular membranes which connects parasites to each other and the host cytosol. Based on these data we conclude reactive nitrogen species generated by iNOS cooperate with the chromosome 3 GBPs to target distinct biology of the PV that are necessary for optimal parasite clearance in murine myeloid cells.
Collapse
Affiliation(s)
- Xiao-Yu Zhao
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
- The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Samantha L. Lempke
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
- The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Jan C. Urbán Arroyo
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
- The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Bocheng Yin
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
- The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Nadia K. Holness
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
- The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Jamison Smiley
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
- The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Sarah E. Ewald
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
- The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| |
Collapse
|
5
|
Feng TY, Melchor SJ, Zhao XY, Ghumman H, Kester M, Fox TE, Ewald SE. Tricarboxylic acid (TCA) cycle, sphingolipid, and phosphatidylcholine metabolism are dysregulated in T. gondii infection-induced cachexia. Heliyon 2023; 9:e17411. [PMID: 37456044 PMCID: PMC10344712 DOI: 10.1016/j.heliyon.2023.e17411] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 06/15/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023] Open
Abstract
Cachexia is a life-threatening disease characterized by chronic, inflammatory muscle wasting and systemic metabolic impairment. Despite its high prevalence, there are no efficacious therapies for cachexia. Mice chronically infected with the protozoan parasite Toxoplasma gondii represent a novel animal model recapitulating the chronic kinetics of cachexia. To understand how perturbations to metabolic tissue homeostasis influence circulating metabolite availability we used mass spectrometry analysis. Despite the significant reduction in circulating triacylglycerides, non-esterified fatty acids, and glycerol, sphingolipid long-chain bases and a subset of phosphatidylcholines (PCs) were significantly increased in the sera of mice with T. gondii infection-induced cachexia. In addition, the TCA cycle intermediates α-ketoglutarate, 2-hydroxyglutarate, succinate, fumarate, and malate were highly depleted in cachectic mouse sera. Sphingolipids and their de novo synthesis precursors PCs are the major components of the mitochondrial membrane and regulate mitochondrial function consistent with a causal relationship in the energy imbalance driving T. gondii-induced chronic cachexia.
Collapse
Affiliation(s)
- Tzu-Yu Feng
- Department of Microbiology, Immunology, and Cancer Biology and The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | - Stephanie J. Melchor
- Department of Microbiology, Immunology, and Cancer Biology and The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | - Xiao-Yu Zhao
- Department of Microbiology, Immunology, and Cancer Biology and The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | - Haider Ghumman
- Department of Microbiology, Immunology, and Cancer Biology and The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | - Mark Kester
- Department of Pharmacology at the University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | - Todd E. Fox
- Department of Pharmacology at the University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | - Sarah E. Ewald
- Department of Microbiology, Immunology, and Cancer Biology and The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| |
Collapse
|
6
|
Souza JS, Farani PSG, Ferreira BIS, Barbosa HS, Menna-Barreto RFS, Moreira OC, Mariante RM. Establishment of a murine model of congenital toxoplasmosis and validation of a qPCR assay to assess the parasite load in maternal and fetal tissues. Front Microbiol 2023; 14:1124378. [PMID: 36922978 PMCID: PMC10009190 DOI: 10.3389/fmicb.2023.1124378] [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: 12/15/2022] [Accepted: 02/06/2023] [Indexed: 03/03/2023] Open
Abstract
Toxoplasma gondii is the causative agent of toxoplasmosis, a disease that affects warm-blooded animals and one third of the human population worldwide. Pregnant women who have never been exposed to the parasite constitute an important risk group, as infection during pregnancy often leads to congenital toxoplasmosis, the most severe form of the disease. Current therapy for toxoplasmosis is the same as it was 50 years ago and has little or no effect when vertical transmission occurs. Therefore, it is urgent to develop new strategies to prevent mother-to-fetus transmission. The implementation of experimental animal models of congenital toxoplasmosis that reproduces the transmission rates and clinical signs in humans opens an avenue of possibilities to interfere in the progression of the disease. In addition, knowing the parasite load in maternal and fetal tissues after infection, which may be related to organ abnormalities and disease outcome, is another important step in designing a promising intervention strategy. Therefore, we implemented here a murine model of congenital toxoplasmosis with outbred Swiss Webster mice infected intravenously with tachyzoites of the ME49 strain of T. gondii that mimics the frequency of transmission of the parasite, as well as important clinical signs of human congenital toxoplasmosis, such as macrocephaly, in addition to providing a highly sensitive quantitative real-time PCR assay to assess parasite load in mouse tissues. As the disease is not restricted to humans, also affecting several domestic animals, including companion animals and livestock, they can also benefit from the model presented in this study.
Collapse
Affiliation(s)
- Jéssica S Souza
- Laboratório de Biologia Estrutural, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
| | - Priscila S G Farani
- Plataforma de PCR em Tempo Real RPT09A, Laboratório de Virologia Molecular, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil.,Department of Biological Science, Border Biomedical Research Center, The University of Texas at El Paso, El Paso, TX, United States
| | - Beatriz I S Ferreira
- Plataforma de PCR em Tempo Real RPT09A, Laboratório de Virologia Molecular, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
| | - Helene S Barbosa
- Laboratório de Biologia Estrutural, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
| | | | - Otacilio C Moreira
- Plataforma de PCR em Tempo Real RPT09A, Laboratório de Virologia Molecular, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
| | - Rafael M Mariante
- Laboratório de Biologia Estrutural, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
| |
Collapse
|
7
|
Amouei A, Sarvi S, Mizani A, Hashemi-Soteh MB, Salehi S, Javidnia J, Hosseini SA, Amuei F, Alizadeh A, Shabanzade S, Gholami S, Daryani A. Genetic characterization of Toxoplasma gondii in meat-producing animals in Iran. Parasit Vectors 2022; 15:255. [PMID: 35821057 PMCID: PMC9277799 DOI: 10.1186/s13071-022-05360-1] [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: 03/07/2022] [Accepted: 06/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The consumption of uncooked or undercooked food from infected intermediate hosts can result in Toxoplasma gondii infection in humans. However, few studies have investigated the genetic diversity of this protozoan parasite in Iran. The aim of the present study was to genetically characterize isolates of T. gondii from intermediate host animals in Mazandaran Province, Iran. METHODS Blood and heart tissue samples were collected from 204 ruminants, and brain tissue was collected from 335 birds. The prevalence of T. gondii infection in these samples was determined serologically using the modified agglutination test and by conventional PCR assays. Those PCR samples positive for T. gondii DNA and 13 DNA samples extracted from aborted fetuses in a previous study were genotyped with 12 genetic markers using the multilocus-nested PCR-restriction fragment length polymorphism (Mn-PCR-RFLP) technique. RESULTS Antibodies for parasites were found in 35.7% of the ruminant (39.1% of sheep and 26.4% of goats) samples and in 51.3% of the bird (100% of geese, 52.3% of free-range chickens and 46% of ducks) samples. Molecular detection by PCR of the repetitive 529-bp DNA fragment revealed contamination of 13.2% of ruminant (14.6% of sheep and 9.4% of goats) samples and of 9.6% of bird (11.1% of chickens, 5.7% of ducks and 0% of geese samples). The results from 30 DNA samples revealed five ToxoDB (genome database for the genus Toxoplasma) PCR-RFLP genotypes, including #1 (Type II), #2 (Type III), #10 (Type I), #27 and #48, with genotype #1 the most predominant. CONCLUSIONS As evidenced by the results of this study, ruminants and birds are infected with T. gondii in the region, suggesting that they are likely to be involved in the transmission of T. gondii to humans through meat consumption. The identification of different genotypes may suggest a higher genetic diversity of this parasite in Mazandaran, reflecting local environmental contamination. These results have important public health implications for the prevention and control strategies of infection.
Collapse
Affiliation(s)
- Afsaneh Amouei
- Toxoplasmosis Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Parasitology, School of Medicine, Mazandaran University of Medical Science, Sari, 4847191971, Mazandaran, Iran
| | - Shahabeddin Sarvi
- Toxoplasmosis Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Parasitology, School of Medicine, Mazandaran University of Medical Science, Sari, 4847191971, Mazandaran, Iran
| | - Azadeh Mizani
- Department of Parasitology, Pasteur Institute of Iran, Tehran, Iran
| | - Mohammad Bagher Hashemi-Soteh
- Department of Clinical Biochemistry and Genetics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Saeid Salehi
- Mazandaran Provincial Veterinary Department of Medical Sciences, Sari, Iran
| | - Javad Javidnia
- Department of Mycology, School of Medicine, Mazandaran University of Medical Science, Sari, Iran
| | - Seyed Abdollah Hosseini
- Toxoplasmosis Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Parasitology, School of Medicine, Mazandaran University of Medical Science, Sari, 4847191971, Mazandaran, Iran
| | - Fateme Amuei
- Department of Organic Chemistry, University of Mazandaran, Babolsar, Iran
| | - Ahad Alizadeh
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Shafigheh Shabanzade
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Science, Shiraz, Iran
| | - Sara Gholami
- Department of Parasitology, School of Medicine, Mazandaran University of Medical Science, Sari, 4847191971, Mazandaran, Iran
| | - Ahmad Daryani
- Toxoplasmosis Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran. .,Department of Parasitology, School of Medicine, Mazandaran University of Medical Science, Sari, 4847191971, Mazandaran, Iran.
| |
Collapse
|
8
|
Robert MG, Brenier-Pinchart MP, Garnaud C, Fricker-Hidalgo H, Pelloux H. Molecular diagnosis of toxoplasmosis: recent advances and a look to the future. Expert Rev Anti Infect Ther 2021; 19:1529-1542. [PMID: 34112045 DOI: 10.1080/14787210.2021.1941867] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Toxoplasmosis is a globally distributed parasitic infection that can be particularly severe when opportunistic or congenital. Its diagnosis requires accurate and rapid techniques that rely mainly on serology and molecular methods. AREAS COVERED The aim of this review was to discuss the positioning of the molecular diagnosis of toxoplasmosis according to the different clinical situations possibly resulting from infection with T. gondii, and to detail recent developments in this technique. The English and French literature were searched with the following keywords: 'Toxoplasmosis', "Molecular diagnosis" and 'PCR'. EXPERT OPINION Molecular techniques have revolutionized the diagnosis of toxoplasmosis, and practices have considerably evolved over the past decades. However, there is still a high degree of inter-laboratory heterogeneity which impairs comparisons between results and studies. Efforts to standardize practices are underway.
Collapse
Affiliation(s)
- Marie Gladys Robert
- Service de Parasitologie-Mycologie, CHU Grenoble Alpes, Grenoble, France.,Université Grenoble Alpes, Institut pour l'Avancée des Biosciences (IAB), Grenoble, France
| | - Marie-Pierre Brenier-Pinchart
- Service de Parasitologie-Mycologie, CHU Grenoble Alpes, Grenoble, France.,Université Grenoble Alpes, Institut pour l'Avancée des Biosciences (IAB), Grenoble, France.,Centre National de Référence Toxoplasmose - Pôle Biologie Moléculaire, France
| | - Cécile Garnaud
- Service de Parasitologie-Mycologie, CHU Grenoble Alpes, Grenoble, France.,Université Grenoble Alpes, CNRS, CHU Grenoble Alpes, Grenoble INP, TIMC-IMAG, Grenoble, France
| | | | - Hervé Pelloux
- Service de Parasitologie-Mycologie, CHU Grenoble Alpes, Grenoble, France.,Université Grenoble Alpes, Institut pour l'Avancée des Biosciences (IAB), Grenoble, France.,Centre National de Référence Toxoplasmose - Pôle Biologie Moléculaire, France
| |
Collapse
|
9
|
Gaulin C, Ramsay D, Thivierge K, Tataryn J, Courville A, Martin C, Cunningham P, Désilets J, Morin D, Dion R. Acute Toxoplasmosis among Canadian Deer Hunters Associated with Consumption of Undercooked Deer Meat Hunted in the United States. Emerg Infect Dis 2021; 26:199-205. [PMID: 31961291 PMCID: PMC6986818 DOI: 10.3201/eid2602.191218] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Health professionals should be aware that such outbreaks might be more common in the future We conducted a recent investigation in Quebec, Canada, concerning Canadian deer hunters who went to the United States to hunt deer and returned with symptoms of fever, severe headache, myalgia, and articular pain of undetermined etiology. Further investigation identified that a group of 10 hunters from Quebec attended a hunting retreat in Illinois (USA) during November 22–December 4, 2018. Six of the 10 hunters had similar symptoms and illness onset dates. Serologic tests indicated a recent toxoplasmosis infection for all symptomatic hunters, and the risk factor identified was consumption of undercooked deer meat. Among asymptomatic hunters, 2 were already immune to toxoplasmosis, 1 was not immune, and the immune status of 1 remains unknown. Outbreaks of acute toxoplasmosis infection are rare in North America, but physicians should be aware that such outbreaks could become more common.
Collapse
|
10
|
Hosseini-Safa A, Shojaee S, Salami SA, Mohebali M, Hantoushzadeh S, Mousavi P, Dehghan Manshadi SA, Keshavarz Valian H. Development of High Resolution Melting Analysis as a Diagnostic Tool for Molecular Detection of Toxoplasma Infection in Pregnant Women and HIV Positive Cases. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:1983-1991. [PMID: 33346240 PMCID: PMC7719646 DOI: 10.18502/ijph.v49i10.4704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Toxoplasma gondii is an obligate intracellular protozoan with worldwide distribution. Diagnosis of toxoplasmosis is a very critical issue, especially in pregnant women and immunocompromised patients. The aim of this study was rapid detection of T. gondii DNA in peripheral blood samples (PBS) employing HRM technique and using RE gene. Methods Totally, 242 samples from pregnant women and human immunodeficiency virus (HIV) patients were collected from different hospitals and medical centers of Tehran during Oct 2017 to Dec 2018. High resolution melting analysis (HRM) using partial sequences of repetitive element (RE) gene was done and compared with ELISA test. Results Overall, 51 were positive for acute toxoplasmosis that among them, 12 and 20 reported as positive in pregnant women and HIV+ patients, respectively using HRM technique. Among 70 patients in chronic phase of disease, 10 and 3 samples were reported as positive for pregnant women and HIV+ patients respectively. From 121 negative control, 3 (4.62%) samples associated with HIV+ patients, showed positive real-time PCR and HRM analysis results. Conclusion For the first time, HRM technique via employing RE gene was used for detection of T. gondii infection in PBS. This method is suitable, helpful and in parallel with serological methods for early diagnosis of acute as well as active form of toxoplasmosis in pregnant women and HIV+ patients. The use of techniques based on melt curve and through employing next-generation dyes for diagnosis of T. gondii would be accessible for patients in developing countries.
Collapse
Affiliation(s)
- Ahmad Hosseini-Safa
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeedeh Shojaee
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Alireza Salami
- Department Biotechnology, School of Agricultural Sciences and Engineering, University of Tehran, Tehran, Iran
| | - Mehdi Mohebali
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
| | - Sedigheh Hantoushzadeh
- Maternal, Fetal and Neonatal Research Center, Vali-Asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Parisa Mousavi
- Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Ali Dehghan Manshadi
- Department of Infectious Diseases and Tropical Medicine and Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Keshavarz Valian
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
11
|
Melchor SJ, Hatter JA, Castillo ÉAL, Saunders CM, Byrnes KA, Sanders I, Abebayehu D, Barker TH, Ewald SE. T. gondii infection induces IL-1R dependent chronic cachexia and perivascular fibrosis in the liver and skeletal muscle. Sci Rep 2020; 10:15724. [PMID: 32973293 PMCID: PMC7515928 DOI: 10.1038/s41598-020-72767-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/03/2020] [Indexed: 02/06/2023] Open
Abstract
Cachexia is a progressive muscle wasting disease that contributes to death in a wide range of chronic diseases. Currently, the cachexia field lacks animal models that recapitulate the long-term kinetics of clinical disease, which would provide insight into the pathophysiology of chronic cachexia and a tool to test therapeutics for disease reversal. Toxoplasma gondii (T. gondii) is a protozoan parasite that uses conserved mechanisms to infect rodents and human hosts. Infection is lifelong and has been associated with chronic weight loss and muscle atrophy in mice. We have recently shown that T. gondii-induced muscle atrophy meets the clinical definition of cachexia. Here, the longevity of the T. gondii-induced chronic cachexia model revealed that cachectic mice develop perivascular fibrosis in major metabolic organs, including the adipose tissue, skeletal muscle, and liver by 9 weeks post-infection. Development of cachexia, as well as liver and skeletal muscle fibrosis, is dependent on intact signaling through the type I IL-1R receptor. IL-1α is sufficient to activate cultured fibroblasts and primary hepatic stellate cells (myofibroblast precursors in the liver) in vitro, and IL-1α is elevated in the sera and liver of cachectic, suggesting a mechanism by which chronic IL-1R signaling could be leading to cachexia-associated fibrosis.
Collapse
Affiliation(s)
- Stephanie J Melchor
- Department of Microbiology, Immunology, and Cancer Biology and The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Jessica A Hatter
- Department of Pharmacology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | | | - Claire M Saunders
- Department of Microbiology, Immunology, and Cancer Biology and The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Kari A Byrnes
- Department of Microbiology, Immunology, and Cancer Biology and The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Imani Sanders
- Department of Microbiology, Immunology, and Cancer Biology and The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Daniel Abebayehu
- Department of Biomedical Engineering, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Thomas H Barker
- Department of Biomedical Engineering, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Sarah E Ewald
- Department of Microbiology, Immunology, and Cancer Biology and The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, USA.
| |
Collapse
|
12
|
Pineda CO, Leal DAG, Fiuza VRDS, Jose J, Borelli G, Durigan M, Pena HFJ, Bueno Franco RM. Toxoplasma
gondii
oocysts,
Giardia
cysts and
Cryptosporidium
oocysts in outdoor swimming pools in Brazil. Zoonoses Public Health 2020; 67:785-795. [DOI: 10.1111/zph.12757] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 07/07/2020] [Accepted: 07/10/2020] [Indexed: 02/02/2023]
Affiliation(s)
- Carolina Ortiz Pineda
- Laboratório de Protozoologia Departamento de Biologia Animal Instituto de Biologia Universidade Estadual de Campinas (UNICAMP) Campinas Brazil
| | - Diego Averaldo Guiguet Leal
- Laboratório de Parasitologia Ambiental Departamento de Patologia Básica, Setor de Ciências Biológicas Universidade Federal do Paraná (UFPR) Curitiba Brazil
| | - Vagner Ricardo da Silva Fiuza
- Instituto de Biociências, Parasitologia Animal Universidade Federal do Mato Grosso do Sul (UFMS) Campo Grande Brazil
| | - Juliana Jose
- Laboratório de Genômica e Expressão Departamento de Genética Evolução e Bioagentes Instituto de Biologia Universidade Estadual de Campinas (UNICAMP) Campinas Brazil
| | - Guilherme Borelli
- Laboratório de Genômica e Expressão Departamento de Genética Evolução e Bioagentes Instituto de Biologia Universidade Estadual de Campinas (UNICAMP) Campinas Brazil
| | | | - Hilda Fátima Jesus Pena
- Laboratório de Doenças Parasitárias Departamento de Medicina Veterinária Preventiva e Saúde Animal Faculdade de Medicina Veterinária e Zootecnia Universidade de São Paulo (USP) São Paulo Brazil
| | - Regina Maura Bueno Franco
- Laboratório de Protozoologia Departamento de Biologia Animal Instituto de Biologia Universidade Estadual de Campinas (UNICAMP) Campinas Brazil
| |
Collapse
|
13
|
Melchor SJ, Saunders CM, Sanders I, Hatter JA, Byrnes KA, Coutermarsh-Ott S, Ewald SE. IL-1R Regulates Disease Tolerance and Cachexia in Toxoplasma gondii Infection. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2020; 204:3329-3338. [PMID: 32350081 PMCID: PMC7323938 DOI: 10.4049/jimmunol.2000159] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 04/01/2020] [Indexed: 12/19/2022]
Abstract
Toxoplasma gondii is an obligate intracellular parasite that establishes life-long infection in a wide range of hosts, including humans and rodents. To establish a chronic infection, pathogens often exploit the trade-off between resistance mechanisms, which promote inflammation and kill microbes, and tolerance mechanisms, which mitigate inflammatory stress. Signaling through the type I IL-1R has recently been shown to control disease tolerance pathways in endotoxemia and Salmonella infection. However, the role of the IL-1 axis in T. gondii infection is unclear. In this study we show that IL-1R-/- mice can control T. gondii burden throughout infection. Compared with wild-type mice, IL-1R-/- mice have more severe liver and adipose tissue pathology during acute infection, consistent with a role in acute disease tolerance. Surprisingly, IL-1R-/- mice had better long-term survival than wild-type mice during chronic infection. This was due to the ability of IL-1R-/- mice to recover from cachexia, an immune-metabolic disease of muscle wasting that impairs fitness of wild-type mice. Together, our data indicate a role for IL-1R as a regulator of host homeostasis and point to cachexia as a cost of long-term reliance on IL-1-mediated tolerance mechanisms.
Collapse
Affiliation(s)
- Stephanie J Melchor
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, VA 22908
- The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA 22908
| | - Claire M Saunders
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, VA 22908
- The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA 22908
| | - Imani Sanders
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, VA 22908
- The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA 22908
| | - Jessica A Hatter
- Department of Pharmacology, University of Virginia School of Medicine, Charlottesville, VA 22908; and
| | - Kari A Byrnes
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, VA 22908
- The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA 22908
| | - Sheryl Coutermarsh-Ott
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA 24060
| | - Sarah E Ewald
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, VA 22908;
- The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA 22908
| |
Collapse
|
14
|
Döşkaya M, Pullukçu H, Karakavuk M, Şahar EA, Taşbakan MS, Taşbakan MI, Yılmaz M, Can H, Döşkaya AD, Gürüz AY. Comparison of an in house and a commercial real-time polymerase chain reaction targeting Toxoplasma gondii RE gene using various samples collected from patients in Turkey. BMC Infect Dis 2019; 19:1042. [PMID: 31823777 PMCID: PMC6902542 DOI: 10.1186/s12879-019-4666-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 11/29/2019] [Indexed: 02/07/2023] Open
Abstract
Background Toxoplasma gondii is an opportunistic protozoan parasite that can infect all warm-blooded animals including humans and cause serious clinical manifestations. Toxoplasmosis can be diagnosed using histological, serological, and molecular methods. In this study, we aimed to detect T. gondii RE gene in various human samples by in house and commercial real time polymerase chain reactions. Methods A total of 38 suspected cases of toxoplasmosis [peripheral blood (n:12), amnion fluid (n:11), tissue (n:9), cerebrospinal fluid (n:5), and intraocular fluid (n:1)] were included to the study. An in house and a commercial RT-PCR were applied to investigate the T. gondii RE gene in these samples. Results The compatibility rate of the two tests was 94.7% (37/38). When the commercial RT-PCR kit was taken as reference, the sensitivity and specificity of in house RT-PCR test was 87.5 and 100%. When the in house RT-PCR test was taken as reference, the commercial RT-PCR kit has 100% sensitivity and 96.8% specificity. Incompatibility was detected in only in a buffy coat sample with high protein content. Conclusions Both the commercial and in house RT-PCR tests can be used to investigate T. gondii RE gene in various clinical specimens with their high sensitivity and specificity. In house RT-PCR assay can be favorable due to cost savings compared to using the commercial test.
Collapse
Affiliation(s)
- Mert Döşkaya
- Department of Parasitology, Ege University Faculty of Medicine, 35100, İzmir, Bornova, Turkey
| | - Hüsnü Pullukçu
- Department of Infectious Diseases, Ege University Faculty of Medicine, İzmir, Bornova, Turkey
| | - Muhammet Karakavuk
- Department of Parasitology, Ege University Faculty of Medicine, 35100, İzmir, Bornova, Turkey.,Ege University, Ödemiș Vocational High School, İzmir, Ödemiș, Turkey
| | - Esra Atalay Şahar
- Department of Parasitology, Ege University Faculty of Medicine, 35100, İzmir, Bornova, Turkey.,Department of Biotechnology, Ege University Faculty of Engineering, İzmir, Bornova, Turkey
| | - Mehmet Sezai Taşbakan
- Department of Chest Diseases, Ege University Faculty of Medicine, İzmir, Bornova, Turkey
| | - Meltem Işıkgöz Taşbakan
- Department of Infectious Diseases, Ege University Faculty of Medicine, İzmir, Bornova, Turkey
| | - Mümtaz Yılmaz
- Department of Internal Medicine, Ege University Faculty of Medicine, İzmir, Bornova, Turkey
| | - Hüseyin Can
- Department of Biology, Molecular Biology Section, Ege University Faculty of Sciences, İzmir, Bornova, Turkey
| | - Aysu Değirmenci Döşkaya
- Department of Parasitology, Ege University Faculty of Medicine, 35100, İzmir, Bornova, Turkey.
| | - Adnan Yüksel Gürüz
- Department of Parasitology, Ege University Faculty of Medicine, 35100, İzmir, Bornova, Turkey
| |
Collapse
|
15
|
Coupe A, Howe L, Shapiro K, Roe WD. Comparison of PCR assays to detect Toxoplasma gondii oocysts in green-lipped mussels (Perna canaliculus). Parasitol Res 2019; 118:2389-2398. [PMID: 31197544 DOI: 10.1007/s00436-019-06357-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 05/16/2019] [Indexed: 12/17/2022]
Abstract
Toxoplasma gondii is recognised as an important pathogen in the marine environment, with oocysts carried to coastal waters in overland runoff. Currently, there are no standardised methods to detect T. gondii directly in seawater to assess the extent of marine ecosystem contamination, but filter-feeding shellfish may serve as biosentinels. A variety of PCR-based methods have been used to confirm presence of T. gondii DNA in marine shellfish; however, systematic investigations comparing molecular methods are scarce. The primary objective of this study was to evaluate analytical sensitivity and specificity of two nested-PCR (nPCR) assays targeting dhps and B1 genes and two real-time (qPCR) assays targeting the B1 gene and a 529-bp repetitive element (rep529), for detection of T. gondii. These assays were subsequently validated for T. gondii detection in green-lipped mussel (Perna canaliculus) haemolymph using oocyst spiking experiments. All assays could reliably detect 50 oocysts spiked into mussel haemolymph. The lowest limit of detection was 5 oocysts using qPCR assays, with the rep529 primers performing best, with good correlation between oocyst concentrations and Cq values, and acceptable efficiency. Assay specificity was evaluated by testing DNA from closely related protozoans, Hammondia hammondi, Neospora caninum, and Sarcocystis spp. Both nPCR assays were specific to T. gondii. Both qPCR assays cross-reacted with Sarcocystis spp. DNA, and the rep529 primers also cross-reacted with N. caninum DNA. These studies suggest that the rep529 qPCR assay may be preferable for future mussel studies, but direct sequencing is required for definitive confirmation of T. gondii DNA detection.
Collapse
Affiliation(s)
- Alicia Coupe
- Institute of Veterinary, Animal and Biomedical Sciences, College of Sciences, Massey University, Private Bag 11 - 222, Palmerston North, 4442, New Zealand. .,EpiCentre, Wool Building, University Avenue, Massey University Manawatū Campus, Palmerston North, New Zealand.
| | - Laryssa Howe
- Institute of Veterinary, Animal and Biomedical Sciences, College of Sciences, Massey University, Private Bag 11 - 222, Palmerston North, 4442, New Zealand
| | - Karen Shapiro
- One Health Institute and School of Veterinary Medicine, University of California, Davis, CA, USA.,Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Wendi D Roe
- Institute of Veterinary, Animal and Biomedical Sciences, College of Sciences, Massey University, Private Bag 11 - 222, Palmerston North, 4442, New Zealand
| |
Collapse
|
16
|
Dai F, Zhuo X, Kong Q, Du J, Yu H, Zhou S, Song X, Tong Q, Lou D, Lou Q, Lu L, Lv Y, Sa X, Lu S. Early Detection of Toxoplasma gondii Infection in Mongolian Gerbil by Quantitative Real-Time Pcr. J Parasitol 2019. [DOI: 10.1645/18-95] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Fangwei Dai
- Laboratory Animal Centre of Zhejiang Academy of Medical Sciences, Hangzhou, 310013, China
| | - Xunhui Zhuo
- Department of Immunity and Biochemistry, Institute of Parasitic Disease, Zhejiang Academy of Medical
| | - Qingming Kong
- Department of Immunity and Biochemistry, Institute of Parasitic Disease, Zhejiang Academy of Medical
| | - Jiangtao Du
- Laboratory Animal Centre of Zhejiang Academy of Medical Sciences, Hangzhou, 310013, China
| | - Haijie Yu
- Jiaxing Vocational Technical College, Jiaxing, China
| | - Shasang Zhou
- Laboratory Animal Centre of Zhejiang Academy of Medical Sciences, Hangzhou, 310013, China
| | - Xiaoming Song
- Laboratory Animal Centre of Hangzhou Normal University, Hangzhou, 310036, China
| | - Qunbo Tong
- Department of Immunity and Biochemistry, Institute of Parasitic Disease, Zhejiang Academy of Medical
| | - Di Lou
- Department of Immunity and Biochemistry, Institute of Parasitic Disease, Zhejiang Academy of Medical
| | - Qi Lou
- Laboratory Animal Centre of Zhejiang Academy of Medical Sciences, Hangzhou, 310013, China
| | - Lingqun Lu
- Laboratory Animal Centre of Zhejiang Academy of Medical Sciences, Hangzhou, 310013, China
| | - Yu Lv
- Laboratory Animal Centre of Zhejiang Academy of Medical Sciences, Hangzhou, 310013, China
| | - Xiaoying Sa
- Laboratory Animal Centre of Zhejiang Academy of Medical Sciences, Hangzhou, 310013, China
| | - Shaohong Lu
- Department of Immunity and Biochemistry, Institute of Parasitic Disease, Zhejiang Academy of Medical
| |
Collapse
|
17
|
Gomez CA, Sahoo MK, Kahn GY, Zhong L, Montoya JG, Pinsky BA, Doan T. Dual-target, real-time PCR for the diagnosis of intraocular Toxoplasma gondii infections. Br J Ophthalmol 2019; 103:569-572. [PMID: 30636207 PMCID: PMC6691874 DOI: 10.1136/bjophthalmol-2018-313064] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/25/2018] [Accepted: 11/14/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND Toxoplasma gondii is the most common infectious cause of posterior uveitis worldwide. Two multicopy targets (B1 and Rep529) are commonly used in T. gondii PCR assays, but studies evaluating these targets in ocular fluid samples are limited. Herein, we determine the analytical characteristics of a single-reaction, internally controlled, dual-target, real-time T. gondii PCR and evaluate the clinical performance of this assay in intraocular fluid samples obtained at a reference ophthalmologic centre in the USA. METHODS Lower limits of detection for the B1 and Rep529 components of the dual-target assay were determined using serial dilutions of cultured T. gondii strain Z185. The dual-target assay was then used to test 148 archived intraocular samples (132 vitreous,16 aqueous humour) collected at the Francis I. Proctor Foundation between January 2010 and December 2015 for testing by a nested, conventional PCR targeting the B1 gene. RESULTS The 95% lower limits of detection for the dual-target assay was determined to be 1.05 tachyzoites/mL for B1 and 0.83 tachyzoites/mL for Rep529. Using archived clinical intraocular specimens, the dual-target assay demonstrated 97.2% positive per cent agreement (n=35/36; 95% CI 83.7% to 99.9%) and 99.1% negative per cent agreement (n=111/112; 95% CI 94.4% to 100%) compared with the nested, conventional B1 PCR. CONCLUSION This single-reaction, internally controlled, dual-target (B1, Rep529) real-time PCR for the detection of T. gondii DNA in intraocular specimens demonstrated excellent agreement with nested, conventional, B1 PCR. The dual-target design may ensure T. gondii detection when variation is present in one of two target regions.
Collapse
Affiliation(s)
- Carlos A Gomez
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.,Palo Alto Medical Foundation Toxoplasma Serology Laboratory, National Reference Center for the Study and Diagnosis of Toxoplasmosis, Palo Alto, California, USA
| | - Malaya K Sahoo
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Ghazala Yasmeen Kahn
- Clinical Virology Laboratory, Stanford Health Care and Stanford Children's Health, Stanford, California, USA
| | - Lina Zhong
- F.I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA
| | - José G Montoya
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.,Palo Alto Medical Foundation Toxoplasma Serology Laboratory, National Reference Center for the Study and Diagnosis of Toxoplasmosis, Palo Alto, California, USA
| | - Benjamin A Pinsky
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA .,Department of Pathology, Stanford University School of Medicine, Stanford, California, USA.,Clinical Virology Laboratory, Stanford Health Care and Stanford Children's Health, Stanford, California, USA
| | - Thuy Doan
- F.I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.,Department of Ophthalmology, University of California, San Francisco, California, USA
| |
Collapse
|
18
|
Hatter JA, Kouche YM, Melchor SJ, Ng K, Bouley DM, Boothroyd JC, Ewald SE. Toxoplasma gondii infection triggers chronic cachexia and sustained commensal dysbiosis in mice. PLoS One 2018; 13:e0204895. [PMID: 30379866 PMCID: PMC6209157 DOI: 10.1371/journal.pone.0204895] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 09/13/2018] [Indexed: 01/14/2023] Open
Abstract
Toxoplasma gondii is a protozoan parasite with a predation-mediated transmission cycle between rodents and felines. Intermediate hosts acquire Toxoplasma by eating parasite cysts which invade the small intestine, disseminate systemically and finally establish host life-long chronic infection in brain and muscles. Here we show that Toxoplasma infection can trigger a severe form of sustained cachexia: a disease of progressive lean weight loss that is a causal predictor of mortality in cancer, chronic disease and many infections. Toxoplasma cachexia is characterized by acute anorexia, systemic inflammation and loss of 20% body mass. Although mice recover from symptoms of peak sickness, they fail to regain muscle mass or visceral adipose depots. We asked whether the damage to the intestinal microenvironment observed at acute time points was sustained in chronic infection and could thereby play a role in sustaining cachexia. We found that parasites replicate in the same region of the distal jejunum/proximal ileum throughout acute infection, inducing the development of secondary lymphoid structures and severe, regional inflammation. Small intestine pathology was resolved by 5 weeks post-infection. However, changes in the commensal populations, notably an outgrowth of Clostridia spp., were sustained in chronic infection. Importantly, uninfected animals co-housed with infected mice display similar changes in commensal microflora but never display symptoms of cachexia, indicating that altered commensals are not sufficient to explain the cachexia phenotype alone. These studies indicate that Toxoplasma infection is a novel and robust model to study the immune-metabolic interactions that contribute to chronic cachexia development, pathology and potential reversal.
Collapse
Affiliation(s)
- Jessica A. Hatter
- Department of Microbiology, Immunology and Cancer Biology and the Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, United States of America
| | - Yue Moi Kouche
- Department of Comparative Medicine, Stanford University, Stanford CA, United States of America
| | - Stephanie J. Melchor
- Department of Microbiology, Immunology and Cancer Biology and the Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, United States of America
| | - Katherine Ng
- Department of Microbiology and Immunology, Stanford University, Stanford CA, United States of America
| | - Donna M. Bouley
- Department of Comparative Medicine, Stanford University, Stanford CA, United States of America
| | - John C. Boothroyd
- Department of Microbiology and Immunology, Stanford University, Stanford CA, United States of America
| | - Sarah E. Ewald
- Department of Microbiology, Immunology and Cancer Biology and the Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, VA, United States of America
| |
Collapse
|
19
|
Khan K, Khan W. Congenital toxoplasmosis: An overview of the neurological and ocular manifestations. Parasitol Int 2018; 67:715-721. [PMID: 30041005 DOI: 10.1016/j.parint.2018.07.004] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 07/03/2018] [Accepted: 07/11/2018] [Indexed: 12/21/2022]
Abstract
Toxoplasma gondii is an obligate intracellular parasite which is known to infect one-third of the total world population chronically though it is asymptomatic in immunocompetent patients. However, in an immunocompromised patient or an infected fetus, it may cause devastating effects. The parasite may cross the placenta of an infected pregnant woman and probably infect the fetus congenitally. The severity of the infection depends on the gestational age at which the infection has occurred i.e., if it has occurred in the early phase, the rate of transmission is low but the severity is high if the fetus is infected and if it has occurred in the later phase then transmission rate is higher while the severity would be low. Congenital toxoplasmosis may result in non-specific consequences like abortion, intra-uterine growth restriction, jaundice, hepatosplenomegaly or even intra-uterine death. It may also result in neurological or ocular manifestations like intracranial calcifications, hydrocephalus or retinochoroiditis. The diagnosis may be done by serological screening of anti-Toxoplasma antibodies (IgM and IgG) while PCR of the amniotic fluid or the placenta is the confirmatory test. Acute or chronic infections may be differentiated by IgG avidity tests. The treatment regimens include spiramycin to prevent congenital transmission from an infected mother, pyrimethamine, sulfadoxine and folinic acid to treat the infected fetus, CSF shunting for the treatment of hydrocephalus and a combination of pyrimethamine, azithromycin, and corticosteroids for treating ocular toxoplasmosis.
Collapse
Affiliation(s)
- Khadija Khan
- Department of Zoology, Section of Parasitology, Aligarh Muslim University, India
| | - Wajihullah Khan
- Department of Zoology, Section of Parasitology, Aligarh Muslim University, India.
| |
Collapse
|
20
|
Abstract
PURPOSE OF REVIEW Toxoplasmosis in immunocompromised patients is associated with a high mortality rate. Molecular techniques are important tools to diagnose acute disease in immunocompromised patients, but there are various methods with variable efficiency. Some of them have been validated for the diagnosis of congenital toxoplasmosis, but the impact of their use has not been evaluated in immunocompromised patients. RECENT FINDINGS Toxoplasmosis is of increasing importance in non-HIV immunocompromised patients. In addition, the picture of disease shows greater severity in South America, both in immunocompetent study participants and in congenitally infected infants. These epidemiological differences could influence the sensitivity of diagnostic methods. This review analyzes recent data on molecular diagnosis and compares them with older ones, in light of progress gained in molecular techniques and of recent epidemiological findings. Most recent studies were conducted in South America and used PCR targeting the B1 gene. PCR on blood could allow diagnosing a significant proportion of patients with ocular toxoplasmosis in Brazil. SUMMARY Quantitative PCR methods with specific probes should be used to improve sensitivity and warrant specificity. Performance of quantitative PCR targeting the repeated 529 bp sequence for the diagnosis of toxoplasmosis in immunocompromised patients needs evaluation in field studies in South America and in western countries.
Collapse
|
21
|
Prusa AR, Kasper DC, Sawers L, Walter E, Hayde M, Stillwaggon E. Congenital toxoplasmosis in Austria: Prenatal screening for prevention is cost-saving. PLoS Negl Trop Dis 2017; 11:e0005648. [PMID: 28692640 PMCID: PMC5503164 DOI: 10.1371/journal.pntd.0005648] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/17/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Primary infection of Toxoplasma gondii during pregnancy can be transmitted to the unborn child and may have serious consequences, including retinochoroiditis, hydrocephaly, cerebral calcifications, encephalitis, splenomegaly, hearing loss, blindness, and death. Austria, a country with moderate seroprevalence, instituted mandatory prenatal screening for toxoplasma infection to minimize the effects of congenital transmission. This work compares the societal costs of congenital toxoplasmosis under the Austrian national prenatal screening program with the societal costs that would have occurred in a No-Screening scenario. METHODOLOGY/PRINCIPAL FINDINGS We retrospectively investigated data from the Austrian Toxoplasmosis Register for birth cohorts from 1992 to 2008, including pediatric long-term follow-up until May 2013. We constructed a decision-analytic model to compare lifetime societal costs of prenatal screening with lifetime societal costs estimated in a No-Screening scenario. We included costs of treatment, lifetime care, accommodation of injuries, loss of life, and lost earnings that would have occurred in a No-Screening scenario and compared them with the actual costs of screening, treatment, lifetime care, accommodation, loss of life, and lost earnings. We replicated that analysis excluding loss of life and lost earnings to estimate the budgetary impact alone. Our model calculated total lifetime costs of €103 per birth under prenatal screening as carried out in Austria, saving €323 per birth compared with No-Screening. Without screening and treatment, lifetime societal costs for all affected children would have been €35 million per year; the implementation costs of the Austrian program are less than €2 million per year. Calculating only the budgetary impact, the national program was still cost-saving by more than €15 million per year and saved €258 million in 17 years. CONCLUSIONS/SIGNIFICANCE Cost savings under a national program of prenatal screening for toxoplasma infection and treatment are outstanding. Our results are of relevance for health care providers by supplying economic data based on a unique national dataset including long-term follow-up of affected infants.
Collapse
Affiliation(s)
- Andrea-Romana Prusa
- Department of Pediatrics and Adolescent Medicine, Toxoplasmosis Reference Laboratory, Medical University of Vienna, Vienna, Austria
| | - David C. Kasper
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Larry Sawers
- Department of Economics, American University, Washington DC, United States of America
| | - Evelyn Walter
- Institute for Pharmaeconomic Research, Vienna, Austria
| | - Michael Hayde
- Department of Pediatrics and Adolescent Medicine, Toxoplasmosis Reference Laboratory, Medical University of Vienna, Vienna, Austria
| | - Eileen Stillwaggon
- Department of Economics, Gettysburg College, Gettysburg, Pennsylvania, United States of America
- * E-mail:
| |
Collapse
|
22
|
Yildirim Y, Ertas Onmaz N, Gonulalan Z, Al S, Yildirim A, Karadal F, Hizlisoy H, Pamuk Ş. Microbiological quality of pastrami and associated surfaces at the point of sale in Kayseri, Turkey. Public Health 2017; 146:152-158. [PMID: 28216007 DOI: 10.1016/j.puhe.2017.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 12/21/2016] [Accepted: 01/04/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study is to trace the possible relations between the hygienic status of slicing utensils and the microbiological quality of pastrami. STUDY DESIGN A total of 75 pastrami retail markets were visited in Kayseri, Turkey, where the pastrami (a ready-to-eat meat product) is commonly produced and consumed. Sliced pastrami, the cutting board and knife surface swabs were collected from each pastrami retail point to trace possible sources of contamination. METHODS Samples were analysed for the presence of total viable counts (TVC), total coliforms, Escherichia coli, members of Enterobacteriaceae, Staphylococcus aureus and Listeria spp. In addition, pastrami samples were analysed for sulphite-reducing Clostridium spp. and Toxoplasma gondii. RESULTS When compared with the target values of related literatures, a total of 6 (8%) pastrami samples were found unsatisfactory as a result of TVC (5.3%), Enterobacteriaceae (5.3%), E. coli (2.6%), S. aureus (2.6%), Listeria spp. (2.6%) and Listeria monocytogenes (1.3%) contaminations. No T. gondii positivity was observed among the pastrami samples. None of the cutting board and knife surface swabs were found to harbour TVC level >103 cfu/cm2, E. coli and L. monocytogenes. For the total coliforms, 7 (9.3%) and 5 (6.6%) of cutting board and knife surface swabs were found to exceed the target value (<2.5 cfu/cm2), respectively. No statistically significant correlation was detected between the organisms on pastrami and slicing utensils indicating that pastrami were not cross-contaminated by the contact surfaces. CONCLUSION More emphasis needs to be placed for training of food handlers and to apply good hygienic practices at the point of pastrami sale. The conditions at retail points must be monitored and inspections should be tightened to protect public health.
Collapse
Affiliation(s)
- Y Yildirim
- University of Erciyes, Veterinary Faculty, Department of Food Hygiene and Technology, 38039, Kayseri, Turkey.
| | - N Ertas Onmaz
- University of Erciyes, Veterinary Faculty, Department of Food Hygiene and Technology, 38039, Kayseri, Turkey
| | - Z Gonulalan
- University of Erciyes, Veterinary Faculty, Department of Food Hygiene and Technology, 38039, Kayseri, Turkey
| | - S Al
- University of Erciyes, Veterinary Faculty, Department of Food Hygiene and Technology, 38039, Kayseri, Turkey
| | - A Yildirim
- University of Erciyes, Veterinary Faculty, Department of Parasitology, 38039, Kayseri, Turkey
| | - F Karadal
- University of Nigde, Bor Vocational School, 51700, Nigde, Turkey
| | - H Hizlisoy
- University of Erciyes, Veterinary Faculty, Department of Veterinary Public Health, 38039, Kayseri, Turkey
| | - Ş Pamuk
- University of Afyon Kocatepe, Veterinary Faculty, Department of Food Hygiene and Technology, Afyon, Turkey
| |
Collapse
|
23
|
Evaluation of Toxoplasma ELITe MGB Real-Time PCR Assay for Diagnosis of Toxoplasmosis. J Clin Microbiol 2017; 55:1369-1376. [PMID: 28202794 DOI: 10.1128/jcm.02379-16] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 02/05/2017] [Indexed: 11/20/2022] Open
Abstract
Molecular diagnosis of congenital toxoplasmosis or disseminated toxoplasmosis is based mainly on PCR. The repeated DNA element rep529 has become the main DNA target used in most PCR methods, whether laboratory developed or commercial. In this multicenter study, we evaluated the Toxoplasma ELITe MGB (Elitech) commercial kit by comparison with three reference quantitative PCR assays (RAs) used routinely in three proficient laboratories of the French National Reference Center for Toxoplasmosis network, using Toxoplasma calibrated suspensions diluted to obtain a range of concentrations from 0.1 to 10,000 parasites/ml. These suspensions were extracted with either the DNA extraction kit (EXTRAblood; Elitech) recommended by the manufacturer or the QIAamp DNA minikit (Qiagen). The Toxoplasma ELITe MGB assay was also evaluated on a panel of 128 clinical samples, including 56 amniotic fluid samples, 55 placenta samples, and various other samples, of which 95 originated from patients with proven toxoplasmosis. The ELITe MGB assay amplified low-concentration replicates (<10 parasites/ml) of calibrated suspensions less frequently than the RAs of 2/3 laboratories. Additionally, the combination of EXTRAblood and Toxoplasma ELITe MGB yielded poorer sensitivity than the combination of QIAamp DNA minikit and ELITe MGB for low parasite concentrations (P < 0.001 for 1 parasite/ml). On clinical samples, the sensitivity and the specificity of the commercial assay were 89% and 100%, respectively. The sensitivity ranged from 79% (placenta samples) to 100% (amniotic fluid samples). Overall, this study shows that the Toxoplasma ELITe MGB assay is suitable for the diagnosis of toxoplasmosis from non-cell-rich or non-hemoglobin-rich samples and that the EXTRAblood kit is not optimal.
Collapse
|
24
|
Wells B, Shaw H, Innocent G, Guido S, Hotchkiss E, Parigi M, Opsteegh M, Green J, Gillespie S, Innes EA, Katzer F. Molecular detection of Toxoplasma gondii in water samples from Scotland and a comparison between the 529bp real-time PCR and ITS1 nested PCR. WATER RESEARCH 2015; 87:175-181. [PMID: 26408950 DOI: 10.1016/j.watres.2015.09.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 08/21/2015] [Accepted: 09/07/2015] [Indexed: 06/05/2023]
Abstract
Waterborne transmission of Toxoplasma gondii is a potential public health risk and there are currently no agreed optimised methods for the recovery, processing and detection of T. gondii oocysts in water samples. In this study modified methods of T. gondii oocyst recovery and DNA extraction were applied to 1427 samples collected from 147 public water supplies throughout Scotland. T. gondii DNA was detected, using real time PCR (qPCR) targeting the 529bp repeat element, in 8.79% of interpretable samples (124 out of 1411 samples). The samples which were positive for T. gondii DNA originated from a third of the sampled water sources. The samples which were positive by qPCR and some of the negative samples were reanalysed using ITS1 nested PCR (nPCR) and results compared. The 529bp qPCR was the more sensitive technique and a full analysis of assay performance, by Bayesian analysis using a Markov Chain Monte Carlo method, was completed which demonstrated the efficacy of this method for the detection of T. gondii in water samples.
Collapse
Affiliation(s)
- Beth Wells
- Moredun Research Institute, Pentlands Science Park, Penicuik, Midlothian, EH26 0PZ, Scotland, United Kingdom.
| | - Hannah Shaw
- Moredun Research Institute, Pentlands Science Park, Penicuik, Midlothian, EH26 0PZ, Scotland, United Kingdom.
| | - Giles Innocent
- Biomathematics and Statistics Scotland (BioSS), JCMB, King's Buildings, Peter Guthrie Tait Road, Edinburgh, EH9 3FD, Scotland, United Kingdom.
| | - Stefano Guido
- Moredun Research Institute, Pentlands Science Park, Penicuik, Midlothian, EH26 0PZ, Scotland, United Kingdom.
| | - Emily Hotchkiss
- Moredun Research Institute, Pentlands Science Park, Penicuik, Midlothian, EH26 0PZ, Scotland, United Kingdom.
| | - Maria Parigi
- Moredun Research Institute, Pentlands Science Park, Penicuik, Midlothian, EH26 0PZ, Scotland, United Kingdom; School of Agriculture and Veterinary Medicine, University of Bologna, Italy.
| | - Marieke Opsteegh
- Moredun Research Institute, Pentlands Science Park, Penicuik, Midlothian, EH26 0PZ, Scotland, United Kingdom; National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
| | - James Green
- Scottish Water, Juniper House, Heriot Watt Research Centre, Edinburgh, EH14 4AP, United Kingdom.
| | - Simon Gillespie
- Scottish Water, Juniper House, Heriot Watt Research Centre, Edinburgh, EH14 4AP, United Kingdom.
| | - Elisabeth A Innes
- Moredun Research Institute, Pentlands Science Park, Penicuik, Midlothian, EH26 0PZ, Scotland, United Kingdom.
| | - Frank Katzer
- Moredun Research Institute, Pentlands Science Park, Penicuik, Midlothian, EH26 0PZ, Scotland, United Kingdom.
| |
Collapse
|
25
|
Liu Q, Wang ZD, Huang SY, Zhu XQ. Diagnosis of toxoplasmosis and typing of Toxoplasma gondii. Parasit Vectors 2015; 8:292. [PMID: 26017718 PMCID: PMC4451882 DOI: 10.1186/s13071-015-0902-6] [Citation(s) in RCA: 243] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 05/18/2015] [Indexed: 11/25/2022] Open
Abstract
Toxoplasmosis, caused by the obligate intracellular protozoan Toxoplasma gondii, is an important zoonosis with medical and veterinary importance worldwide. The disease is mainly contracted by ingesting undercooked or raw meat containing viable tissue cysts, or by ingesting food or water contaminated with oocysts. The diagnosis and genetic characterization of T. gondii infection is crucial for the surveillance, prevention and control of toxoplasmosis. Traditional approaches for the diagnosis of toxoplasmosis include etiological, immunological and imaging techniques. Diagnosis of toxoplasmosis has been improved by the emergence of molecular technologies to amplify parasite nucleic acids. Among these, polymerase chain reaction (PCR)-based molecular techniques have been useful for the genetic characterization of T. gondii. Serotyping methods based on polymorphic polypeptides have the potential to become the choice for typing T. gondii in humans and animals. In this review, we summarize conventional non-DNA-based diagnostic methods, and the DNA-based molecular techniques for the diagnosis and genetic characterization of T. gondii. These techniques have provided foundations for further development of more effective and accurate detection of T. gondii infection. These advances will contribute to an improved understanding of the epidemiology, prevention and control of toxoplasmosis.
Collapse
Affiliation(s)
- Quan Liu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046, People's Republic of China. .,Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Military Veterinary Institute, Academy of Military Medical Sciences, Changchun, Jilin Province, 130122, People's Republic of China.
| | - Ze-Dong Wang
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Military Veterinary Institute, Academy of Military Medical Sciences, Changchun, Jilin Province, 130122, People's Republic of China.
| | - Si-Yang Huang
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046, People's Republic of China. .,Jiangsu Co-innovation Center for the Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University College of Veterinary Medicine, Yangzhou, Jiangsu Province, 225009, People's Republic of China.
| | - Xing-Quan Zhu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046, People's Republic of China. .,Jiangsu Co-innovation Center for the Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University College of Veterinary Medicine, Yangzhou, Jiangsu Province, 225009, People's Republic of China.
| |
Collapse
|
26
|
A 10-year retrospective comparison of two target sequences, REP-529 and B1, for Toxoplasma gondii detection by quantitative PCR. J Clin Microbiol 2015; 53:1294-300. [PMID: 25653416 DOI: 10.1128/jcm.02900-14] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This study aimed to evaluate the repeated sequence REP-529 compared to that of the B1 gene in the molecular diagnosis of toxoplasmosis by quantitative PCR (qPCR) in routine diagnosis. Over a 10-year period (2003 to 2013), all patients prospectively diagnosed with a positive REP-529 qPCR result for toxoplasmosis were included. All DNA samples (76 samples from 56 patients) were simultaneously tested using the two qPCR methods (REP-529 and B1). The mean cycle threshold (CT) obtained with the B1 qPCR was significantly higher (+4.71 cycles) than that obtained with REP-529 qPCR (P<0.0001). Thirty-one out of 69 extracts (45.6%) positive with REP-529 qPCR were not amplified with the B1 qPCR (relative sensitivity of 54.4% compared to that with REP-529), yielding false-negative results with 15/28 placenta, 5 cord blood, 2 amniotic fluid, 4 cerebrospinal fluid, 1 aqueous humor, 2 lymph node puncture, and 1 abortion product sample. This defect in sensitivity would have left 20/56 patients undiagnosed, distributed as follows: 12/40 congenital toxoplasmosis, 4/5 cerebral toxoplasmosis, 2/8 patients with retinochoroiditis, and 2 patients with chronic lymphadenopathy. This poor performance of B1 qPCR might be related to low parasite loads, since the mean Toxoplasma quantification in extracts with B1 false-negative results was 0.4 parasite/reaction. These results clearly show the superiority of the REP-529 sequence in the diagnosis of toxoplasmosis by PCR and suggest that this target should be adopted as part of the standardization of the PCR assay.
Collapse
|
27
|
Prusa AR, Kasper DC, Pollak A, Gleiss A, Waldhoer T, Hayde M. The Austrian Toxoplasmosis Register, 1992-2008. Clin Infect Dis 2014; 60:e4-e10. [PMID: 25216688 DOI: 10.1093/cid/ciu724] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND We aimed to determine the incidence of primary gestational infections with Toxoplasma gondii and congenital toxoplasmosis in Austria, a country with a nationwide prenatal serological screening program since 1974. METHODS We analyzed retrospective data from the Austrian Toxoplasmosis Register of pregnant women with Toxoplasma infection and their offspring with births between 1992 and 2008, identified by the prenatal mandatory screening program. Treatment was administered to women from diagnosis of a Toxoplasma infection until delivery. Infected infants were treated up to 1 year of life routinely. Clinical manifestations in infected infants were monitored at least for 1 year and documented in the register. RESULTS The Austrian Toxoplasmosis Register included 2147 pregnant women with suspected Toxoplasma infection. Annually, 8.5 per 10 000 women acquired Toxoplasma infection during pregnancy, and 1.0 per 10 000 infants had congenital toxoplasmosis (13% mean transmission rate). Our data showed that women treated according to the Austrian scheme had a 6-fold decrease in the maternofetal transmission rate compared to women without treatment. CONCLUSIONS Results from the Austrian Toxoplasmosis Register show the efficiency of the prenatal screening program. Our results are of clinical relevance for infants, healthcare systems, and policy makers to consider preventive Toxoplasma screening as a potential tool to reduce the incidence of congenital toxoplasmosis.
Collapse
Affiliation(s)
| | - David C Kasper
- Research Core Unit for Pediatric Biochemistry and Analytics
| | | | - Andreas Gleiss
- Center for Medical Statistics, Informatics and Intelligent Systems
| | - Thomas Waldhoer
- Department of Epidemiology, Center of Public Health, Medical University of Vienna, Austria
| | | |
Collapse
|
28
|
Witola WH, Bauman B, McHugh M, Matthews K. Silencing of GRA10 protein expression inhibits Toxoplasma gondii intracellular growth and development. Parasitol Int 2014; 63:651-8. [PMID: 24832208 DOI: 10.1016/j.parint.2014.05.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Revised: 03/29/2014] [Accepted: 05/02/2014] [Indexed: 02/01/2023]
Abstract
Toxoplasma gondii dense granule proteins (GRAs) are secreted abundantly in both the tachyzoite and bradyzoite stages of the parasite and are known to localize to various compartments of the parasitophorous vacuole (PV) that interfaces with the host cell milieu. Thus, GRAs may play significant roles in the biogenesis of the PV that is important for survival of intracellular T. gondii. GRA10 is a dense granule protein whose role in T. gondii has not yet been characterized. Therefore, in this study, we endeavored to determine the role of GRA10 in the growth and survival of intracellular T. gondii by using phosphorodiamidate morpholino oligomers (PPMOs) antisense knockdown approach to disrupt the translation of GRA10 mRNA in the parasites. We expressed and purified a truncated recombinant GRA10 protein to generate anti-GRA10 polyclonal antibodies that we used to characterize GRA10 in T. gondii. We found that GRA10 is a soluble, dense granule-associated protein that is secreted into the parasite cytosol and the parasitophorous vacuole milieu. Using in vitro cultures, we found that knockdown of GRA10 results in severe inhibition of T. gondii growth in human fibroblasts and in ovine monocytic cells. Together, our findings define GRA10 as a dense granule protein that plays a significant role in the growth and propagation of intracellular T. gondii in human fibroblasts and in ovine monocytic cells.
Collapse
Affiliation(s)
- William H Witola
- Room 312 Milbank Hall, College of Agriculture, Environment and Nutrition Sciences, Tuskegee University, Tuskegee, AL 36088, USA.
| | - Bretta Bauman
- Room 312 Milbank Hall, College of Agriculture, Environment and Nutrition Sciences, Tuskegee University, Tuskegee, AL 36088, USA
| | - Mark McHugh
- Room 312 Milbank Hall, College of Agriculture, Environment and Nutrition Sciences, Tuskegee University, Tuskegee, AL 36088, USA
| | - Kwame Matthews
- Room 312 Milbank Hall, College of Agriculture, Environment and Nutrition Sciences, Tuskegee University, Tuskegee, AL 36088, USA
| |
Collapse
|
29
|
Yu H, Huang B, Zhuo X, Chen X, Du A. Evaluation of a real-time PCR assay based on the single-copy SAG1 gene for the detection of Toxoplasma gondii. Vet Parasitol 2013; 197:670-3. [PMID: 23867074 DOI: 10.1016/j.vetpar.2013.06.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 06/03/2013] [Accepted: 06/12/2013] [Indexed: 10/26/2022]
Abstract
Real-time PCR-based detection of Toxoplasma gondii is very sensitive and convenient for diagnosing toxoplasmosis. However, the performance of the PCR assays could be influenced by the target gene chosen. Here we evaluate a real-time PCR assay using double-stranded DNA dyes (SYBR(®) Green I assay) with a new set of primers targeting the SAG1 gene for the fast and specific detection of T. gondii. The assay showed higher sensitivity than conventional PCR protocols using T. gondii DNA as template. The detection limit of the developed real-time PCR assay was in the order of 1 tachyzoite. The assay was also assessed by experimentally infected mice and showed positive results for blood (25%), spleen (50%) and lung (50%) as early as 1 dpi. The specificity of the assay was confirmed by using DNA from Neospora caninum, Escherichia coli, Babesia bovis, Trypanosoma brucei, Cryptosporidium parvum, and Toxocara canis. Assay applicability was successfully tested in blood samples collected from slaughtered pigs. These results indicate that, based on SYBR(®) green I, the quantitative SAG1 assay may also be useful in the study of the pathogenicity, immunoprophylaxis, and treatment of T. gondii.
Collapse
Affiliation(s)
- Haijie Yu
- Institute of Preventive Veterinary Medicine, College of Animal Sciences, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | | | | | | | | |
Collapse
|
30
|
Abstract
Real-time PCR (qPCR) was positive in 72/150 (48%) blood samples of newborns with congenital toxoplasmosis. Among infants with active retinochoroiditis, 68% had positive qPCR results, while positivity was 29% (P=0.009) in the absence of ocular involvement. Positive qPCR was associated with the presence of retinochoroidal lesions, with an odds ratio of 2.8.
Collapse
|
31
|
Mandelbrot L. Prévention de la transmission mère-enfant de la toxoplasmose : perspectives. ACTA ACUST UNITED AC 2012; 40:591-8. [DOI: 10.1016/j.gyobfe.2012.07.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2012] [Accepted: 07/05/2012] [Indexed: 10/27/2022]
|
32
|
Evaluation of the liaison automated testing system for diagnosis of congenital toxoplasmosis. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2012; 19:1859-63. [PMID: 23015644 DOI: 10.1128/cvi.00489-12] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Congenital toxoplasmosis is a worldwide health problem, and different screening strategies exist. Testing of toxoplasma-specific antibodies in infants identifies congenital toxoplasmosis during the first year of life. However, experience with commercial available immunoassays is limited. The aim of this study was to evaluate both the performance and analytical characteristics of the Liaison diagnostic system in infants. In a retrospective study, serum Toxoplasma gondii antibodies were measured in samples from 333 infants, including 212 noninfected infants and 121 infants with congenital toxoplasmosis. A total of 1,157 umbilical cord blood and peripheral serum samples were analyzed. Liaison toxoplasma-specific IgG and IgM antibodies and the IgG avidity index were compared to the infection status of the infant, determined by the Sabin-Feldman dye test and immunosorbent agglutination assay--IgM. All noninfected infants were seronegative by Liaison IgG within the first year of life. The Liaison system showed a sensitivity of 81.8%, a specificity of 100.0%, a positive predictive value of 100.0%, a negative predictive value of 90.6%, and overall agreement of 84.4% by comparison with the dye test. Overall agreement of both IgM test systems was 96.0%. In this study cohort, avidity did not show a potential diagnostic benefit for the detection of congenital infection. In conclusion, the Liaison system is a valuable tool to monitor the serologic course of infants at risk. A final serologic confirmatory test is recommended to improve the rate of detection of congenital toxoplasmosis at 1 year of life. Protocols of routine follow-up testing in infants and accurate diagnostic tools after acute gestational infections are needed to improve medical care.
Collapse
|
33
|
Marques P, O’ Donovan J, Williams E, Gutierrez J, Worrall S, McElroy M, Proctor A, Brady C, Sammin D, Bassett H, Buxton D, Maley S, Markey B, Nally J. Detection of Toxoplasma gondii antigens reactive with antibodies from serum, amniotic, and allantoic fluids from experimentally infected pregnant ewes. Vet Parasitol 2012; 185:91-100. [DOI: 10.1016/j.vetpar.2011.10.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Revised: 10/12/2011] [Accepted: 10/19/2011] [Indexed: 10/15/2022]
|
34
|
Chuang YC, Chen JY, Ji DD, Su PH. Congenital toxoplasmosis in a neonate with significant neurologic manifestations. J Formos Med Assoc 2012; 111:232-3. [PMID: 22526213 DOI: 10.1016/j.jfma.2011.06.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 06/24/2011] [Accepted: 06/25/2011] [Indexed: 11/25/2022] Open
Affiliation(s)
- Ya-Cheng Chuang
- Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | | | | | | |
Collapse
|
35
|
Carlier Y, Truyens C, Deloron P, Peyron F. Congenital parasitic infections: a review. Acta Trop 2012; 121:55-70. [PMID: 22085916 DOI: 10.1016/j.actatropica.2011.10.018] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 10/27/2011] [Accepted: 10/29/2011] [Indexed: 12/11/2022]
Abstract
This review defines the concepts of maternal-fetal (congenital) and vertical transmissions (mother-to-child) of pathogens and specifies the human parasites susceptible to be congenitally transferred. It highlights the epidemiological features of this transmission mode for the three main congenital parasitic infections due to Toxoplasma gondii, Trypanosoma cruzi and Plasmodium sp. Information on the possible maternal-fetal routes of transmission, the placental responses to infection and timing of parasite transmission are synthesized and compared. The factors susceptible to be involved in parasite transmission and development of congenital parasitic diseases, such as the parasite genotypes, the maternal co-infections and parasitic load, the immunological features of pregnant women and the capacity of some fetuses/neonates to overcome their immunological immaturity to mount an immune response against the transmitted parasites are also discussed and compared. Analysis of clinical data indicates that parasitic congenital infections are often asymptomatic, whereas symptomatic newborns generally display non-specific symptoms. The long-term consequences of congenital infections are also mentioned, such as the imprinting of neonatal immune system and the possible trans-generational transmission. The detection of infection in pregnant women is mainly based on standard serological or parasitological investigations. Amniocentesis and cordocentesis can be used for the detection of some fetal infections. The neonatal infection can be assessed using parasitological, molecular or immunological methods; the place of PCR in such neonatal diagnosis is discussed. When such laboratory diagnosis is not possible at birth or in the first weeks of life, standard serological investigations can also be performed 8-10 months after birth, to avoid detection of maternal transmitted antibodies. The specific aspects of treatment of T. gondii, T. cruzi and Plasmodium congenital infections are mentioned. The possibilities of primary and secondary prophylaxes, as well as the available WHO corresponding recommendations are also presented.
Collapse
|
36
|
Variation of B1 gene and AF146527 repeat element copy numbers according to Toxoplasma gondii strains assessed using real-time quantitative PCR. J Clin Microbiol 2012; 50:1452-4. [PMID: 22259209 DOI: 10.1128/jcm.06514-11] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Using the multicopy B1 gene and AF146527 element for the amplification of Toxoplasma gondii DNA raises the issue of reliable quantification for clinical diagnosis. We applied relative quantification to reference strains using the single-copy P30 gene as a reference. According to the parasite type, the copy numbers for the B1 gene and AF146527 element were found to be 5 to 12 and 4 to 8 times lower than the previous estimations of 35 and 230 copies, respectively.
Collapse
|
37
|
Spatio-temporal variations and age effect on Toxoplasma gondii seroprevalence in seals from the Canadian Arctic. Parasitology 2011; 138:1362-8. [DOI: 10.1017/s0031182011001260] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
SUMMARYToxoplasmosis is a significant public health threat for Inuit in the Canadian Arctic. This study aimed to investigate arctic seals as a possible food-borne source of infection. Blood samples collected from 828 seals in 7 Canadian Arctic communities from 1999 to 2006 were tested for Toxoplasma gondii antibodies using a direct agglutination test. Polymerase chain reaction (PCR) was used to detect T. gondii DNA in tissues of a subsample of seals. Associations between seal age, sex, species, diet, community and year of capture, and serological test results were investigated by logistic regression. Overall seroprevalence was 10·4% (86/828). All tissues tested were negative by PCR. In ringed seals, seroprevalence was significantly higher in juveniles than in adults (odds ratio=2·44). Overall, seroprevalence varied amongst communities (P=0·0119) and by capture year (P=0·0001). Our study supports the hypothesis that consumption of raw seal meat is a significant source of infection for Inuit. This work raises many questions about the mechanism of transfer of this terrestrial parasite to the marine environment, the preponderance of infection in younger animals and the natural course of infection in seals. Further studies to address these questions are essential to fully understand the health risks for Inuit communities.
Collapse
|
38
|
Marques PX, O’ Donovan J, Souda P, Gutierrez J, Williams EJ, Worrall S, McElroy M, Proctor A, Brady C, Sammin D, Basset H, Whitelegge JP, Markey BK, Nally JE. Amniotic and allantoic fluids from experimentally infected sheep contain immunoglobulin specific for Chlamydophila abortus. Vet Immunol Immunopathol 2011; 140:1-9. [DOI: 10.1016/j.vetimm.2010.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Revised: 10/29/2010] [Accepted: 11/01/2010] [Indexed: 11/29/2022]
|
39
|
Polymerase chain reaction in the diagnosis of congenital toxoplasmosis: more than two decades of development and evaluation. Parasitol Res 2011; 108:505-12. [PMID: 21221639 DOI: 10.1007/s00436-010-2245-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2010] [Accepted: 12/21/2010] [Indexed: 10/18/2022]
Abstract
Toxoplasmosis, a protozoan disease caused by the coccidian parasite Toxoplasma gondii, is one of the most prevalent parasitic diseases of humans. Although most infections are subclinical and asymptomatic, it has a great importance with respect to immunocompromized hosts and congenitally infected newborns. The diagnosis of T. gondii infection has gained in great interest over the past decades with a wide variety of techniques being investigated from animal inoculation to advanced molecular techniques. This paper reviews and highlights the development and evaluation of polymerase chain reaction in the diagnosis of congenital toxoplasmosis in human population to present the redundant research on it in a chronologically simple approach.
Collapse
|
40
|
Affiliation(s)
- Miriam Englander
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA
| | | |
Collapse
|
41
|
Hutson SL, Mui E, Kinsley K, Witola WH, Behnke MS, El Bissati K, Muench SP, Rohrman B, Liu SR, Wollmann R, Ogata Y, Sarkeshik A, Yates JR, McLeod R. T. gondii RP promoters & knockdown reveal molecular pathways associated with proliferation and cell-cycle arrest. PLoS One 2010; 5:e14057. [PMID: 21124925 PMCID: PMC2989910 DOI: 10.1371/journal.pone.0014057] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Accepted: 10/25/2010] [Indexed: 01/16/2023] Open
Abstract
Molecular pathways regulating rapid proliferation and persistence are fundamental for pathogens but are not elucidated fully in Toxoplasma gondii. Promoters of T. gondii ribosomal proteins (RPs) were analyzed by EMSAs and ChIP. One RP promoter domain, known to bind an Apetela 2, bound to nuclear extract proteins. Promoter domains appeared to associate with histone acetyl transferases. To study effects of a RP gene's regulation in T. gondii, mutant parasites (Δrps13) were engineered with integration of tetracycline repressor (TetR) response elements in a critical location in the rps13 promoter and transfection of a yellow fluorescent-tetracycline repressor (YFP-TetR). This permitted conditional knockdown of rps13 expression in a tightly regulated manner. Δrps13 parasites were studied in the presence (+ATc) or absence of anhydrotetracycline (-ATc) in culture. -ATc, transcription of the rps13 gene and expression of RPS13 protein were markedly diminished, with concomitant cessation of parasite replication. Study of Δrps13 expressing Myc-tagged RPL22, -ATc, showed RPL22 diminished but at a slower rate. Quantitation of RNA showed diminution of 18S RNA. Depletion of RPS13 caused arrest of parasites in the G1 cell cycle phase, thereby stopping parasite proliferation. Transcriptional differences ±ATc implicate molecules likely to function in regulation of these processes. In vitro, -ATc, Δrps13 persists for months and the proliferation phenotype can be rescued with ATc. In vivo, however, Δrps13 could only be rescued when ATc was given simultaneously and not at any time after 1 week, even when L-NAME and ATc were administered. Immunization with Δrps13 parasites protects mice completely against subsequent challenge with wildtype clonal Type 1 parasites, and robustly protects mice against wildtype clonal Type 2 parasites. Our results demonstrate that G1 arrest by ribosomal protein depletion is associated with persistence of T. gondii in a model system in vitro and immunization with Δrps13 protects mice against subsequent challenge with wildtype parasites.
Collapse
Affiliation(s)
- Samuel L. Hutson
- Department of Surgery (Ophthalmology), The University of Chicago, Chicago, Illinois, United States of America
| | - Ernest Mui
- Department of Surgery (Ophthalmology), The University of Chicago, Chicago, Illinois, United States of America
| | - Karen Kinsley
- Department of Surgery (Ophthalmology), The University of Chicago, Chicago, Illinois, United States of America
| | - William H. Witola
- Department of Surgery (Ophthalmology), The University of Chicago, Chicago, Illinois, United States of America
| | - Michael S. Behnke
- Department of Veterinary Molecular Biology, Montana State University, Bozeman, Montana, United States of America
| | - Kamal El Bissati
- Department of Surgery (Ophthalmology), The University of Chicago, Chicago, Illinois, United States of America
| | - Stephen P. Muench
- Institute of Membrane and Systems Biology, University of Leeds, Leeds, United Kingdom
| | - Brittany Rohrman
- Department of Surgery (Ophthalmology), The University of Chicago, Chicago, Illinois, United States of America
| | - Susan R. Liu
- Department of Surgery (Ophthalmology), The University of Chicago, Chicago, Illinois, United States of America
| | - Robert Wollmann
- Department of Pathology, The University of Chicago, Chicago, Illinois, United States of America
| | - Yuko Ogata
- Seattle Biomedical Research Institute, Seattle, Washington, United States of America
| | - Ali Sarkeshik
- Department of Chemical Physiology, Scripps Research Institute, La Jolla, California, United States of America
| | - John R. Yates
- Department of Chemical Physiology, Scripps Research Institute, La Jolla, California, United States of America
| | - Rima McLeod
- Department of Surgery (Ophthalmology), The University of Chicago, Chicago, Illinois, United States of America
- Department of Pediatrics (Infectious Disease), The University of Chicago, Chicago, Illinois, United States of America
- Committees on Immunology, Molecular Medicine, and Genetics, Institute of Genomics and Systems Biology, The College, The University of Chicago, Chicago, Illinois, United States of America
| |
Collapse
|
42
|
Prusa AR, Hayde M, Unterasinger L, Pollak A, Herkner KR, Kasper DC. Evaluation of the Roche Elecsys Toxo IgG and IgM electrochemiluminescence immunoassay for the detection of gestational Toxoplasma infection. Diagn Microbiol Infect Dis 2010; 68:352-7. [PMID: 20884150 DOI: 10.1016/j.diagmicrobio.2010.07.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 07/15/2010] [Accepted: 07/21/2010] [Indexed: 11/26/2022]
Abstract
Unidentified gestational infection with Toxoplasma gondii may lead to fetal infection with severe complications later in childhood. Because diagnosis of maternal infection solely depends on serology, routine tests with high sensitivity and specificity are required. In this study, the new Roche Elecsys Toxo IgG and IgM immunoassay was compared with Sabin-Feldman dye test and immunosorbent agglutination assay-IgM as reference test. Serum samples were analyzed from 927 pregnant women, including 100 negative, 706 chronic, and 121 acute infections. The combination of both Elecsys IgG and IgM assays demonstrated high sensitivity and specificity of 97.1% and 100.0%, respectively, and a positive and negative predictive value of 100.0% and 81.3%, respectively. The Elecsys assay is a useful tool as a first-line screening method to detect gestational infections. However, if gestational infection is assumed, confirmatory testing by a reference laboratory might be necessary to discriminate between pre- and postconceptional infection to start antiparasitic treatment to avoid mother-to-fetus transmission and severe sequelae.
Collapse
Affiliation(s)
- Andrea-Romana Prusa
- Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | | | | | | | | | | |
Collapse
|
43
|
Accuracy of real-time polymerase chain reaction for Toxoplasma gondii in amniotic fluid. Obstet Gynecol 2010; 115:727-733. [PMID: 20308831 DOI: 10.1097/aog.0b013e3181d57b09] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To provide clinicians with information about the accuracy of real-time polymerase chain reaction (PCR) analysis of amniotic fluid for the prenatal diagnosis of congenital Toxoplasma infection. METHODS This was a prospective cohort study of women with Toxoplasma infection identified by prenatal screening in three centers routinely carrying out real-time PCR for the detection of Toxoplasma gondii in amniotic fluid. The data available were gestational age at maternal infection, types and dates of maternal treatment, results of amniocentesis and neonatal work-up and definitive infectious status of the child. We estimated sensitivity, specificity and positive and negative predictive values both overall and per trimester of pregnancy at the time of maternal infection. RESULTS Polymerase chain reaction analysis was carried out on amniotic fluid for 261 of the 377 patients included (69%). It was accurate with the exception of four negative results in children who were infected. Overall sensitivity and negative predictive value were 92.2% (95% confidence interval [CI] 81-98%) and 98.1% (95% CI 95-99.5%), respectively. There was no significant association with the trimester of pregnancy during which maternal infection occurred. Specificity and positive predictive values of 100% were obtained for all trimesters. CONCLUSION Real-time PCR analysis significantly improves the detection of T. gondii on amniotic fluid. It provides an accurate tool to predict fetal infection and to decide on appropriate treatment and surveillance. However, postnatal follow-up remains necessary in the first year of life to fully exclude infection in children for whom PCR results were negative. LEVEL OF EVIDENCE III.
Collapse
|
44
|
Mason S, Quinnell RJ, Smith JE. Detection of Toxoplasma gondii in lambs via PCR screening and serological follow-up. Vet Parasitol 2010; 169:258-63. [DOI: 10.1016/j.vetpar.2010.01.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2009] [Revised: 01/09/2010] [Accepted: 01/14/2010] [Indexed: 10/19/2022]
|
45
|
Kasper DC, Mechtler TP, Reischer GH, Witt A, Langgartner M, Pollak A, Herkner KR, Berger A. The bacterial load of Ureaplasma parvum in amniotic fluid is correlated with an increased intrauterine inflammatory response. Diagn Microbiol Infect Dis 2010; 67:117-21. [PMID: 20207094 DOI: 10.1016/j.diagmicrobio.2009.12.023] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2009] [Revised: 12/22/2009] [Accepted: 12/30/2009] [Indexed: 01/08/2023]
Abstract
Ureaplasma spp. are the most frequently isolated microorganisms inside the amniotic cavity and have been associated with spontaneous abortion, chorioamnionitis, premature rupture of the membranes (PROM), and preterm labor (PL). We analyzed 118 samples from amniotic fluid of preterm infants before 34 weeks of gestation by quantitative polymerase chain reaction (qPCR). Bacterial load, Ureaplasma biovar discrimination (Ureaplasma urealyticum and Ureaplasma parvum), and the level of inflammation were correlated with short-term clinical outcome. U. parvum was the predominant biovar, and increased bacterial load was significantly linked to histologic chorioamnionitis, PROM + PL, early-onset sepsis, and bronchopulmonary dysplasia. Furthermore, there was a positive correlation between the amount of U. parvum and the magnitude of inflammatory response inside the amniotic cavity observed by elevated interleukin 8 levels. We postulate that the bacterial load of Ureaplasma spp. measured by qPCR should be determined in studies investigating the potential clinical impact of intrauterine Ureaplasma spp. on the outcome of preterm infants.
Collapse
Affiliation(s)
- David C Kasper
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, A-1090 Vienna, Austria.
| | | | | | | | | | | | | | | |
Collapse
|
46
|
Garcia-Méric P, Franck J, Dumon H, Piarroux R. [Management of congenital toxoplasmosis in France: current data]. Presse Med 2009; 39:530-8. [PMID: 19926248 DOI: 10.1016/j.lpm.2009.09.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2009] [Revised: 09/04/2009] [Accepted: 09/11/2009] [Indexed: 11/30/2022] Open
Abstract
Congenital toxoplasmosis is caused by transplacental contamination of the fetus withToxoplasma gondiifollowing maternal primary infection. The risk of mother-to-child transmission depends on the term of pregnancy at the time of maternal infection. The risk is lower than 5% in the first trimester but can reach 90% in the last days of pregnancy. Inversely, however, fetal disease is more severe when contamination occurs early in pregnancy. The French prevention program officially recommends monthly serological screening of susceptible women during pregnancy and information about hygiene and dietary rules. Prenatal diagnosis of congenital toxoplasmosis is based on a combination of examinations: PCR testing for the parasite in amniotic fluid, mouse inoculation, fetal ultrasonography, and magnetic resonance imaging. Neonatal screening consists of PCR of the placenta, mouse inoculation, detection of specific IgM and IgA in the newborn, ocular fundus examinations by indirect ophthalmoscopy, and transfontanellar ultrasonography. As soon as maternal infection is suspected, preventive treatment with spiramycin begins; the treatment is changed to a combination of pyrimethamine-sulfonamide if fetal infection is proved. Some teams are using this combination as first-line treatment after 30 weeks of gestation, without performing amniocentesis. Recent European multicenter studies raise questions about the effectiveness of prenatal treatment on mother-to-child transmission and on the reduction in the number and severity of fetal sequelae. A randomized controlled trial is required to prove the efficacy of prenatal treatment in general and of specific drugs, in particular. As soon as infection is confirmed, infected children are treated with the pyrimethamine-sulfonamide combination for 12 to 24 months. Recent multicenter studies show that postnatal treatment does not prevent ocular lesions: 5% of treated children had choroiditis lesions at birth, 20% at 5 years, and 30% at 8 years of age. Furthermore no consensus exists about the duration of postnatal treatment (3 months in Denmark versus 12 months in France). A multicenter randomized controlled trial is necessary to assess the efficacy of postnatal treatment and determine its duration. A surveillance system was set up in 2007 by the National Reference Center for Toxoplasmosis to determine the perinatal burden of this infection and to assess the national policy.
Collapse
Affiliation(s)
- Patricia Garcia-Méric
- Département de médecine néonatale, CHU de la Conception, F-13385 Marseille Cedex, France.
| | | | | | | |
Collapse
|
47
|
Moving towards an integrated approach to molecular detection and identification ofToxoplasma gondii. Parasitology 2009; 137:1-11. [DOI: 10.1017/s0031182009991065] [Citation(s) in RCA: 389] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARYThe development of simple, sensitive and rapid methods for the detection and identification ofToxoplasma gondiiis important for the diagnosis and epidemiological studies of the zoonotic disease toxoplasmosis. In the past 2 decades, molecular methods based on a variety of genetic markers have been developed, each with its advantages and limitations. The application of these methods has generated invaluable information to enhance our understanding of the epidemiology, population genetics and phylogeny ofT. gondii. However, since most studies focused solely on the detection but not genetic characterization ofT. gondii, the information obtained was limited. In this review, we discuss some widely used molecular methods and propose an integrated approach for the detection and identification ofT. gondii, in order to generate maximum information for epidemiological, population and phylogenetic studies of this key pathogen.
Collapse
|