Toxoplasmosis, behaviour and personality

Study on the effect of koumiss on the intestinal microbiota of mice infected with Toxoplasma gondii

Toxoplasma gondii is a worldwide food-borne parasite that can infect almost all warm-blooded animals, including humans. To date, there are no effective drugs to prevent or eradicate T. gondii infection. Recent studies have shown that probiotics could influence the relationship between the microbiota and parasites in the host. Koumiss has been used to treat many diseases based on its probiotic diversity. Therefore, we explored the effect of koumiss on T. gondii infection via its effect on the host intestinal microbiota. BALB/c mice were infected with T. gondii and treated with PBS, koumiss and mares' milk. Brain cysts were counted, and long-term changes in the microbiota and the effect of koumiss on gut microbiota were investigated with high-throughput sequencing technology. The results suggested that koumiss treatment significantly decreased the cyst counts in the brain (P < 0.05). Moreover, T. gondii infection changed the microbiota composition, and koumiss treatment increased the relative abundance of Lachnospiraceae and Akkermansia muciniphila, which were associated with preventing T. gondii infection. Moreover, koumiss could inhibit or ameliorate T. gondii infection by increasing the abundance of certain bacteria that control unique metabolic pathways. The study not only established a close interaction among the host, intracellular pathogens and intestinal microbiota but also provided a novel focus for drug development to prevent and eradicate T. gondii infection.

The Experimental Role of Medicinal Plants in Treatment of Toxoplasma gondii Infection: A Systematic Review

BACKGROUND

Toxoplasma gondii is the global protozoa that could cause contamination in warm-blooded animals and is considered among the opportunistic pathogens in immunocompromised patients. Among the people at risk, toxoplasmosis infection can lead to the incidence of severe clinical manifestations, encephalitis, chorioretinitis, and even death.

PURPOSE

The present research is focused on the new research for the treatment of toxoplasmosis parasitic disease using medicinal herbs.

METHODS

The search was performed in five English databases, including Scopus, PubMed, Web of Science, EMBASE, and Google Scholar up from 2010 to December 2019. Studies in any language were entered in the searching step if they had an English abstract. The words and terms were used as a syntax with specific tags of each database.

RESULTS

Out of 1832 studies, 36 were eligible to be reviewed. The findings showed that 17 studies (47%) were performed in vitro, 14 studies (39%) in vivo, and 5 studies (14%) both in vivo and in vitro.

CONCLUSION

The studies showed that the plant extracts can be a good alternative in reducing the toxoplasmosis effects in the host and the herbal extracts can be used to produce natural product-based drugs affecting toxoplasmosis with fewer side-effects than synthetic drugs.

Toxoplasma gondii infection in Colombia with a review of hosts and their ecogeographic distribution

Toxoplasma gondii is one of the most prevalent zoonotic protozoan parasites among warm-blooded animal populations (humans included) around the world, causing multiple clinic manifestations including death in the most severe cases of infection. Due to the versatile life cycle of T. gondii and its diversity of potential hosts, there is a common perception that natural areas and wildlife are highly prevalent reservoirs for the parasite; however, information and reports of the parasite on wildlife populations in Colombia are scarce. Using PRC-based detection analyses of the B1 gene, we evaluated the presence of T. gondii in 49 native small mammal species (10% of the mammal species of Colombia) from 4 different undisturbed natural habitats. Additionally, to understand the ecogeographical distribution of the parasite in Colombia, we developed a literature search of infection reports including information on the host species, density of records and occurrence patterns (using landcover and ecoregions) in natural, rural and urban areas. Our literature review showed a total of 8,103 reports of T. gondii for Colombia of which 86% were related to humans, and 14% to non-human mammals and other categories, with just a single report associated to wildlife; additionally, 82% of all reports were associated to urban areas whereas only 18% to rural sites. Based on the negative results for the presence of T. gondii in our PCR-based analyses and our literature search, we suggest that T. gondii has a synanthropic distribution in Colombia occurring in ecoregions as variable as the xeric scrubs in the northern lowlands and humid montane Andean forests, also we show a lack of information on the parasite relationship with wildlife, a concerning fact given that zoonoses are the leading mechanism for the emergence of infectious diseases.

Association between Toxoplasma gondii infection and psychiatric disorders in Zhejiang, Southeastern China

Increased rates of exposure to Toxoplasma gondii have been found in patients with psychiatric disorders globally, but there is scarce information about the epidemiology of T. gondii infection in psychiatric patients in Zhejiang Province, Southeastern China. In a case-control survey, we measured IgG and IgM class antibodies against T. gondii in 798 patients from a public psychiatric hospital in the city of Wenzhou, Zhejiang Province, and in 681 non-psychiatric controls from the general population in the same region. Subjects in each group were matched by sex and age with an enzyme-linked immunoassay. Seroprevalence of anti-Toxoplasma IgG antibodies in psychiatric patients (13.3%, 106/798) was significantly higher than in the control population (9.4%, 64/681) (P =  0.022). Anti-Toxoplasma IgM antibodies were also significantly higher in the psychiatric patients (4.1%, 33/798) than in the control group (1.9%, 13/681) (P =  0.016). Additionally, we found significantly elevated seropositive rates of anti-Toxoplasma IgG and IgM in patients with schizophrenia, as well as those with bipolar disorder. The identification of specific anti-Toxoplasma antibodies in psychiatric patients may be useful for assessing infection and timely initiation of treatment.

Toxoplasma gondii infection and behavioral outcomes in humans: a systematic review

Studies suggest that the protozoan Toxoplasma gondii can disturb human behavior. This study aimed to systematically review the scientific literature on the possible associations between Toxoplasma gondii infection and neurobehavioral abnormalities in humans. We reviewed and summarized the studies published since 1990. The descriptors used were related to T. gondii infection and behavioral outcomes in humans; the main databases of the medical literature were accessed. The results of eight original articles published between 1994 and 2016 were evaluated and described. The most common serological method was the enzyme immunoassay. Most of the researchers used validated instruments for behavioral evaluation. Seven studies reported some association between the prevalence of anti-T. gondii antibodies and some altered behavioral aspects in adult humans; these studies focused on adult population in Europe and the USA. The most reported behavioral deviations are related to greater impulsivity and aggressiveness. There are very few studies on this subject, which present some limitations for inference and conclusions: most were cross-sectional studies, with a small sample size and in similar populations. Investigations with a larger sample size of different population groups should be performed to evaluate multiple factors.

Serological and molecular diagnosis of Toxoplasma gondii in patients with schizophrenia

Schizophrenia is a persistent neuropsychiatric syndrome of uncertain source. Toxoplasmosis is the most prevalent parasitic protozoan infecting one-third of the worldwide human population. Infectious agents such as toxoplasma are the probable cause of schizophrenia. This study was aimed to evaluate the association between schizophrenia and toxoplasmosis using SAG1 and B1 Target gene. During February to December 2016, 92 patients with schizophrenia are imported in our study. All cases were assessed by serological (IgG and IgM antibodies) and molecular examinations. ELISA was performed by Commercial kits according to manufactures procedure. DNA was extracted and nested PCR was done using two pairs of primers. From 92 patients, 59 (64.13%) cases were positive for toxoplasmosis by serological examinations (14 samples positive for IgM and IgG, 40 samples positive for only IgG and 5 samples Positive for only IgM) and 58 (63.04%) were positive by Nested PCR technique. Based on the nested PCR method, 68.47 and 47.82% of samples were positive by B1 and SAG1 genes, respectively. Our results showed the importance of use both serological and molecular diagnostic methods for accurate recognition of T. gondii in patients with schizophrenia. Moreover our results indicated that B1 gene is more sensitive than SAG1 gene.

T. gondii rhoptry protein ROP18 induces apoptosis of neural cells via endoplasmic reticulum stress pathway

Background

The neurotropic parasite T. gondii is widespread among mammalian hosts including humans. During the course of T. gondii infection, the central nervous system is the most commonly damaged of all invasive organs. The polymorphic rhoptry protein ROP18 has been identified as a key factor in the pathogenesis of T. gondii; however, the molecular mechanism by which this protein exerts neuropathogenesis remains elusive.

Methods

Immunofluorescence staining was performed to detect neuropathogenesis of the mouse brain tissues. The apoptosis of neural cells and the expressions of related proteins in the endoplasmic reticulum stress (ER Stress)-mediated apoptosis pathway were detected by flow cytometry and Western blotting.

Results

Immunofluorescence staining reveals induction of the propidium iodide (PI) - positive neural cells in mouse cerebral cortex and hippocampus infected with ROP18 over-expressing transgenic tachyzoites. Western blotting analyses reveal that ROP18 increases the expressions of cleaved caspase-12, CHOP and cleaved caspase-3 when compared to the control groups. After the pretreatment of Z-ATAD-FMK (a specific caspase-12 inhibitor), the apoptotic level of neural cells had an apparent decline, and correspondingly, the expressions of those related proteins were notably decreased.

Conclusions

Our findings here highlight that the virulence factor ROP18 in T. gondii may contribute to neuronal apoptosis through the ER stress-mediated apoptosis pathway, which may be a potential molecular mechanism responsible for neurological disorders of toxoplasmosis.

Serological evidences link toxoplasmosis with schizophrenia and major depression disorder

The etiology of psychiatric disorders is largely unknown. A role of environmental insults during early neurodevelopment have been suggested. Infections are possible risk factors for psychiatric disorders especially Toxoplasma gondii, a neurotropic parasite with a lifelong residence in brain. This study has investigated a possible role of toxoplasmosis in the development of schizophrenia and major depression disorder (MDD). The influence of other covariates; age, gender and family history was also studied. A cross-sectional study on a total of 177 individuals, where anti-Toxoplasma IgG and IgM in sera of schizophrenia (n = 63) and MDD (n = 39) patients, all fulfilling DSM-5 diagnostic criteria, were compared to healthy volunteers (n = 55). Toxoplasma positivity was highest (31.75%) among schizophrenics followed by MDD (25.64%) and controls (14.55%). IgG levels were significantly higher in toxo-positive schizophrenics (230.1 ± 22.9) and MDD (220.56 ± 24.8) compared to controls (9.98 ±1.78). Three patients only, all schizophrenic, have positive IgM antibodies. Age and male gender appear to have positive associations to toxoplasmosis and psychiatric disorders while family history has no obvious additive role. This report is one of few linking Toxoplasma infection to MDD and adds to many suggesting a link between latent toxoplasmosis and schizophrenia.

A protein extract and a cysteine protease inhibitor enriched fraction from Jatropha curcas seed cake have in vitro anti-Toxoplasma gondii activity

Toxoplasma gondii is a parasite of great medical and veterinary importance that has worldwide distribution and causes toxoplasmosis. There are few treatments available for toxoplasmosis and the search for plant extracts and compounds with anti-Toxoplasma activity is of utmost importance for the discovery of new active drugs. The objective of this study was to investigate the action of a protein extract and a protease inhibitor enriched fraction from J. curcas seed cake on developing tachyzoites of T. gondii-infected Vero cells. The protein extract (JcCE) was obtained after solubilization of the J. curcas seed cake with 100 mM sodium borate buffer, pH 10, centrifugation and dialysis of the resulting supernatant with the extracting buffer. JcCE was used for the in vitro assays of anti-Toxoplasma activity at 0.01, 0.1, 0.5, 1.5, 3.0 and 5.0 mg/ml concentration for 24 h. The results showed that JcCE reduced the percentage of infection and the number of intracellular parasites, but had no effect on the morphology of Vero cells up to 3.0 mg/mL. The cysteine protease inhibitor enriched fraction, which was obtained after chromatography of JcCE on Sephadex G-75 and presented a unique protein band following SDS-PAGE, reduced both the number of T. gondii infected cells and intracellular parasites. These results suggest that both JcCE and the cysteine protease inhibitor enriched fraction interfere with the intracellular growth of T. gondii.

Helminth infection alters mood and short-term memory as well as levels of neurotransmitters and cytokines in the mouse hippocampus

Helminthic infections are important causes of morbidity and mortality in many developing countries, where children bear the greatest health burden. The ability of parasites to cause behavioral changes in the host has been observed in a variety of host-parasite systems, including the Taenia crassiceps-mouse model. In murine cysticercosis, mice exhibit a disruption in the sexual, aggressive and avoidance predator behaviors.

OBJECTIVE

The present study was conducted to characterize short-term memory and depression-like behavior, as well as levels of neurotransmitters and cytokines in the hippocampus of cysticercotic male and female mice.

METHODS

Cytokines were detected by RT-PCR and neurotransmitters were quantified by HPLC.

RESULTS

Chronic cysticercosis infection induced a decrease in short-term memory in both male and female mice, having a more pronounced effect in females. Infected females showed a significant increase in forced swimming tests with a decrease in immobility. In contrast, male mice showed an increment in total activity and ambulation tests. Serotonin levels decreased by 30% in the hippocampus of infected females whereas noradrenaline levels significantly increased in infected males. The hippocampal expression of IL-4 increased in infected female mice, but decreased in infected male mice.

CONCLUSION

Our study suggests that intraperitoneal chronic infection with cysticerci in mice leads to persistent deficits in tasks dependent on the animal's hippocampal function. Our findings are a first approach to elucidating the role of the neuroimmune network in controlling short-term memory and mood in T. crassiceps-infected mice.

LINE-1 retrotransposition in the nervous system

Long interspersed element-1 (LINE-1 or L1) is a repetitive DNA retrotransposon capable of duplication by a copy-and-paste genetic mechanism. Scattered throughout mammalian genomes, L1 is typically quiescent in most somatic cell types. In developing neurons, however, L1 can express and retrotranspose at high frequency. The L1 element can insert into various genomic locations including intragenic regions. These insertions can alter the dynamic of the neuronal transcriptome by changing the expression pattern of several nearby genes. The consequences of L1 genomic alterations in somatic cells are still under investigation, but the high level of mutagenesis within neurons suggests that each neuron is genetically unique. Furthermore, some neurological diseases, such as Rett syndrome and ataxia telangiectasia, misregulate L1 retrotransposition, which could contribute to some pathological aspects. In this review, we survey the literature related to neurodevelopmental retrotransposition and discuss possible relevance to neuronal function, evolution, and neurological disease.

Trypanosoma cruzi-induced depressive-like behavior is independent of meningoencephalitis but responsive to parasiticide and TNF-targeted therapeutic interventions

Inflammatory cytokines and microbe-borne immunostimulators have emerged as triggers of depressive behavior. Behavioral alterations affect patients chronically infected by the parasite Trypanosoma cruzi. We have previously shown that C3H/He mice present acute phase-restricted meningoencephalitis with persistent central nervous system (CNS) parasitism, whereas C57BL/6 mice are resistant to T. cruzi-induced CNS inflammation. In the present study, we investigated whether depression is a long-term consequence of acute CNS inflammation and a contribution of the parasite strain that infects the host. C3H/He and C57BL/6 mice were infected with the Colombian (type I) and Y (type II) T. cruzi strains. Forced-swim and tail-suspension tests were used to assess depressive-like behavior. Independent of the mouse lineage, the Colombian-infected mice showed significant increases in immobility times during the acute and chronic phases of infection. Therefore, T. cruzi-induced depression is independent of active or prior CNS inflammation. Furthermore, chronic depressive-like behavior was triggered only by the type I Colombian T. cruzi strain. Acute and chronic T. cruzi infection increased indoleamine 2,3-dioxygenase (IDO) expression in the CNS. Treatment with the selective serotonin reuptake inhibitor (SSRI) fluoxetine abrogated the T. cruzi-induced depressive-like behavior. Moreover, treatment with the parasiticide drug benznidazole abrogated depression. Chronic T. cruzi infection of C57BL/6 mice increased tumor necrosis factor (TNF) expression systemically but not in the CNS. Importantly, TNF modulators (anti-TNF and pentoxifylline) reduced immobility. Therefore, direct or indirect parasite-induced immune dysregulation may contribute to chronic depressive disorder in T. cruzi infection, which opens a new therapeutic pathway to be explored.

[Toxoplasma gondii: a potential role in the genesis of psychiatric disorders]

INTRODUCTION

Toxoplasma gondii is the most common protozoan parasite in developed nations. Up to 43% of the French population may be infected, depending on eating habits and exposure to cats, and almost one third of the world human's population may be infected. Two types of infection have been described: a congenital form and an acquired form. Although the medical profession treats these latent cases as asymptomatic and clinically unimportant, results of animal studies and recent studies of personality profiles, behavior, and psychomotor performance have led to reconsider this assumption.

PRECLINICAL DATA

Among rats: parasite cysts are more abundant in amygdalar structures than those found in other regions of the brain. Infection does not influence locomotion, anxiety, hippocampal-dependent learning, fear conditioning (or its extinction) and neophobia in rats. Rats' natural predator is the cat, which is also T. gondii's reservoir. Naturally, rats have an aversion to cat urine, but the parasite suppresses this aversion in rats, thus influencing the infection cycle. Tachyzoites may invade different types of nervous cells, such as neurons, astrocytes and microglial cells in the brain, and Purkinje cells in cerebellum. Intracellular tachyzoites manipulate several signs for transduction mechanisms involved in apoptosis, antimicrobial effectors functions, and immune cell maturation. Dopamine levels are 14% higher in mice with chronic infections. These neurochemical changes may be factors contributing to mental and motor abnormalities that accompany or follow toxoplasmosis in rodents and possibly in humans. Moreover, the antipsychotic haloperidol and the mood stabilizer valproic acid most effectively inhibit Toxoplasma growth in vitro with synergistic activity.

CLINICAL DATA

The effects of the parasite are not due to the manipulation in an evolutionary sense but merely due to neuropathological or neuroimmunological effects of the parasite's presence. Toxoplasmosis and schizophrenia: epidemiological studies point to a role for toxoplasmosis in schizophrenia's etiology, probably during pregnancy and early life, this association being congruent with studies in animal models indicating that animal exposures of the developing brain to infectious agents or immune modulating agents can be associated with behavioral changes that do not appear until the animal reaches full maturity. Psychiatric patients have increased rates of toxoplasmic antibodies, the differences between cases and controls being greatest in individuals who are assayed near the time of the onset of their symptoms. The increase of dopamine in the brain of infected subjects can represent the missing link between toxoplasmosis and schizophrenia. Toxoplasmosis and Obsessive Compulsive Disorder (OCD): the seropositivity rate for anti-T. gondii IgG antibodies among OCD patients is found to be significantly higher than the rate in healthy volunteers. Infection of basal ganglia may be implicated in the pathogenesis of OCD among Toxoplasma seropositive subjects. Toxoplasmosis and personality: infected men appear to be more dogmatic, less confident, more jealous, more cautious, less impulsive and more orderly than others. Conversely, infected women seem warmest, more conscientious, more insecure, more sanctimonious and more persistent than others. It is possible that differences in the level of testosterone may be responsible for the observed behavioral differences between Toxoplasma-infected and Toxoplasma-free subjects.

CONCLUSION

In the future two major avenues for research seem essential. On one hand, prospective studies and research efforts must still be carried out to understand the mechanisms by which the parasite induces these psychiatric disorders. On the other hand, it has not yet been demonstrated that patients with positive toxoplasmic serology may better respond to haloperidol's or valproic acid's antiparasitic activity. These results may appear as a major issue in the drug's prescribing choices and explain variability in response to the treatment of patients with schizophrenia that is not explained by the genetic polymorphism.

Leptin, a tool of parasites?

One common physiological phenomenon that is involved both in infectious and in malignant processes is the reduction in appetite: disease anorexia. An increase in plasma levels of leptin with inflammation is thought to be involved in this process. However, from an evolutionary perspective, in certain cases, it would be more adaptive for an internal parasite to stimulate the appetite of the host instead of causing its suppression. We tested whether a parasitic infection with the larvae of the helminth parasite Taenia taeniaformis affects the levels of appetite-regulating proteins, such as leptin, ghrelin and neuropeptide-Y (NPY) in wild yellow-necked mouse (Apodemus flavicollis). We found that infected mice had lower plasma levels of leptin and increased levels of NPY than the uninfected subjects. Ghrelin levels were not associated with the occurrence of the parasites; however, these levels strongly correlated with the levels of NPY. This study suggests a possible manipulation by parasitic larvae of appetite regulation in infected subjects.

Cerebral toxoplasmosis combined with disseminated tuberculosis

A 24-year-old man presented with mental change, fever, abdominal pain, tenderness and palpable mass on the lower abdomen. He was a non-Korean engineer and did not accompany a legal guardian, so medical history taking was difficult due to his mental status. Brain magnetic resonance imaging showed multiple rim-enhanced lesions of the brain, and abdominal computed tomography showed huge paraspinal abscess. Chest X-ray and computed tomography showed poorly defined nodular opacities. We initially thought that this patient was infected with toxoplasmosis with typical cerebral image finding and immunoglobulin laboratory finding of cerebrospinal fluid and serum study. The abdominal abscess was confirmed as tuberculosis through the pathologic finding of caseous necrosis. We used anti-tuberculosis medication and anti-toxoplasmosis medication for almost 4 months, and then his clinical state and radiological findings were considerably improved.

Behavioral changes in mice caused by Toxoplasma gondii invasion of brain

Toxoplasma gondii, a protozoan parasite, is capable of infecting a broad range of intermediate warm-blooded hosts including humans. The parasite undergoes sexual reproduction resulting in genetic variability only in the intestine of the definitive host (a member of the cat family). The parasite seems to be capable of altering the natural behavior of the host to favor its transmission in the environment. The aim of this study was to evaluate the number of parasite cysts formed in the hippocampus and amygdala of experimentally infected mice as these regions are involved in defense behaviors control and emotion processing, and to assess the influence of the infection on mice behavior. The obtained results revealed the presence of parasite cysts both in the hippocampus and the amygdala of infected mice; however, no clear region-dependent distribution was observed. Furthermore, infected mice showed significantly diminished exploratory activity described by climbing and rearing, smaller preference for the central, more exposed part of the OF arena and engaged in less grooming behavior compared to uninfected controls.

Parasites or cohabitants: cruel omnipresent usurpers or creative "éminences grises"?

This paper presents many types of interplays between parasites and the host, showing the history of parasites, the effects of parasites on the outcome of wars, invasions, migrations, and on the development of numerous regions of the globe, and the impact of parasitic diseases on the society and on the course of human evolution. It also emphasizes the pressing need to change the look at the parasitism phenomenon, proposing that the term “cohabitant” is more accurate than parasite, because every living being, from bacteria to mammals, is a consortium of living beings in the pangenome. Even the term parasitology should be replaced by cohabitology because there is no parasite alone and host alone: both together compose a new adaptive system: the parasitized-host or the cohabitant-cohabited being. It also suggests switching the old paradigm based on attrition and destruction, to a new one founded on adaptation and living together.

CD8 T Cells and Toxoplasma gondii: A New Paradigm

CD8 T cells are essential for control of Toxoplasma gondii infection. Once activated they undergo differentiation into short-lived effector and memory precursor effector cells. As effector cells, CD8 T cells exert immune pressure on the parasite via production of inflammatory cytokines and through their cytolytic activity. Once immune control has been established, the parasite encysts and develops into chronic infection regulated by the memory CD8 T-cell population. Several signals are needed for this process to be initiated and for development of fully differentiated memory CD8 T cells. With newly developed tools including CD8 T-cell tetramers and TCR transgenic mice, dissecting the biology behind T. gondii-specific CD8 T-cell responses can now be more effectively addressed. In this paper, we discuss what is known about the signals required for effective T. gondii-specific CD8 T-cell development, their differentiation, and effector function.

Is there a relationship between Toxoplasma gondii infection and idiopathic Parkinson's disease?

Idiopathic Parkinson's disease defines a group of Parkinson's disease (PD) of which the aetiology is unknown but an underlying brain disease is suspected. We selected patients of this subgroup of PD and investigated the seropositivity rate for anti-Toxoplasma IgG antibody by Sabin-Feldman dye test (SFDT). By measuring seropositivity in PD patients, we searched for a probable relationship between Toxoplasma gondii infection and idiopathic PD incidence. Fifty patients diagnosed with idiopathic PD and 50 healthy volunteers were included in the study. Blood samples were taken from all 100 participants and anti-T. gondii antibody titres were investigated using SFDT. Anti-T. gondii antibodies were detected at a titre of >or=1/16 in 25 of the 50 patients (50%) and in 20 of the control group (40%). No higher antibody titre was found in the control group. In conclusion, despite the emerging literature on a possible relationship between T. gondii infection and neurological disease, and the high anti-T. gondii seropositivity found in our PD patients, we did not detect any statistically significant association between T. gondii and idiopathic PD.

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

BACKGROUND

There is growing interest in the role of microbial agents in the causation of psychiatric disorders. The neurotropic protozoan parasite Toxoplasma gondii is one of the main candidates and has been associated with various psychiatric conditions, including schizophrenia.

METHODS

A narrative review of the literature from the main medical databases (Medline, PubMed, PsycINFO), Google Scholar and Google using combinations of applicable terms.

RESULTS

T. gondii affects the brain in both the acute and the latent stages of infection causing apparent brain pathologies in infected rodents and both immuno-compromised and immuno-competent humans. In immuno-competent individuals, behavioural disorders are primarily related to the latent stages of the illness. Behavioural/mental disorders that include schizophrenia, mood disorders, personality changes and cognitive impairments may be related to infection with T. gondii. Evidence for a behavioural effect of T. gondii comes from observational reports in animal models and controlled behavioural analysis in humans. Indirect clues of infection also come from raised seroprevalence or serotitres of antitoxoplasma antibodies among those with mental disorders. The pathophysiologic mechanism through which T. gondii may exert its effect is not clear, but direct impact on the brain and changes in neuroimmunomodulation, neurotransmission and some gene-environment interactions are postulated.

CONCLUSION

There is evidence supporting a potential role of T. gondii infection in the onset of some behavioural disorders. Confirmation of such a role would prove a significant breakthrough in the search for the aetiology, treatment and prevention of behavioural disorders, such as schizophrenia. However, the associations remain preliminary.

Toxoplasma gondii: the effects of infection at different stages of pregnancy on the offspring of mice

Congenital toxoplasmosis can cause fetal damage in humans and domestic animals. This study was focused on the effects of Toxoplasma gondii (Prugniaud strain) infection at different stages of pregnancy on the offspring of mice. Results showed that newborn mice from all infected groups were significantly lower in weight than those from the control group but significant difference was not found among these groups at day 60 after birth. The survival rate of the offspring from the group of mice infected at the earlier stage of pregnancy was significantly lower than those of infected and control groups. The positive offspring (with cysts found in their brain tissues) born from the mice infected at the earlier and intermediate stages of pregnancy showed a shorter latency and greater number of errors in the step-through passive avoidance test than those born from the mice infected at the late stage of pregnancy, the control group and the negative offspring from the infected groups. The number of cysts in the brain tissue was significantly higher in the offspring born from the groups of mice infected at the earlier and intermediate stages of pregnancy than those from the group of mice infected at the late stage of pregnancy. In addition, our results indicated that a high congenital transmission rate (90%) occurred in this NIH mouse model. In conclusion, the earlier and intermediate maternal infection of T. gondii can result in severe congenital toxoplasmosis, exhibiting conditions such as stillbirth or non-viability, and learning or memory capability damage in this mouse model. These results not only provide useful data for better understanding the effects of T. gondii infection on the offspring of mice infected at different stages of pregnancy but also for better consideration of the effect of this infection on other mammalian hosts including humans.

Trimethoprim as adjuvant treatment in schizophrenia: a double-blind, randomized, placebo-controlled clinical trial

Various infectious agents, such as Toxoplasma gondii, have been hypothesized to be potentially relevant etiological factors in the onset of some cases of schizophrenia. We conducted a randomized, double-blind, placebo-controlled treatment trial in an attempt to explore the hypothesis that the symptoms of schizophrenia may be related to infection of the central nervous system with toxoplasma gondii. Systematically selected patients with ongoing and at least moderately severe schizophrenia from Butajira, in rural Ethiopia, were randomly allocated to trimethoprim or placebo, which were added on to participants' regular antipsychotic treatments. Trial treatments were given for 6 months. The Positive and Negative Syndrome Scale (PANSS) was used to assess outcome. Ninety-one patients were included in the study, with 80 cases (87.9%) positive for T. gondii immunoglobulin G antibody. Seventy-nine subjects (87.0%) completed the trial. The mean age of subjects was 35.3 (SD = 8.0) years, with a mean duration of illness of 13.2 (SD = 6.7) years. Both treatment groups showed significant reduction in the overall PANSS score with no significant between-group difference. In this sample of patients with chronic schizophrenia, trimethoprim used as adjuvant treatment is not superior to placebo. However, it is not possible to draw firm conclusion regarding the etiological role of toxoplasmosis on schizophrenia based on this study because the timing and the postulated mechanisms through which toxoplasmosis produces schizophrenia are variable.

Toxoplasma and schizophrenia

Research on infectious agents as a possible cause of schizophrenia has become prominent in the past decade. Toxoplasma gondii has emerged as a prime candidate for a variety of reasons; (i) many studies have reported that individuals with schizophrenia, compared to controls, have a higher prevalence of antibodies to T. gondii, (ii) some individuals with adult toxoplasmosis develop psychotic symptoms similar to those of schizophrenia, (iii) epidemiologically, there are many similarities between toxoplasmosis and schizophrenia, (iv) antipsychotic drugs known to be effective in schizophrenia also inhibit some parasites, including T. gondii, (v) Toxoplasma has been shown to induce elevated levels of dopamine in experimentally infected animals (elevated dopamine is commonly seen in individuals with schizophrenia) and (vi) studies have shown that individuals with schizophrenia, compared to controls, have had greater exposure to cats in childhood. A number of questions remain concerning a role for Toxoplasma in the aetiology of schizophrenia, including the roles of strain variation, the timing and source of infection, and the role of host genes in determining disease susceptibility. The establishment of a firm association between Toxoplasma and the aetiology of schizophrenia and related disorders would represent a major breakthrough in the understanding of these disorders and would lead to novel methods for their treatment and prevention.

The schizophrenia and Toxoplasma gondii connection: infectious, immune or both?

INTRODUCTION

Recent research has suggested a possible link between toxoplasmic agents and schizophrenia. We aimed to assess this by measuring Toxoplasma gondii-associated antibodies in schizophrenia patients and controls

METHODS

We used a commercially available enzyme-linked immunosorbent assay (ELISA) kit to measure the level of immunoglobulin G (IgG) and IgM antibodies in serum samples from schizophrenia patients (n=40) and from a group of non-schizophrenic control subjects (n=37)

RESULTS

Among schizophrenic patients, 16 (40%) showed IgG seropositivity and two (5%) showed IgM seropositivity. Among the control group, five (13.5%) were found have IgG seropositivity and one (2.7%) showed IgM seropositivity. In our study we found that IgG T gondii antibodies were significantly higher in schizophrenia patients compared with controls

CONCLUSIONS

This study supports the theory that toxoplasmic agents may have a role in the aetiology of schizophrenia.

Poorer results of mice with latent toxoplasmosis in learning tests: impaired learning processes or the novelty discrimination mechanism?

The heteroxenous protozoan parasite Toxoplasma gondii is transmitted from the intermediate host (any warm-blooded animal) to the definitive host (members of the felidae) by carnivory. The infected intermediate hosts develop several specific behavioural changes that are usually considered products of manipulative activity of the parasite aimed to increase the probability of its transmission to the definitive host. Among other changes, the infected rodents were shown to have impaired learning capability. All previous studies were done 2–6 weeks after the infection. Therefore, it was difficult to resolve whether the observed impairment of learning processes was a result of acute or latent toxoplasmosis, i.e. whether it was a side-effect of the disease or a product of manipulation activity. Here we studied the learning capability of Toxoplasma-infected mice in the static rod test and 8-arm radial maze test and their spontaneous activity in the wheel running test 10 weeks after the infection. The infected mice achieved worse scores in the learning tests but showed higher spontaneous activity in the wheel running test. However, a detailed study of the obtained results as well as of the data reported by other authors suggested that the differences between infected and control mice were a result of impaired ability to recognize novel stimuli rather than of impaired learning capacity in animals with latent toxoplasmosis.

Is Toxoplasma gondii a potential risk for traffic accidents in Turkey?

In Turkey, traffic accidents are the major causes of mortality and morbidity. According to the statistics made by Turkish Security Headquarters in the year 2000, 7500 people are killed in the traffic accidents every year. Drivers are mostly blamed for the traffic accidents. Tired, weary, sleepy and absentminded driving are common reasons for traffic accidents due to many reasons. Among these reasons mental and reflex conditions of drivers are significant. Toxoplasmosis is one of the most common zoonoses throughout the world. In immunocomponent adults, toxoplasmosis has no clinical signs or symptoms and infection in such people can only be detected by serological examinations. This kind of latent or dormant toxoplasmosis can be located in neural or muscular tissues and cause prolonged reaction times of the muscles. Extended reaction times also lead to deceleration of the reflexes which could be a major cause of the traffic accidents. By the light of this situation, the incidence of Toxoplasma gondii is investigated among the population who were involved in a traffic accident while driving. A total of 185 people (100 men and 85 women), aged between 21 and 40 years, living in Izmir and Manisa cities, were enrolled in the study group (SG) during a period of 6 months time. Their informed consents were taken initially and the laboratory tests of all these individuals related to blood alcohol levels after the accidents were found negative. The control group (CG) were also consisted 185 people (95 men and 90 women), residents of the same region, in same age group. The people in CG had no clinical signs or symptoms concerning toxoplasmosis. All collected sera were examined using a commercial IgG and IgM ELISA kit. According to the results of serological tests of the SG, 45 (24.32%) sera were IgG positive, six (3.24%) were IgM positive and 10 (5.40%) were both IgG and IgM positive. On the other hand in CG, 12 (6.48%) people found IgG positive, one (0.54%) found IgM positive and three (1.62%) found both IgG and IgM positive. This data was considered as statistically significant by Yates corrected chi2-test. (p < 0.05). In conclusion, there is an increased risk for traffic accidents for drivers owing to these high seroprevalence of latent toxoplasmosis. Prospective studies are still necessary on this subject but latent toxoplasmosis of drivers should be taken into account while developing strategies to prevent traffic accidents in Turkey.

Prevalence of Toxoplasma infection in first-episode schizophrenia and comparison between Toxoplasma-seropositive and Toxoplasma-seronegative schizophrenia

OBJECTIVE

To compare the prevalence of Toxoplasma infection between the first-episode schizophrenia and the controls and to compare the clinical features between the Toxoplasma-seronegative and Toxoplasma-seropositive patients with schizophrenia.

METHOD

The rate of serum reactivity to Toxoplasma in 600 schizophrenia, 600 affective disorders, and 400 controls was investigated. The clinical symptoms of the schizophrenia patients were scored and compared.

RESULTS

The rate of IgG antibody, not IgM in the schizophrenia patients, was higher than the control groups, and the odds ratio of schizophrenia associated with IgG antibody was 2.22-5.12. The affective disorders did not differ in the rate of IgG or IgM antibody from the normal or the physical disease control. The seropositive schizophrenia patients had higher scores on the positive subscale and three components of Positive and Negative Symptoms Scale than the seronegative patients.

CONCLUSION

This study lent further weight to the hypothesis that exposure to Toxoplasma may be a risk factor for schizophrenia.

Influence of latent 'asymptomatic' toxoplasmosis on body weight of pregnant women

The latent toxoplasmosis is usually considered to be asymptomatic, however, this paradigm has never been rigorously tested. Here we searched for symptoms of deterioration of physical health (decrease of weight) in infected people by analysis of clinical records of 758 women tested for toxoplasmosis in the 16th week of gravidity. Toxoplasma-positive women have a lower body weight in the 16th week of gravidity (p = 0.02) than Toxoplasma-negative women. Moreover, a negative correlation between weight and the duration of toxoplasmosis was found in a subset of 174 Toxoplasma-positive women (p = 0.04), suggesting that slow and cumulative effects of latent toxoplasmosis, rather than a transient effect of acute toxoplasmosis, are responsible for the decreased weight of infected subjects. Longer duration of gravidity estimated from the date of last menstruation in the set of Toxoplasma-positive women in the 16th week of gravidity estimated with ultrasonography (p = 0.04) suggests a possibility of retarded foetal growth in Toxoplasma-positive women. The prevalence of latent toxoplasmosis is extremely high. Therefore, even its mild symptoms such as the decreased body weight in Toxoplasma-positive pregnant women might in fact indicate an unrecognized serious public health problem.

Transmission of Toxoplasma: clues from the study of sea otters as sentinels of Toxoplasma gondii flow into the marine environment

Toxoplasma gondii affects a wide variety of hosts including threatened southern sea otters (Enhydra lutris nereis) which serve as sentinels for the detection of the parasite's transmission into marine ecosystems. Toxoplasmosis is a major cause of mortality and contributor to the slow rate of population recovery for southern sea otters in California. An updated seroprevalence analysis showed that 52% of 305 freshly dead, beachcast sea otters and 38% of 257 live sea otters sampled along the California coast from 1998 to 2004 were infected with T. gondii. Areas with high T. gondii exposure were predominantly sandy bays near urban centres with freshwater runoff. Genotypic characterisation of 15 new T. gondii isolates obtained from otters in 2004 identified only X alleles at B1 and SAG1. A total of 38/50 or 72% of all otter isolates so far examined have been infected with a Type X strain. Type X isolates were also obtained from a Pacific harbor seal (Phoca vitulina) and California sea lion (Zalophus californianus). Molecular analysis using the C8 RAPD marker showed that the X isolates were more genetically heterogeneous than archetypal Type I, II and III genotypes of T. gondii. The origin and transmission of the Type X T. gondii genotype are not yet clear. Sea otters do not prey on known intermediate hosts for T. gondii and vertical transmission appears to play a minor role in maintaining infection in the populations. Therefore, the most likely source of infection is by infectious, environmentally resistant oocysts that are shed in the feces of felids and transported via freshwater runoff into the marine ecosystem. As nearshore predators, otters serve as sentinels of protozoal pathogen flow into the marine environment since they share the same environment and consume some of the same foods as humans. Investigation into the processes promoting T. gondii infections in sea otters will provide a better understanding of terrestrial parasite flow and the emergence of disease at the interface between wildlife, domestic animals and humans.

Increased risk of traffic accidents in subjects with latent toxoplasmosis: a retrospective case-control study

BACKGROUND

The parasite Toxoplasma gondii infects 30-60% of humans worldwide. Latent toxoplasmosis, i.e., the life-long presence of Toxoplasma cysts in neural and muscular tissues, leads to prolongation of reaction times in infected subjects. It is not know, however, whether the changes observed in laboratory influence the performance of subjects in real-life situations.

METHODS

The seroprevalence of latent toxoplasmosis in subjects involved in traffic accidents (N=146) and in the general population living in the same area (N=446) was compared by a Mantel-Haenszel test for age-stratified data. Correlation between relative risk of traffic accident and a level of anti-Toxoplasma antibody titre was evaluated with the Cochran-Armitage test for trend.

RESULTS

A higher seroprevalence was found in the traffic accident set than in the general population (Chi2MH=21.45, p<0.0001). The value of the odds ratio (OR) suggests that subjects with latent toxoplasmosis had a 2.65 (C.I.95= 1.764.01) times higher risk of an accident than the toxoplasmosis-negative subjects. The OR significantly increased with level of anti-Toxoplasma antibody titre (p<0.0001), being low (OR=1.86, C.I.95=1.14-3.03) for the 99 subjects with low antibody titres (8 and 16), higher (OR=4.78, C.I.95=2.39-9.59) for the 37 subjects with moderate titres (32 and 64), and very high (OR=16.03, C.I.95=1.89-135.66) for the 6 subjects with titres higher than 64.

CONCLUSION

The subjects with latent toxoplasmosis have significantly increased risk of traffic accidents than the noninfected subjects. Relative risk of traffic accidents decreases with the duration of infection. These results suggest that 'asymptomatic' acquired toxoplasmosis might in fact represent a serious and highly underestimated public health as well as economic problem.

Host cell invasion by the opportunistic pathogen Toxoplasma gondii

Toxoplasma gondii is an obligate intracellular protozoan that infects an astonishing variety of vertebrate hosts including humans. Classified in the phylum Apicomplexa, T. gondii causes an opportunistic disease, toxoplasmosis, in individuals with immune dysfunction and congenital disease in infected infants. Re-emergence of toxoplasmosis as a life-threatening disease in patients with AIDS is anticipated in the wake of emerging multi-drug resistant strains of HIV. In immunodeficient patients, the available evidence suggests that tissue pathology associated with T. gondii infection is due to parasite-directed lytic destruction of individual host cells. The Toxoplasma lytic cycle begins when the parasite actively invades a target cell. In association with invasion, T. gondii sequentially discharges three sets of secretory organelles beginning with the micronemes, which contain adhesive proteins involved in parasite attachment to a host cell. Deployed as protein complexes, several micronemal proteins possess vertebrate-derived adhesive sequences that function in binding receptors on the surface of a target cell. Each protein in these adhesive complexes fulfills a specific role in movement through the secretory pathway, targeting to the micronemes, or adhesion. It is anticipated that these adhesive complexes recognize a variety of host receptors, including some that are expressed on multiple cell types, and that this diversity in host cell receptors contributes to the remarkably broad tissue- and host-range of T. gondii.

The schizophrenia-rheumatoid arthritis connection: infectious, immune, or both?

Schizophrenia and rheumatoid arthritis share an impressive number of similarities. Both are chronic, relapsing diseases of unknown etiology. Both became prominent in the early 19th century and have prevalences of approximately 1% in North America and Europe. Both run in families, have pairwise concordance rates of approximately 30% among monozygotic twins, and are more common among individuals born in urban areas. For both diseases, studies have reported greater exposure to cats in childhood than in controls. Both diseases have been associated with similar class II HLA antigens. Both have also been suspected of having infectious etiology, with similar agents--retroviruses, herpesviruses including EBV, and Toxoplasma gondii--having been associated in some cases. Since there is also a well-documented inverse correlation between these two diseases, it is possible that they share a common infectious and/or immune etiology and that once a person gets one of the diseases then they are relatively immune to the other.

Rats, cats, people and parasites: the impact of latent toxoplasmosis on behaviour

The manipulation hypothesis states a parasite may alter host behaviour for its own benefit, often by enhancing its transmission rate through the food chain. This paper reviews studies on the potential impact of one parasite, Toxoplasma gondii, on host behaviour, both on rodents, where altered responses may be proposed to benefit the parasite, and humans, where altered responses may arise as a side-effect of infection with no current adaptive significance.

Antibodies to Toxoplasma gondii in individuals with first-episode schizophrenia

We employed enzyme immunoassay (EIA) and Western blotting techniques to measure the level of antibodies to Toxoplasma gondii proteins in serum samples from 38 individuals undergoing their first episode of schizophrenia and from a group of matched control subjects. We found that the individuals with first-episode schizophrenia had significantly increased levels of IgG, IgM, and IgA class antibodies to Toxoplasma proteins, as compared with the control subjects.

Quinonic derivatives active against a virulent strain of Toxoplasma gondii. Synthesis of 2-methylfuro[2,3-g]- and [3,2-g]isoquinolinetriones

2-methylfuro[2,3-g]isoquinoline-4,7,9-trione (4) and 2-methylfuro[3,2-g]isoquinoline-4,6,9-trione (5) were prepared regiospecifically from 2-azadiene 9 and bromobenzofuran-4,7-diones 1 or 11. The activity of these two compounds and some other quinonic derivatives was evaluated in vitro against a virulent strain of Toxoplasma gondii. Compounds 4 and 7 were found to be as active as pyrimethamine.