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Fadel EF, EL-Hady HA, Ahmed AM, Tolba MEM. Molecular diagnosis of human toxoplasmosis: the state of the art. J Parasit Dis 2024; 48:201-216. [PMID: 38840888 PMCID: PMC11147977 DOI: 10.1007/s12639-024-01667-1] [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: 06/15/2023] [Accepted: 03/23/2024] [Indexed: 06/07/2024] Open
Abstract
Toxoplasma gondii (T. gondii) is an obligate intracellular apicomplexan protozoan that causes toxoplasmosis. Approximately one-third of the world's population is currently T. gondii-seropositive. Although most infections are symptomless, a few can produce retinal lesions and, in immunocompromised persons or when congenitally contracted, can progress to life-threatening central nervous system disseminated infections. Therefore, quick, and precise diagnosis is a must. Molecular techniques nowadays play a crucial role in toxoplasmosis diagnosis, particularly in immunocompromised patients or congenital toxoplasmosis. This review aimed to detail recent advancements in molecular diagnostics of T. gondii infections. The terms "Toxoplasmosis," "Molecular diagnostics," "PCR," "qPCR," "B1," and "rep529" were used to search the English-language literature. In developed nations, conventional PCR (PCR) and nested PCR have been supplanted by quantitative PCR (qPCR), although they are still widely employed in poor nations. The diagnosis of toxoplasmosis has been revolutionized by the emergence of molecular diagnostics. Unfortunately, there is still substantial interlaboratory variability. There is an immediate need for standardization to increase the comparability of results between laboratories and clinical trials. Graphical abstract A graphical abstract highlighting the summary of Toxoplasma molecular diagnostics, created using Biorender.com.
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Affiliation(s)
- Eman Fathi Fadel
- Department of Medical Parasitology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Hanaa Ahmed EL-Hady
- Department of Medical Parasitology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Amal Mostafa Ahmed
- Department of Medical Parasitology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mohammed Essa Marghany Tolba
- Department of Microbiology and Clinical Parasitology, Faculty of Medicine, King Khaled University, Abha, Saudi Arabia
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Guitard J, Brenier-Pinchart MP, Varlet-Marie E, Dalle F, Rouges C, Argy N, Bonhomme J, Capitaine A, Guégan H, Lavergne RA, Dardé ML, Pelloux H, Robert-Gangneux F, Yera H, Sterkers Y. Multicenter evaluation of the Toxoplasma gondii Real-TM (Sacace) kit performance for the molecular diagnosis of toxoplasmosis. J Clin Microbiol 2024; 62:e0142823. [PMID: 38470023 PMCID: PMC11005372 DOI: 10.1128/jcm.01428-23] [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: 10/30/2023] [Accepted: 02/20/2024] [Indexed: 03/13/2024] Open
Abstract
The molecular detection of Toxoplasma gondii DNA is a key tool for the diagnosis of disseminated and congenital toxoplasmosis. This multicentric study from the Molecular Biology Pole of the French National Reference Center for toxoplasmosis aimed to evaluate Toxoplasma gondii Real-TM PCR kit (Sacace). The study compared the analytical and clinical performances of this PCR assay with the reference PCRs used in proficient laboratories. PCR efficiencies varied from 90% to 112%; linearity zone extended over four log units (R2 > 0.99) and limit of detection varied from 0.01 to ≤1 Tg/mL depending on the center. Determined on 173 cryopreserved DNAs from a large range of clinical specimens, clinical sensitivity was 100% [106/106; 95 confidence interval (CI): 96.5%-100%] and specificity was 100% (67/67; 95 CI: 94.6%-100%). The study revealed two potential limitations of the Sacace PCR assay: the first was the inconsistency of the internal control (IC) when added to the PCR mixture. This point was not found under routine conditions when the IC was added during the extraction step. The second is a lack of practicality, as the mixture is distributed over several vials, requiring numerous pipetting operations. Overall, this study provides useful information for the molecular diagnosis of toxoplasmosis; the analytical and clinical performances of the Sacace PCR kit were satisfactory, the kit having sensitivity and specificity similar to those of expert center methods and being able to detect low parasite loads, at levels where multiplicative analysis gives inconsistently positive results. Finally, the study recommends multiplicative analysis in particular for amniotic fluids, aqueous humor, and other single specimens.
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Affiliation(s)
- Juliette Guitard
- Sorbonne University, INSERM, Centre de Recherche Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Saint-Antoine Hospital Parasitology-Mycology Laboratory, Paris, France
- Molecular Biology group of the French National Reference Center for Toxoplasmosis, Montpellier, France
| | - Marie-Pierre Brenier-Pinchart
- Molecular Biology group of the French National Reference Center for Toxoplasmosis, Montpellier, France
- Parasitology-Mycology Laboratory, CHU Grenoble Alpes, Grenoble Alpes University, Grenoble, France
| | - Emmanuelle Varlet-Marie
- Molecular Biology group of the French National Reference Center for Toxoplasmosis, Montpellier, France
- Department of Parasitology-Mycology, University of Montpellier, CNRS, IRD, University Hospital Center (CHU) of Montpellier, MiVEGEC, Montpellier, France
| | - Frédéric Dalle
- Molecular Biology group of the French National Reference Center for Toxoplasmosis, Montpellier, France
- Parasitology-Mycology Laboratory, CHU Dijon, Dijon, France
| | - Celia Rouges
- Parasitology-Mycology Laboratory, Cochin Hospital, Paris, France
| | - Nicolas Argy
- Parasitology-Mycology Laboratory, Bichat Hospital, Paris, France
| | - Julie Bonhomme
- Parasitology-Mycology Laboratory, CHU Caen Normandie, Caen, France
| | - Agathe Capitaine
- Parasitology-Mycology Laboratory, CHU Caen Normandie, Caen, France
| | - Hélène Guégan
- Molecular Biology group of the French National Reference Center for Toxoplasmosis, Montpellier, France
- Parasitology-Mycology Laboratory, CHU Rennes, Rennes, France
| | - Rose-Anne Lavergne
- Nantes Université, CHU Nantes, Cibles et Médicaments des Infections et de l’Immunité, IICiMed, UR, Nantes, France
| | | | - Hervé Pelloux
- Molecular Biology group of the French National Reference Center for Toxoplasmosis, Montpellier, France
- Parasitology-Mycology Laboratory, CHU Grenoble Alpes, Grenoble Alpes University, Grenoble, France
| | - Florence Robert-Gangneux
- Molecular Biology group of the French National Reference Center for Toxoplasmosis, Montpellier, France
- Parasitology-Mycology Laboratory, CHU Rennes, Rennes, France
| | - Hélène Yera
- Parasitology-Mycology Laboratory, Cochin Hospital, Paris, France
- Parasitology-Mycology Laboratory, CHU Limoges, Limoges, France
| | - Yvon Sterkers
- Molecular Biology group of the French National Reference Center for Toxoplasmosis, Montpellier, France
- Parasitology-Mycology Laboratory, Cochin Hospital, Paris, France
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Franco PS, Scussel ACMO, Silva RJ, Araújo TE, Gonzaga HT, Marcon CF, Brito-de-Sousa JP, Diniz ALD, Paschoini MC, Barbosa BF, Martins-Filho OA, Mineo JR, Ferro EAV, Gomes AO. Systematic Review and Meta-Analysis of Congenital Toxoplasmosis Diagnosis: Advances and Challenges. J Trop Med 2024; 2024:1514178. [PMID: 38419946 PMCID: PMC10901580 DOI: 10.1155/2024/1514178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 10/21/2023] [Accepted: 02/06/2024] [Indexed: 03/02/2024] Open
Abstract
Objective To understand how congenital toxoplasmosis (CT) diagnosis has evolved over the years, we performed a systematic review and meta-analysis to summarize the kind of analysis that has been employed for CT diagnosis. Methods PubMed and Lilacs databases were used in order to access the kind of analysis that has been employed for CT diagnosis in several samples. Our search combined the following combining terms: "congenital toxoplasmosis" or "gestational toxoplasmosis" and "diagnosis" and "blood," "serum," "amniotic fluid," "placenta," or "colostrum." We extracted data on true positive, true negative, false positive, and false negative to generate pooled sensitivity, specificity, and diagnostic odds ratio (DOR). Random-effects models using MetaDTA were used for analysis. Results Sixty-five articles were included in the study aiming for comparisons (75.4%), diagnosis performance (52.3%), diagnosis improvement (32.3%), or to distinguish acute/chronic infection phases (36.9%). Amniotic fluid (AF) and placenta were used in 36.9% and 10.8% of articles, respectively, targeting parasites and/or T. gondii DNA. Blood was used in 86% of articles for enzymatic assays. Colostrum was used in one article to search for antibodies. In meta-analysis, PCR in AF showed the best performance for CT diagnosis based on the highest summary sensitivity (85.1%) and specificity (99.7%) added to lower magnitude heterogeneity. Conclusion Most of the assays being researched to diagnose CT are basically the same traditional approaches available for clinical purposes. The range in diagnostic performance and the challenges imposed by CT diagnosis indicate the need to better explore pregnancy samples in search of new possibilities for diagnostic tools. Exploring immunological markers and using bioinformatics tools and T. gondii recombinant antigens should address the research needed for a new generation of diagnostic tools to face these challenges.
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Affiliation(s)
- Priscila Silva Franco
- Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil
| | | | - Rafaela José Silva
- Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil
| | - Thadia Evelyn Araújo
- Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil
- Instituto René Rachou, Fundação Oswaldo Cruz, Avenida Augusto de Lima, 1715, Barro Preto 30190-002, Belo Horizonte, MG, Brazil
| | - Henrique Tomaz Gonzaga
- Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil
| | - Camila Ferreira Marcon
- Universidade Federal do Triângulo Mineiro, Rua Frei Paulino, 30, Nossa Sra. da Abadia 38025-180, Uberaba, MG, Brazil
| | - Joaquim Pedro Brito-de-Sousa
- Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil
- Instituto René Rachou, Fundação Oswaldo Cruz, Avenida Augusto de Lima, 1715, Barro Preto 30190-002, Belo Horizonte, MG, Brazil
| | - Angélica Lemos Debs Diniz
- Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil
| | - Marina Carvalho Paschoini
- Universidade Federal do Triângulo Mineiro, Rua Frei Paulino, 30, Nossa Sra. da Abadia 38025-180, Uberaba, MG, Brazil
| | - Bellisa Freitas Barbosa
- Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil
| | - Olindo Assis Martins-Filho
- Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil
- Instituto René Rachou, Fundação Oswaldo Cruz, Avenida Augusto de Lima, 1715, Barro Preto 30190-002, Belo Horizonte, MG, Brazil
| | - José Roberto Mineo
- Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil
| | - Eloisa Amália Vieira Ferro
- Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil
| | - Angelica Oliveira Gomes
- Universidade Federal do Triângulo Mineiro, Rua Frei Paulino, 30, Nossa Sra. da Abadia 38025-180, Uberaba, MG, Brazil
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Arkhis S, Rouges C, Dahane N, Guegan H, Yéra H, Robert-Gangneux F. Could PLATELIA Toxo IgM be the new gold standard for the serological diagnosis of congenital toxoplasmosis: a French multicenter study. J Clin Microbiol 2024; 62:e0122223. [PMID: 38259072 PMCID: PMC10865801 DOI: 10.1128/jcm.01222-23] [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: 09/18/2023] [Accepted: 12/05/2023] [Indexed: 01/24/2024] Open
Abstract
To assess the performance of PLATELIA Toxo IgM (Bio-Rad) and Toxo ISAGA (BioMérieux) to detect anti-Toxoplasma IgM in infants at risk of congenital toxoplasmosis, a retrospective multicenter study was conducted comparing serological results obtained in the framework of routine diagnosis work-up for congenital toxoplasmosis. All infants born to mothers infected with T. gondii during pregnancy from 2010 to 2020 with at least 6 months of serological follow-up were included (n = 1,010). One thousand ten cases were included, of which 250 infants (24.75%) had congenital toxoplasmosis. A total of 1039 sera were included. The concordance between the two techniques was 96%, with kappa coefficient of 0.87, showing an almost perfect agreement between ISAGA and PLATELIA. Cumulative sensitivity and specificity were 73.2% and 99.5.% and 74.8% and 100% for ISAGA and PLATELIA, respectively. The mean time to detect IgM using ISAGA and PLATELIA tests was 6.9 ± 20.1 days and 5.6 ± 14.7 days, respectively not significant (ns). Finally, the sensitivity of ISAGA and PLATELIA to detect IgM antibodies in infected neonates at 5 days of life was 62% and 64%, respectively. Performances of PLATELIA Toxo IgM assay were comparable to the gold standard ISAGA. This enzyme-linked immunosorbent assay is suitable for routine serology for the diagnosis of congenital toxoplasmosis in newborns. IMPORTANCE This study will help clinical microbiologists to chose an alternative serological method for the neonatal diagnosis of congenital toxoplasmosis, once the gold standard technique ISAGA will be withdrawn next year.
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Affiliation(s)
- Safya Arkhis
- Laboratory of Parasitology and Mycology, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Celia Rouges
- Department of Parasitology and Mycology, Cochin University Hospital, AP-HP, Paris, France
| | - Naïma Dahane
- Department of Parasitology and Mycology, Cochin University Hospital, AP-HP, Paris, France
| | - Hélène Guegan
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Travail), Rennes, France
| | - Hélène Yéra
- Department of Parasitology and Mycology, Cochin University Hospital, AP-HP, Paris, France
- Department of Parasitology and Mycology, Dupuytren University Hospital, Limoges, France
| | - Florence Robert-Gangneux
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Travail), Rennes, France
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Rico-Torres CP, Valenzuela-Moreno LF, Luna-Pastén H, Cedillo-Peláez C, Correa D, Morales-Salinas E, Martínez-Maya JJ, Alves BF, Pena HFJ, Caballero-Ortega H. Genotyping of toxoplasma gondii isolates from México reveals non-archetypal and potentially virulent strains for mice. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2023; 113:105473. [PMID: 37353185 DOI: 10.1016/j.meegid.2023.105473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/14/2023] [Accepted: 06/20/2023] [Indexed: 06/25/2023]
Abstract
Genotyping and virulence studies of Toxoplasma gondii are essential to investigate the pathogenesis of strains circulating worldwide. In this study, eight T. gondii isolates obtained from a congenitally infected newborn, a calf, two cats, three dogs, and a wallaby from five states of México were genotyped by Mn-PCR-RFLP with 11 typing markers (SAG1, SAG2 5'3', alt. SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1 and Apico), five virulence markers (CS3, ROP16, ROP17, ROP18 and ROP5), 15 microsatellite markers (TUB-2, W35, TgM-A, B18, B17, M33, IV.1, XI.1, M48, M102, N60, N82, AA, N61, N83), and sequencing. A phylogenetic network was built to determine the relationship between Mexican isolates and those reported worldwide. Six different genotypes were identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), ToxoDB #8, #10, #28 (n = 3), #48, #116, and #282. Genotyping by microsatellite analysis differentiated the three PCR-RFLP genotype #28 isolates into two strains, revealing a total of seven microsatellite genotypes. Three different allele combinations of ROP18/ROP5 virulence markers were also found, 3/3, 1/1, and 4/1. The last two combinations are predicted to be highly virulent in the murine model. According to the phylogenetic network, the T. gondii strains studied here are related to archetypal strains I and III, but none are related to the strains previously reported in México. The genotypes identified in this study in different species of animals demonstrate the great genetic diversity of T. gondii in México. The ToxoDB-PCR-RFLP #28 genotype was found in three isolates from different hosts and states. Additionally, four of the isolates are predicted to be highly virulent in mice. The next step will be to perform in vitro and in vivo assays to determine the phenotype of these T. gondii isolates in murine models.
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Affiliation(s)
- Claudia Patricia Rico-Torres
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700C, Colonia Insurgentes Cuicuilco, Alcaldía Coyoacán, C.P. 04530 Ciudad de México, Mexico
| | - Luis Fernando Valenzuela-Moreno
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700C, Colonia Insurgentes Cuicuilco, Alcaldía Coyoacán, C.P. 04530 Ciudad de México, Mexico
| | - Héctor Luna-Pastén
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700C, Colonia Insurgentes Cuicuilco, Alcaldía Coyoacán, C.P. 04530 Ciudad de México, Mexico
| | - Carlos Cedillo-Peláez
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700C, Colonia Insurgentes Cuicuilco, Alcaldía Coyoacán, C.P. 04530 Ciudad de México, Mexico
| | - Dolores Correa
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700C, Colonia Insurgentes Cuicuilco, Alcaldía Coyoacán, C.P. 04530 Ciudad de México, Mexico
| | - Elizabeth Morales-Salinas
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Av. Universidad 3000, Circuito Exterior s/n, Alcaldía Coyoacán, C.P. 04510, Ciudad Universitaria, Ciudad de México, Mexico
| | - José Juan Martínez-Maya
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Av. Universidad 3000, Circuito Exterior s/n, Alcaldía Coyoacán, C.P. 04510, Ciudad Universitaria, Ciudad de México, Mexico
| | - Bruna Farias Alves
- 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, SP, 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, SP, Brazil.
| | - Heriberto Caballero-Ortega
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700C, Colonia Insurgentes Cuicuilco, Alcaldía Coyoacán, C.P. 04530 Ciudad de México, Mexico.
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Aly NSM, Kim HS, Marei YM, Elhamshary AS, Bayoumi IR, Omar RE, Mohammed DA, Miyoshi SI, Rashed GA. Diagnosis of Toxoplasmosis Using Surface Antigen Grade 1 Detection by ELISA, Nano-Gold ELISA, and PCR in Pregnant Women. Int J Nanomedicine 2023; 18:1335-1345. [PMID: 36974071 PMCID: PMC10039636 DOI: 10.2147/ijn.s401876] [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: 12/29/2022] [Accepted: 03/14/2023] [Indexed: 03/29/2023] Open
Abstract
Introduction The accurate diagnosis of toxoplasmosis has critical importance in pregnant women. Nanotechnology and molecular biology are making possible opportunities for accurate and rapid diagnosis of many infectious diseases. Aim and Methods The aim of our study was to compare nano-gold ELISA with ELISA and PCR for diagnosis of toxoplasmosis using Toxoplasma surface antigen grade 1 (SAG1) in pregnant women seeking antenatal care in outpatient clinics. Results PCR showed the highest diagnostic values than nano-gold ELISA and ELISA regarding sensitivity (97.3% versus 89.2% and 83.8%); specificity (100% versus 94% and 88%); and diagnostic accuracy (98.9% versus 91.95% and 86.2%), respectively. There is no statistical difference between PCR and nanogold ELISA results. Discussion Nano-gold ELISA had a significant improvement in diagnosis than the traditional ELISA method. Most likely with the assistance of nanoparticles, more antibodies enter the antigen-antibody complex because of the considerable improvement in the surface area of nano-gold particles. Conclusion Although PCR had higher diagnostic values than nano ELISA, nano ELISA is cheaper and easier than PCR. We recommend nano-gold ELISA with SAG1 as a promising technique in the diagnosis of toxoplasmosis and survey studies.
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Affiliation(s)
- Nagwa S M Aly
- Department of Parasitology, Benha Faculty of Medicine, Benha University, Benha, 13511, Egypt
- Division of International Infectious Diseases Control, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, 700-8530, Japan
- Correspondence: Nagwa SM Aly, Department of Parasitology, Benha Faculty of Medicine, Benha University, Fareed Nada Street, Benha, 13511, Egypt, Tel +2-13-9101186, Email
| | - Hye-Sook Kim
- Division of International Infectious Diseases Control, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, 700-8530, Japan
| | - Yasmin M Marei
- Medical Biochemistry Department, Faculty of Medicine, Benha University, Benha, 13511, Egypt
| | - Azza S Elhamshary
- Department of Parasitology, Benha Faculty of Medicine, Benha University, Benha, 13511, Egypt
| | - Ibrahim R Bayoumi
- Parasitology Department, Theodor Bilharz Research Institute, Giza, Egypt
| | - Rabab E Omar
- Department of Parasitology, Benha Faculty of Medicine, Benha University, Benha, 13511, Egypt
| | - Dina A Mohammed
- Department of Parasitology, Benha Faculty of Medicine, Benha University, Benha, 13511, Egypt
| | - Shin-Ichi Miyoshi
- Department of Sanitary Microbiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, 700-8530, Japan
| | - Gehan A Rashed
- Department of Parasitology, Benha Faculty of Medicine, Benha University, Benha, 13511, Egypt
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Paraboni MLR, Manfredini V, Schreiner GE, Gonçalves IL, Silveira C, Commodaro AG, Belfort R. Comparative study of oxidative stress and antioxidative markers in patients infected with Toxoplasma gondii. Parasitol Int 2022; 91:102645. [PMID: 35977613 DOI: 10.1016/j.parint.2022.102645] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/11/2022] [Indexed: 11/28/2022]
Abstract
Recently, oxidative stress and antioxidative compounds have been described as potential biomarkers. However, there is no consensus on the most appropriate oxidative and antioxidative biomarkers for patients with Toxoplasma gondii. In the present study, we evaluated the levels of lipid, protein, DNA oxidative damage and antioxidants in samples from patients infected with T. gondii with and without ocular toxoplasmosis. The levels of MDA, TBARS, micronuclei, carbonyl, GSH, vitamin C and vitamin E were measured on samples from 8 patients positive for T. gondii antibodies with ocular toxoplasmosis (OT), 20 patients positive for T. gondii antibodies without ocular toxoplasmosis (non OT), and 12 healthy individuals negative for T. gondii antibodies. The levels of MDA, TBARS, carbonyl and micronuclei were significantly higher in non OT patients, while MDA and TBARS levels were lower in OT patients. In contrast, the antioxidative factors, GSH and vitamin E levels were significantly lower in non OT patients, while vitamin C was lower in non OT and OT patients. Additionally, non OT patients were indicated to be high producers of oxidative markers (TBARS, MDA, micronuclei and carbonyl), while control group was indicated to be high producer of antioxidative markers (GSH, vitamins C and E). However, OT patients were not found as high producers of oxidative nor antioxidative markers. Our results provide a starting point of possible markers to better understand the disease pathogenesis in patients infected with T. gondii. Additional studies are needed to clarify the potential contribution of oxidative and antioxidative markers in these patients population.
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Affiliation(s)
- Marisa Lúcia Romani Paraboni
- Department of Ophthalmology, Federal University of Sao Paulo, Sao Paulo, Brazil; Universidade Regional Integrada Alto Uruguai e Missões, Sete de Setembro Avenue, 1621, Erechim, Rio Grande do Sul 99709-910, Brazil.
| | - Vanusa Manfredini
- Programa de Pós-graduação em Bioquímica, Universidade Federal do Pampa, BR 472, Km 585, Uruguaiana, RS, Brazil
| | - Gênifer Erminda Schreiner
- Programa de Pós-graduação em Bioquímica, Universidade Federal do Pampa, BR 472, Km 585, Uruguaiana, RS, Brazil
| | - Itamar Luís Gonçalves
- Universidade Regional Integrada Alto Uruguai e Missões, Sete de Setembro Avenue, 1621, Erechim, Rio Grande do Sul 99709-910, Brazil
| | - Claudio Silveira
- Clinica Silveira, Sete de Setembro Avenue, 1502, Erechim, Rio Grande do Sul, Brazil
| | | | - Rubens Belfort
- Department of Ophthalmology, Federal University of Sao Paulo, Sao Paulo, Brazil
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de Barros RAM, Torrecilhas AC, Marciano MAM, Mazuz ML, Pereira-Chioccola VL, Fux B. Toxoplasmosis in Human and Animals Around the World. Diagnosis and Perspectives in the One Health Approach. Acta Trop 2022; 231:106432. [PMID: 35390311 DOI: 10.1016/j.actatropica.2022.106432] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/25/2022] [Accepted: 03/27/2022] [Indexed: 12/12/2022]
Abstract
Toxoplasmosis is a unique health disease that significantly affects the health of humans, domestic animals, wildlife and is present in ecosystems, including water, soil and food. Toxoplasma gondii is one of the best-adapted parasites in the word. This parasite is able to persist for long periods in its hosts, in different geographic regions of the word. This review summarizes the current literature of these themes, focusing on: (1) toxoplasmosis, a zoonotic infection; (2) One health approach and toxoplasmosis; (3) human toxoplasmosis; (4) animal toxoplasmosis; (5) toxoplasmosis diagnosis, as immunological, parasitological and molecular diagnosis; (6) T. gondii outbreaks caused by infected meat, milk and dairy products, as well as, vegetables and water consume; (7) studies in experimental models; (8) genetic characterization of T. gondii strains; (9) extracellular vesicles and miRNA; and (10) future perspectives on T. gondii and toxoplasmosis. The vast prevalence of toxoplasmosis in both humans and animals and the dispersion and resistence of T. gondii parasites in environment highlight the importance of the one health approach in diagnostic and control of the disease. Here the different aspects of the one health approach are presented and discussed.
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Affiliation(s)
- Rosangela Aparecida Müller de Barros
- Unidade de Medicina Tropical, Departamento de Patologia, Universidade Federal do Espirito Santo, Vitoria, ES, Brazil.; Programa em Doenças Infecciosas, Centro de Doenças Infecciosas, Universidade Federal do Espirito Santo, Vitoria, ES, Brazil..
| | - Ana Claudia Torrecilhas
- Laboratório de Imunologia Celular e Bioquímica de Fungos e Protozoários, Departamento de Ciências Farmacêuticas, Universidade Federal de São Paulo (UNIFESP), Campus Diadema, Sao Paulo, SP, Brazil..
| | | | - Monica Leszkowicz Mazuz
- Parasitology Division, Kimron Veterinary Institute, Israeli Veterinary Service and Animal Health, Ministry of Agriculture and Rural Development Beit Dagan, 5025000, Israel..
| | | | - Blima Fux
- Unidade de Medicina Tropical, Departamento de Patologia, Universidade Federal do Espirito Santo, Vitoria, ES, Brazil.; Programa em Doenças Infecciosas, Centro de Doenças Infecciosas, Universidade Federal do Espirito Santo, Vitoria, ES, Brazil..
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9
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Valenzuela-Moreno LF, Carmona-Muciño MDC, Cedillo-Peláez C, Rico-Torres CP, Luna-Pastén H, Hernández-Rodríguez MA, Caballero-Ortega H. Acute Disseminated Toxoplasmosis in Two Specimens of Macropus rufogriseus Caused by a Genotype so far Exclusive to South America. Front Vet Sci 2022; 9:923976. [PMID: 35782563 PMCID: PMC9240756 DOI: 10.3389/fvets.2022.923976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022] Open
Abstract
Macropods are included among the species considered highly susceptible to Toxoplasma gondii infection. Clinically, it is difficult to distinguish between acute toxoplasmosis due to primary infection and reactivation of chronic latent infection in susceptible species until pathologic studies are performed. Here, we described the clinical cases and lesions found in two deceased Bennett's wallabies (Macropus rufogriseus) with a presumptive diagnosis of toxoplasmosis, as well as the genetic characterization of the T. gondii isolates obtained from these specimens. Both animals presented acute infection lesions in the lungs, liver, spleen and lymph nodes associated to T. gondii infection. Histopathology and immunohistochemistry also demonstrated tissue cysts of different sizes, indicating that the wallabies were previously infected with this parasite. Two isolates were obtained, one from each specimen and the molecular characterization was done; both isolates were the ToxoDB #116 genotype. This is the first study that reports the isolation of this particular genotype outside South America, and given the histopathological findings, it could be considered virulent for this species. The dynamics of infection that T. gondii is causing in definitive and intermediate hosts in a region allows us to know the risks to which the animals and humans that live in the area are exposed, and in the future to implement a preventive medicine plan against this parasite.
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Affiliation(s)
- Luis Fernando Valenzuela-Moreno
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Demarcación Territorial Coyoacán, Ciudad de México, Mexico
| | | | - Carlos Cedillo-Peláez
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Demarcación Territorial Coyoacán, Ciudad de México, Mexico
| | - Claudia Patricia Rico-Torres
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Demarcación Territorial Coyoacán, Ciudad de México, Mexico
| | - Héctor Luna-Pastén
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Demarcación Territorial Coyoacán, Ciudad de México, Mexico
| | | | - Heriberto Caballero-Ortega
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Demarcación Territorial Coyoacán, Ciudad de México, Mexico
- *Correspondence: Heriberto Caballero-Ortega
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10
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Brenier-Pinchart MP, Filisetti D, Cassaing S, Varlet-Marie E, Robert-Gangneux F, Delhaes L, Guitard J, Yéra H, Bastien P, Pelloux H, Sterkers Y. Molecular Diagnosis of Toxoplasmosis: Multicenter Evaluation of the Toxoplasma RealCycler Universal PCR Assay on 168 Characterized Human Samples. J Mol Diagn 2022; 24:687-696. [PMID: 35452843 DOI: 10.1016/j.jmoldx.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/20/2022] [Accepted: 03/04/2022] [Indexed: 10/18/2022] Open
Abstract
Real-time PCR plays a crucial role in the diagnosis of toxoplasmosis. In this multicenter study, the Toxoplasma RealCycler Universal assay was assessed for the diagnosis of toxoplasmosis by eight reference laboratories. DNAs from diverse clinical samples were included: 141 characterized samples from patients with different clinical forms of proven toxoplasmosis and 27 from patients without toxoplasmosis were tested in duplicate with the commercial assay. Final diagnosis was affirmed by each center by analysis of clinical settings and biological follow-up. Calibrated Toxoplasma gondii standards and 11 external quality control samples were also included. Discrepant results observed after the first run of commercial PCR were controlled by both reference and commercial PCR assays. Using the commercial assay, the detection threshold varied from 0.01 to 1 tachyzoites/mL, depending on the center. The relationship between crossing point and DNA concentration was linear over 4 log units (r2 > 0.99), and PCR efficiencies were satisfactory (89% to 104%). The results of the 11 external quality control samples were concordant after one retesting, but those for 3 clinical samples remained discrepant. Sensitivity and specificity were calculated at 97.8% (95% CI, 97.8%-100%) and 100% (95% CI, 87.2%-100%), respectively. Provided that PCRs are performed at least in duplicate to detect low parasitic loads, Toxoplasma RealCycler Universal PCR showed suitable performances to diagnose the different forms of toxoplasmosis.
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Affiliation(s)
- Marie-Pierre Brenier-Pinchart
- Parasitology-Mycology Laboratory, Centre Hospitalier Universitaire Grenoble Alpes and University of Grenoble Alpes, Grenoble, France; "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France.
| | - Denis Filisetti
- "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France; Parasitology-Medical Mycology Laboratory, Parasitology and Tropical Diseases Institute, University Hospitals and University of Strasbourg, Strasbourg, France
| | - Sophie Cassaing
- "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France; Parasitology-Mycology Laboratory, Centre Hospitalier Universitaire de Toulouse and University of Toulouse, Toulouse, France
| | - Emmanuelle Varlet-Marie
- "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France; Parasitology-Mycology Department, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Florence Robert-Gangneux
- "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France; Centre Hospitalier Universitaire de Rennes and Ecole des Hautes Etudes en Santé Publique, University of Rennes, Rennes, France
| | - Laurence Delhaes
- "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France; Parasitology-Mycology Laboratory, Centre Hospitalier Universitaire de Bordeaux and Cardio-Thoracic Research Center, University of Bordeaux, Bordeaux, France
| | - Juliette Guitard
- "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France; Parasitology Mycology Department, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris and Saint-Antoine Research Center, Sorbonne University, Paris, France
| | - Hélène Yéra
- "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France; Parasitology-Mycology Laboratory, Cochin Hospital, Assistance Publique-Hôpitaux de Paris and University of Paris, Paris, France
| | - Patrick Bastien
- "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France; Parasitology-Mycology Department, Centre Hospitalier Universitaire de Montpellier and MiVEGEC, Institut de Recherche pour Le Développement, University of Montpellier, Montpellier, France
| | - Hervé Pelloux
- "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France; Parasitology-Mycology Laboratory, Centre Hospitalier Universitaire Grenoble Alpes and University of Grenoble Alpes, Grenoble, France
| | - Yvon Sterkers
- "Molecular Biology" Pole of the National Reference Center for Toxoplasmosis, Montpellier, France; Parasitology-Mycology Department, Centre Hospitalier Universitaire de Montpellier and MiVEGEC, Institut de Recherche pour Le Développement, University of Montpellier, Montpellier, France
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11
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Diagnosis of Congenital Toxoplasmosis: Performance of Four IgG and IgM Automated Assays at Birth in a Tricentric Evaluation. J Clin Microbiol 2022; 60:e0011522. [DOI: 10.1128/jcm.00115-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
For postnatal diagnosis of congenital toxoplasmosis (CT), the gold standard for the detection of anti-
Toxoplasma
IgM in newborns relies on the immunosorbent agglutination assay (ISAGA), which is manufactured from whole
Toxoplasma
parasites that become difficult to maintain. For IgG, only the Platelia assay provides a validated assay for cord blood according to the manufacturer, allowing its use in this context.
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12
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Ludwig A, D'ambroso Fernandes F, Rojas Guerra R, Braünig P, Silva Ramos L, Souto Pacheco L, Sangioni LA, Silveira Flores Vogel F. Molecular detection of Toxoplasma gondii in placentas of women who received therapy during gestation in a toxoplasmosis outbreak. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2022; 97:105145. [PMID: 34798319 DOI: 10.1016/j.meegid.2021.105145] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/10/2021] [Accepted: 11/14/2021] [Indexed: 06/13/2023]
Abstract
Toxoplasmosis is a disease caused by T. gondii, a protozoa which affects humans and animals and is widely distributed worldwide. In humans, there is great concern due to the serious consequences that can occur in the infection of pregnant women and the newborn. The early diagnosis of gestational toxoplasmosis is important for treatment to be carried out in order to prevent vertical transmission or reduce damage. The diagnosis can be made through the detection of antibodies in pregnant women or neonates and PCR of amniotic fluid. Previous studies have also reported PCR of the placenta as a good diagnostic test. Our study evaluated the detection of T. gondii DNA in placenta samples from parturients seen at the University Hospital of Santa Maria, Southern Brazil and treated during the pregnancy. We performed PCR in forty samples and five were positive, representing 12.5%. When correlating the treatment time and the detection of DNA in the placentas, no significant result was found. The prevalence of positive samples was lower than in other studies in the literature. The data reaffirm the importance of carrying out the analysis of the placenta.
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Affiliation(s)
- Aline Ludwig
- Laboratório de Doenças Parasitárias (LADOPAR), Departamento de Medicina Veterinária Preventiva (DMVP), Centro de Ciências Rurais (CCR), Universidade Federal de Santa Maria (UFSM), Av. Roraima, n°1000, Prédio 63C, Bairro Camobi, CEP: 97105-900 Santa Maria, RS, Brazil
| | - Fagner D'ambroso Fernandes
- Laboratório de Doenças Parasitárias (LADOPAR), Departamento de Medicina Veterinária Preventiva (DMVP), Centro de Ciências Rurais (CCR), Universidade Federal de Santa Maria (UFSM), Av. Roraima, n°1000, Prédio 63C, Bairro Camobi, CEP: 97105-900 Santa Maria, RS, Brazil.
| | - Renata Rojas Guerra
- Departamento de Estatística (DE), Centro de Ciências Naturais e Exatas (CCNE), Universidade Federal de Santa Maria (UFSM), Av. Roraima, n°1000, Prédio 13, Bairro Camobi, CEP: 97105-900 Santa Maria, Brazil
| | - Patricia Braünig
- Laboratório de Doenças Parasitárias (LADOPAR), Departamento de Medicina Veterinária Preventiva (DMVP), Centro de Ciências Rurais (CCR), Universidade Federal de Santa Maria (UFSM), Av. Roraima, n°1000, Prédio 63C, Bairro Camobi, CEP: 97105-900 Santa Maria, RS, Brazil
| | | | | | - Luis Antonio Sangioni
- Laboratório de Doenças Parasitárias (LADOPAR), Departamento de Medicina Veterinária Preventiva (DMVP), Centro de Ciências Rurais (CCR), Universidade Federal de Santa Maria (UFSM), Av. Roraima, n°1000, Prédio 63C, Bairro Camobi, CEP: 97105-900 Santa Maria, RS, Brazil
| | - Fernanda Silveira Flores Vogel
- Departamento de Estatística (DE), Centro de Ciências Naturais e Exatas (CCNE), Universidade Federal de Santa Maria (UFSM), Av. Roraima, n°1000, Prédio 13, Bairro Camobi, CEP: 97105-900 Santa Maria, Brazil
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13
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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.
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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
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Multicenter Comparative Assessment of the TIB MolBiol Toxoplasma gondii Detection Kit and Four Laboratory-Developed PCR Assays for Molecular Diagnosis of Toxoplasmosis. J Mol Diagn 2021; 23:1000-1006. [PMID: 34082073 DOI: 10.1016/j.jmoldx.2021.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/19/2021] [Accepted: 05/06/2021] [Indexed: 11/21/2022] Open
Abstract
Toxoplasmosis can be a life-threatening infection, particularly during pregnancy and in immunocompromised patients. The biological diagnosis of toxoplasmosis is challenging and has been revolutionized by molecular detection methods. This article summarizes the data of a multicenter study involving four centers to assess the performances of a commercial PCR assay as compared with four in-house PCR assays using Toxoplasma gondii standards, 20 external quality control specimens, and 133 clinical samples. This clinical cohort includes well-characterized clinical samples corresponding to different clinical situations: confirmed congenital toxoplasmosis (44 samples), toxoplasmosis in immunocompromised patients (25 samples), and chorioretinitis (5 samples). Furthermore, 59 samples from patients without toxoplasmosis were included as negative controls. The analytical sensitivities of the five methods tested were very similar; and the limit of Toxoplasma DNA detection was around 0.01 T. gondii genome per reaction for all the methods. The overall concordance between the commercial PCR and the four in-house PCR assays was 97.7% (130/133). The clinical sensitivity and specificity were >98% and could be increased for the commercial kit when PCR was performed in multiplicate to detect low parasitic loads. In conclusion, the commercial PCR assay shows suitable performances to diagnose the different clinical forms of toxoplasmosis.
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15
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Conceição AR, Belucik DN, Missio L, Gustavo Brenner L, Henrique Monteiro M, Ribeiro KS, Costa DF, Valadão MCDS, Commodaro AG, de Oliveira Dias JR, Belfort R. Ocular Findings in Infants with Congenital Toxoplasmosis after a Toxoplasmosis Outbreak. Ophthalmology 2021; 128:1346-1355. [PMID: 33711379 DOI: 10.1016/j.ophtha.2021.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/28/2021] [Accepted: 03/05/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE We investigated the prevalence of ocular abnormalities in infants vertically exposed to Toxoplasma gondii infection during an outbreak in Santa Maria City, Brazil. DESIGN Consecutive case series. PARTICIPANTS A total of 187 infants were included. METHODS The infants were recruited from January 2018 to November 2019. All mothers were screened for syphilis and human immunodeficiency virus before delivery. Toxoplasmosis infection was confirmed in all mothers and infants based on the presence of serum anti-T. gondii immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies. All infants underwent an ophthalmologic examination; ocular abnormalities were documented using a wide-field digital imaging system. Neonatal cranial sonography or head computed tomography was performed in 181 infants, and the cerebrospinal fluid (CSF) was screened for anti-T. gondii IgG and IgM antibodies in 159 infants. Peripheral blood samples from 9 infants and their mothers were analyzed for the presence of T. gondii DNA by real-time polymerase chain reaction. MAIN OUTCOME MEASURES Ocular abnormalities associated with congenital toxoplasmosis. RESULTS A total of 187 infants were examined. Twenty-nine infants (15.5%) had congenital toxoplasmosis, of whom 19 (10.2%) had ocular abnormalities, including retinochoroiditis in 29 of 38 eyes (76.3%), optic nerve abnormalities in 5 eyes (13.2%), microphthalmia in 1 eye (2.6%), and cataract in 2 eyes (5.3%). Bilateral retinal choroidal lesions were found in 10 of 19 infants (52.6%). Nine eyes of 6 infants had active lesions, with retinal choroidal cellular infiltrates at the first examination. Thirteen (7.2%) of 181 infants screened presented with cerebral calcifications. Eighty-three percent of the screened infants were positive for anti-T. gondii IgG and negative for IgM antibodies in the CSF. Congenital toxoplasmosis was higher in mothers infected during the third pregnancy trimester, and maternal treatment during pregnancy was not associated with a lower rate of congenital toxoplasmosis. CONCLUSIONS High prevalence rates of clinical manifestations were observed in infants with congenital toxoplasmosis after a waterborne toxoplasmosis outbreak, the largest yet described. Cerebral calcifications were higher in infants with ocular abnormalities, and maternal infection during the third pregnancy trimester was associated with a higher rate of congenital toxoplasmosis independent of maternal treatment.
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Affiliation(s)
| | | | - Lilian Missio
- Federal University of Santa Maria, Santa Maria, RS, Brazil
| | | | | | - Kleber Silva Ribeiro
- Department of Ophthalmology, Federal University of São Paulo, Paulista Medical School, São Paulo, SP, Brazil
| | - Deise Fialho Costa
- Department of Ophthalmology, Federal University of São Paulo, Paulista Medical School, São Paulo, SP, Brazil; Vision Institute, São Paulo, SP, Brazil
| | | | | | | | - Rubens Belfort
- Department of Ophthalmology, Federal University of São Paulo, Paulista Medical School, São Paulo, SP, Brazil; Vision Institute, São Paulo, SP, Brazil
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16
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El-Sayad MH, Salem AI, Fazary H, Alzainny HN, Abd El-Latif NF. Detection of toxoplasmosis in aborted women in Alexandria, Egypt using ELISA and PCR. J Parasit Dis 2021; 45:539-545. [PMID: 34295052 DOI: 10.1007/s12639-020-01327-0] [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: 08/20/2020] [Accepted: 11/21/2020] [Indexed: 10/22/2022] Open
Abstract
Toxoplasmosis is a worldwide infection that can be acquired through the ingestion of tissue cysts in poorly cooked meat, and/or oblivious intake of sporulated oocysts in cat faeces, and transplacental. The infection in pregnant women is mainly asymptomatic. It produces abortion or congenital infection. The present study aimed to test the utility of polymerase chain reaction (PCR) on placental tissues in comparison to enzyme-linked immunosorbent assay (ELISA) to detect infections with Toxoplasma gondii in aborted women presented to Al-Shatby Maternity Hospital, Alexandria University, Egypt. Specific Toxoplasma gondii IgG and IgM were detected in serum by ELISA. Placental tissues from each participant were subjected to DNA extraction and PCR amplification. It was found that overall seroprevalence was 73%, DNA was detected in placenta tissues by using PCR analysis in 46% of cases. {× 2 (p) 18.124(< 0.001)}. Toxoplasma IgG/IgM by ELISA was positive in 23% of the cases, 20% showed amplified DNA by PCR. Positive IgG without IgM was seen in 27% cases, only 2% of them were positive by PCR. Moreover, positive PCR among positive ELISA IgM aborted women was 21 of the 23 cases. Positive PCR was obtained in three seronegative women. Our results showed that PCR sensitivity was 58.90 specificity 88.89, positive predictive value was 93.48%, and negative predictive value 44.44%. Although ELISA assay is still the gold standard of diagnosis of Toxoplasmosis, other diagnostic modalities are highly required particularly in those ELISA seronegative cases. PCR can be used as a sensitive and precise modality.
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Affiliation(s)
- Mona Hassan El-Sayad
- Department of Parasitology, Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria, Egypt
| | - Aziza Ibrahim Salem
- Department of Parasitology, Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria, Egypt
| | - Hisham Fazary
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Haneen Nawaf Alzainny
- Department of Parasitology, Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria, Egypt
| | - Naglaa Fathi Abd El-Latif
- Department of Parasitology, Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria, Egypt
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Maternal Anti- Toxoplasma Treatment during Pregnancy Is Associated with Reduced Sensitivity of Diagnostic Tests for Congenital Infection in the Neonate. J Clin Microbiol 2021; 59:JCM.01368-20. [PMID: 33208476 DOI: 10.1128/jcm.01368-20] [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] [Received: 06/04/2020] [Accepted: 11/13/2020] [Indexed: 11/20/2022] Open
Abstract
Neonatal diagnosis of congenital toxoplasmosis is based on a combination of serological and molecular tests. Maternal screening and treatment differ according to national policies and may impact the sensitivity of diagnostic methods in infants at birth. In this multicenter study, 115 neonates born to 61 treated (53%) and 54 (47%) untreated women were retrospectively included in three centers (France, Serbia, and the United States) to assess the impact of maternal anti-Toxoplasma treatment on the performance of neonatal workup at birth (neosynthesized anti-Toxoplasma IgM, IgA, and IgG and quantitative PCR [qPCR]) using univariate and multivariate approaches. Independently of the time of maternal seroconversion, the serological techniques were impacted differently by maternal treatment. The detection of IgM by immunosorbent agglutination assay (ISAGA) and Western blotting (WB) dropped from 90.7% and 88.2% in untreated neonates to 53.3% and 51.9% in treated neonates (P < 0.05), whereas IgM enzyme-linked immunosorbent assay (ELISA) and IgA ISAGA were not significantly affected by maternal treatment. A 2-fold reduction in the sensitivity of neosynthesized IgG by WB was also observed in the case of treatment during pregnancy (37.7% versus 82.3%). Interestingly, the effect of treatment was shown to be duration dependent, especially for IgM detection, when the treatment course exceeded 8 weeks, whatever the therapy. The sensitivity of Toxoplasma PCR in blood was also lowered by maternal treatment from 39.1% to 23.2%. These results highlight that anti-Toxoplasma therapy during pregnancy may set back biological evidence of neonatal infection at birth and underline the need for a careful serological follow-up of infants with normal workup.
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18
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Marciano MAM, Silva RA, Barbosa ML, Ferreira ARS, Pereira-Chioccola VL. Determination of the viability of Toxoplasma gondii oocysts by PCR real-time after treatment with propidium monoazide. Rev Inst Med Trop Sao Paulo 2020; 62:e84. [PMID: 33146312 PMCID: PMC7608075 DOI: 10.1590/s1678-9946202062084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 10/01/2020] [Indexed: 11/23/2022] Open
Abstract
This study aimed to investigate a methodology for discriminating viable and non-viable T. gondii oocysts in water. Analyses included two steps: (i) microscopic investigation with vital dyes; (ii) molecular investigation, using a real time PCR (qPCR), after parasite treatment (or not) with propidium monoazide (PMA). The method was called qPCR-PMA. Oocyst aliquots were incubated (15 min) at 25 ºC or 100 ºC and analyzed by microscopy, after trypan blue and neutral red staining. Microscopic investigation determined viable and non-viable oocysts. For the molecular investigation, both aliquots of oocysts were treated with PMA. Non-viable oocysts, after PMA treatment, exhibited an inhibition of DNA amplification by qPCR. Although analyses were carried out with oocysts treated experimentally, these results suggest that qPCR-PMA can be a useful strategy to distinguish viable and non-viable T. gondii oocysts in water safety testing, showing if water is safe to drink.
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Affiliation(s)
| | | | - Maria Luisa Barbosa
- Instituto Adolfo Lutz , Núcleo de Morfologia e Microscopia , São Paulo , São Paulo , Brazil
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19
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Toxoplasmosis in pregnancy: a clinical, diagnostic, and epidemiological study in a referral hospital in Rio de Janeiro, Brazil. Braz J Infect Dis 2020; 24:517-523. [PMID: 33147432 PMCID: PMC9392127 DOI: 10.1016/j.bjid.2020.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 09/10/2020] [Accepted: 10/09/2020] [Indexed: 11/21/2022] Open
Abstract
Toxoplasmosis in pregnant women can cause significant morbidity and mortality in the fetus, which may be mitigated by early diagnosis and treatment. Social factors have also been related to the risk of developing the congenital form of toxoplasmosis, since some of these factors interfere directly in the quality of prenatal care. This study aimed to describe the clinical, laboratory, and epidemiological data of pregnant women diagnosed with toxoplasmosis and their newborns followed up at a referral hospital in Rio de Janeiro, Brazil. This was descriptive cohort study of 334 pregnant women with toxoplasmosis followed from May 2014 to December 2017. We conducted interviews to assess knowledge about the disease and its preventive measures, analyzed clinical and laboratory data during antenatal visits, and collected data from the newborns’ medical charts. Results This was a predominantly low-income women cohort study, with little schooling, mainly referred from public health services late in pregnancy (178; 53.3%), in the second and third trimesters (286; 85.6%). Diagnosis of acute toxoplasmosis had not been confirmed in 171 cases (51.2%). Out of 183 (54.9%) women who had initiated treatment at the original health services, 45 (24.6%) received an incorrect prescription. Seventy-two amniocenteses were performed, with positive real-time polymerase chain reaction (qPCR) in the amniotic fluid in two cases (2.8%). Congenital toxoplasmosis at birth was identified in eight newborns (5.4%). Conclusion Late referral to specialized medical services, inadequate toxoplasmosis management at the original prenatal care services, and social vulnerabilities are contributing factors to the persistent occurrence of congenital toxoplasmosis cases.
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Valenzuela-Moreno LF, Cedillo-Peláez C, Rico-Torres CP, Hernández-Rodríguez MA, Carmona-Muciño MDC, Farfán-Morales JE, Correa D, Caballero-Ortega H. Toxoplasma gondii infection in European mouflons ( Ovis musimon) and captive wild felines from Puebla, México. INTERNATIONAL JOURNAL FOR PARASITOLOGY-PARASITES AND WILDLIFE 2020; 13:1-6. [PMID: 32760649 PMCID: PMC7390760 DOI: 10.1016/j.ijppaw.2020.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/13/2020] [Accepted: 07/13/2020] [Indexed: 01/30/2023]
Abstract
The presence of Toxoplasma gondii in zoos is cause of alert because many susceptible species kept in captivity die of clinical toxoplasmosis. Moreover, excretion of T. gondii oocysts by infected captive wild felines into the facilities could pose a risk to workers. Herbivores in wild collections can serve as sentinels of local transmission, since they get infected by the consumption of oocysts present in ground or water. Both herbivores and felids may reveal the parasite variants which are circulating in the region. We determined the seroprevalence of T. gondii in European mouflons (n = 55) and wild felines (n = 15) from a private zoological collection located in the Eastern region of México, as well as the incidence in 41 of the mouflons using ELISA. The prevalence of T. gondii in mouflons was 14.5% (n = 55) and 17.1% (n = 41) in 2011 and 19.5% in 2012. The estimated incidence was 9.8%–12.2%. In wild felines the frequency was 80%. Four sero-positive animals (two mouflons and the two oldest African lions) were euthanized. Histopathology, conventional PCR (for B1 and SeqRep529 loci) and molecular characterization were carried out. All euthanized animals were positive to T. gondii by PCR. We identified a triple infection (I + II + III) in the brain of a mouflon. In conclusion, a high infective pressure of T. gondii in the collection was found, supported by changes in its prevalence in European mouflons. A high prevalence of infection in wild felines was determined. At least four genotypes of T. gondii are present in herbivores and carnivores, and one mouflon had a mixed infection. High infective pressure of T. gondii in mouflons and wild felines of a private collection in Puebla, Mexico. Four genotypes of T. gondii are present in herbivores and carnivores. A triple infection was found in one mouflon. First prospective cross-sectional study, not using serum banks.
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Affiliation(s)
- Luis Fernando Valenzuela-Moreno
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P, 04530, Ciudad de México, Mexico
| | - Carlos Cedillo-Peláez
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P, 04530, Ciudad de México, Mexico
| | - Claudia Patricia Rico-Torres
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P, 04530, Ciudad de México, Mexico
| | | | | | - José Eduardo Farfán-Morales
- Departamento de Anatomía Patológica, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P, 04530, Ciudad de México, Mexico
| | - Dolores Correa
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P, 04530, Ciudad de México, Mexico
| | - Heriberto Caballero-Ortega
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P, 04530, Ciudad de México, Mexico
- Corresponding author. Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P, 04530, Ciudad de México, Mexico.
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21
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Azadi Y, Ahmadpour E, Ahmadi A. Targeting Strategies in Therapeutic Applications of Toxoplasmosis: Recent Advances in Liposomal Vaccine Delivery Systems. Curr Drug Targets 2020; 21:541-558. [DOI: 10.2174/1389450120666191023151423] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/10/2019] [Accepted: 10/15/2019] [Indexed: 11/22/2022]
Abstract
Toxoplasma gondii is a prevalent parasitic pathogen that infected over one-third of the global population. Toxoplasmosis is diagnosed by isolating the parasite and detecting host antibodies. In contrast, the main problem with diagnosis relates to the sensitivity and specificity of the tests. Currently, treatment with pyrimethamine and sulfadiazine is recommended, despite their side effects and toxicity to humans. Moreover, the absence of a vaccine to completely protect against this infection is the main obstacle to the effective treatment and prevention of toxoplasmosis. Recently, nanoparticles and nanomaterials have been studied as delivery systems for the immunization and treatment of T. gondii infections. One of the most important applications of liposomes is drug and vaccine delivery, due to their biodegradability, low inherent toxicity, and immunogenicity. Liposomes are flexible delivery systems and immunological adjuvants able not only to load diverse antigens, such as proteins, peptides, nucleic acids, and carbohydrates but also to combine them with immunostimulators. Liposomes have the incredible potential within the development of modern types of vaccines and numerous endeavors have been made to improve the effectiveness of vaccines in recent years. In this review, we concentrate on the viable targeting strategies of liposome-based vaccine delivery systems to prevent, control and treat toxoplasmosis.
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Affiliation(s)
- Yaghob Azadi
- Infectious and Tropical Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ehsan Ahmadpour
- Infectious and Tropical Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amirhossein Ahmadi
- Pharmaceutical Sciences Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
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22
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Isolation and molecular characterization of Toxoplasma gondii from placental tissues of pregnant women who received toxoplasmosis treatment during an outbreak in southern Brazil. PLoS One 2020; 15:e0228442. [PMID: 31999785 PMCID: PMC6992202 DOI: 10.1371/journal.pone.0228442] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 01/15/2020] [Indexed: 11/19/2022] Open
Abstract
Toxoplasma gondii is a protozoan that has great genetic diversity and is prevalent worldwide. In 2018, an outbreak of toxoplasmosis occurred in Santa Maria, Brazil, which was considered the largest outbreak ever described in the world. This paper describes the isolation and molecular characterization of Toxoplasma gondii from the placenta of two pregnant women with acute toxoplasmosis who had live births and were receiving treatment for toxoplasmosis during the outbreak. For this, placental tissue samples from two patients underwent isolation by mice bioassay, conventional PCR and genotyping using PCR-RFLP with twelve markers. Both samples were positive in isolation in mice. The isolate was lethal to mice, suggesting high virulence. In addition, the samples were positive in conventional PCR and isolates submitted to PCR-RFLP genotyping presented an atypical genotype, which had never been described before. This research contributes to the elucidation of this great outbreak in Brazil.
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23
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Is Real-Time PCR Targeting Rep 529 Suitable for Diagnosis of Toxoplasmosis in Patients Infected with Non-Type II Strains in North America? J Clin Microbiol 2020; 58:JCM.01223-19. [PMID: 31694976 DOI: 10.1128/jcm.01223-19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/23/2019] [Indexed: 11/20/2022] Open
Abstract
Toxoplasma gondii DNA detection is essential to antenatally diagnose a congenital infection and reactivation of a past infection in an immunocompromised patient. Initially, PCR methods targeted the 35-fold repetitive B1 gene, and more recently, coding sequence Rep 529 has been preferred, as it was reported to be repeated 200- to 300-fold and yielded far better sensitivity than amplification of the B1 sequence. To date, few data are available in regard to the efficacy of Rep 529 for non-type II genotypes. In this study, we compared the results of B1 quantitative PCR (qPCR) with those of two different Rep 529 qPCRs performed on 111 samples in two different laboratories (Rep 529-1 and Rep 529-2). The performances of the 3 qPCRs were also compared according to the genotypes of the isolates for 13 type II and 21 non-type II samples. The performance of the Rep 529 target was superior to that of the B1 target regardless of the genotype (threshold cycle [CT ] values for the Rep 529-1 and Rep 529-2 qPCRs were lower than those for the B1 qPCR [P < 0.001 and P < 0.01, respectively]). The same results were observed when a comparison was made according to the genotype of the strain (type II and non-type II genotypes). To our knowledge, these results provide the first relative quantitative data revealing that the efficiency of Rep 529 qPCR does not depend on the genotype of T. gondii isolates and that, in fact, it is superior to B1 qPCR.
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24
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Valenzuela-Moreno LF, Rico-Torres CP, Cedillo-Peláez C, Luna-Pastén H, Méndez-Cruz ST, Reyes-García ME, Correa D, Alves BF, Pena HFJ, Caballero-Ortega H. Stray dogs in the tropical state of Chiapas, Mexico, harbour atypical and novel genotypes of Toxoplasma gondii. Int J Parasitol 2019; 50:85-90. [PMID: 31863764 DOI: 10.1016/j.ijpara.2019.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 12/11/2019] [Accepted: 12/11/2019] [Indexed: 10/25/2022]
Abstract
Genotyping of Toxoplasma gondii remains a relevant topic of study, since genotypes can be related to the presentation and severity of toxoplasmosis. To date, 292 restriction fragment length polymorphism genotypes have been described around the world. Serosurveys in southeastern Mexico have documented exposure in over 70% of people and certain animals. Recently, we have described new genotypes and mixed infections in feral cats from Quintana Roo. Thus, the aim of this study was to genotype T. gondii and to describe its genetic variability, from naturally infected stray dogs of Chiapas, which has different geographical and climatic conditions from those found at the Yucatan Peninsula and the other parts of the country. Eleven stray dogs were captured and bled to obtain DNA, and then they were euthanized to perform necropsies and to collect target tissues. Diagnosis of T. gondii was done by quantitative real-time PCR (qPCR) and endpoint PCR. Genotyping was carried out, amplifying 12 polymorphic markers and 15 microsatellites. Atypical SAG3 gene products were cloned and sequenced. All blood samples of dogs were positive to T. gondii DNA by PCR. Two isolates were obtained from pooled heart and diaphragm tissue of two dogs. Two complete PCR-RFLP genotypes were identified (type BrIII and #28). Four animals had mixed infections. A new RFLP atypical allele for the SAG3 marker was observed; cloning and sequencing analysis of this locus revealed mixed infection by a strain identical to GT1, and one type I × II intragenic recombinant. The microsatellite analysis revealed that both isolates are atypical. Thus, atypical new genotypes of T. gondii and mixed infections were found in dogs of Chiapas. The results found here and in genotyping studies in México suggest that the southeastern region favours wide genetic diversity of T. gondii and the possible presence of virulent genotypes such as those found in central and South America.
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Affiliation(s)
- Luis Fernando Valenzuela-Moreno
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P. 04530 Ciudad de México, Mexico; Programa de Doctorado en Ciencias de la Producción y de la Salud Animal, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Av. Universidad 3000, Circuito Exterior S/N Delegación Coyoacán, C.P. 04510 Ciudad Universitaria, Ciudad de México, Mexico
| | - Claudia Patricia Rico-Torres
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P. 04530 Ciudad de México, Mexico
| | - Carlos Cedillo-Peláez
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P. 04530 Ciudad de México, Mexico
| | - Héctor Luna-Pastén
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P. 04530 Ciudad de México, Mexico
| | - Sara Teresa Méndez-Cruz
- Laboratorio de Bioquímica Genética, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P. 04530 Ciudad de México, Mexico
| | - María Eréndira Reyes-García
- Laboratorio de Biotecnología de Pequeños Rumiantes y Patología, FMVZ-UNACH, Tuxtla Gutiérrez, Chiapas, Mexico
| | - Dolores Correa
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P. 04530 Ciudad de México, Mexico
| | - Bruna Farias Alves
- 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, SP, 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, SP, Brazil.
| | - Heriberto Caballero-Ortega
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Insurgentes-Cuicuilco, Delegación Coyoacán, C.P. 04530 Ciudad de México, Mexico.
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25
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Hannachi E, Bouratbine A, Mousli M. Enhancing the detection of Toxoplasma gondii via an anti-SAG1 scFv-alkaline phosphatase immunoconjugate. BIOTECHNOLOGY REPORTS (AMSTERDAM, NETHERLANDS) 2019; 23:e00360. [PMID: 31341791 PMCID: PMC6630058 DOI: 10.1016/j.btre.2019.e00360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/29/2019] [Accepted: 06/30/2019] [Indexed: 12/11/2022]
Abstract
The purpose of this study was to implement a fluorometric method for enhancing the detection sensitivity of Toxoplasma gondii in biological fluids. To address this challenge, we designed and produced a recombinant immunoconjugate tool based on a single-chain antibody fragment anti-T. gondii SAG1 antigen (scFvSG15) genetically fused to the bacterial alkaline phosphatase (AP) using 4-methyl-umbelliferyl-phosphate as fluorogenic substrate. The anti-SAG1 scFv-AP conjugate was fully bifunctional and was used successfully in different assays including immunoblot, fluorometric ELISA and direct immunofluorescence. The fluorometric immunoassay afforded an extremely low detection limit (1 tachyzoite/well), which was in agreement with the real-time PCR control test. The immunofluorescence imaging has provided captivating visual evidence of T. gondii detection. These results strongly suggest that the recombinant anti-SAG1-AP conjugate generated here might serve as useful and highly sensitive immunoassay probe to direct detect T. gondii in a one-step procedure, opening up new perspectives for diagnosis of toxoplasmosis.
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Affiliation(s)
| | | | - Mohamed Mousli
- Laboratoire de Parasitologie Médicale, Biotechnologies et Biomolécules, LR11-IPT06, Institut Pasteur de Tunis, Université Tunis El-Manar, 13 Place Pasteur -BP74, 1002 Tunis-Belvédère, Tunisia
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26
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Barakat AMA, Ahmed SO, Zaki MS, El Fadaly HA, Abd El-Razik KA, El-Hariri HM, Johar D. New approach to differentiate primary from latent Toxoplasma gondii abortion through immunoglobulin and DNA interpretation. Microb Pathog 2018; 125:66-71. [PMID: 30189233 DOI: 10.1016/j.micpath.2018.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/18/2018] [Accepted: 09/01/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Toxoplasma gondii is an acute or latent zoonotic abortifacient human protozoan. Women may be aborted due to recent or latent infection during pregnancy or order to flare up of the dormant bradyzoites to acute tachyzoites (latent opportunistic relapse). AIMS 1) to validate the interpretation of IgM and IgG immunoglobulins seromonotoring with DNA comparative results in differentiating recent from latent T. gondii abortion. METHOD Blood with the corresponding placental or uterine wash samples were collected from 73 aborted Egyptian women from Cairo and Giza labour wards. Patients aborted in any of the phases (Ph-1, Ph-2, Ph-3 and Ph-4 were corresponding to abortion at the 1st, 2nd and 3rd trimesters plus females who gave birth with congenital anomalies), respectively. All aborted patients were assayed serologically by Enzyme Linked Immunosorbent Assay (ELISA) for IgM and IgG titers and the compatible DNA from placenta and uterine wash tissues by conventional Polymerase Chain Reaction (PCR) specific for T. gondii. RESULTS Sero-positive aborted women were 50.7% by ELISA versus 37% by PCR. Not all T. gondii sero-positive aborted women were having T. gondii DNA or harboring compatible placental T. gondii cysts. This denotes that immunoglobulins alone are insufficient criteria for confirming toxoplasma abortion. CONCLUSION Immunoglobulins with DNA comparative results can possibly differentiate recent from latent T. gondii abortion at higher precision. We recommend the need for routine monitoring of T. gondii i.e. (pre-, during and post-delivery).
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Affiliation(s)
- Ashraf M A Barakat
- Department of Zoonotic Diseases, National Research Centre, Dokki, 12622, Giza, Egypt.
| | - Sylvia O Ahmed
- Department of Animal Hygiene and Zoonosis, Faculty of Veterinary Medicine, Assiut University, Assiut, Egypt.
| | - Mona S Zaki
- Hydrobiology Department, National Research Centre, Dokki, 12622, Giza, Egypt.
| | - Hassan A El Fadaly
- Department of Zoonotic Diseases, National Research Centre, Dokki, 12622, Giza, Egypt.
| | - Khaled A Abd El-Razik
- Department of Animal Reproduction and Artificial Insemination, National Research Centre, Dokki, Giza, Egypt.
| | - Hazem M El-Hariri
- Department of Community Medicine Research, National Research Centre, Cairo, Egypt.
| | - Dina Johar
- Department of Biochemistry and Nutrition, Faculty of Women for Arts, Sciences and Education, Ain Shams University, Heliopolis, Cairo, Egypt.
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Sardarian K, Maghsood AH, Farimani M, Hajiloii M, Saidijam M, Rezaeepoor M, Mahaki H, Zamani A. Evaluation of Toxoplasma gondii B1 gene in Placental Tissues of Pregnant Women with Acute Toxoplasmosis. Adv Biomed Res 2018; 7:119. [PMID: 30211132 PMCID: PMC6124216 DOI: 10.4103/abr.abr_58_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background: One of the consequences of toxoplasmosis is the risk of passing it from mother to fetus and the onset of congenital toxoplasmosis during pregnancy. The purpose of this study was to evaluate the B1 gene of Toxoplasma gondii in the placental tissues of pregnant women with acute toxoplasmosis. Materials and Methods: The study was a cross-sectional study. Serum samples of pregnant women who attended to Fatemieh Hospital of Hamadan University of Medical Sciences were tested for immunoglobulin G (IgG) antibodies against T. gondii by enzyme-linked immunosorbent assay. Then, polymerase chain reaction was used to identify the specific B1 gene of T. gondii in IgG seropositive women. The placental tissues of the pregnant women with positive serum B1 gene examined for this gene. Anti-Toxoplasma immunoglobulin M (IgM) was performed on the umbilical cord and neonate blood. Results: Anti-Toxoplasma IgG was detected in 167 out of 653 (25.6%) pregnant women. T. gondii B1 gene was identified in 36 out of 167 (21.6%) of IgG seropositive women. After delivery, the B1 gene was evaluated in 15 out of 36 (41.7%) patients’ placental tissues, 13 of which were positive for this gene (86.7%). Anti-Toxoplasma IgM was detected neither in any umbilical cord nor in neonatal blood samples. All newborns, with the exception of one case, were born with normal birth weight and in term birth. Conclusion: The B1 gene was detected in 86.7% of the placental tissue of women who were involved in acute toxoplasmosis during pregnancy.
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Affiliation(s)
- Khosro Sardarian
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.,Department of Medical Parasitology and Mycology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amir Hossein Maghsood
- Department of Medical Parasitology and Mycology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Marzieh Farimani
- Department of Endometrium and Endometriosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mehrdad Hajiloii
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.,Department of Immunology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Massoud Saidijam
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahsa Rezaeepoor
- Department of Immunology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hanie Mahaki
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Alireza Zamani
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.,Department of Immunology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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Roux G, Varlet-Marie E, Bastien P, Sterkers Y. Evolution of Toxoplasma-PCR methods and practices: a French national survey and proposal for technical guidelines. Int J Parasitol 2018; 48:701-707. [DOI: 10.1016/j.ijpara.2018.03.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 02/27/2018] [Accepted: 03/05/2018] [Indexed: 11/15/2022]
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Autier B, Dion S, Robert-Gangneux F. The liver as an organ at risk for Toxoplasma transmission during transplantation: myth or reality? J Clin Pathol 2018. [PMID: 29535213 DOI: 10.1136/jclinpath-2018-205066] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
AIM Toxoplasmosis following liver transplant with donor-recipient mismatch is rare, but is often life-threatening. However, there are no data on the frequency of cyst carriage in the liver, nor consensual chemoprophylaxis guidelines. This study aimed at describing frequency and localisation of Toxoplasma cysts in the liver in a mouse model of chronic infection to predict the risk in liver transplantation. METHODS Heart, brain and liver lobes of 21 mice chronically infected with Toxoplasma were collected for DNA extraction and amplification of Toxoplasma gondii rep529 sequence by real-time PCR. RESULTS Parasite DNA was detected in the liver of 19/21 mice (90.5%), with no preferential anatomical localisation, but with higher parasite loads in the papillary process. Parasite loads in the liver were far lower than in brain and heart. The number of infected lobes was inversely correlated to the total liver weight, but was independent of the brain parasite load and of the parasite strain. CONCLUSIONS The liver is a frequent site of cyst carriage, confirming that transplantation of an organ from a seropositive donor to seronegative recipient is at high risk for acquired toxoplasmosis. Systematic serological screening prior to transplantation and chemoprophylaxis in patients at risk are fully justified.
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Affiliation(s)
- Brice Autier
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Sarah Dion
- Institut de recherche en santé, environnement et travail, Inserm U0185, Rennes, France.,Université Rennes 1, Rennes, France
| | - Florence Robert-Gangneux
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Rennes, Rennes, France.,Institut de recherche en santé, environnement et travail, Inserm U0185, Rennes, France.,Université Rennes 1, Rennes, France
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Camilo LM, Pereira-Chioccola VL, Gava R, Meira-Strejevitch CDS, Vidal JE, Brandão de Mattos CC, Frederico FB, De Mattos LC, Spegiorin LCJF. Molecular diagnosis of symptomatic toxoplasmosis: a 9-year retrospective and prospective study in a referral laboratory in São Paulo, Brazil. Braz J Infect Dis 2017; 21:638-647. [PMID: 28968510 PMCID: PMC9425505 DOI: 10.1016/j.bjid.2017.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 07/19/2017] [Accepted: 07/23/2017] [Indexed: 01/01/2023] Open
Abstract
Symptomatic forms of toxoplasmosis are a serious public health problem and occur in around 10–20% of the infected people. Aiming to improve the molecular diagnosis of symptomatic toxoplasmosis in Brazilian patients, this study evaluated the performance of real time PCR testing two primer sets (B1 and REP-529) in detecting Toxoplasma gondii DNA. The methodology was assayed in 807 clinical samples with known clinical diagnosis, ELISA, and conventional PCR results in a 9-year period. All samples were from patients with clinical suspicion of several features of toxoplasmosis. According to the minimum detection limit curve (in CT), REP-529 had greater sensitivity to detect T. gondii DNA than B1. Both primer sets were retrospectively evaluated using 515 DNA from different clinical samples. The 122 patients without toxoplasmosis provided high specificity (REP-529, 99.2% and B1, 100%). From the 393 samples with positive ELISA, 146 had clinical diagnosis of toxoplasmosis and positive conventional PCR. REP-529 and B1 sensitivities were 95.9% and 83.6%, respectively. Comparison of REP-529 and B1 performances was further analyzed prospectively in 292 samples. Thus, from a total of 807 DNA analyzed, 217 (26.89%) had positive PCR with, at least one primer set and symptomatic toxoplasmosis confirmed by clinical diagnosis. REP-529 was positive in 97.23%, whereas B1 amplified only 78.80%. After comparing several samples in a Brazilian referral laboratory, this study concluded that REP-529 primer set had better performance than B1 one. These observations were based after using cases with defined clinical diagnosis, ELISA, and conventional PCR.
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Affiliation(s)
- Lilian Muniz Camilo
- Centro de Parasitologia e Micologia, Instituto Adolfo Lutz, São Paulo, SP, Brazil
| | | | - Ricardo Gava
- Centro de Parasitologia e Micologia, Instituto Adolfo Lutz, São Paulo, SP, Brazil
| | | | - Jose Ernesto Vidal
- Instituto de Infectologia Emilio Ribas, São Paulo, SP, Brazil; Faculdade de Medicina, Hospital das Clínicas, da Universidade de São Paulo, São Paulo, SP, Brazil; Laboratório de Investigação Médica (LIM) 49, Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Fábio Batista Frederico
- Ambulatório de Oftalmologia, Fundação Faculdade Regional de Medicina-Hospital de Base, São José do Rio Preto, SP, Brazil
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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.
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Maldonado YA, Read JS. Diagnosis, Treatment, and Prevention of Congenital Toxoplasmosis in the United States. Pediatrics 2017; 139:peds.2016-3860. [PMID: 28138010 DOI: 10.1542/peds.2016-3860] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Ayi I, Sowah AOK, Blay EA, Suzuki T, Ohta N, Ayeh-Kumi PF. Toxoplasma gondii infections among pregnant women, children and HIV-seropositive persons in Accra, Ghana. Trop Med Health 2016; 44:17. [PMID: 27433136 PMCID: PMC4940749 DOI: 10.1186/s41182-016-0018-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 05/13/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Toxoplasma gondii infection can lead to severe disease outcomes in immune-compromised people. This study sought to determine the seroprevalence of anti-T. gondii antibodies among pregnant women, hospitalized children (<5 years old) and HIV-seropositive persons in Accra. METHODS A cross-sectional study was conducted in two hospitals in Accra, and a total of 450 voluntary participants were recruited for the study consisting of 125 pregnant women, 200 children and 125 HIV-seropositive persons. Serum was obtained from venous blood safely drawn from each participant and tested for specific anti-Toxoplasma antibodies IgG and IgM by ELISA. A serological criterion for seropositivity was a positive test result for any of the two anti-Toxoplasma antibodies or a combination of both. Questionnaire interviews were conducted to obtain personal information and Toxoplasma infection risk-related data. RESULTS Those who tested seropositive for anti-T. gondii antibodies were 51.2 % (64/125) pregnant women, 58.0 % (116/200) children and 57.6 % (72/125) HIV patients. The major risk factors associated with anti-T. gondii seropositivity were identified as age (in children), handling raw meat and gravida status (in pregnant women). The results of this study confirmed that the seroprevalence of T. gondii infection is high among pregnant women, hospitalized children <5 years old and HIV patients. CONCLUSIONS A further study to investigate pre-pregnancy infections with T. gondii among women of childbearing age, seroconversion rate in pregnant women, rate of mother-to-child transmission and reactivated infections among HIV-seropositive persons is recommended.
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Affiliation(s)
- Irene Ayi
- />Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Science, University of Ghana, P. O. Box LG 581, Legon, Accra, Ghana
| | - Augustine Odoi-Kpoti Sowah
- />Korle-Bu Central Laboratory, Korle-Bu Teaching Hospital, P. O. Box 77, Korle-Bu, Accra, Ghana
- />School of Biological and Allied Health Sciences, College of Health Science, University of Ghana, Korle-Bu, Accra, Ghana
| | - Emmanuel Awusah Blay
- />Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Science, University of Ghana, P. O. Box LG 581, Legon, Accra, Ghana
- />Department of Environmental Parasitology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519 Japan
| | - Takashi Suzuki
- />Department of Environmental Parasitology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519 Japan
| | - Nobuo Ohta
- />Department of Environmental Parasitology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519 Japan
| | - Patrick F. Ayeh-Kumi
- />School of Biological and Allied Health Sciences, College of Health Science, University of Ghana, Korle-Bu, Accra, Ghana
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Blay EA, Ghansah A, Otchere J, Koku R, Kwofie KD, Bimi L, Takashi S, Ohta N, Ayi I. Congenital toxoplasmosis and pregnancy malaria detection post-partum: Effective diagnosis and its implication for efficient management of congenital infection. Parasitol Int 2015; 64:603-8. [DOI: 10.1016/j.parint.2015.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 07/25/2015] [Accepted: 08/07/2015] [Indexed: 11/28/2022]
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Contribution of neonatal amniotic fluid testing to diagnosis of congenital toxoplasmosis. J Clin Microbiol 2015; 53:1719-21. [PMID: 25694528 DOI: 10.1128/jcm.02358-14] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 02/10/2015] [Indexed: 11/20/2022] Open
Abstract
We evaluated the molecular diagnosis of congenital toxoplasmosis (CT) on neonatal amniotic fluid samples from 488 mother-child pairs. Maternal infection during pregnancy was diagnosed and dated or could not be ruled out. Forty-six cases of CT were defined according to the European Research Network on CT classification system and case definitions. Neonatal amniotic fluid testing had an overall sensitivity of 54% (95% confidence interval [95% CI], 39 to 69%) and a specificity of 100% (95% CI, 99 to 100%). Its sensitivity was 33% (95% CI, 13 to 59%) when antenatal diagnosis was positive and 68% (95% CI, 48 to 84%) when antenatal diagnosis was negative or lacking. This difference in sensitivity may have been due to treatment of antenatally diagnosed cases. Relative to postnatal serology, neonatal amniotic fluid testing allowed an earlier diagnosis to be made in 26% of the cases (95% CI, 9 to 51%).
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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.
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First isolation and molecular characterization of Toxoplasma gondii from a human placenta in Argentina. Parasitol Int 2014; 63:470-2. [DOI: 10.1016/j.parint.2013.10.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 10/11/2013] [Accepted: 10/17/2013] [Indexed: 11/21/2022]
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Baquero-Artigao F, del Castillo Martín F, Fuentes Corripio I, Goncé Mellgren A, Fortuny Guasch C, de la Calle Fernández-Miranda M, González-Tomé M, Couceiro Gianzo J, Neth O, Ramos Amador J. Guía de la Sociedad Española de Infectología Pediátrica para el diagnóstico y tratamiento de la toxoplasmosis congénita. An Pediatr (Barc) 2013; 79:116.e1-116.e16. [DOI: 10.1016/j.anpedi.2012.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 12/03/2012] [Accepted: 12/04/2012] [Indexed: 10/27/2022] Open
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Delhaes L, Yera H, Ache S, Tsatsaris V, Houfflin-Debarge V. Contribution of molecular diagnosis to congenital toxoplasmosis. Diagn Microbiol Infect Dis 2013; 76:244-7. [DOI: 10.1016/j.diagmicrobio.2013.02.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 01/16/2013] [Accepted: 02/07/2013] [Indexed: 10/27/2022]
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Novel interpretation of molecular diagnosis of congenital toxoplasmosis according to gestational age at the time of maternal infection. J Clin Microbiol 2012; 50:3944-51. [PMID: 23035201 DOI: 10.1128/jcm.00918-12] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
From a prospective cohort of 344 women who seroconverted for toxoplasmosis during pregnancy, 344 amniotic fluid, 264 placenta, and 216 cord blood samples were tested for diagnosis of congenital toxoplasmosis using the same PCR assay. The sensitivity and negative predictive value of the PCR assay using amniotic fluid were 86.3% and 97.2%, respectively, and both specificity and positive predictive value were 100%. Using placenta and cord blood, sensitivities were 79.5% and 21.2%, and specificities were 92% and 100%, respectively. In addition, the calculation of pretest and posttest probabilities and the use of logistic regression allowed us to obtain curves that give a dynamic interpretation of the risk of congenital toxoplasmosis according to gestational age at maternal infection, as represented by the three sample types (amniotic fluid, placenta, and cord blood). Two examples are cited here: for a maternal infection at 25 weeks of amenorrhea, a negative result of prenatal diagnosis allowed estimation of the probability of congenital toxoplasmosis at 5% instead of an a priori (pretest) risk estimate of 33%. For an infection at 10 weeks of amenorrhea associated with a pretest congenital toxoplasmosis risk of 7%, a positive PCR result using placenta at birth yields a risk increase to 43%, while a negative result damps down the risk to 0.02%. Thus, with a molecular diagnosis performing at a high level, and in spite of the persistence of false negatives, posttest risk curves using both negative and positive results prove highly informative, allowing a better assessment of the actual risk of congenital toxoplasmosis and finally an improved decision guide to treatment.
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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]
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42
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Séroconversion toxoplasmique périconceptionnelle : à propos de 79 cas. ACTA ACUST UNITED AC 2012; 41:546-52. [DOI: 10.1016/j.jgyn.2012.03.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 03/14/2012] [Accepted: 03/19/2012] [Indexed: 11/23/2022]
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Comparison of mother and child antibodies that target high-molecular-mass Toxoplasma gondii antigens by immunoblotting improves neonatal diagnosis of congenital toxoplasmosis. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2012; 19:1326-8. [PMID: 22695159 DOI: 10.1128/cvi.00060-12] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This retrospective study proposes a new reading of immunoblotting (IB) in the diagnosis of congenital toxoplasmosis. Our findings demonstrate that a three-IgM-band association at 75, 90, and 100 kDa called the IgM triplet increases the sensitivity to 95.8% when combined with prenatal and serological neonatal tests.
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Robert-Gangneux F, Dardé ML. Epidemiology of and diagnostic strategies for toxoplasmosis. Clin Microbiol Rev 2012; 25:264-96. [PMID: 22491772 PMCID: PMC3346298 DOI: 10.1128/cmr.05013-11] [Citation(s) in RCA: 982] [Impact Index Per Article: 81.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The apicomplexan parasite Toxoplasma gondii was discovered a little over 100 years ago, but knowledge of its biological life cycle and its medical importance has grown in the last 40 years. This obligate intracellular parasite was identified early as a pathogen responsible for congenital infection, but its clinical expression and the importance of reactivations of infections in immunocompromised patients were recognized later, in the era of organ transplantation and HIV infection. Recent knowledge of host cell-parasite interactions and of parasite virulence has brought new insights into the comprehension of the pathophysiology of infection. In this review, we focus on epidemiological and diagnostic aspects, putting them in perspective with current knowledge of parasite genotypes. In particular, we provide critical information on diagnostic methods according to the patient's background and discuss the implementation of screening tools for congenital toxoplasmosis according to health policies.
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Affiliation(s)
- Florence Robert-Gangneux
- Service de Parasitologie, Faculté de Médecine et Centre Hospitalier Universitaire de Rennes, Rennes, France.
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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: 98] [Impact Index Per Article: 8.2] [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.
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Robert-Gangneux F, Murat JB, Fricker-Hidalgo H, Brenier-Pinchart MP, Gangneux JP, Pelloux H. The placenta: a main role in congenital toxoplasmosis? Trends Parasitol 2011; 27:530-6. [PMID: 22079164 DOI: 10.1016/j.pt.2011.09.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Revised: 09/09/2011] [Accepted: 09/21/2011] [Indexed: 02/08/2023]
Abstract
Systemic infections, such as toxoplasmosis, acquired during pregnancy can lead to placental infection and have profound effects on the mother-to-child relationship and the success of pregnancy. Placental permeability to Toxoplasma gondii is a main parameter that determines parasite transmission to the foetus, and the use of antibiotics to decrease placental parasite load and prevent congenital toxoplasmosis has been suggested for decades. Although parasitological examination of the placenta at birth is commonly used to diagnose neonatal congenital toxoplasmosis, this approach can be controversial. Here we argue in favour of placental examination for both diagnostic and epidemiological purposes.
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Affiliation(s)
- Florence Robert-Gangneux
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier et Universitaire de Rennes, Rennes, France.
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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.
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Robert-Gangneux F, Gangneux JP, Vu N, Jaillard S, Guiguen C, Amiot L. High level of soluble HLA-G in amniotic fluid is correlated with congenital transmission of Toxoplasma gondii. Clin Immunol 2010; 138:129-34. [PMID: 21185786 DOI: 10.1016/j.clim.2010.12.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 12/06/2010] [Accepted: 12/06/2010] [Indexed: 01/08/2023]
Abstract
The expression of human leukocyte antigen (HLA)-G on cytotrophoblast cells contributes to maternal-fetal tolerance. Soluble forms of HLA-G (sHLA-G) can be detected in amniotic fluid (AF) and a decrease of sHLA-G is known to be correlated to fetal loss. In this work we investigated the role of sHLA-G in the transplacental passage of the protozoan parasite Toxoplasma gondii, responsible for congenital toxoplasmosis in about 30% of fetuses when primary infection (PI) occurs during pregnancy. We determined the sHLA-G concentration in 61 AF from women with PI and 24 controls. Our results showed higher sHLA-G levels in AF from PI than in controls (p<0.001). Moreover sHLA-G level from congenitally infected fetuses (n=12) was higher than in fetus in whom congenital infection was ruled out (n=49, p<0.05). These data suggest that sHLA-G could participate in immunomodulation necessary to avoid fetal loss due to Toxoplasma infection, but that over-expression could favor congenital transmission.
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Affiliation(s)
- Florence Robert-Gangneux
- Laboratoire de Parasitologie, Faculté de Médecine et Centre Hospitalier Universitaire de Rennes, Rennes, France.
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Correlation of parasite load determined by quantitative PCR to clinical outcome in a heart transplant patient with disseminated toxoplasmosis. J Clin Microbiol 2010; 48:2541-5. [PMID: 20463167 DOI: 10.1128/jcm.00252-10] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Disseminated toxoplasmosis is a life-threatening infection in transplant recipients, which results either from reactivation of latent infection or from organ-transmitted primary infection. Preventive measures and diagnostic screening methods differ between countries and are related to the seroprevalence of Toxoplasma spp. in the general population. Here we report a case of disseminated toxoplasmosis in a heart transplant recipient with previous immunity that occurred after cotrimoxazole prophylaxis for the prevention of Pneumocystis jirovecii pneumonia was stopped. Quantitative PCR proved useful for the diagnosis and monitoring of Toxoplasma infection. Decreasing parasitic burdens in sequential samples of cerebrospinal fluid, blood, and bronchoalveolar lavage fluid correlated with a favorable outcome and allowed modulation of the immunosuppressive drug regimen. The duration of anti-Toxoplasma treatment and the need for maintenance prophylaxis are discussed, as well as prophylaxis for solid-organ transplant recipients. Although a rare event in heart transplant recipients, Toxoplasma reactivation must be investigated promptly, since early treatment improves the prognosis.
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