1
|
Ju K, Zhang Y, Xu Z, Li L, Zhao X, Zhou H. Protective Efficacy of a Novel DNA Vaccine with a CL264 Molecular Adjuvant against Toxoplasma gondii in a Murine Model. Vaccines (Basel) 2024; 12:577. [PMID: 38932306 PMCID: PMC11209281 DOI: 10.3390/vaccines12060577] [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: 04/22/2024] [Revised: 05/15/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024] Open
Abstract
Toxoplasmosis is a significant global zoonosis with devastating impacts, and an effective vaccine against toxoplasmosis for humans has not yet been developed. In this study, we designed and formulated a novel DNA vaccine encoding the inhibitor of STAT1 transcriptional activity (IST) of T. gondii utilizing the eukaryotic expression vector pEGFP-N1 for the first time, with CL264 being a molecular adjuvant. Following intramuscular injection of the vaccine into mice, the levels of antibodies and cytokines were assessed to evaluate the immune response. Additionally, mice were challenged with highly virulent RH-strain tachyzoites of T. gondii, and their survival time was observed. The results show that the levels of IgG in serum, the ratio of IgG2a/IgG1 and the levels of IFN-γ in splenocytes of mice were significantly higher in the pEGFP-TgIST group and the pEGFP-TgIST + CL264 group than in the control group. In addition, the proportion of CD4+/CD8+ T cells was higher in mice immunized with either the pEGFP-TgIST group (p < 0.001) or the pEGFP-TgIST + CL264 group (p < 0.05) compared to the three control groups. Notably, TgIST-immunized mice exhibited prolonged survival times after T. gondii RH strain infection (p < 0.05). Our findings collectively demonstrate that the TgIST DNA vaccine elicits a significant humoral and cellular immune response and offers partial protection against acute T. gondii infection in the immunized mice, which suggests that TgIST holds potential as a candidate for further development as a DNA vaccine.
Collapse
Affiliation(s)
| | | | | | | | | | - Huaiyu Zhou
- Department of Pathogen Biology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (K.J.); (Y.Z.); (Z.X.); (L.L.); (X.Z.)
| |
Collapse
|
2
|
Dragomir A, Lupu MA, Lighezan R, Paduraru AA, Olariu TR. Toxoplasma gondii Infection in Patients with Cardiovascular Diseases from Western Romania: A Case-Control Study. Life (Basel) 2023; 13:1575. [PMID: 37511950 PMCID: PMC10382031 DOI: 10.3390/life13071575] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/14/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Toxoplasma gondii infects approximately one third of the world's human population. The seroepidemiology of T. gondii in cardiovascular patients is poorly discussed in the existing literature. We aimed to evaluate, for the first time, the seroprevalence of T. gondii in cardiovascular patients from Western Romania. (2) Methods: Serologic testing to demonstrate the presence of T. gondii antibodies was conducted in 256 patients with cardiovascular diseases and 261 matched blood donors. (3) Results: The overall seroprevalence of T. gondii antibodies was 64.06% in patients with cardiovascular diseases and 52.88% in blood donors and tended to increase with age in both groups. The seroprevalence of T. gondii antibodies was significantly higher in cardiovascular male patients (69.94%) compared to male blood donors (55.69%) (p = 0.006). When compared to the control group, a significantly higher prevalence of T. gondii antibodies was found among patients with hypertension (82.35%; p = 0.01) and unstable angina (67.56%; p = 0.02). (4) Conclusions: This study brings new epidemiological information on the prevalence of T. gondii in Romanian cardiovascular patients. T. gondii seroprevalence was significantly higher in patients with hypertension and unstable angina, suggesting that individuals with these diagnoses may be more frequently infected with T. gondii. This study may be a valuable starting point for further research to better evaluate the impact of T. gondii exposure on patients with cardiovascular diseases.
Collapse
Affiliation(s)
- Angela Dragomir
- Discipline of Parasitology, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Clinical Laboratory, Institute of Cardiovascular Diseases, 300310 Timisoara, Romania
- Center for Diagnosis and Study of Parasitic Diseases, Department of Infectious Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Maria Alina Lupu
- Discipline of Parasitology, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Clinical Laboratory, Institute of Cardiovascular Diseases, 300310 Timisoara, Romania
- Center for Diagnosis and Study of Parasitic Diseases, Department of Infectious Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Patogen Preventia, 300124 Timisoara, Romania
| | - Rodica Lighezan
- Discipline of Parasitology, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center for Diagnosis and Study of Parasitic Diseases, Department of Infectious Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Regional Blood Transfusion Center, 300737 Timisoara, Romania
| | - Ana Alexandra Paduraru
- Discipline of Parasitology, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center for Diagnosis and Study of Parasitic Diseases, Department of Infectious Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Patogen Preventia, 300124 Timisoara, Romania
| | - Tudor Rares Olariu
- Discipline of Parasitology, Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center for Diagnosis and Study of Parasitic Diseases, Department of Infectious Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Patogen Preventia, 300124 Timisoara, Romania
- Clinical Laboratory, Municipal Clinical Emergency Teaching Hospital, 300254 Timisoara, Romania
| |
Collapse
|
3
|
TZD-Based Hybrid Molecules Act as Dual Anti- Mycobacterium tuberculosis and Anti- Toxoplasma gondii Agents. Int J Mol Sci 2023; 24:ijms24032069. [PMID: 36768392 PMCID: PMC9916616 DOI: 10.3390/ijms24032069] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 01/21/2023] Open
Abstract
Two distinct intracellular pathogens, namely Mycobacterium tuberculosis (Mtb) and Toxoplasma gondii (Tg), cause major public health problems worldwide. In addition, serious and challenging health problems of co-infections of Tg with Mtb have been recorded, especially in developing countries. Due to this fact, as well as the frequent cases of resistance to the current drugs, novel anti-infectious therapeutics, especially those with dual (anti-Tg and anti-Mtb) modes of action, are needed. To address this issue, we explored the anti-Tg potential of thiazolidinedione-based (TZD-based) hybrid molecules with proven anti-Mtb potency. Several TZD hybrids with pyridine-4-carbohydrazone (PCH) or thiosemicarbazone (TSC) structural scaffolds were more effective and more selective than sulfadiazine (SDZ) and trimethoprim (TRI). Furthermore, all of these molecules were more selective than pyrimethamine (PYR). Further studies for the most potent TZD-TSC hybrids 7, 8 and 10 and TZD-PCH hybrid molecule 2 proved that these compounds are non-cytotoxic, non-genotoxic and non-hemolytic. Moreover, they could cross the blood-brain barrier (BBB), which is a critical factor linked with ideal anti-Tg drug development. Finally, since a possible link between Tg infection and the risk of glioblastoma has recently been reported, the cytotoxic potential of TZD hybrids against human glioblastoma cells was also evaluated. TZD-PCH hybrid molecule 2 was found to be the most effective, with an IC50 of 19.36 ± 1.13 µg/mL against T98G cells.
Collapse
|
4
|
Cheng A, Zhang H, Chen B, Zheng S, Wang H, Shi Y, You S, Li M, Jiang L. Modulation of autophagy as a therapeutic strategy for Toxoplasma gondii infection. Front Cell Infect Microbiol 2022; 12:902428. [PMID: 36093185 PMCID: PMC9448867 DOI: 10.3389/fcimb.2022.902428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 08/05/2022] [Indexed: 12/05/2022] Open
Abstract
Toxoplasma gondii infection is a severe health threat that endangers billions of people worldwide. T. gondii utilizes the host cell membrane to form a parasitophorous vacuole (PV), thereby fully isolating itself from the host cell cytoplasm and making intracellular clearance difficult. PV can be targeted and destroyed by autophagy. Autophagic targeting results in T. gondii killing via the fusion of autophagosomes and lysosomes. However, T. gondii has developed many strategies to suppress autophagic targeting. Accordingly, the interplay between host cell autophagy and T. gondii is an emerging area with important practical implications. By promoting the canonical autophagy pathway or attenuating the suppression of autophagic targeting, autophagy can be effectively utilized in the development of novel therapeutic strategies against T gondii. Here, we have illustrated the complex interplay between host cell mediated autophagy and T. gondii. Different strategies to promote autophagy in order to target the parasite have been elucidated. Besides, we have analyzed some potential new drug molecules from the DrugBank database using bioinformatics tools, which can modulate autophagy. Various challenges and opportunities focusing autophagy mediated T. gondii clearance have been discussed, which will provide new insights for the development of novel drugs against the parasite.
Collapse
Affiliation(s)
- Ao Cheng
- Department of Parasitology, Xiangya School of Medicine, Central South University, Changsha, China
| | - Huanan Zhang
- Department of Parasitology, Xiangya School of Medicine, Central South University, Changsha, China
| | - Baike Chen
- Department of Parasitology, Xiangya School of Medicine, Central South University, Changsha, China
| | - Shengyao Zheng
- Department of Parasitology, Xiangya School of Medicine, Central South University, Changsha, China
| | - Hongyi Wang
- Department of Parasitology, Xiangya School of Medicine, Central South University, Changsha, China
| | - Yijia Shi
- Department of Parasitology, Xiangya School of Medicine, Central South University, Changsha, China
| | - Siyao You
- Department of Parasitology, Xiangya School of Medicine, Central South University, Changsha, China
| | - Ming Li
- Department of Immunology, Xiangya School of Medicine, Central South University, Changsha, China
- *Correspondence: Liping Jiang, ; Ming Li,
| | - Liping Jiang
- Department of Parasitology, Xiangya School of Medicine, Central South University, Changsha, China
- China-Africa Research Center of Infectious Diseases, Xiangya School of Medicine, Central South University, Changsha, China
- *Correspondence: Liping Jiang, ; Ming Li,
| |
Collapse
|
5
|
López Ureña NM, Chaudhry U, Calero Bernal R, Cano Alsua S, Messina D, Evangelista F, Betson M, Lalle M, Jokelainen P, Ortega Mora LM, Álvarez García G. Contamination of Soil, Water, Fresh Produce, and Bivalve Mollusks with Toxoplasma gondii Oocysts: A Systematic Review. Microorganisms 2022; 10:517. [PMID: 35336093 PMCID: PMC8954419 DOI: 10.3390/microorganisms10030517] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/13/2022] [Accepted: 02/25/2022] [Indexed: 02/06/2023] Open
Abstract
Toxoplasma gondii is a major foodborne pathogen capable of infecting all warm-blooded animals, including humans. Although oocyst-associated toxoplasmosis outbreaks have been documented, the relevance of the environmental transmission route remains poorly investigated. Thus, we carried out an extensive systematic review on T. gondii oocyst contamination of soil, water, fresh produce, and mollusk bivalves, following the PRISMA guidelines. Studies published up to the end of 2020 were searched for in public databases and screened. The reference sections of the selected articles were examined to identify additional studies. A total of 102 out of 3201 articles were selected: 34 articles focused on soil, 40 focused on water, 23 focused on fresh produce (vegetables/fruits), and 21 focused on bivalve mollusks. Toxoplasma gondii oocysts were found in all matrices worldwide, with detection rates ranging from 0.09% (1/1109) to 100% (8/8) using bioassay or PCR-based detection methods. There was a high heterogeneity (I2 = 98.9%), which was influenced by both the sampling strategy (e.g., sampling site and sample type, sample composition, sample origin, season, number of samples, cat presence) and methodology (recovery and detection methods). Harmonized approaches are needed for the detection of T. gondii in different environmental matrices in order to obtain robust and comparable results.
Collapse
Affiliation(s)
- Nadia María López Ureña
- SALUVET Research Group, Animal Health Department, Veterinary Faculty, Complutense University of Madrid, 28040 Madrid, Spain; (N.M.L.U.); (R.C.B.); (L.M.O.M.)
| | - Umer Chaudhry
- Veterinary Epidemiology and Public Health Department, School of Veterinary Medicine, University of Surrey, Guildford GU2 7XH, UK; (U.C.); or (D.M.); (F.E.); (M.B.)
| | - Rafael Calero Bernal
- SALUVET Research Group, Animal Health Department, Veterinary Faculty, Complutense University of Madrid, 28040 Madrid, Spain; (N.M.L.U.); (R.C.B.); (L.M.O.M.)
| | - Santiago Cano Alsua
- Computing Services, Research Support Center, Complutense University of Madrid, 28040 Madrid, Spain;
| | - Davide Messina
- Veterinary Epidemiology and Public Health Department, School of Veterinary Medicine, University of Surrey, Guildford GU2 7XH, UK; (U.C.); or (D.M.); (F.E.); (M.B.)
- Division of Veterinary Clinical Science, School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, Loughborough LE12 5RD, UK
| | - Francisco Evangelista
- Veterinary Epidemiology and Public Health Department, School of Veterinary Medicine, University of Surrey, Guildford GU2 7XH, UK; (U.C.); or (D.M.); (F.E.); (M.B.)
| | - Martha Betson
- Veterinary Epidemiology and Public Health Department, School of Veterinary Medicine, University of Surrey, Guildford GU2 7XH, UK; (U.C.); or (D.M.); (F.E.); (M.B.)
| | - Marco Lalle
- Unit of Foodborne and Neglected Parasitic Diseases, Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Roma, Italy;
| | - Pikka Jokelainen
- Department of Bacteria, Parasites and Fungi, Infectious Disease Preparedness, Statens Serum Institute, University of Copenhagen, 2300 Copenhagen, Denmark;
| | - Luis Miguel Ortega Mora
- SALUVET Research Group, Animal Health Department, Veterinary Faculty, Complutense University of Madrid, 28040 Madrid, Spain; (N.M.L.U.); (R.C.B.); (L.M.O.M.)
| | - Gema Álvarez García
- SALUVET Research Group, Animal Health Department, Veterinary Faculty, Complutense University of Madrid, 28040 Madrid, Spain; (N.M.L.U.); (R.C.B.); (L.M.O.M.)
| |
Collapse
|
6
|
Wang ZH, Zhang W, Zhang XZ, Yao XR, Huang W, Jia H, Liu XL, Hou SH, Wang XJ. Development of a real-time recombinase-aided amplification (RT-RAA) molecular diagnosis assay for sensitive and rapid detection of Toxoplasma gondii. Vet Parasitol 2021; 298:109489. [PMID: 34384956 DOI: 10.1016/j.vetpar.2021.109489] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/08/2021] [Accepted: 06/01/2021] [Indexed: 10/20/2022]
Abstract
Toxoplasma gondii, a protozoan intracellular parasite, is present in a wide range of hosts, including virtually all species of warm-blooded vertebrates. Toxoplasmosis spreads to humans through a variety of pathways, including contaminated food or water, and close contact with various types of domestic animals. It poses a severe threat to human health, and contributes to important economic losses, not only in cost-of-illness but also in surveillance programs. It is thus necessary to develop a rapid point-of-care field diagnostic technology to control or prevent pathogen transmission to economically important livestock animals, domestic animals, and human beings. In this study, we develop a real-time isothermal amplification method capable of detecting the T. gondii genome in swine and feline blood samples. This method can detect toxoplasma genome with a lowest detection limit of 102 copies of per reaction under optimal reaction conditions of 36 °C for 25 min. The assay displayed advantages in sensitivity and specificity in comparison to traditional real-time PCR, and can be performed in a portable instrument.
Collapse
Affiliation(s)
- Zhao-Hua Wang
- Key Laboratory of Animal Epidemiology of the Ministry of Agriculture, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
| | - Wei Zhang
- Beijing Veterinary Research Institute of Chinese Academy of Agricultural Sciences, Beijing 100193, China
| | - Xiu-Zhong Zhang
- Key Laboratory of Animal Epidemiology of the Ministry of Agriculture, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
| | - Xin-Ran Yao
- Key Laboratory of Animal Epidemiology of the Ministry of Agriculture, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
| | - Wei Huang
- Key Laboratory of Animal Epidemiology of the Ministry of Agriculture, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China
| | - Hong Jia
- Beijing Veterinary Research Institute of Chinese Academy of Agricultural Sciences, Beijing 100193, China
| | - Xiao-Lei Liu
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis/College of Veterinary Medicine, Jilin University, Changchun 130000, China
| | - Shao-Hua Hou
- Beijing Veterinary Research Institute of Chinese Academy of Agricultural Sciences, Beijing 100193, China.
| | - Xiao-Jia Wang
- Key Laboratory of Animal Epidemiology of the Ministry of Agriculture, College of Veterinary Medicine, China Agricultural University, Beijing 100193, China.
| |
Collapse
|
7
|
Węglińska L, Bekier A, Dzitko K, Pacholczyk-Sienicka B, Albrecht Ł, Plech T, Paneth P, Paneth A. 1,3,4-Thiadiazoles Effectively Inhibit Proliferation of Toxoplasma gondii. Cells 2021; 10:1053. [PMID: 33946881 PMCID: PMC8145641 DOI: 10.3390/cells10051053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/15/2021] [Accepted: 04/26/2021] [Indexed: 11/24/2022] Open
Abstract
Congenital and acquired toxoplasmosis caused by the food- and water-born parasite Toxoplasma gondii (T. gondii) is one of the most prevalent zoonotic infection of global importance. T. gondii is an obligate intracellular parasite with limited capacity for extracellular survival, thus a successful, efficient and robust host cell invasion process is crucial for its survival, proliferation and transmission. In this study, we screened a series of novel 1,3,4-thiadiazole-2-halophenylamines functionalized at the C5 position with the imidazole ring (1b-12b) for their effects on T. gondii host cell invasion and proliferation. To achieve this goal, these compounds were initially subjected to in vitro assays to assess their cytotoxicity on human fibroblasts and then antiparasitic efficacy. Results showed that all of them compare favorably to control drugs sulfadiazine and trimethoprim in terms of T. gondii growth inhibition (IC50) and selectivity toward the parasite, expressed as selectivity index (SI). Subsequently, the most potent of them with meta-fluoro 2b, meta-chloro 5b, meta-bromo 8b, meta-iodo 11b and para-iodo 12b substitution were tested for their efficacy in inhibition of tachyzoites invasion and subsequent proliferation by direct action on established intracellular infection. All the compounds significantly inhibited the parasite invasion and intracellular proliferation via direct action on both tachyzoites and parasitophorous vacuoles formation. The most effective was para-iodo derivative 12b that caused reduction in the percentage of infected host cells by 44% and number of tachyzoites per vacuole by 93% compared to non-treated host cells. Collectively, these studies indicate that 1,3,4-thiadiazoles 1b-12b, especially 12b with IC50 of 4.70 µg/mL and SI of 20.89, could be considered as early hit compounds for future design and synthesis of anti-Toxoplasma agents that effectively and selectively block the invasion and subsequent proliferation of T. gondii into host cells.
Collapse
Affiliation(s)
- Lidia Węglińska
- Department of Organic Chemistry, Faculty of Pharmacy, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland;
| | - Adrian Bekier
- Department of Molecular Microbiology, Faculty of Biology and Environmental Protection, University of Lodz, Banacha 12/16, 90-237 Lodz, Poland;
| | - Katarzyna Dzitko
- Department of Molecular Microbiology, Faculty of Biology and Environmental Protection, University of Lodz, Banacha 12/16, 90-237 Lodz, Poland;
| | - Barbara Pacholczyk-Sienicka
- Institute of Organic Chemistry, Faculty of Chemistry, Lodz University of Technology, Zeromskiego 116, 90-924 Lodz, Poland; (B.P.-S.); (Ł.A.)
| | - Łukasz Albrecht
- Institute of Organic Chemistry, Faculty of Chemistry, Lodz University of Technology, Zeromskiego 116, 90-924 Lodz, Poland; (B.P.-S.); (Ł.A.)
| | - Tomasz Plech
- Department of Pharmacology, Faculty of Health Sciences, Medical University of Lublin, Chodzki 4a, 20-093 Lublin, Poland;
| | - Piotr Paneth
- Institute of Applied Radiation Chemistry, Lodz University of Technology, Zeromskiego 116, 90-924 Lodz, Poland;
- International Centre for Research on Innovative Biobased Materials (ICRI-BioM)—International Research Agenda, Lodz University of Technology, Zeromskiego 116, 90-924 Lodz, Poland
| | - Agata Paneth
- Department of Organic Chemistry, Faculty of Pharmacy, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland;
| |
Collapse
|
8
|
Zhou Z, Ortiz Lopez HIA, Pérez GE, Burgos LM, Farina JM, Saldarriaga C, Lopez-Santi R, Cotella JI, Pérez ALS, Baranchuk A. Toxoplasmosis and the Heart. Curr Probl Cardiol 2020; 46:100741. [PMID: 33183832 DOI: 10.1016/j.cpcardiol.2020.100741] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 10/04/2020] [Indexed: 01/24/2023]
Abstract
Toxoplasmosis is a common disease caused by Toxoplasma gondii, a parasite with high prevalence in tropical regions. Most infections show minimal symptoms, but immunocompromised patients tend to have a poor prognosis. Cardiovascular manifestations in toxoplasmosis are rare and reported in a limited number of patients. As part of the "Neglected Tropical Diseases and Other Infectious Diseases Affecting the Heart" (NET-Heart) project, this paper aims to systematically review all available information regarding the cardiovascular implications of toxoplasmosis. Relevant studies were identified in the MEDLINE and/or PubMed database, and 48 articles were ultimately included. This was completed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Cardiac compromise in toxoplasmosis mainly involves myocarditis, and complications vary widely in severity. Toxoplasmic myocarditis is challenging to diagnose, as endomyocardial biopsy is usually required. This article provides a summary of cardiac toxoplasmosis, including an original algorithm facilitating diagnosis and treatment.
Collapse
Affiliation(s)
- Zier Zhou
- Division of Cardiology, Kingston Health Sciences Centre, Queen's University, Kingston, Ontario, Canada
| | | | | | - Lucrecia Maria Burgos
- Department of Heart Failure, Pulmonary Hypertension and Heart Transplant, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | | | - Clara Saldarriaga
- Department of Cardiology and Heart Failure Clinic, Cardiovascular Clinic Santa Maria, University of Antioquia, Medellín, Colombia
| | - Ricardo Lopez-Santi
- Division of Cardiology, Hospital Italiano de La Plata, Buenos Aires, Argentina
| | - Juan Ignacio Cotella
- Division of Cardiology, Centro Privado de Cardiología San Miguel de Tucumán, Tucumán, Argentina
| | | | - Adrian Baranchuk
- Division of Cardiology, Kingston Health Sciences Centre, Queen's University, Kingston, Ontario, Canada.
| |
Collapse
|
9
|
Almeria S, Dubey JP. Foodborne transmission of Toxoplasma gondii infection in the last decade. An overview. Res Vet Sci 2020; 135:371-385. [PMID: 33148402 DOI: 10.1016/j.rvsc.2020.10.019] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 10/14/2020] [Accepted: 10/20/2020] [Indexed: 01/07/2023]
Abstract
Toxoplasmosis is a zoonotic disease of global distribution and importance. It is caused by the protozoan parasite Toxoplasma gondii, the only species in the Toxoplasma genus. This parasite can infect most warm-blooded animals, including humans and livestock. Main routes of transmission are by ingestion of tissue cysts in raw or undercooked meat of infected animals, ingestion of raw vegetables or water contaminated with T. gondii oocysts from cat feces, and transplacental. Around one-third of human beings are chronically infected with T. gondii. Most infections appear to be asymptomatic in immunocompetent persons, but toxoplasmosis can be fatal to the fetus and immunocompromised adults. Water and foodborne outbreaks have been caused by this parasite worldwide, but few are well documented. Importantly, T. gondii is a parasite of high importance in animal health, causing reproductive failure, particularly in small ruminants, and clinical toxoplasmosis in many species. This overview discusses the knowledge of T. gondii infections in the last decade focusing on the foodborne transmission of this parasite.
Collapse
Affiliation(s)
- S Almeria
- Department of Health and Human Services, Food and Drug Administration, Center for Food Safety and Nutrition, Office of Applied Research and Safety Assessment, Division of Virulence Assessment, Laurel, MD 20708, USA.
| | - J P Dubey
- USA Department of Agriculture, Agricultural Research Service, Beltsville Agricultural Research Service, Animal Parasitic Disease Laboratory, Building 1001, BARC-East, Beltsville, MD 20705-2350, USA
| |
Collapse
|
10
|
Lopes CS, Silva TL, de Almeida JCN, Costa LVS, Mineo TWP, Mineo JR. Transmission of Toxoplasma gondii Infection Due to Bone Marrow Transplantation: Validation by an Experimental Model. Front Med (Lausanne) 2019; 6:227. [PMID: 31681783 PMCID: PMC6804406 DOI: 10.3389/fmed.2019.00227] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 09/30/2019] [Indexed: 12/24/2022] Open
Abstract
Toxoplasmosis is an opportunistic infectious disease and may present a fatal outcome for human bone marrow transplant (BMT) recipients, due to the rapid disease course in immunosuppressed individuals. Several reports about occurrence of toxoplasmosis after BMT have been published in the literature, but this disease has been associated mainly due to reactivation of latent infection rather than primary infection. Even though there are reports of acute toxoplasmosis in recipients who were seronegative for T. gondii, suggesting transmission of infection after BMT, the source of infection in those cases has not been clearly demonstrated, whether it is due to the transplantation procedure by itself or from environmental source. Thus, the present study aimed to observe if it could be possible to demonstrate the parasite‘s ability to infect bone marrow (BM) cells and cause toxoplasmosis, when using an experimental model. Our results showed that 11% of hematopoietic and 7.1% of nonhematopoietic lineages may become infected when using in vitro experiments. Also, in vivo experiments demonstrated that, when C57BL/6 mice were infected with RH-RFP or ME-49-GFP T. gondii strains, the BM cells may be infected at different time points of infection. The parasites were detected by both fluorescent microscopy and qPCR. Also, when those BM samples were collected and used for BMT, the transplanted animals presented high rates of mortality and 87.5% of them became seropositive for T. gondii. Taken together, our results clearly demonstrated that it is possible to acquire primary T. gondii infection from the donor cells after BMT. Therefore, we are emphasizing that, before transplantation, serological screening for T. gondii infection from both donors and recipients, in addition to DNA search for this parasite from donor bone marrow cells, are necessary procedures to avoid the risk of T. gondii infection for immunocompromised patients.
Collapse
Affiliation(s)
- Carolina Salomão Lopes
- Laboratory of Immunoparasitology "Dr. Mario Endsfeldz Camargo", Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Brazil
| | - Tamires Lopes Silva
- Laboratory of Immunoparasitology "Dr. Mario Endsfeldz Camargo", Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Brazil
| | - Julio Cesar Neves de Almeida
- Laboratory of Immunoparasitology "Dr. Mario Endsfeldz Camargo", Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Brazil
| | - Lucas Vasconcelos Soares Costa
- Laboratory of Immunoparasitology "Dr. Mario Endsfeldz Camargo", Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Brazil
| | - Tiago Wilson Patriarca Mineo
- Laboratory of Immunoparasitology "Dr. Mario Endsfeldz Camargo", Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Brazil
| | - José Roberto Mineo
- Laboratory of Immunoparasitology "Dr. Mario Endsfeldz Camargo", Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Brazil
| |
Collapse
|
11
|
Pastorello RG, Costa ADCL, Sawamura MVY, Nicodemo AC, Duarte-Neto AN. Disseminated toxoplasmosis in a patient with advanced acquired immunodeficiency syndrome. AUTOPSY AND CASE REPORTS 2018; 8:e2018012. [PMID: 29588907 PMCID: PMC5861962 DOI: 10.4322/acr.2018.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 01/24/2018] [Indexed: 01/15/2023] Open
Abstract
Extracerebral toxoplasmosis, with pulmonary involvement and shock, is a rare form of toxoplasmosis in patients with advanced AIDS. It can mimic pneumocystosis, histoplasmosis, and disseminated tuberculosis, and should be considered in the differential diagnosis of causes of respiratory failure and fulminant disease in this group of individuals, especially in areas where the Toxoplasma gondii infection is highly prevalent and in those without proper use of antimicrobial prophylaxis. We report the case of a 46-year-old male patient who presented to the emergency department with uremia, requiring urgent dialysis. During the laboratorial investigation, the patient had confirmed HIV infection, with a low CD4+ peripheral T-cell count (74 cells/µL). During hospitalization, the patient presented drug-induced hepatitis due to trimethoprim/sulfamethoxazole in a prophylactic dose, requiring interruption of this medication. On the 55th day of hospitalization, the patient developed refractory shock and died. At the autopsy, disseminated toxoplasmosis with encephalitis and severe necrotizing pneumonia were diagnosed, with numerous tachyzoites in the areas of pulmonary necrosis.
Collapse
Affiliation(s)
| | | | | | - Antonio Carlos Nicodemo
- University of São Paulo, Faculty of Medicine, Parasitary and Infectious Diseases Department. São Paulo, SP, Brasil
| | - Amaro Nunes Duarte-Neto
- University of São Paulo, Faculty of Medicine, Pathology Department. São Paulo, SP, Brasil.,University of São Paulo, Faculty of Medicine, Clinical Emergencies Discipline. São Paulo, SP, Brasil
| |
Collapse
|
12
|
Rahman T, Rahman A, Chakraborty S. Infection of <i>Toxoplasma gondii</i> in Humans and Livestock Animals: An Emerging Silent Threat for Bangladesh. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/ojmm.2018.84010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
13
|
Recombinase polymerase amplification (RPA) combined with lateral flow (LF) strip for detection of Toxoplasma gondii in the environment. Vet Parasitol 2017; 243:199-203. [PMID: 28807294 DOI: 10.1016/j.vetpar.2017.06.026] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 06/23/2017] [Accepted: 06/25/2017] [Indexed: 02/04/2023]
Abstract
Toxoplasma gondii infects all warm-blooded vertebrates, resulting in a great threat to human health and significant economic loss to the livestock industry. Ingestion of infectious oocysts of T. gondii from the environment is the major source of transmission. Detection of T. gondii oocysts by existing methods is laborious, time-consuming and expensive. The objective of the present study was to develop a recombinase polymerase amplification (RPA) method combined with a lateral flow (LF) strip for detection of T. gondii oocysts in the soil and water. The DNA of T. gondii oocysts was amplified by a pair of specific primers based on the T. gondii B1 gene over 15min at a constant temperature ranging from 30°C to 45°C using RPA. The amplification product was visualized by the lateral flow (LF) strip within 5min using the specific probe added to the RPA reaction system. The sensitivity of the established assay was 10 times higher than that of nested PCR with a lower detection limit of 0.1 oocyst per reaction, and there was no cross-reactivity with other closely related protozoan species. Fifty environmental samples were further assessed for the detection validity of the LF-RPA assay (B1-LF-RPA) and compared with nested PCR based on the B1 gene sequence. The B1-LF-RPA and nested PCR both showed that 5 out of the 50 environmental samples were positive. The B1-LF-RPA method was also proven to be sufficiently tolerant of existing inhibitors in the environment. In addition, the advantages of simple operation, speediness and cost-effectiveness make B1-LF-RPA a promising molecular detection tool for T. gondii.
Collapse
|
14
|
Ellis JE, Heuser R, Missan DS, Martinez D, Heningburg A, Shabilla M, Schwartz R, Fry S. Evidence for polymicrobial communities in explanted vascular filters and atheroma debris. Mol Cell Probes 2017; 33:65-77. [PMID: 28411089 DOI: 10.1016/j.mcp.2017.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 03/07/2017] [Accepted: 04/06/2017] [Indexed: 10/19/2022]
Abstract
RATIONALE Microbial communities have been implicated in a variety of disease processes and have been intermittently observed in arterial disease; however, no comprehensive unbiased community analysis has been performed. We hypothesize that complex microbial communities may be involved in chronic vascular diseases as well and may be effectively characterized by molecular assays. OBJECTIVE The main objective is to survey vascular debris, atheroma, and vascular filters for polymicrobial communities consisting of prokaryotic and eukaryotic microbes, specifically eukaryotic microbes. METHODS AND RESULTS We examined vascular aspirates of atheromatous debris or embolic protection filters in addition to matched peripheral blood samples, from fifteen patients, as well as three cadaveric coronary arteries from two separate patients, for microbial communities. General fluorescence microscopy by Höechst and ethidium bromide DNA stains, prokaryotic and eukaryotic community analysis by Next Generation DNA Sequencing (NGS), and a eukaryotic microbial 9 probe multiplexed quantitative PCR were used to detect and characterize the presence of putative polymicrobial communities. No prokaryotes were detected in peripheral blood; however, in 4 of 9 sequenced filters and in 2 of 7 sequenced atheroma debris samples, prokaryotic populations were identified. By DNA sequencing, eukaryotic microbes were detected in 4 of 15 blood samples, 5 of the 9 sequenced filters, and 3 of the 7 atheroma debris samples. The quantitative multiplex PCR detected sequences consistent with eukaryotic microbes in all 9 analyzed filter samples as well as 5 of the 7 atheroma debris samples. Microscopy reveals putative polymicrobial communities within filters and atheroma debris. The main contributing prokaryotic species in atheroma debris suggest a diverse and novel composition. Additionally, Funneliformis mosseae, an arbuscular mycorrhizal fungus in the Glomeraceae family, was detected in the coronary hard plaque from two patients. Well studied biofilm forming bacteria were not detectable in circulating peripheral blood and were not universally present in atheroma or filters. Analyses of the sequenced eukaryotes are consistent with a diverse of array poorly studied environmental eukaryotes. In summary, out of 15 patients, 6 exhibited molecular evidence of prokaryotes and 14 had molecular evidence of eukaryotic and/or polymicrobial communities in vivo, while 2 post-mortem coronary plaque samples displayed evidence of fungi. CONCLUSION Prokaryotes are not consistently observed in atheroma debris or filter samples; however, detection of protozoa and fungi in these samples suggests that they may play a role in arterial vascular disease or atheroma formation.
Collapse
Affiliation(s)
| | - Richard Heuser
- St. Luke's Phoenix Heart Center, Phoenix, AZ 85006, USA; University of Arizona, College of Medicine, Phoenix, AZ 85006, USA
| | | | | | | | | | | | - Stephen Fry
- Fry Laboratories, LLC, Scottsdale, AZ 85260, USA.
| |
Collapse
|
15
|
|
16
|
Alvarado-Esquivel C, Salcedo-Jaquez M, Sanchez-Anguiano LF, Hernandez-Tinoco J, Rabago-Sanchez E, Beristain-Garcia I, Liesenfeld O, Estrada-Martinez S, Perez-Alamos AR, Alvarado-Soto E. Association Between Toxoplasma gondii Exposure and Heart Disease: A Case-Control Study. J Clin Med Res 2016; 8:402-9. [PMID: 27081427 PMCID: PMC4817581 DOI: 10.14740/jocmr2525w] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2016] [Indexed: 11/11/2022] Open
Abstract
Background The parasite Toxoplasma gondii causes infections all around the world. Infections with T. gondii are systemic and the parasite can persist in the heart muscle. Very little is known about the impact of T. gondii on patients with heart disease. We determined the association between T. gondii exposure and patients suffering from heart diseases attending in a public hospital in Durango, Mexico; the association of T. gondii exposure with socio-demographic, behavioral, and clinical characteristics of these patients was also investigated. Methods Through a case-control study, we examined the seroprevalence of anti-T. gondii IgG and IgM antibodies in 400 patients with heart diseases and 400 age- and gender-matched controls using enzyme-linked immunoassays. In addition, we analyzed the association of patient characteristics as determined by a standardized questionnaire with T. gondii exposure by bivariate and multivariate analyses. Results Fifty-five (13.8%) of 400 patients and 32 (8.0%) of 400 controls had anti-T. gondii IgG antibodies (odds ratio (OR) = 1.83; 95% confidence interval (CI): 1.15 - 2.90; P = 0.01). High anti-T. gondii IgG levels (> 150 IU/mL) were found in 28 (50.9%) of the 55 positive cases and in 14 (43.8%) of the 32 positive controls (P = 0.51). Anti-T. gondii IgM antibodies were found in 13 (23.6%) of the 55 anti-T. gondii IgG positive patients and in 19 (59.4%) of 32 anti-T. gondii IgG positive controls (OR = 0.21; 95% CI: 0.08 - 0.54; P = 0.0008). Multivariate analysis showed that T. gondii exposure was positively associated with being born out of Durango State (OR = 2.93; 95% CI: 1.40 - 6.13; P = 0.004), and with consumption of alcohol (OR = 2.04; 95% CI: 1.01 - 4.12; P = 0.04). Conclusions Results obtained in this study indicate that T. gondii infection is associated with heart disease, and suggest that heart disease might be related with a chronic infection. This is the first report of an association of T. gondii exposure with alcohol consumption in this population. Results warrant for further research to determine the epidemiological impact of T. gondii exposure on patients with heart diseases. Risk factors associated with T. gondii exposure are critical to design future prevention strategies against T. gondii exposure.
Collapse
Affiliation(s)
- Cosme Alvarado-Esquivel
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Misael Salcedo-Jaquez
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Luis Francisco Sanchez-Anguiano
- Institute for Scientific Research "Dr. Roberto Rivera-Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Jesus Hernandez-Tinoco
- Institute for Scientific Research "Dr. Roberto Rivera-Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Elizabeth Rabago-Sanchez
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico; Hospital General, Servicios de Salud de Durango, Cuauhtemoc 225 norte. 34000 Durango, Mexico
| | - Isabel Beristain-Garcia
- Facultad de Enfermeria y Obstetricia, Juarez University of Durango State, Cuauhtemoc 223 norte, 34000 Durango, Mexico
| | - Oliver Liesenfeld
- Institute for Microbiology and Hygiene, Campus Benjamin Franklin, Charite Medical School, Hindenburgdamm 27, D-12203 Berlin, Germany; Present address: Roche Molecular Diagnostics, Pleasanton, CA, USA
| | - Sergio Estrada-Martinez
- Institute for Scientific Research "Dr. Roberto Rivera-Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Alma Rosa Perez-Alamos
- Institute for Scientific Research "Dr. Roberto Rivera-Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Ediyair Alvarado-Soto
- Facultad de Enfermeria y Obstetricia, Juarez University of Durango State, Cuauhtemoc 223 norte, 34000 Durango, Mexico
| |
Collapse
|
17
|
Liu Q, Wang ZD, Huang SY, Zhu XQ. Diagnosis of toxoplasmosis and typing of Toxoplasma gondii. Parasit Vectors 2015; 8:292. [PMID: 26017718 PMCID: PMC4451882 DOI: 10.1186/s13071-015-0902-6] [Citation(s) in RCA: 242] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 05/18/2015] [Indexed: 11/25/2022] Open
Abstract
Toxoplasmosis, caused by the obligate intracellular protozoan Toxoplasma gondii, is an important zoonosis with medical and veterinary importance worldwide. The disease is mainly contracted by ingesting undercooked or raw meat containing viable tissue cysts, or by ingesting food or water contaminated with oocysts. The diagnosis and genetic characterization of T. gondii infection is crucial for the surveillance, prevention and control of toxoplasmosis. Traditional approaches for the diagnosis of toxoplasmosis include etiological, immunological and imaging techniques. Diagnosis of toxoplasmosis has been improved by the emergence of molecular technologies to amplify parasite nucleic acids. Among these, polymerase chain reaction (PCR)-based molecular techniques have been useful for the genetic characterization of T. gondii. Serotyping methods based on polymorphic polypeptides have the potential to become the choice for typing T. gondii in humans and animals. In this review, we summarize conventional non-DNA-based diagnostic methods, and the DNA-based molecular techniques for the diagnosis and genetic characterization of T. gondii. These techniques have provided foundations for further development of more effective and accurate detection of T. gondii infection. These advances will contribute to an improved understanding of the epidemiology, prevention and control of toxoplasmosis.
Collapse
Affiliation(s)
- Quan Liu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046, People's Republic of China. .,Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Military Veterinary Institute, Academy of Military Medical Sciences, Changchun, Jilin Province, 130122, People's Republic of China.
| | - Ze-Dong Wang
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Military Veterinary Institute, Academy of Military Medical Sciences, Changchun, Jilin Province, 130122, People's Republic of China.
| | - Si-Yang Huang
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046, People's Republic of China. .,Jiangsu Co-innovation Center for the Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University College of Veterinary Medicine, Yangzhou, Jiangsu Province, 225009, People's Republic of China.
| | - Xing-Quan Zhu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046, People's Republic of China. .,Jiangsu Co-innovation Center for the Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University College of Veterinary Medicine, Yangzhou, Jiangsu Province, 225009, People's Republic of China.
| |
Collapse
|
18
|
Schmidt SK, Ebel S, Keil E, Woite C, Ernst JF, Benzin AE, Rupp J, Däubener W. Regulation of IDO activity by oxygen supply: inhibitory effects on antimicrobial and immunoregulatory functions. PLoS One 2013; 8:e63301. [PMID: 23675474 PMCID: PMC3652816 DOI: 10.1371/journal.pone.0063301] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 04/02/2013] [Indexed: 01/06/2023] Open
Abstract
Tryptophan is an essential amino acid for human beings as well as for some microorganisms. In human cells the interferon-γ (IFN-γ) inducible enzyme indoleamine 2,3-dioxygenase (IDO) reduces local tryptophan levels and is therefore able to mediate broad-spectrum effector functions: IDO activity restricts the growth of various clinically relevant pathogens such as bacteria, parasites and viruses. On the other hand, it has been observed that IDO has immunoregulatory functions as it efficiently controls the activation and survival of T-cells. Although these important effects have been analysed in much detail, they have been observed in vitro using cells cultured in the presence of 20% O2 (normoxia). Such high oxygen concentrations are not present in vivo especially within infected and inflamed tissues. We therefore analysed IDO-mediated effects under lower oxygen concentrations in vitro and observed that the function of IDO is substantially impaired in tumour cells as well as in native cells. Hypoxia led to reduced IDO expression and as a result to reduced production of kynurenine, the downstream product of tryptophan degradation. Consequently, effector functions of IDO were abrogated under hypoxic conditions: in different human cell lines such as tumour cells (glioblastoma, HeLa) but also in native cells (human foreskin fibroblasts; HFF) IDO lost the capacity to inhibit the growth of bacteria (Staphylococcus aureus), parasites (Toxoplasma gondii) or viruses (herpes simplex virus type 1). Additionally, IDO could no longer efficiently control the proliferation of T-cells that have been co-cultured with IDO expressing HFF cells in vitro. In conclusion, the potent antimicrobial as well as immunoregulatory functions of IDO were substantially impaired under hypoxic conditions that pathophysiologically occurs in vivo.
Collapse
Affiliation(s)
- Silvia K. Schmidt
- Institute of Medical Microbiology and Hospital Hygiene, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Sebastian Ebel
- Institute of Medical Microbiology and Hospital Hygiene, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Eric Keil
- Institute of Medical Microbiology and Hospital Hygiene, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Claudia Woite
- Institute of Medical Microbiology and Hospital Hygiene, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Joachim F. Ernst
- Institute for Molecular Mycology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Anika E. Benzin
- Institute of Medical Microbiology and Hygiene, University of Lübeck, Lübeck, Germany
| | - Jan Rupp
- Institute of Medical Microbiology and Hygiene, University of Lübeck, Lübeck, Germany
- Medical Clinic III/UK-SH, Campus Lübeck, Lübeck, Germany
| | - Walter Däubener
- Institute of Medical Microbiology and Hospital Hygiene, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- * E-mail:
| |
Collapse
|
19
|
Brownback KR, Crosser MS, Simpson SQ. A 49-year-old man with chest pain and fever after returning from France. Chest 2012; 141:1618-1621. [PMID: 22670025 DOI: 10.1378/chest.11-2085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Kyle R Brownback
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Kansas Medical Center, Kansas City, KS.
| | - Michael S Crosser
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Steven Q Simpson
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Kansas Medical Center, Kansas City, KS
| |
Collapse
|
20
|
Roubille F, Roubille C, Lattuca B, Gervasoni R, Vernhet-Kovacsik H, Leclercq F. Recent Toxoplasmosis Infection With Acute Myopericarditis and Persistent Troponin Elevation in an Immunocompetent Patient. Cardiol Res 2012; 3:189-191. [PMID: 28348686 PMCID: PMC5358212 DOI: 10.4021/cr200w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2012] [Indexed: 12/04/2022] Open
Abstract
Although often considered as "begnin", acute infections in young healthy adults can lead to heart inflammation, including acute myocarditis. We report a rare case of myopericarditis in a young immunocompetent adult, in the context of recent toxoplasmosis infection. Clinical presentation was common acute pericarditis, but with risk biomarkers: high troponin I levels and multiple inflammation-compatible images on MR-scan. Diagnosis of myopericarditis was established. In spite of spontaneous favourable clinical evolution, troponin remained elevated. MR-scan is shown; acute myocarditis in the context of an acute toxoplasmosis infection is discussed.
Collapse
Affiliation(s)
- François Roubille
- CHU Arnaud de Villeneuve, Cardiology Department, Montpellier, France
| | - Camille Roubille
- CHU Saint Eloi, Internal Medicine Department, Montpellier, France
| | - Benoît Lattuca
- CHU Arnaud de Villeneuve, Cardiology Department, Montpellier, France
| | - Richard Gervasoni
- CHU Arnaud de Villeneuve, Cardiology Department, Montpellier, France
| | | | - Florence Leclercq
- CHU Arnaud de Villeneuve, Cardiology Department, Montpellier, France
| |
Collapse
|
21
|
Demar M, Hommel D, Djossou F, Peneau C, Boukhari R, Louvel D, Bourbigot AM, Nasser V, Ajzenberg D, Darde ML, Carme B. Acute toxoplasmoses in immunocompetent patients hospitalized in an intensive care unit in French Guiana. Clin Microbiol Infect 2011; 18:E221-31. [PMID: 21958195 DOI: 10.1111/j.1469-0691.2011.03648.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Atypical Toxoplasma gondii strains, unrelated to archetypal clonal lineages (I, II, III), have been reported more frequently over the last decade in areas other than Europe and North America. A newly described form of toxoplasmosis, 'Amazonian toxoplasmosis' (AT), has been reported since 2002 in French Guiana. It is characterized by severe cases and atypical strains linked to a neotropical forest-based cycle. We report on the cases of AT that required intensive care management. We performed a prospective observational study on hospitalized adults in the Intensive Care Unit (ICU) from 2002 to 2008. Clinical and laboratory data, microbiological findings and outcomes were recorded. Data, including the ICU simplified acute physiology score and the pneumonia severity index, were calculated. Epidemiological risk factors for AT were assessed through questionnaires. Eleven non-immunodeficient patients were admitted to the ICU in Cayenne for life-threatening pneumonia associated with disseminated toxoplasmosis. Mechanical ventilation was necessary in seven patients, four of whom required immediate orotracheal intubation. Cardiac and ophthalmological abnormalities were found in five and four patients, respectively. One patient died from multiple organ failure. The genetic characterization of Toxoplasma DNA using six microsatellite markers revealed unique and atypical genotypes in eight patients. All patients presented epidemiological risk factors for AT. In French Guiana, significant T. gondii-related infectious syndrome associated with the lungs, a high level of LDH activity and the reported risk factors for AT was strongly suggestive of disseminated toxoplasmosis with a possible trend toward life-threatening pneumonia.
Collapse
Affiliation(s)
- M Demar
- Unit of Infectious and Tropical Diseases, Cayenne Hospital, Cayenne, French Guiana.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Kovari H, Ebnöther C, Schweiger A, Berther N, Kuster H, Günthard HF. Pulmonary toxoplasmosis, a rare but severe manifestation of a common opportunistic infection in late HIV presenters: report of two cases. Infection 2010; 38:141-4. [PMID: 20352286 PMCID: PMC7102080 DOI: 10.1007/s15010-009-9367-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Accepted: 12/07/2009] [Indexed: 11/26/2022]
Abstract
Pulmonary toxoplasmosis is rare, particularly in the era of highly active antiretroviral therapy (HAART). Here, we describe two severe cases in patients not known to be HIV-infected. In both patients, early diagnosis and therapy led to a favourable outcome. Pulmonary toxoplasmosis should be considered in the differential diagnosis in potentially HIV-infected patients with respiratory symptoms.
Collapse
Affiliation(s)
- H Kovari
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland.
| | | | | | | | | | | |
Collapse
|
23
|
Chen X, Remotti F, Tong GX, Gorczyca E, Hamele-Bena D. Fine-needle aspiration cytology of subcutaneous toxoplasmosis: A case report. Diagn Cytopathol 2009; 38:716-20. [PMID: 20014129 DOI: 10.1002/dc.21281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Toxoplasmosis is a common opportunistic infection in patients with AIDS in whom it typically presents as encephalitis, pneumonia, lymphadenitis, and myocarditis. Skin involvement is very rare and, to our best knowledge, Toxoplasma gondii forming a subcutaneous mass has not been reported. Here, we report the findings of an interesting case of subcutaneous toxoplasmosis with the cytological appearance of an inflammatory fibrovascular lesion in a HIV-positive patient and discuss the differential diagnosis.
Collapse
Affiliation(s)
- Xiaowei Chen
- Department of Pathology, Columbia University Medical Centre, New York, NY 10032, USA.
| | | | | | | | | |
Collapse
|
24
|
Acute Disseminated Toxoplasmosis in Patients With Human Immunodeficiency Virus Infection: A Clinical Challenge. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2009. [DOI: 10.1097/ipc.0b013e318184db1e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
25
|
Fricker‐Hidalgo H, Bulabois C, Brenier‐Pinchart M, Hamidfar R, Garban F, Brion J, Timsit J, Cahn J, Pelloux H. Diagnosis of Toxoplasmosis after Allogeneic Stem Cell Transplantation: Results of DNA Detection and Serological Techniques. Clin Infect Dis 2009; 48:e9-e15. [DOI: 10.1086/595709] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
|