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Yang L, Wang B, Yang Z, Zheng S, Xin Z, Wu S, Zou W, Peng H. Toxoplasma gondii infection positively associated with schizophrenia: Evidences from UK Biobank cohort and case-controlled studies. J Psychiatr Res 2024; 175:243-250. [PMID: 38749298 DOI: 10.1016/j.jpsychires.2024.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/03/2024] [Accepted: 05/08/2024] [Indexed: 09/06/2024]
Abstract
Toxoplasma gondii (T. gondii) is an opportunistic pathogen affecting about 1/3 of world population. While often asymptomatic in immunocompetent individuals, it can lead to severe toxoplasmosis in immunocompromised patients. Recent research has unveiled a potential link between T. gondii infection and neuropsychiatric diseases. We implemented both a cohort study and a case control study to further identify this association. In the cohort study, we analyzed data from the UK Biobank database, which included 8814 individuals tested for T. gondii SAG1 antibodies and free of neuropsychiatric disorders at baseline. Among them, 22.52% (n = 1985) tested positive for SAG1 antibody. Over an average follow-up period of 12.26 years, Cox proportional hazards models and logistic regression analysis revealed a significant association between the SAG1 seropositivity at baseline and the incidence of schizophrenia (HR: 5.89; 95% CI: 1.69-20.53). In our case-control study, 239 patients diagnosed with schizophrenia and 455 healthy individuals were involved. Using the modified agglutination test (MAT) to detect T. gondii antibodies, logistic regression analysis showed a higher prevalence of T. gondii infection among schizophrenia patients (10.04%) compared to healthy controls (3.74%). T. gondii infection emerged as a significant risk factor for schizophrenia (OR: 3.33; 95% CI: 1.68-6.61). However, our investigations did not reveal a robust association between T. gondii infection and other neuropsychiatric conditions, including Alzheimer's disease, dementia, anxiety, depression, neurodegenerative disorders, and peripheral neurological disorders such as neurological and plexus disorders.
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Affiliation(s)
- Lili Yang
- Department of Pathogen Biology, Guangdong Provincial Key Laboratory of Tropical Diseases Research, School of Public Health, Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education, Southern Medical University, 1023-1063 South Shatai Rd, Guangzhou City, Guangdong Province, China. 510515.
| | - Biyun Wang
- Department of Pathogen Biology, Guangdong Provincial Key Laboratory of Tropical Diseases Research, School of Public Health, Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education, Southern Medical University, 1023-1063 South Shatai Rd, Guangzhou City, Guangdong Province, China. 510515; Department of Biobank, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Zihan Yang
- Department of Pathogen Biology, Guangdong Provincial Key Laboratory of Tropical Diseases Research, School of Public Health, Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education, Southern Medical University, 1023-1063 South Shatai Rd, Guangzhou City, Guangdong Province, China. 510515
| | - Shuyu Zheng
- Department of Pathogen Biology, Guangdong Provincial Key Laboratory of Tropical Diseases Research, School of Public Health, Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education, Southern Medical University, 1023-1063 South Shatai Rd, Guangzhou City, Guangdong Province, China. 510515
| | - Zixuan Xin
- Department of Pathogen Biology, Guangdong Provincial Key Laboratory of Tropical Diseases Research, School of Public Health, Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education, Southern Medical University, 1023-1063 South Shatai Rd, Guangzhou City, Guangdong Province, China. 510515
| | - Shuizhen Wu
- Department of Pathogen Biology, Guangdong Provincial Key Laboratory of Tropical Diseases Research, School of Public Health, Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education, Southern Medical University, 1023-1063 South Shatai Rd, Guangzhou City, Guangdong Province, China. 510515
| | - Weihao Zou
- Department of Pathogen Biology, Guangdong Provincial Key Laboratory of Tropical Diseases Research, School of Public Health, Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education, Southern Medical University, 1023-1063 South Shatai Rd, Guangzhou City, Guangdong Province, China. 510515
| | - Hongjuan Peng
- Department of Pathogen Biology, Guangdong Provincial Key Laboratory of Tropical Diseases Research, School of Public Health, Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education, Southern Medical University, 1023-1063 South Shatai Rd, Guangzhou City, Guangdong Province, China. 510515.
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Grada S, Mihu AG, Oatis DA, Marc CC, Chicea LM, Petrescu C, Lupu AM, Olariu TR. Seroprevalence and Associated Risk Factors of Toxoplasma gondii in Patients Diagnosed with Schizophrenia: A Case-Control Cross Sectional Study. Biomedicines 2024; 12:998. [PMID: 38790960 PMCID: PMC11117935 DOI: 10.3390/biomedicines12050998] [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: 04/06/2024] [Revised: 04/27/2024] [Accepted: 04/29/2024] [Indexed: 05/26/2024] Open
Abstract
The protozoan parasite, Toxoplasma gondii, has been linked to several psychiatric disorders, including schizophrenia. The aim of this study was to assess the prevalence of T. gondii IgG antibodies and risk factors associated with seroprevalence in patients diagnosed with schizophrenia. This seroepidemiological study assessed 196 participants, divided into two groups. The study group consisted of 98 schizophrenic patients and was matched with 98 healthy blood donors. A questionnaire was used to gather information regarding potential risk factors associated with T. gondii seroprevalence. Results revealed a higher seroprevalence of T. gondii IgG antibodies in schizophrenic patients (69.39%, 68/98) when compared to healthy controls (51.02%, 50/98) (OR: 2.18; 95% CI: 1.21-3.9; p = 0.01). Patients with schizophrenia who consumed raw or undercooked meat (80.65%, 25/31) (OR: 3.75; 95% CI: 1.25-11.21, p = 0.02) and those with a lower educational level (77.59%, 45/58) (OR: 3.5; 95% CI: 1.59-7.54, p = 0.002) presented increased T. gondii seropositivity rates versus their control counterparts. Our findings indicate a high T. gondii IgG seroprevalence in patients diagnosed with schizophrenia compared to healthy blood donors. Factors associated with T. gondii seroprevalence were consumption of raw or uncooked meat and a lower educational attainment. This study provided the first data regarding the potential risk factors for toxoplasmosis in Romanian patients diagnosed with schizophrenia and may serve as a foundation for future research and the development of preventive strategies.
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Affiliation(s)
- Sebastian Grada
- Discipline of Parasitology, Department of Infectious Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (S.G.); (T.R.O.)
- Center for Diagnosis and Study of Parasitic Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Alin Gabriel Mihu
- “Aurel Ardelean” Institute of Life Sciences, Vasile Goldis Western University of Arad, 86 Rebreanu, 310414 Arad, Romania;
- Department of Biology and Life Sciences, Vasile Goldis Western University, 310300 Arad, Romania
- Patogen Preventia, 300124 Timisoara, Romania
| | - Daniela Adriana Oatis
- “Aurel Ardelean” Institute of Life Sciences, Vasile Goldis Western University of Arad, 86 Rebreanu, 310414 Arad, Romania;
- Department of Infectious Disease, Faculty of Medicine, Vasile Goldis Western University, 310300 Arad, Romania
| | - Constantin Catalin Marc
- Center for Diagnosis and Study of Parasitic Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Department of Biology and Life Sciences, Vasile Goldis Western University, 310300 Arad, Romania
| | - Liana Maria Chicea
- Department II Medical Clinic, “Victor Papilian” Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania;
- Internal Medicine Department, Academic Emergency Hospital, 550245 Sibiu, Romania
| | - Cristina Petrescu
- Discipline of Hygiene, Department of Microbiology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Alina Maria Lupu
- Discipline of Parasitology, Department of Infectious Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (S.G.); (T.R.O.)
- Center for Diagnosis and Study of Parasitic Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Patogen Preventia, 300124 Timisoara, Romania
- Clinical Laboratory, Institute of Cardiovascular Diseases, 300310 Timisoara, Romania
| | - Tudor Rares Olariu
- Discipline of Parasitology, Department of Infectious Disease, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (S.G.); (T.R.O.)
- Center for Diagnosis and Study of Parasitic Diseases, “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
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Li X, Wang Q, Li X, Wang C, Lu J, Zhang E, Liang C, Wang W, Fu Y, Li C, Zhang L, Li T. Carbon nanospheres dual spectral-overlapped fluorescence quenching lateral flow immunoassay for rapid diagnosis of toxoplasmosis in humans. J Pharm Biomed Anal 2024; 241:115986. [PMID: 38310830 DOI: 10.1016/j.jpba.2024.115986] [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: 10/16/2023] [Revised: 01/03/2024] [Accepted: 01/13/2024] [Indexed: 02/06/2024]
Abstract
Toxoplasmosis is a common zoonotic disease caused by a protozoan parasite Toxoplasma gondii (Tox), approximately infecting one-third of human populations worldwide. This study developed the carbon nanospheres (CNPs) based dual spectral-overlapped fluorescence quenching lateral flow immunoassay (CNPs-FQLFIA) for detection of Tox antibodies (ToxAbs). The CNPs have been effectively coupled with Tox antigen (ToxAg), which can completely overlap the excitation and emission spectra of europium nanospheres (EuNPs) and CdSe/ZnS quantum dots (QDs) in testing strips of CNPs-QDs-FQLFIA or CNPs-EuNPs-FQLFIA. The sensitivity of CNPs-EuNPs-FQLFIA or CNPs-QDs-FQLFIA was 4 or 8 IU/mL under natural light readout, or both 4 IU/mL ToxAbs under ultraviolet (UV) light readout by the naked eyes, respectively. The limit of detection (LOD) of two types of CNPs-FQLFIA was both 1 IU/mL ToxAbs under UV light by a dry fluorescence analyzer, but no cross-reaction was found with other antibodies. The intra-assay coefficient variation (CV) of both CNPs-EuNPs-FQLFIA and CNPs-QDs-FQLFIA was less than 8%, while the inter-assay CV was less than 14%, respectively. The correlation coefficient (R2) of CNPs-EuNPs-FQLFIA or CNPs-QDs-FQLFIA to measure the different concentrations of ToxAbs spiked serum samples was 0.99712 and 0.99896, respectively. The CNPs-FQLFIA presented a characteristics of 94.3% sensitivity, 100% specificity and 98% accuracy for detection of ToxAbs in clinical serum samples. In conclusion, CNPs-FQLFIA with EuNPs or QDs fluorescence reporter was an easy, rapid, sensitive, precise and quantitative assay for detecting Tox antibodies in human blood samples.
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Affiliation(s)
- Xiaozhou Li
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou 510515, China
| | - Qi Wang
- Department of Laboratory Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
| | - Xintong Li
- Guangzhou Blood Center, Guangzhou, China
| | - Cong Wang
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou 510515, China; Guangzhou Bai Rui Kang (BRK) Biological Science and Technology Limited Company, Guangzhou 510000, China
| | - Jinhui Lu
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou 510515, China
| | - Enhui Zhang
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou 510515, China
| | - Chaolan Liang
- Department of Blood Transfusion, Shenzhen Third People's Hospital, Shenzhen 518112, China
| | - Wenjing Wang
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou 510515, China
| | - Yongshui Fu
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou 510515, China; Guangzhou Blood Center, Guangzhou, China
| | - Chengyao Li
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou 510515, China
| | - Ling Zhang
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou 510515, China.
| | - Tingting Li
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou 510515, China.
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Zerekidze A, Li M, Refisch A, Shameya J, Sobanski T, Walter M, Wagner G. Impact of Toxoplasma gondii and Human Microbiome on Suicidal Behavior: A Systematic Review. J Clin Med 2024; 13:593. [PMID: 38276099 PMCID: PMC10816148 DOI: 10.3390/jcm13020593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/10/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Suicide remains a persistent global health challenge, resisting widespread prevention efforts. According to previous findings, toxoplasmosis is particularly associated with altered decision making, which could lead to risk-taking behavior, thereby increasing the likelihood for suicidal behavior (SB). In addition, discussion about the role of microbiome in psychiatric disorders has emerged lately, which also makes it relevant to investigate its role in the context of SB. Therefore, two systematic reviews are integrated in this paper, and the existing knowledge is comprehensively summarized regarding the association between microbial pathogens and SB. METHODS We conducted a systematic search with keywords including SB and Toxoplasma gondii (Suicid* AND Toxoplasm*) and microbiome (Suicid* AND Microbiome AND Microbiota) throughout PubMed and Scopus to retrieve related studies up to 9 November 2023, identifying 24 eligible records. The subjects of the included studies had to have fulfilled the criteria of an SB disorder as defined by DSM-5, and death cases needed to have been defined as suicide. RESULTS Most studies reported significant association between toxoplasmosis and SB, suggesting a higher likelihood of SB in the infected population. Regarding the microbiome, only very few studies investigated an association between SB and alterations in the microbiome. Based on six included studies, there were some indications of a link between changes in the microbiome and SB. CONCLUSION The cognitive aspects of decision making in T. gondii-infected individuals with SB should be further investigated to unravel the underlying mechanisms. Further sufficiently powered studies are needed to establish a link between SB and alterations in the microbiome.
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Affiliation(s)
- Ani Zerekidze
- Department of Psychiatry and Psychotherapy, Jena Center for Mental Health, Jena University Hospital, 07743 Jena, Germany
| | - Meng Li
- Department of Psychiatry and Psychotherapy, Jena Center for Mental Health, Jena University Hospital, 07743 Jena, Germany
- Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, 07743 Jena, Germany
| | - Alexander Refisch
- Department of Psychiatry and Psychotherapy, Jena Center for Mental Health, Jena University Hospital, 07743 Jena, Germany
- Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, 07743 Jena, Germany
| | - Justina Shameya
- Department of Psychiatry and Psychotherapy, Jena Center for Mental Health, Jena University Hospital, 07743 Jena, Germany
| | - Thomas Sobanski
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Center for Mental Health, Thueringen-Kliniken “Georgius Agricola”, 07318 Saalfeld, Germany;
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, Jena Center for Mental Health, Jena University Hospital, 07743 Jena, Germany
- Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, 07743 Jena, Germany
- German Center for Mental Health (DZPG), Partner Site Jena, 07743 Jena, Germany
| | - Gerd Wagner
- Department of Psychiatry and Psychotherapy, Jena Center for Mental Health, Jena University Hospital, 07743 Jena, Germany
- Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, 07743 Jena, Germany
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Xie H, Sun H, Dong H, Dai L, Xu H, Zhang L, Wang Q, Zhang J, Zhao G, Xu C, Yin K. Label-free quantitative proteomic analyses of mouse astrocytes provides insight into the host response mechanism at different developmental stages of Toxoplasma gondii. PLoS Negl Trop Dis 2023; 17:e0011102. [PMID: 37721957 PMCID: PMC10538781 DOI: 10.1371/journal.pntd.0011102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 09/28/2023] [Accepted: 08/07/2023] [Indexed: 09/20/2023] Open
Abstract
Toxoplasma gondii (T. gondii) is an opportunistic parasite that can infect the central nervous system (CNS), causing severe toxoplasmosis and behavioral cognitive impairment. Mortality is high in immunocompromised individuals with toxoplasmosis, most commonly due to reactivation of infection in the CNS. There are still no effective vaccines and drugs for the prevention and treatment of toxoplasmosis. There are five developmental stages for T. gondii to complete life cycle, of which the tachyzoite and bradyzoite stages are the key to the acute and chronic infection. In this study, to better understanding of how T. gondii interacts with the host CNS at different stages of infection, we constructed acute and chronic infection models of T. gondii in astrocytes, and used label-free proteomics to detect the proteome changes before and after infection, respectively. A total of 4676 proteins were identified, among which 163 differentially expressed proteins (fold change ≥ 1.5 or ≤ 0.67 and p-value ≤ 0.05) including 109 up-regulated proteins and 54 down-regulated proteins in C8-TA vs C8 group, and 719 differentially expressed proteins including 495 up-regulated proteins and 224 down-regulated proteins in C8-BR vs C8-TA group. After T. gondii tachyzoites infected astrocytes, differentially expressed proteins were enriched in immune-related biological processes to promote the formation of bradyzoites and maintain the balance of T. gondii, CNS and brain. After T. gondii bradyzoites infected astrocytes, the differentially expressed proteins up-regulated the host's glucose metabolism, and some up-regulated proteins were strongly associated with neurodegenerative diseases. These findings not only provide new insights into the psychiatric pathogenesis of T. gondii, but also provide potential targets for the treatment of acute and chronic Toxoplasmosis.
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Affiliation(s)
- Huanhuan Xie
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining, Shandong, China
| | - Hang Sun
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining, Shandong, China
| | - Hongjie Dong
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining, Shandong, China
| | - Lisha Dai
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining, Shandong, China
| | - Haozhi Xu
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining, Shandong, China
| | - Lixin Zhang
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining, Shandong, China
- Xingan League Center for Disease Control and Prevention, Ulanhot, Inner Mongolia, China
| | - Qi Wang
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining, Shandong, China
| | - Junmei Zhang
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining, Shandong, China
| | - Guihua Zhao
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining, Shandong, China
| | - Chao Xu
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining, Shandong, China
| | - Kun Yin
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining, Shandong, China
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Montazeri M, Moradi E, Moosazadeh M, Hosseini SH, Fakhar M. Relationship between Toxoplasma gondii infection and psychiatric disorders in Iran: A systematic review with meta-analysis. PLoS One 2023; 18:e0284954. [PMID: 37552680 PMCID: PMC10409283 DOI: 10.1371/journal.pone.0284954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Toxoplasma gondii, a ubiquitous parasitic protozoan, may be an important cause of neurological and psychiatric diseases. The present systematic review and meta-analysis, therefore, was conducted to investigate the scientific evidence regarding the potential association between T. gondii infection and psychiatric disorders in Iran. METHODS We systematically reviewed articles from world-wide databases, including PubMed, Scopus, Science Direct, Web of Science, Google Scholar, and Iranian national databases up to July 30th, 2021. The Newcastle Ottawa Scale (NOS) was used to assess the quality of included studies. The common odds ratio (OR) was estimated using inverse variance and a random-effects model. Heterogeneity was assessed using the χ2-based Cochrane test (Q) and the I2 index. Also, sensitivity analyses and publication bias were calculated. Moreover, subgroup analysis was performed based on the type of disorder and quality score of different eligible studies. RESULTS 16 studies were included in this meta-analysis. Our meta-analyses found that the OR of the risk of anti- T. gondii IgG and IgM in psychiatric patients compared to the control group was 1.56 (95% CI; 1.23-1.99) and 1.76 (95% CI: 1.19-2.61), respectively. Subgroup analysis based on the type of disorder showed that the OR of the risk of anti- T. gondii IgG in Iranian schizophrenia patients and other psychiatric disorders compared to the control group were 1.50 (95% CI; 1.09-2.07) and 2.03 (95% CI: 1.14-3.60), respectively, which are statistically significant. Also, the OR of the risk of anti- T. gondii IgM in Iranian schizophrenia and depression patients compared to the control group was 1.54 (95% CI; 0.9-2.64) and 1.03 (95% CI: 0.2-5.24), respectively, which are not statistically significant. Additionally, subgroup analysis based on quality scores showed no significant influence on the results according to the moderate quality studies. However, this association was significant according to the high quality studies. The obtained results of Egger's test were 1.5 (95% CI; -0.62-3.73, P = 0.15) and 0.47 (95% CI; -0.82-1.76, P = 0.45), respectively, indicating publication bias. The significant results of the heterogeneity analysis confirmed a high level of heterogeneity in the IgG test (P = 0.000, I2 = 66.6%). However, no significant results from the test of heterogeneity were detected in the IgM test (P = 0.15, I2 = 27.5%). The results of the sensitivity analysis showed that the impact of each study on the meta-analysis was not significant on overall estimates. CONCLUSIONS Despite the limited number of studies, these outcomes supported a possible link between T. gondii infection and psychiatric disorders in Iran. However, more high-quality investigations are needed in the future.
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Affiliation(s)
- Mahbobeh Montazeri
- Toxoplasmosis Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Elahe Moradi
- Toxoplasmosis Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Hamzeh Hosseini
- Toxoplasmosis Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Psychiatry and Behavioral Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Fakhar
- Iranian National Registry Center for Toxoplasmosis (INRCT), Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
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Bisetegn H, Debash H, Ebrahim H, Mahmood N, Gedefie A, Tilahun M, Alemayehu E, Mohammed O, Feleke DG. Global seroprevalence of Toxoplasma gondii infection among patients with mental and neurological disorders: A systematic review and meta-analysis. Health Sci Rep 2023; 6:e1319. [PMID: 37287705 PMCID: PMC10242185 DOI: 10.1002/hsr2.1319] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/09/2023] [Accepted: 05/24/2023] [Indexed: 06/09/2023] Open
Abstract
Background and Aim Toxoplasmosis is the most widespread zoonotic disease that affects one-third of the world's population, and imposes a major public health problem worldwide. This study aimed to assess the prevalence of toxoplasmosis among patients with neuropsychiatric patients. Methods Electronic databases PubMed, Google Scholar, Web of Science, Research Gate, and Scopus were thoroughly searched from February to March 2022 to identify all relevant studies. The quality of studies was evaluated using the Newcastle-Ottawa quality scale for case-control and cross-sectional studies. Statistical analysis was done using STATA version 12 software. A random effect model was used to compute the global pooled seroprevalence of Toxoplasma gondii infection. Heterogeneity was quantified by using I 2 value. Subgroup analysis was done, and publication bias was assessed using a funnel plot and Egger's test. Result Of 1250 studies, 49 containing 21,093 participants and conducted in 18 countries were included. The global pooled seroprevalence of T. gondii IgG antibody was 38.27% (95% CI: 32.04-44.9) among neuropsychiatric patients and 25.31% (95% CI: 21.53-29.08) in healthy controls with substantial heterogeneity of 98.3%. The prevalence of T. gondii IgG antibody was higher in males (17.52%) than in females (12.35%) neuropsychiatric patients. The highest pooled prevalence of T. gondii IgG antibody was in Europe (57%) followed by Africa (45.25%) and Asia (43%). Time based analysis showed the highest pooled prevalence of T. gondii IgG antibody in 2012-2016 (41.16%).The global pooled seroprevalence T. gondii IgM antibody among neuropsychiatric patients and healthy controls was 6.78% (95% CI: 4.87-8.69) and 3.13% (95% CI: 2.02-4.24), respectively. Conclusion The pooled prevalence of chronic and acute T. gondii infection among neuropsychiatric patients was 38.27% and 6.78%, respectively. This showed a high burden of toxoplasmosis among neurological and psychiatric patients and urges routine screening of those patients and providing appropriate treatment. It also indicates the need for different stakeholders to develop targeted prevention and control strategies for T. gondii infection.
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Affiliation(s)
- Habtye Bisetegn
- Department of Medical Laboratory Sciences, College of Medicine and Health SciencesWollo UniversityDessieEthiopia
| | - Habtu Debash
- Department of Medical Laboratory Sciences, College of Medicine and Health SciencesWollo UniversityDessieEthiopia
| | - Hussen Ebrahim
- Department of Medical Laboratory Sciences, College of Medicine and Health SciencesWollo UniversityDessieEthiopia
| | | | - Alemu Gedefie
- Department of Medical Laboratory Sciences, College of Medicine and Health SciencesWollo UniversityDessieEthiopia
| | - Mihret Tilahun
- Department of Medical Laboratory Sciences, College of Medicine and Health SciencesWollo UniversityDessieEthiopia
| | - Ermiyas Alemayehu
- Department of Medical Laboratory Sciences, College of Medicine and Health SciencesWollo UniversityDessieEthiopia
| | - Ousman Mohammed
- Department of Medical Laboratory Sciences, College of Medicine and Health SciencesWollo UniversityDessieEthiopia
| | - Daniel Getacher Feleke
- Department of Microbiology, Immunology and Parasitology, College of Health SciencesAddis Ababa UniversityAddis AbabaEthiopia
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Liu T, Gao P, Bu D, Liu D. Association between Toxoplasma gondii infection and psychiatric disorders: a cross-sectional study in China. Sci Rep 2022; 12:15092. [PMID: 36064811 PMCID: PMC9445102 DOI: 10.1038/s41598-022-16420-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 07/11/2022] [Indexed: 11/28/2022] Open
Abstract
Psychiatric patients have become the focus of public attention, and current research suggests a possible link between Toxoplasma gondii (T. gondii) infection and mental illness. To understand the current situation of T. gondii infection in psychiatric patients in the study area, the relationship between T. gondii infection and mental diseases, and the influence of T. gondii infection on psychiatric patients, this study examined 3101 psychiatric inpatients from 2015 to 2020. All people included in the study were tested for anti-Toxoplasma IgM antibody and anti-Toxoplasma IgG antibody. Additionally, 4040 individuals from the general population were included as controls. The chi-square test and logistic regression analysis were carried out to determine the association between psychiatric disorders and T. gondii infection. The seroprevalence of anti-Toxoplasma IgM antibody was 0.23% (7/3101) in psychiatric inpatients and 0.11% (2/1846) in the general population, and there was no significant difference (p > 0.05). The seroprevalence rate of anti-Toxoplasma IgG antibodies was 3.03% (94/3101) in psychiatric inpatients and 1.05% (23/2194) in the general population, and there was a significant difference (p < 0.01). The seroprevalence of anti-Toxoplasma IgG antibody in psychiatric inpatients was significantly different between different age groups (p < 0.01). The positivity rate of anti-Toxoplasma IgG antibodies was 5.17% (3/58) in patients with mania, 3.24% (8/247) in patients with recurrent depressive disorder, 3.54% (13/367) in patients with depression, 3.22% (39/1213) in patients with schizophrenia, 2.41% (18/748) in patients with bipolar disorder and 2.25% (2/89) in patients with dissociative disorder. Compared to the general population, patients with mania (OR = 5.149 95% CI 1.501–17.659 p = 0.009), schizophrenia (OR = 3.136 95% CI 1.864–5.275 p = 0.000), depression (OR = 3.466 95% CI 1.740–6.906 p = 0.000), recurrent depressive disorder (OR = 3.160 95% CI 1.398–7.142 p = 0.006) and bipolar disorder (OR = 2.327 95% CI 1.249–4.337 p = 0.008) were found to be significantly associated with the seroprevalence of anti-Toxoplasma IgG antibody. This study suggests that the seroprevalence of T. gondii infection in psychiatric patients was higher and that age was an influencing factor of T. gondii infection in psychiatric patients. T. gondii infection was associated with mania, schizophrenia, depression, recurrent depressive disorder and bipolar disorder.
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Affiliation(s)
- Taixiu Liu
- Department of Clinical Laboratory, Shandong Daizhuang Hospital, Jining, 272051, Shandong, People's Republic of China
| | - Peng Gao
- Department of Clinical Laboratory, Shandong Daizhuang Hospital, Jining, 272051, Shandong, People's Republic of China
| | - Deyun Bu
- Department of Clinical Laboratory, Qingdao Sanatorium of Shandong Province, Qingdao, 266071, Shandong, People's Republic of China
| | - Dong Liu
- Department of Clinical Laboratory, Affiliated Hospital of Jining Medical University, Jining, 272029, Shandong, People's Republic of China.
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9
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Virus MA, Ehrhorn EG, Lui LM, Davis PH. Neurological and Neurobehavioral Disorders Associated with Toxoplasma gondii Infection in Humans. J Parasitol Res 2021; 2021:6634807. [PMID: 34712493 PMCID: PMC8548174 DOI: 10.1155/2021/6634807] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 09/15/2021] [Indexed: 01/17/2023] Open
Abstract
The intracellular parasite Toxoplasma gondii is estimated to infect up to 30% of the world population, leading to lifelong chronic infection of the brain and muscle tissue. Although most latent T. gondii infections in humans have traditionally been considered asymptomatic, studies in rodents suggest phenotypic neurological changes are possible. Consequently, several studies have examined the link between T. gondii infection and diseases such as schizophrenia, epilepsy, depression, bipolar disorder, dysphoria, Alzheimer's disease, Parkinson's disease, and obsessive-compulsive disorder (OCD). To date, there is varying evidence of the relationship of T. gondii to these human neurological or neurobehavioral disorders. A thorough review of T. gondii literature was conducted to highlight and summarize current findings. We found that schizophrenia was most frequently linked to T. gondii infection, while sleep disruption showed no linkage to T. gondii infection, and other conditions having mixed support for a link to T. gondii. However, infection as a cause of human neurobehavioral disease has yet to be firmly established.
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Affiliation(s)
- Maxwell A. Virus
- Department of Biology, University of Nebraska at Omaha, Omaha, Nebraska, USA
| | - Evie G. Ehrhorn
- Department of Biology, University of Nebraska at Omaha, Omaha, Nebraska, USA
| | - LeeAnna M. Lui
- Department of Biology, University of Nebraska at Omaha, Omaha, Nebraska, USA
| | - Paul H. Davis
- Department of Biology, University of Nebraska at Omaha, Omaha, Nebraska, USA
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10
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Lan HW, Lu YN, Zhao XD, Jin GN, Lu JM, Jin CH, Ma J, Jin X, Xu X, Piao LX. New role of sertraline against Toxoplasma gondii-induced depression-like behaviours in mice. Parasite Immunol 2021; 43:e12893. [PMID: 34637545 DOI: 10.1111/pim.12893] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/27/2021] [Accepted: 10/06/2021] [Indexed: 12/31/2022]
Abstract
Toxoplasma gondii (T. gondii) is a neurotropic protozoan parasite, which can cause mental and behavioural disorders. The present study aimed to elucidate the effects and underlying molecular mechanisms of sertraline (SERT) on T. gondii-induced depression-like behaviours. In the present study, a mouse model and a microglial cell line (BV2 cells) model were established by infecting with the T. gondii RH strain. In in vivo and in vitro experiments, the underlying molecular mechanisms of SERT in inhibiting depression-like behaviours and cellular perturbations caused by T. gondii infection were investigated in the mouse brain and BV2 cells. The administration of SERT significantly ameliorated depression-like behaviours in T. gondii-infected mice. Furthermore, SERT inhibited T. gondii proliferation. Treatment with SERT significantly inhibited the activation of microglia and decreased levels of pro-inflammatory cytokines such as tumour necrosis factor-alpha, and interferon-gamma, by down-regulating tumour necrosis factor receptor 1/nuclear factor-kappa B signalling pathway, thereby ameliorating the depression-like behaviours induced by T. gondii infection. Our study provides insight into the underlying molecular mechanisms of the newly discovered role of SERT against T. gondii-induced depression-like behaviours.
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Affiliation(s)
- Hui-Wen Lan
- Key Laboratory of Natural Resources of Changbai Mountain & Functional Molecules, Ministry of Education, Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, Jilin, China
| | - Yu-Nan Lu
- Key Laboratory of Natural Resources of Changbai Mountain & Functional Molecules, Ministry of Education, Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, Jilin, China
| | - Xu-Dong Zhao
- Key Laboratory of Natural Resources of Changbai Mountain & Functional Molecules, Ministry of Education, Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, Jilin, China
| | - Guang-Nan Jin
- Key Laboratory of Natural Resources of Changbai Mountain & Functional Molecules, Ministry of Education, Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, Jilin, China
| | - Jing-Mei Lu
- Key Laboratory of Natural Resources of Changbai Mountain & Functional Molecules, Ministry of Education, Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, Jilin, China
| | - Cheng-Hua Jin
- Key Laboratory of Natural Resources of Changbai Mountain & Functional Molecules, Ministry of Education, Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, Jilin, China
| | - Juan Ma
- Key Laboratory of Natural Resources of Changbai Mountain & Functional Molecules, Ministry of Education, Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, Jilin, China
| | - Xuejun Jin
- Key Laboratory of Natural Resources of Changbai Mountain & Functional Molecules, Ministry of Education, Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, Jilin, China
| | - Xiang Xu
- Key Laboratory of Natural Resources of Changbai Mountain & Functional Molecules, Ministry of Education, Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, Jilin, China
| | - Lian-Xun Piao
- Key Laboratory of Natural Resources of Changbai Mountain & Functional Molecules, Ministry of Education, Molecular Medicine Research Center, College of Pharmacy, Yanbian University, Yanji, Jilin, China
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11
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Alvarado-Esquivel C, Mendoza-Larios LA, García-Dolores F, Sánchez-Anguiano LF, Antuna-Salcido EI, Hernández-Tinoco J, Rocha-Salais A, Segoviano-Mendoza MA, Sifuentes-Álvarez A. Association between Toxoplasma gondii Infection in Brain and a History of Depression in Suicide Decedents: A Cross-Sectional Study. Pathogens 2021; 10:pathogens10101313. [PMID: 34684262 PMCID: PMC8539687 DOI: 10.3390/pathogens10101313] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/30/2021] [Accepted: 10/06/2021] [Indexed: 11/16/2022] Open
Abstract
We assessed the association between Toxoplasma gondii (T. gondii) infection of the central nervous system and suicide correlates in suicide decedents. Eighty-seven decedents who died by suicide received in a forensic setting for medico-legal autopsies in Mexico City were studied. Two samples of brain (amygdala and prefrontal cortex) from each decedent were examined for detection of T. gondii using immunohistochemistry. Correlates of suicide including a history of previous suicide attempts, co-morbid mental disorder, consumption of alcohol or tobacco, irritability and aggression, economic problems, presence of drugs or alcohol in blood and suicide method were obtained and analyzed for their association with T. gondii infection. T. gondii immunohistochemistry was positive in prefrontal cortex sections in 6 decedents and in an amygdala section in one decedent. Thus, the prevalence of T. gondii infection in brain in suicide victims was 8.0% (7/87). Bivariate and logistic regression analysis of suicide correlates showed that only a history of depression was associated with T. gondii infection of the brain in suicide victims (OR: 12.00; 95% CI: 2.26–63.46; p = 0.003). Our results provide evidence that T. gondii infection in brain is associated with a history of depression in suicide decedents.
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Affiliation(s)
- Cosme Alvarado-Esquivel
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango 34000, Mexico; (L.F.S.-A.); (J.H.-T.); (A.R.-S.); (M.A.S.-M.); (A.S.-Á.)
- Correspondence:
| | | | - Fernando García-Dolores
- Amphitheater and Department of Education, Institute of Forensic Sciences, Mexico 06720, Mexico; (L.A.M.-L.); (F.G.-D.)
| | - Luis Francisco Sánchez-Anguiano
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango 34000, Mexico; (L.F.S.-A.); (J.H.-T.); (A.R.-S.); (M.A.S.-M.); (A.S.-Á.)
| | | | - Jesús Hernández-Tinoco
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango 34000, Mexico; (L.F.S.-A.); (J.H.-T.); (A.R.-S.); (M.A.S.-M.); (A.S.-Á.)
| | - Adriana Rocha-Salais
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango 34000, Mexico; (L.F.S.-A.); (J.H.-T.); (A.R.-S.); (M.A.S.-M.); (A.S.-Á.)
| | - Marcela Araceli Segoviano-Mendoza
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango 34000, Mexico; (L.F.S.-A.); (J.H.-T.); (A.R.-S.); (M.A.S.-M.); (A.S.-Á.)
| | - Antonio Sifuentes-Álvarez
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango 34000, Mexico; (L.F.S.-A.); (J.H.-T.); (A.R.-S.); (M.A.S.-M.); (A.S.-Á.)
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12
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Akgül Ö, Demirel ÖF, Aksoy Poyraz C, Tanriöver Aydin E, Uysal N, Bulu E, Sapmaz B, Çalişkan R, Öner YA. Toxoplasma gondii infection by serological and molecular methods in schizophrenia patients with and without suicide attempts: An age-sex-matched case-control study. Int J Clin Pract 2021; 75:e14449. [PMID: 34106507 DOI: 10.1111/ijcp.14449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 05/11/2021] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION The opinion that latent Toxoplasma gondii infection is having a broadly asymptomatic projection has now been interrogated, in specific due to the echoed association between the latent infection and an elevated incidence of schizophrenia or even suicide attempts. Notwithstanding conducted studies aimed to understand this feasible link are restricted. METHODS In the present case-control study, we focused to illuminate the relationship between the serological and molecular presence of T gondii and schizophrenia with or without the suicide attempts by comparing it with healthy individuals. A total of 237 participants (117 in schizophrenia and 120 in healthy control) were included in this study. RESULTS Overall, latent T gondii infections were found statistically higher in 63 (53.8%) of the 117 patients with schizophrenia and in 33 (27.5%) of the 120 controls (P < .001). In schizophrenia patients, seroprevalence T gondii was again found to be statistically higher in suicide attempters (59.6%), compared with no history of suicide attempts (48.3%; P < .05). The molecular positivity rate of T gondii DNA was higher in the schizophrenia group, compared with the healthy control group (P < .05), whereas the history of suicide attempts was not statistically associated (P = .831) with T gondii DNA positivity by polymerase chain reaction. CONCLUSION This case-control study enlightens additional demonstration to the belief that T gondii infection would be an underlying component for the pathophysiology of schizophrenia. Regardless of the clarity results of this study, this supposition warrants further endorsement.
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Affiliation(s)
- Özer Akgül
- Department of Medical Microbiology, School of Medicine, Istanbul Aydin University, Istanbul, Turkey
| | - Ömer Faruk Demirel
- Department of Psychiatry, Istanbul University - Cerrahpaşa, Cerrahpaşa School of Medicine, Istanbul, Turkey
| | - Cana Aksoy Poyraz
- Department of Psychiatry, Istanbul University - Cerrahpaşa, Cerrahpaşa School of Medicine, Istanbul, Turkey
| | - Ezgi Tanriöver Aydin
- Department of Psychiatry, Istanbul University - Cerrahpaşa, Cerrahpaşa School of Medicine, Istanbul, Turkey
| | - Nuray Uysal
- Department of Psychiatry, Istanbul University - Cerrahpaşa, Cerrahpaşa School of Medicine, Istanbul, Turkey
| | - Ersel Bulu
- Department of Psychiatry, Istanbul University - Cerrahpaşa, Cerrahpaşa School of Medicine, Istanbul, Turkey
| | - Burcu Sapmaz
- Department of Medical Microbiology, School of Medicine, Istanbul Aydin University, Istanbul, Turkey
| | - Reyhan Çalişkan
- Department of Medical Microbiology, School of Medicine, Istanbul Aydin University, Istanbul, Turkey
| | - Yaşar Ali Öner
- Department of Medical Microbiology, School of Medicine, Istanbul Aydin University, Istanbul, Turkey
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13
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Galván-Ramírez MDLL, Navarro Machuca G, Covarrubias Castillo SA, Benavides González JC, Rodríguez Pérez LR, Dueñas Jiménez SH, Dueñas Jiménez JM. Toxoplasmosis Is More Frequent in Schizophrenia Patients Than in the General Population in Mexico and Is Not Associated with More Severe Course of Schizophrenia Measured with the Brief Psychiatric Rating Scale. Pathogens 2021; 10:pathogens10070820. [PMID: 34208827 PMCID: PMC8308891 DOI: 10.3390/pathogens10070820] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/26/2021] [Accepted: 06/26/2021] [Indexed: 11/16/2022] Open
Abstract
Toxoplasmosis is a disease, which was discovered in 1908, caused by the intracellular parasite Toxoplasma gondii. T. gondii infects neuronal, glial, and muscle cells, and chronic infections are characterized by the presence of cysts, in the brain and muscle cells, formed by bradyzoites. T. gondii is capable of synthesizing L-DOPA, a precursor of dopamine. Dopamine is a neurotransmitter that is key in the etiology of neuropsychological disorders such as schizophrenia. Previous studies have shown high levels of IgG Toxoplasma antibodies in schizophrenia patients. Many published studies show that the prevalence of toxoplasmosis is higher in schizophrenia patients. In this study, we aimed to identify the prevalence of Toxoplasma infection in patients with schizophrenia and the relationships between, sociodemographic factors and the Brief Psychiatric Rating Scale. A total of 27 schizophrenic patients were included and IgG anti-T. gondii was determined in serum samples by ELISA. The Brief Psychiatric Rating Scale, sociodemographic factors were associated with seropositivity. We found that the prevalence of Toxoplasma antibodies was 51.7%. In the Brief Psychiatric Rating Scale, statistical significant association (p = 0.024) was found in Item 13 which is related to motor retardation, however, the association turned non-significant after of correction for multiple tests or after of analyzed with a logistic regression p = 0.059, odds ratio (OR) = 2.316 with a 95% confidence interval [0.970 to 5.532]. Other association was not found between toxoplasmosis and others factors. The prevalence of toxoplasmosis on our population under study was significantly higher than that reported by general population or other group of Mexican schizophrenia patients.
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Affiliation(s)
- María de la Luz Galván-Ramírez
- Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara C.P. 45100, JA, Mexico; (J.C.B.G.); (L.R.R.P.); (S.H.D.J.); (J.M.D.J.)
- Correspondence: ; Tel.: +52-(33)-10585200
| | - Gabriela Navarro Machuca
- Servicio de Psiquiatría del Hospital Civil Fray Antonio Alcalde, Guadalajara C.P. 44280, JA, Mexico; (G.N.M.); (S.A.C.C.)
| | | | - Juan Carlos Benavides González
- Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara C.P. 45100, JA, Mexico; (J.C.B.G.); (L.R.R.P.); (S.H.D.J.); (J.M.D.J.)
| | - Laura Roció Rodríguez Pérez
- Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara C.P. 45100, JA, Mexico; (J.C.B.G.); (L.R.R.P.); (S.H.D.J.); (J.M.D.J.)
| | - Sergio Horacio Dueñas Jiménez
- Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara C.P. 45100, JA, Mexico; (J.C.B.G.); (L.R.R.P.); (S.H.D.J.); (J.M.D.J.)
| | - Judith Marcela Dueñas Jiménez
- Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara C.P. 45100, JA, Mexico; (J.C.B.G.); (L.R.R.P.); (S.H.D.J.); (J.M.D.J.)
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14
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Toxoplasma gondii Infection and Suicidal Behavior in People with Alcohol Consumption. Pathogens 2021; 10:pathogens10060734. [PMID: 34200830 PMCID: PMC8230445 DOI: 10.3390/pathogens10060734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/16/2021] [Accepted: 06/07/2021] [Indexed: 12/16/2022] Open
Abstract
We determined the association between T. gondii infection and suicidal behavior in people with alcohol consumption. One-thousand four-hundred and twenty-three people with alcohol consumption were screened for suicidal behavior and tested for anti-T. gondii IgG and IgM antibodies using commercially available enzyme-linked immunosorbent assays. Anti-T. gondii IgG antibodies were found in 34 of 224 (15.2%) individuals with suicidal ideation and in 118 (9.8%) of 1199 individuals without suicidal ideation (OR: 1.63; 95% CI: 1.08–2.47; p = 0.01). Seropositivity to T. gondii was associated with suicidal ideation in women (OR: 2.24; 95% CI: 1.33–3.78; p = 0.001) and in individuals aged ≤30 years (OR: 2.68; 95% CI: 1.22–5.87; p = 0.01) and >50 years (OR: 2.85; 95% CI: 1.19–6.77; p = 0.01). Anti-T. gondii IgG antibodies were found in 17 of 136 (12.5%) individuals with suicide attempts and in 135 (10.5%) of 1287 individuals without suicide attempts (OR: 1.21; 95% CI: 0.71–2.08; p = 0.47). Seroprevalence of T. gondii infection was associated with suicide attempts in women (OR: 1.88; 95% CI: 0.99–3.55; p = 0.04). No association between anti-T. gondii IgM and suicidal ideation or suicide attempts was found. Results suggest that T. gondii infection is associated with suicidal behavior in people with alcohol consumption.
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15
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Ansari-Lari M, Zendehboodi Z, Masoudian M, Mohammadi F. Additive effect of glutathione S-transferase T1 active genotype and infection with Toxoplasma gondii for increasing the risk of schizophrenia. Nord J Psychiatry 2021; 75:275-280. [PMID: 33191823 DOI: 10.1080/08039488.2020.1843711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE To determine if Toxoplasma gondii (T. gondii) infection may play a role in the development of schizophrenia in genetically susceptible persons with regard to genes encoding glutathione S-transferase T1 (GSTT1) and M1 (GSTM1). METHODS A total of 78 cases with psychiatric diagnosis of schizophrenia were compared with 91 healthy controls. For detection of IgG antibodies, enzyme-linked immunosorbent assay was used. Genotyping of GSTM1 and GSTT1 was performed by multiplex PCR. Chi-square and logistic regression were used for statistical analyses. RESULTS A higher frequency of the GSTT1 active gene in schizophrenic patients was observed. When risk categories based on the combination of T. gondii status and GSTs polymorphisms were compared, risk of schizophrenia increased in T. gondii positive/GSTT1 absent subjects (OR = 4.75, p = 0.05) compared with T. gondii negative/GSTT1 absent group. When T. gondii positive subjects had the GSTT1 active genotype, the risk increased linearly (OR = 10.20, p < 0.001). Odds ratio in T. gondii positive groups were almost the same in combination with the GSTM1 active genotype (OR = 4.45, p = 0.003) or null genotype (OR = 4.37, p = 0.006). CONCLUSIONS Our results showed an additive effect for T. gondii and GSTT1 active genotype as risk factors for schizophrenia in Iranian population. This is a small pilot study and replicating the study with larger groups of patients in multinational investigation to clarify these findings is recommended.
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Affiliation(s)
- Maryam Ansari-Lari
- Department of Food Hygiene and Public Heath, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Zahra Zendehboodi
- Department of Biology, College of Sciences, Shiraz University, Shiraz, Iran
| | - Malihe Masoudian
- Department of Pathobiology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Fahimeh Mohammadi
- Graduated from the School of Veterinary Medicine, Shiraz University, Shiraz, Iran
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16
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Postolache TT, Wadhawan A, Rujescu D, Hoisington AJ, Dagdag A, Baca-Garcia E, Lowry CA, Okusaga OO, Brenner LA. Toxoplasma gondii, Suicidal Behavior, and Intermediate Phenotypes for Suicidal Behavior. Front Psychiatry 2021; 12:665682. [PMID: 34177652 PMCID: PMC8226025 DOI: 10.3389/fpsyt.2021.665682] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/30/2021] [Indexed: 12/27/2022] Open
Abstract
Within the general literature on infections and suicidal behavior, studies on Toxoplasma gondii (T. gondii) occupy a central position. This is related to the parasite's neurotropism, high prevalence of chronic infection, as well as specific and non-specific behavioral alterations in rodents that lead to increased risk taking, which are recapitulated in humans by T. gondii's associations with suicidal behavior, as well as trait impulsivity and aggression, mental illness and traffic accidents. This paper is a detailed review of the associations between T. gondii serology and suicidal behavior, a field of study that started 15 years ago with our publication of associations between T. gondii IgG serology and suicidal behavior in persons with mood disorders. This "legacy" article presents, chronologically, our primary studies in individuals with mood disorders and schizophrenia in Germany, recent attempters in Sweden, and in a large cohort of mothers in Denmark. Then, it reviews findings from all three meta-analyses published to date, confirming our reported associations and overall consistent in effect size [ranging between 39 and 57% elevation of odds of suicide attempt in T. gondii immunoglobulin (IgG) positives]. Finally, the article introduces certain links between T. gondii and biomarkers previously associated with suicidal behavior (kynurenines, phenylalanine/tyrosine), intermediate phenotypes of suicidal behavior (impulsivity, aggression) and state-dependent suicide risk factors (hopelessness/dysphoria, sleep impairment). In sum, an abundance of evidence supports a positive link between suicide attempts (but not suicidal ideation) and T. gondii IgG (but not IgM) seropositivity and serointensity. Trait impulsivity and aggression, endophenotypes of suicidal behavior have also been positively associated with T. gondii seropositivity in both the psychiatrically healthy as well as in patients with Intermittent Explosive Disorder. Yet, causality has not been demonstrated. Thus, randomized interventional studies are necessary to advance causal inferences and, if causality is confirmed, to provide hope that an etiological treatment for a distinct subgroup of individuals at an increased risk for suicide could emerge.
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Affiliation(s)
- Teodor T Postolache
- Department of Psychiatry, Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, United States.,Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, United States.,Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, MD, United States
| | - Abhishek Wadhawan
- Department of Psychiatry, Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Psychiatry, Saint Elizabeth's Hospital, Washington, DC, United States
| | - Dan Rujescu
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Halle, Halle, Germany
| | - Andrew J Hoisington
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, United States.,Department of Systems Engineering and Management, Air Force Institute of Technology, Dayton, OH, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Aline Dagdag
- Department of Psychiatry, Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Enrique Baca-Garcia
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain.,Department of Psychiatry, Madrid Autonomous University, Madrid, Spain.,Department of Psychiatry, Rey Juan Carlos University Hospital, Móstoles, Spain.,Department of Psychiatry, General Hospital of Villalba, Madrid, Spain.,Department of Psychiatry, Infanta Elena University Hospital, Valdemoro, Spain.,Universidad Catolica del Maule, Talca, Chile.,Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
| | - Christopher A Lowry
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States.,Department of Integrative Physiology, Center for Neuroscience, Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, United States
| | - Olaoluwa O Okusaga
- Department of Psychiatry, Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, United States.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States.,Michael E DeBakey VA Medical Center, Houston, TX, United States
| | - Lisa A Brenner
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States.,Department of Psychiatry & Neurology, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
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Fernandes SM, Dias AR, Miranda-Scippa Â. Association between exposure to toxoplasmosis and major psychiatric disorders: a systematic review. BRAZILIAN JOURNAL OF PSYCHIATRY 2020; 43:438-445. [PMID: 32965430 PMCID: PMC8352736 DOI: 10.1590/1516-4446-2020-0904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 05/09/2020] [Indexed: 11/25/2022]
Abstract
Objective: To assess the association between exposure to toxoplasmosis and major psychiatric disorders through a systematic review of the literature. Methods: The literature review was performed in the MEDLINE, SciELO, and PsycINFO databases. To evaluate the quality of the studies included in the review, the Newcastle-Ottawa Scale was used. Results: Thirty-one studies were included, and the majority found an association between exposure to toxoplasmosis and schizophrenia or bipolar disorder (58.3 and 54.5% of the included papers, respectively), but not major depressive disorder. We found no significant difference in mean quality scores between studies that corroborated and contradicted the association hypothesis for either schizophrenia or bipolar disorder. All included papers were considered at least satisfactory according to the Newcastle-Ottawa Scale (total scores ≥ 6 out of 9). Conclusion: Although there was no association between exposure to toxoplasmosis and major depressive disorder, the results indicate an association with both bipolar disorder and schizophrenia, despite their heterogeneity. Further studies should be performed with more specific variables so that the nature of these relationships can be elucidated.
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Affiliation(s)
- Santiago M Fernandes
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil.,Centro de Estudos de Transtornos de Humor e Ansiedade (CETHA), Complexo Hospitalar Universitário Professor Edgard Santos, UFBA, Salvador, BA, Brazil
| | - Alan R Dias
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil.,Centro de Estudos de Transtornos de Humor e Ansiedade (CETHA), Complexo Hospitalar Universitário Professor Edgard Santos, UFBA, Salvador, BA, Brazil
| | - Ângela Miranda-Scippa
- Centro de Estudos de Transtornos de Humor e Ansiedade (CETHA), Complexo Hospitalar Universitário Professor Edgard Santos, UFBA, Salvador, BA, Brazil.,Programa de Pós-Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brazil.,Departamento de Neurociências e Saúde Mental, Faculdade de Medicina da Bahia, UFBA, Salvador, BA, Brazil
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Mirahmadi H, Hasanzadeh R, Malek Raeesi H, Fallahi S, Khoshsima Shahraki M, Badirzadeh A. Loop-Mediated Isothermal Amplification (LAMP) Assay to Detect Toxoplasmosis in Schizophrenia Patients. IRANIAN JOURNAL OF PARASITOLOGY 2020; 15:299-306. [PMID: 33082793 PMCID: PMC7548473 DOI: 10.18502/ijpa.v15i3.4193] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Toxoplasma gondii (T. gondii) causes an important parasitic infection known as toxoplasmosis, which is a globally distributed important zoonosis. One of the major serious characteristics of T. gondii is its ability to manipulate the behavior of intermediate hosts. We performed a cross-sectional study to determine toxoplasmosis in schizophrenic patients, as one of the major neuropsychiatric disorders, using loop-mediated isothermal amplification (LAMP) technic by targeting parasite B1 gene. Methods Blood samples were taken from 118 schizophrenic patients hospitalized in tow hospitals including Baharan, Clinic of Psychiatric Ali-ibn-Abi-Talib Hospital (in Zahedan City), and Amir-al Momenin Psychiatric Hospital (in Zabol City), Sistan and Baluchestan Province, southeast Iran in 2016. They were analyzed using LAMP, and compared with the previous data of nested-PCR and serology. Results Out of the 118 schizophrenic individuals, 56 patients (47.4%) were found to be infected with T. gondii. The diagnosis of toxoplasmosis was confirmed in 41 patients (34.7%) via the nested-PCR. The seroprevalence of toxoplasmosis in schizophrenic patients was 55.9% (66/118). Conclusion We found a high efficiency of LAMP method in identifying toxoplasmosis and its high prevalence among schizophrenic patients. Our findings could provide viable offer implications for the prevention of schizophrenia.
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Affiliation(s)
- Hadi Mirahmadi
- Infectious Diseases and Tropical Medicine Research Center, Resistant Tubercluosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran.,Department of Parasitology and Mycology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Raheleh Hasanzadeh
- Infectious Diseases and Tropical Medicine Research Center, Resistant Tubercluosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran.,Department of Parasitology and Mycology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Hamid Malek Raeesi
- Infectious Diseases and Tropical Medicine Research Center, Resistant Tubercluosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Shirzad Fallahi
- Department of Parasitology and Mycology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | | | - Alireza Badirzadeh
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Amouei A, Moosazadeh M, Nayeri Chegeni T, Sarvi S, Mizani A, Pourasghar M, Hosseini Teshnizi S, Hosseininejad Z, Dodangeh S, Pagheh A, Pourmand AH, Daryani A. Evolutionary puzzle of Toxoplasma gondii with suicidal ideation and suicide attempts: An updated systematic review and meta-analysis. Transbound Emerg Dis 2020; 67:1847-1860. [PMID: 32198980 DOI: 10.1111/tbed.13550] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/10/2020] [Accepted: 03/16/2020] [Indexed: 01/01/2023]
Abstract
The World Health Organization has reported an annual global suicide rate of 14.5 per 100,000 people. On the other hand, it is estimated that approximately one-third of the global population are infected with Toxoplasma gondii (T. gondii) parasite. It is widely assumed that microbial pathogens, such as T. gondii, are probably associated with affective and behavioural modulation. The present article aimed to assess the proposed role of toxoplasmosis in raising the risk of suicidal ideation (SI) and suicide attempts (SA) using the available epidemiological data. Seven major electronic databases and the Internet search engine Google were searched for all the studies published between the 1st of January 1950 and 31st of October 2019. The heterogeneity and the risk of bias within and across studies were assessed. Following data extraction, pooled odds ratios (ORs) with 95% confidence interval (CI) across studies were calculated using the random-effects models. A total number of 9,696 articles were screened and 27 studies were regarded as eligible in our systematic review (SI with five papers and 22 papers on SA). A significant association was detected between antibodies against T. gondii with TA (ORs = 1.57; 95% confidence interval [CI] 1.23-2.00, p = .000). Exploration of the association between T. gondii and SA yielded a positive effect of seropositivity for IgG antibodies but not IgM. Despite the limited number of studies, a statistical association was detected between suicidal behaviours and infection with latent T. gondii.
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Affiliation(s)
- Afsaneh Amouei
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Parasitology, School of Medicine, Mazandaran University of Medical Science, Sari, Iran
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Tooran Nayeri Chegeni
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Parasitology, School of Medicine, Mazandaran University of Medical Science, Sari, Iran
- Mazandaran University of Medical Sciences, Sari, Iran
| | - Shahabeddin Sarvi
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Parasitology, School of Medicine, Mazandaran University of Medical Science, Sari, Iran
| | - Azadeh Mizani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Parasitology, School of Medicine, Mazandaran University of Medical Science, Sari, Iran
| | - Mehdi Pourasghar
- Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Zahra Hosseininejad
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Parasitology, School of Medicine, Mazandaran University of Medical Science, Sari, Iran
- Mazandaran University of Medical Sciences, Sari, Iran
| | - Samira Dodangeh
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Parasitology, School of Medicine, Mazandaran University of Medical Science, Sari, Iran
- Mazandaran University of Medical Sciences, Sari, Iran
| | - Abdolsattar Pagheh
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Amir Hossein Pourmand
- Mazandaran Central Laboratory of Veterinary Organization, Medical Sciences, Sari, Iran
| | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Parasitology, School of Medicine, Mazandaran University of Medical Science, Sari, Iran
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20
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Association of T. gondii infection with suicide: a systematic review and meta-analysis. BMC Public Health 2020; 20:766. [PMID: 32448258 PMCID: PMC7245947 DOI: 10.1186/s12889-020-08898-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 05/11/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Findings on the association between Toxoplasma gondii (T. gondii) infection and suicide are contradictory. This paper aimed to resolve this uncertainty by conducting a meta-analysis. METHODS We found the relevant studies using keywords include "Toxoplasmosis" and "Suicide" and the related synonyms in international databases such as ISI, Medline, and Scopus. The eligible studies were included in the meta-analysis phase. The random effect approach was applied to combine the results. RESULTS Out Of 150 initial studies, 15 were included in the meta-analysis. Odds of suicide in people with T. gondii infection was 43% (OR: 1.43, 95%CI; 1.15 to 1.78) higher than those without this infection. The test for publication bias was not statistically significant, which indicates the absence of likely publication bias. CONCLUSION This study confirms that T. gondii infection is a potential risk factor for suicide. To reduce cases of suicide attributable to T. gondii infection, it is recommended to implement some measures to prevent and control the transmission of the disease.
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21
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Desmettre T. [Toxoplasmosis and behavioural changes (French translation of the article)]. J Fr Ophtalmol 2020; 43:433-438. [PMID: 32248961 DOI: 10.1016/j.jfo.2019.08.028] [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: 07/10/2019] [Revised: 07/29/2019] [Accepted: 08/20/2019] [Indexed: 11/26/2022]
Abstract
Nearly one-third of the planet's population is affected by T. gondii infection. In ophthalmology, toxoplasmosis is even considered to be the most common cause of posterior uveitis of infectious origin. Humans are only an intermediate host, and T. gondii needs to infect cats for its sexual reproduction. All the elements increasing the risk of predation by the definitive host are then favourable to the parasite. Numerous experimental animal model studies have shown that T. gondii infection is associated with predatory risk behaviours such as an attraction of infected mice to cat urine. Infection with the parasite is associated with a demethylation of the promoters of certain genes in the cerebral amygdala of the intermediate hosts, modifying dopaminergic circuits associated with fear. Similarly, T. gondii has been linked to behavioural changes in humans. Toxoplasma infection is classically associated with the frequency of schizophrenia, suicide attempts or "road rage." A more recent study shows that toxoplasma infection prevalence was a consistent, positive predictor of entrepreneurial activity. Fear of failure would be less important in infected individuals, who are more willing than others to start their own business. These elements shed interesting light on behaviours and their possible relationship with toxoplasmosis, which is generally considered benign in adults.
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Affiliation(s)
- T Desmettre
- Centre de rétine médicale, 187, rue de Menin, 59520 Marquette-Lez-Lille, France; Queen Anne Street Medical Centre, 18-22, Queen Anne Street, W1G 8Hun London, Royaume-Uni.
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22
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Desmettre T. Toxoplasmosis and behavioural changes. J Fr Ophtalmol 2020; 43:e89-e93. [PMID: 31980266 DOI: 10.1016/j.jfo.2020.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 10/16/2019] [Accepted: 01/04/2020] [Indexed: 11/25/2022]
Abstract
Nearly one-third of the planet's population is affected by Toxoplasma gondii infection. In ophthalmology, toxoplasmosis is even considered to be the most common cause of posterior uveitis of infectious origin. Humans are only an intermediate host and T. gondii needs to infect cats for its sexual reproduction. All the elements increasing the risk of predation by the definitive host are then favourable to the parasite. Numerous experimental animal model studies have shown that T. gondii infection is associated with predatory risk behaviours such as an attraction of infected mice to cat urine. Infection with the parasite is associated with a demethylation of the promoters of certain genes in the cerebral amygdala of the intermediate hosts, modifying dopaminergic circuits associated with fear. Similarly, T. gondii has been linked to behavioural changes in humans. Toxoplasma infection is classically associated with the frequency of schizophrenia, suicide attempts or "road rage". A more recent study shows that toxoplasma infection prevalence was a consistent, positive predictor of entrepreneurial activity. Fear of failure would be less important in infected individuals, who are more willing than others to start their own business. These elements shed interesting light on behaviours and their possible relationship with toxoplasmosis, which is generally considered benign in adults.
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Affiliation(s)
- T Desmettre
- Centre de rétine médicale, 187, rue de Menin, 59520 Marquette-Lez-Lille, France; Queen Anne Street Medical Centre, 18-22, Queen Anne Street, W1G 8Hun, London, United Kingdom.
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23
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Lindgren M, Holm M, Markkula N, Härkänen T, Dickerson F, Yolken RH, Suvisaari J. Exposure to common infections and risk of suicide and self-harm: a longitudinal general population study. Eur Arch Psychiatry Clin Neurosci 2020; 270:829-839. [PMID: 32219505 PMCID: PMC7474710 DOI: 10.1007/s00406-020-01120-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 03/11/2020] [Indexed: 12/15/2022]
Abstract
Common infectious agents, such as Toxoplasma gondii (T. gondii) and several human herpes viruses, have been linked to increased risk of self-harm. The aim of this study was to investigate the associations between self-harm and seropositivity to T. gondii, Epstein-Barr virus (EBV), Herpes Simplex virus Type 1 (HSV-1), and Cytomegalovirus (CMV). IgM and IgG antibodies to these infections were measured in the Health 2000 project nationally representative of the whole Finnish adult population, and 6250 participants, age 30 and over, were followed for 15 years via registers. In addition, lifetime suicidal ideation and suicide attempts based on medical records and interview were assessed within a subsample of 694 participants screened to a substudy for possible psychotic symptoms or as controls. Among the 6250 participants, 14 individuals died of suicide and an additional 4 individuals had a diagnosis of intentional self-harm during follow-up. Serological evidence of lifetime or acute infections was not found to be associated with these suicidal outcomes. However, in the subsample, those seropositive for CMV had fewer suicide attempts compared to those seronegative, adjusting for gender, age, educational level, childhood family size, regional residence, CRP, and screen status (OR for multiple attempts = 0.40, 95% confidence interval 0.20‒0.83, p = 0.014). To conclude, common infections were not associated with risk of death by suicide or with self-harm diagnoses at a 15-year follow-up in the general population sample. Our finding of an increased number of suicide attempts among persons seronegative for CMV calls for further research.
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Affiliation(s)
- Maija Lindgren
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), PO Box 30, 00271, Helsinki, Finland.
| | - Minna Holm
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), PO Box 30, 00271, Helsinki, Finland
| | - Niina Markkula
- Department of Psychiatry, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Tommi Härkänen
- Health Monitoring Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Faith Dickerson
- Sheppard Pratt Health System, Stanley Research Program, Baltimore, MD, USA
| | - Robert H Yolken
- Stanley Division of Developmental Neurovirology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jaana Suvisaari
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), PO Box 30, 00271, Helsinki, Finland
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24
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Sutterland AL, Kuin A, Kuiper B, van Gool T, Leboyer M, Fond G, de Haan L. Driving us mad: the association of Toxoplasma gondii with suicide attempts and traffic accidents - a systematic review and meta-analysis. Psychol Med 2019; 49:1608-1623. [PMID: 31010440 DOI: 10.1017/s0033291719000813] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Unnatural causes of death due to traffic accidents (TA) and suicide attempts (SA) constitute a major burden on global health, which remained stable in the last decade despite widespread efforts of prevention. Recently, latent infection with Toxoplasma gondii (T. gondii) has been suggested to be a biological risk factor for both TA and SA. Therefore, a systematic search concerning the relationship of T. gondii infection with TA and/or SA according to PRISMA guidelines in Medline, Pubmed and PsychInfo was conducted collecting papers up to 11 February 2019 (PROSPERO #CRD42018090206). The random-effect model was applied and sensitivity analyses were subsequently performed. Lastly, the population attributable fraction (PAF) was calculated. We found a significant association for antibodies against T. gondii with TA [odds ratio (OR) = 1.69; 95% confidence interval (CI) 1.20-2.38, p = 0.003] and SA (OR = 1.39; 95% CI 1.10-1.76, p = 0006). Indication of publication bias was found for TA, but statistical adjustment for this bias did not change the OR. Heterogeneity between studies on SA was partly explained by type of control population used (ORhealthy controls = 1.9, p < 0.001 v. ORpsychiatric controls = 1.06, p = 0.87) and whether subjects with schizophrenia only were analysed (ORschizophrenia = 0.87, p = 0.62 v. ORvarious = 1.8, p < 0.001). The association was significantly stronger with higher antibody titres in TA and in studies that did not focus on schizophrenia subjects concerning SA. PAF of a T. gondii infection was 17% for TA and 10% for SA. This indicates that preventing T. gondii infection may play a role in the prevention of TA or SA, although uncertainty remains whether infection and outcome are truly causally related.
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Affiliation(s)
- Arjen L Sutterland
- Department of Psychiatry,Amsterdam UMC, University of Amsterdam,Meibergdreef 5 1105 AZ, Amsterdam,The Netherlands
| | - Anne Kuin
- Department of Psychiatry,Amsterdam UMC, University of Amsterdam,Meibergdreef 5 1105 AZ, Amsterdam,The Netherlands
| | - Bouke Kuiper
- Department of Psychiatry,Amsterdam UMC, University of Amsterdam,Meibergdreef 5 1105 AZ, Amsterdam,The Netherlands
| | - Tom van Gool
- Department of Parasitology,Amsterdam UMC, University of Amsterdam,Meibergdreef 9 1105 AZ, Amsterdam,The Netherlands
| | | | | | - Lieuwe de Haan
- Department of Psychiatry,Amsterdam UMC, University of Amsterdam,Meibergdreef 5 1105 AZ, Amsterdam,The Netherlands
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25
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Chen X, Chen B, Hou X, Zheng C, Yang X, Ke J, Hu X, Tan F. Association between Toxoplasma gondii infection and psychiatric disorders in Zhejiang, Southeastern China. Acta Trop 2019; 192:82-86. [PMID: 30731066 DOI: 10.1016/j.actatropica.2019.02.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 02/02/2019] [Accepted: 02/02/2019] [Indexed: 12/13/2022]
Abstract
Increased rates of exposure to Toxoplasma gondii have been found in patients with psychiatric disorders globally, but there is scarce information about the epidemiology of T. gondii infection in psychiatric patients in Zhejiang Province, Southeastern China. In a case-control survey, we measured IgG and IgM class antibodies against T. gondii in 798 patients from a public psychiatric hospital in the city of Wenzhou, Zhejiang Province, and in 681 non-psychiatric controls from the general population in the same region. Subjects in each group were matched by sex and age with an enzyme-linked immunoassay. Seroprevalence of anti-Toxoplasma IgG antibodies in psychiatric patients (13.3%, 106/798) was significantly higher than in the control population (9.4%, 64/681) (P = 0.022). Anti-Toxoplasma IgM antibodies were also significantly higher in the psychiatric patients (4.1%, 33/798) than in the control group (1.9%, 13/681) (P = 0.016). Additionally, we found significantly elevated seropositive rates of anti-Toxoplasma IgG and IgM in patients with schizophrenia, as well as those with bipolar disorder. The identification of specific anti-Toxoplasma antibodies in psychiatric patients may be useful for assessing infection and timely initiation of treatment.
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Affiliation(s)
- Xiaojian Chen
- Department of Clinical laboratory, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Bi Chen
- Department of Clinical laboratory, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiangqing Hou
- Department of Preventive Medicine, School of Public Health, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Cunqing Zheng
- Department of Clinical laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, China
| | - Xunjun Yang
- Department of Clinical laboratory, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jiangqiong Ke
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xin Hu
- School of Medical laboratory science and school of life science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Feng Tan
- Department of Parasitology, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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26
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The Association between Toxoplasma gondii Infection and Risk of Parkinson's Disease: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2019; 2019:8186017. [PMID: 30931331 PMCID: PMC6413381 DOI: 10.1155/2019/8186017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/20/2019] [Accepted: 02/12/2019] [Indexed: 02/08/2023]
Abstract
Background Several studies have investigated the association between Toxoplasma gondii (T. gondii) infection and risk of Parkinson's disease (PD) with inconsistent results. Clarifying this relation might be useful for better understanding of the risk factors and the relevant mechanisms of PD, thus a meta-analysis was conducted to explore whether exposure to T. gondii is associated with an increased risk of PD. Methods We conducted this meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A rigorous literature selection was performed by using the databases of PubMed, Embase, Web of Science, Cochrane Library, and ScienceDirect. Odds ratio (OR) and corresponding 95% confidential interval (CI) were pooled by using fixed-effects models. Sensitivity analysis, publication bias test, and methodological quality assessment of studies were also performed. Results Seven studies involving 1086 subjects were included in this meta-analysis. Pooled data by using fixed-effects models suggested both latent infection (OR, 1.17; 95% CI, 0.86 to 1.58; P=0.314) and acute infection (OR, 1.13; 95% CI, 0.30 to 4.35; P=0.855) were not associated with PD risk. Stable and robust estimates were confirmed by sensitivity analysis. No publication bias was found by visual inspection of the funnel plot, Begg's, and Egger's test. Conclusions This meta-analysis does not support any possible association between T. gondii infection and risk of PD. Researches are still warranted to further explore the underlying mechanisms of T. gondii in the pathogenesis of PD and their causal relationship.
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Huang J, Zhang H, Liu S, Wang M, Wan B, Velani B, Zhu Y, Lin S. Is Toxoplasma gondii infection correlated with nonalcoholic fatty liver disease?- a population-based study. BMC Infect Dis 2018; 18:629. [PMID: 30522446 PMCID: PMC6282358 DOI: 10.1186/s12879-018-3547-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 11/23/2018] [Indexed: 01/14/2023] Open
Abstract
Background Previous studies have suggested that Toxoplasma gondii (T. gondii) infection might be associated with fatty liver disease. However, the relationship between non-alcoholic fatty liver disease (NAFLD) and T. gondii infection has not been investigated in a large population. We aimed to study the relationship between those two diseases using a population-based dataset from the United States. Methods The data were collected from the third National Health and Nutrition Examination Survey (NHANES III) between 1988 and 1994. Statistical analysis was applied to compare the prevalence of NAFLD in anti-T. gondii antibody-positive participants with antibody-negative ones. Results A total of 9465 persons with a mean age of 44.33 ± 16.21 years, 46.9% of which were males, were included in the final analysis. Their mean BMI was 27.60 ± 5.96 kg/m2. A total of 2520 participants (26.62%) were positive for the T. gondii antibody. There was an increasing trend of seroprevalence of T. gondii with age (P for trend < 0.001). The incidence of NAFLD in the seropositive group was higher than that in the seronegative group (27.10% vs 23.40%, p < 0.001). In addition to this, metabolic biomarkers, including serum lipid, fasting blood-glucose, and uric acid were also significantly higher in the seropositive group. However, multivariate analysis revealed that T. gondii infection was not an independent risk factor for NAFLD. Age was independently correlated with both the prevalence of T. gondii and NAFLD. Conclusions Patients with T. gondii infection may have a higher prevalence of NAFLD. Age may have an effect on the increase of NAFLD in the T. gondii seropositive population.
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Affiliation(s)
- Jiaofeng Huang
- Department of Liver Research Center, the First Affiliated Hospital of Fujian Medical University, Fuzhou, No. 20, Chazhong Road, Taijiang District, Fuzhou, 350001, Fujian, China
| | - Haoyang Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, 350002, Guangdong, China
| | - Shiying Liu
- Department of Liver Research Center, the First Affiliated Hospital of Fujian Medical University, Fuzhou, No. 20, Chazhong Road, Taijiang District, Fuzhou, 350001, Fujian, China
| | - Mingfang Wang
- Department of Liver Research Center, the First Affiliated Hospital of Fujian Medical University, Fuzhou, No. 20, Chazhong Road, Taijiang District, Fuzhou, 350001, Fujian, China
| | - Bo Wan
- Faculty of Life Sciences and Medicine, King's College London, London, SE1 1UL, UK
| | - Bharat Velani
- Basildon and Thurrock University Hospitals NHS Foundation Trust, Nethermayne, Basildon, Essex, SS16 5NL, UK
| | - Yueyong Zhu
- Department of Liver Research Center, the First Affiliated Hospital of Fujian Medical University, Fuzhou, No. 20, Chazhong Road, Taijiang District, Fuzhou, 350001, Fujian, China
| | - Su Lin
- Department of Liver Research Center, the First Affiliated Hospital of Fujian Medical University, Fuzhou, No. 20, Chazhong Road, Taijiang District, Fuzhou, 350001, Fujian, China.
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28
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Peng X, Brenner LA, Mathai AJ, Cook TB, Fuchs D, Postolache N, Groer MW, Pandey JP, Mohyuddin F, Giegling I, Wadhawan A, Hartmann AM, Konte B, Brundin L, Friedl M, Stiller JW, Lowry CA, Rujescu D, Postolache TT. Moderation of the relationship between Toxoplasma gondii seropositivity and trait impulsivity in younger men by the phenylalanine-tyrosine ratio. Psychiatry Res 2018; 270:992-1000. [PMID: 30057257 PMCID: PMC6371810 DOI: 10.1016/j.psychres.2018.03.045] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 12/23/2017] [Accepted: 03/20/2018] [Indexed: 11/27/2022]
Abstract
Previously, we reported that Toxoplasma gondii (T. gondii)-seropositivity is associated with higher impulsive sensation seeking in younger men. As dopaminergic and serotonergic signaling regulate impulsivity, and as T. gondii directly and indirectly affects dopaminergic signaling and induces activation of the kynurenine pathway leading to the diversion of tryptophan from serotonin production, we investigated if dopamine and serotonin precursors or the tryptophan metabolite kynurenine interact with the T. gondii-impulsivity association. In 950 psychiatrically healthy participants, trait impulsivity scores were related to T. gondii IgG seropositivity. Interactions were also identified between categorized levels of phenylalanine (Phe), tyrosine (Tyr), Phe:Tyr ratio, kynurenine (Kyn), tryptophan (Trp) and Kyn:Trp ratio, and age and gender. Only younger T. gondii-positive men with a high Phe:Tyr ratio, were found to have significantly higher impulsivity scores. There were no significant associations in other demographic groups, including women and older men. No significant effects or interactions were identified for Phe, Tyr, Kyn, Trp, or Kyn:Trp ratio. Phe:Tyr ratio, therefore, may play a moderating role in the association between T. gondii seropositivity and impulsivity in younger men. These results could potentially lead to individualized approaches to reduce impulsivity, based on combined demographic, biochemical and serological factors.
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Affiliation(s)
- Xiaoqing Peng
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA,Saint Elizabeths Hospital, Psychiatry Residency Training Program, Washington, DC, USA
| | - Lisa A. Brenner
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Denver, CO, USA,University of Colorado Anschutz Medical Campus, Departments of Psychiatry, Physical Medicine and Rehabilitation, and Neurology, Denver, CO, USA,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE). Denver, CO, USA
| | - Ashwin J. Mathai
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA,Saint Elizabeths Hospital, Psychiatry Residency Training Program, Washington, DC, USA
| | - Thomas B. Cook
- Department of Public Health & Mercyhurst Institute for Public Health, Mercyhurst University, Erie, PA, USA
| | - Dietmar Fuchs
- Division of Biological Chemistry, Biocenter, Innsbruck Medical University, Innsbruck, Austria
| | - Nadine Postolache
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Janardan P. Pandey
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA
| | - Farooq Mohyuddin
- Saint Elizabeths Hospital, Psychiatry Residency Training Program, Washington, DC, USA
| | - Ina Giegling
- Department of Psychiatry, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
| | - Abhishek Wadhawan
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA,Saint Elizabeths Hospital, Psychiatry Residency Training Program, Washington, DC, USA
| | - Annette M. Hartmann
- Department of Psychiatry, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
| | - Bettina Konte
- Department of Psychiatry, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
| | - Lena Brundin
- Division of Psychiatry and Behavioral Medicine, College of Human Medicine, Michigan State University and the Van Andel Research Institute, Grand Rapids, MI, USA
| | - Marion Friedl
- Department of Psychiatry, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
| | - John W. Stiller
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA,Saint Elizabeths Hospital, Psychiatry Residency Training Program, Washington, DC, USA
| | - Christopher A. Lowry
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Denver, CO, USA,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE). Denver, CO, USA,Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO, USA,Department of Physical Medicine and Rehabilitation and Center for Neuroscience, University of Colorado Anschutz Medical Campus, Denver, CO, USA
| | - Dan Rujescu
- Department of Psychiatry, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
| | - Teodor T. Postolache
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA,Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Denver, CO, USA,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE). Denver, CO, USA,VA Capitol Health Care Network, Mental Illness Research, Education and Clinical Center (VISN 5 MIRECC), Baltimore, MD, USA,Correspondent author. (T.T. Postolache)
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29
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Fond G, Boyer L, Schürhoff F, Berna F, Godin O, Bulzacka E, Andrianarisoa M, Brunel L, Aouizerate B, Capdevielle D, Chereau I, Coulon N, D'Amato T, Dubertret C, Dubreucq J, Faget C, Lançon C, Leignier S, Mallet J, Misdrahi D, Passerieux C, Rey R, Schandrin A, Urbach M, Vidailhet P, Llorca PM, Leboyer M. Latent toxoplasma infection in real-world schizophrenia: Results from the national FACE-SZ cohort. Schizophr Res 2018; 201:373-380. [PMID: 29843964 DOI: 10.1016/j.schres.2018.05.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 04/22/2018] [Accepted: 05/12/2018] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Latent Toxoplasma infection has been associated with widespread brain immune activation, increased blood brain barrier permeability, neural disruption, increased dopamine release in dopaminergic neurons, with NMDA activation and with schizophrenia (SZ) onset risk. Toxoplasma has been suggested to be a source of chronic low-grade inflammation and this inflammation has been associated with cognitive impairment in SZ. The objective of the present study were (i) to determine if latent Toxoplasma infection was associated with specific clinical features in stabilized SZ subjects, with cognitive impairment and with increased low-grade peripheral inflammation and (ii) to determine if Treatments with Anti-Toxoplasmic Activity (TATA) were associated with improved outcomes in subjects with latent Toxoplasma infection. METHODS A comprehensive 2 daylong clinical and neuropsychological battery was administered in 250 SZ subjects included between 2015 and 2017 in the national FondaMental Expert Center (FACE-SZ) Cohort. Solid phase-enzyme microplate immunoassay methods were used to measure IgG class of antibodies to T. gondii in blood sample. Latent Toxoplasma infection was defined by T. gondii IgG ratio ≥0.8, equivalent to ≥10 international units. Chronic peripheral inflammation was defined by highly sensitive C reactive protein blood level ≥ 3 mg/L. RESULTS Latent Toxoplasma infection has been found in 184 (73.6%) of this national multicentric sample. In the multivariate analyses, latent Toxoplasma infection has been significantly associated with higher PANSS negative (aOR = 1.1 [1.1-1.1], p = 0.04) and excitement subscores (aOR = 1.3 [1.1-1.6], p = 0.01), with two specific symptoms (i.e., reference delusion (aOR = 3.6 [1.2-10.6] p = 0.01) and alogia (aOR = 16.7 [2.0-134.7], p = 0.008)) and with chronic low-grade peripheral inflammation (27.2% vs. 7.6%, aOR = 3.8 [1.4-10.3], p = 0.004). Extrapyramidal symptoms remained significantly associated with latent Toxoplasma infection. On the opposite, no significant association of latent Toxoplasma infection with age, gender, age at SZ onset, suicide behavior or cognitive deficits has been found in these models (all p > 0.05). TATA were associated with lower depressive symptoms (aOR = 0.8[0.7-0.9], p = 0.01), and with lower rates of chronic peripheral inflammation (20.9% vs. 48.6%, aOR = 3.5 [1.5-7.9], p = 0.003) but not with higher cognitive scores (p > 0.05). CONCLUSION The present findings suggest that Toxoplasma is almost 3 times more frequent in SZ population compared to general population in France. The potential cerebral underpinnings of the association of latent Toxoplasma infection and the above-mentioned outcomes have been discussed. Future studies should confirm that TATA may be effective to reduce Toxoplasma-associated depressive symptoms and low-grade peripheral inflammation.
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Affiliation(s)
- G Fond
- Fondation FondaMental, Créteil, France; Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France.
| | - L Boyer
- Fondation FondaMental, Créteil, France; Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - F Schürhoff
- Fondation FondaMental, Créteil, France; INSERM U955, équipe de psychiatrie translationnelle, Créteil, France; Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - F Berna
- Fondation FondaMental, Créteil, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - O Godin
- Fondation FondaMental, Créteil, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013 Paris, France; INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013 Paris, France
| | - E Bulzacka
- Fondation FondaMental, Créteil, France; INSERM U955, équipe de psychiatrie translationnelle, Créteil, France; Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - M Andrianarisoa
- Fondation FondaMental, Créteil, France; INSERM U955, équipe de psychiatrie translationnelle, Créteil, France; Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - L Brunel
- Fondation FondaMental, Créteil, France; INSERM U955, équipe de psychiatrie translationnelle, Créteil, France; Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - B Aouizerate
- Fondation FondaMental, Créteil, France; Université de Bordeaux, Centre Hospitalier Charles Perrens, F-33076 Bordeaux, France; INRA, NutriNeuro, University of Bordeaux, U1286 F-33076 Bordeaux, France
| | - D Capdevielle
- Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - I Chereau
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - N Coulon
- Fondation FondaMental, Créteil, France; INSERM U955, équipe de psychiatrie translationnelle, Créteil, France; Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - T D'Amato
- Fondation FondaMental, Créteil, France; INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - C Dubertret
- Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France
| | - J Dubreucq
- Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - C Faget
- Fondation FondaMental, Créteil, France; Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - C Lançon
- Fondation FondaMental, Créteil, France; Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - S Leignier
- Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - J Mallet
- Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France
| | - D Misdrahi
- Fondation FondaMental, Créteil, France; Université de Bordeaux, Centre Hospitalier Charles Perrens, F-33076 Bordeaux, France; CNRS UMR 5287-INCIA, France
| | - C Passerieux
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service de psychiatrie et d'addictologie adulte, Le Chesnay, EA 4047 HANDIReSP, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin-en-Yvelines, Versailles, France
| | - R Rey
- Fondation FondaMental, Créteil, France; INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - A Schandrin
- Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - M Urbach
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service de psychiatrie et d'addictologie adulte, Le Chesnay, EA 4047 HANDIReSP, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin-en-Yvelines, Versailles, France
| | - P Vidailhet
- Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - P M Llorca
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - M Leboyer
- Fondation FondaMental, Créteil, France; INSERM U955, équipe de psychiatrie translationnelle, Créteil, France; Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
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