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Nguyen MN, Yeo SJ, Park H. Identification of novel biomarkers for anti- Toxoplasma gondii IgM detection and the potential application in rapid diagnostic fluorescent tests. Front Microbiol 2024; 15:1385582. [PMID: 38894968 PMCID: PMC11184589 DOI: 10.3389/fmicb.2024.1385582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/03/2024] [Indexed: 06/21/2024] Open
Abstract
Toxoplasmosis, while often asymptomatic and prevalent as a foodborne disease, poses a considerable mortality risk for immunocompromised individuals during pregnancy. Point-of-care serological tests that detect specific IgG and IgM in patient sera are critical for disease management under limited resources. Despite many efforts to replace the T. gondii total lysate antigens (TLAs) by recombinant antigens (rAgs) in commercial kits, while IgG detection provides significant specificity and sensitivity, IgM detection remains comparatively low in sensitivity. In this study, we attempted to identify novel antigens targeting IgM in early infection, thereby establishing an IgM on-site detection kit. Using two-dimensional gel electrophoresis (2DE) and mouse serum immunoblotting, three novel antigens, including EF1γ, PGKI, and GAP50, were indicated to target T. gondii IgM. However, rAg EF1γ was undetectable by IgM of mice sera in Western blotting verification experiments, and ELISA coated with PGKI did not eliminate cross-reactivity, in contrast to GAP50. Subsequently, the lateral flow reaction employing a strip coated with 0.3 mg/mL purified rAg GAP50 and exhibited remarkable sensitivity compared with the conventional ELISA based on tachyzoite TLA, which successfully identified IgM in mouse sera infected with tachyzoites, ranging from 103 to 104 at 5 dpi and 104 at 7 dpi, respectively. Furthermore, by using standard T. gondii-infected human sera from WHO, the limit of detection (LOD) for the rapid fluorescence immunochromatographic test (FICT) using GAP50 was observed at 0.65 IU (international unit). These findings underline the particular immunoreactivity of GAP50, suggesting its potential as a specific biomarker for increasing the sensitivity of the FICT in IgM detection.
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Affiliation(s)
- Minh-Ngoc Nguyen
- Department of Infection Biology, School of Medicine, Zoonosis Research Center, Wonkwang University, Iksan, Republic of Korea
| | - Seon-Ju Yeo
- Department of Tropical Medicine and Parasitology, Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul, Republic of Korea
- Department of Tropical Medicine and Parasitology, Medical Research Center, Institute of Endemic Diseases, Seoul National University, Seoul, Republic of Korea
| | - Hyun Park
- Department of Infection Biology, School of Medicine, Zoonosis Research Center, Wonkwang University, Iksan, Republic of Korea
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Mady RF, El-Temsahy MM, Issa YA, Zaghloul AS, Khedr SI. MicroRNA mmu-miR-511-5p: A promising Diagnostic Biomarker in Experimental Toxoplasmosis Using Different Strains and Infective Doses in Mice with Different Immune States Before and After Treatment. Acta Parasitol 2024; 69:1253-1266. [PMID: 38743178 PMCID: PMC11182863 DOI: 10.1007/s11686-024-00851-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/15/2024] [Indexed: 05/16/2024]
Abstract
PURPOSE Searching for a novel early diagnostic biomarker for toxoplasmosis, real-time-PCR was currently used to measure the serum mmu-miR-511-5p level in male Swiss-albino mice infected with either; ME49 or RH Toxoplasma gondii (T. gondii) strains. METHODS Three mice groups were used; (GI) constituted the non-infected control group, while (GII) and (GIII) were experimentally infected with ME49 or RH strains, respectively. GII mice were orally infected using 10 or 20 ME49 cysts (ME-10 and ME-20), both were subdivided into; non-treated (ME-10-NT and ME-20-NT) and were further subdivided into; immunocompetent (ME-10-IC and ME-20-IC) [euthanized 3-days, 1, 2, 6 or 8-weeks post-infection (PI)], and immunosuppressed using two Endoxan® injections (ME-10-IS and ME-20-IS) [euthanized 6- or 8-weeks PI], and spiramycin-treated (ME-10-SP and ME-20-SP) that received daily spiramycin, for one-week before euthanasia. GIII mice individually received 2500 intraperitoneal RH strain tachyzoites, then, were subdivided into; non-treated (RH-NT) [euthanized 3 or 5-days PI], and spiramycin-treated (RH-SP) that were euthanized 5 or 10-days PI (refer to the graphical abstract). RESULTS Revealed significant upregulation of mmu-miR-511-5p in GII, one-week PI, with gradually increased expression, reaching its maximum 8-weeks PI, especially in ME-20-NT group that received the higher infective dose. Immunosuppression increased the upregulation. Contrarily, treatment caused significant downregulation. GIII recorded significant upregulation 3-days PI, yet, treatment significantly decreased this expression. CONCLUSION Serum mmu-miR-511-5p is a sensitive biomarker for early diagnosis of ME49 and RH infection (as early as one-week and 3-days, respectively), and its expression varies according to T. gondii infective dose, duration of infection, spiramycin-treatment and host immune status.
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Affiliation(s)
- Rasha Fadly Mady
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, 2nd Floor, El Mowasah Medical and Educational Complex, Alexandria, Egypt
| | - Mona Mohamed El-Temsahy
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, 2nd Floor, El Mowasah Medical and Educational Complex, Alexandria, Egypt
| | - Yasmine Amr Issa
- Department of Medical Biochemistry, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Medical Biochemistry, College of Medicine, Arab Academy of Science, Technology and Maritime transport, New Alamein campus, Egypt
| | - Aya Saied Zaghloul
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, 2nd Floor, El Mowasah Medical and Educational Complex, Alexandria, Egypt
| | - Safaa Ibrahim Khedr
- Department of Medical Parasitology, Faculty of Medicine, Alexandria University, 2nd Floor, El Mowasah Medical and Educational Complex, Alexandria, Egypt.
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Boureka E, Tsakiridis I, Kostakis N, Giouleka S, Mamopoulos A, Kalogiannidis I, Athanasiadis A, Dagklis T. Antenatal Care: A Comparative Review of Guidelines. Obstet Gynecol Surv 2024; 79:290-303. [PMID: 38764206 DOI: 10.1097/ogx.0000000000001261] [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: 05/21/2024]
Abstract
Importance Antenatal care plays a crucial role in safely monitoring and ensuring the well-being of both the mother and the fetus during pregnancy, ultimately leading to the best possible perinatal outcomes. Objective The aim of this study was to review and compare the most recently published guidelines on antenatal care. Evidence Acquisition A descriptive review of guidelines from the National Institute for Health and Care Excellence, the Public Health Agency of Canada, the World Health Organization, and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists regarding antenatal care was conducted. Results There is a consensus among the reviewed guidelines regarding the necessary appointments during the antenatal period, the proper timing for induction of labor, the number and frequency of laboratory examinations for the assessment of mother's well-being, and management strategies for common physiological problems during pregnancy, such as nausea and vomiting, heartburn, pelvic pain, leg cramps, and symptomatic vaginal discharge. In addition, special consideration should be given for mental health issues and timely referral to a specialist, reassurance of complete maternal vaccination, counseling for safe use of medical agents, and advice for cessation of substance, alcohol, and tobacco use during pregnancy. Controversy surrounds clinical evaluation during the antenatal period, particularly when it comes to the routine use of an oral glucose tolerance test and symphysis-fundal height measurement for assessing fetal growth, whereas routine cardiotocography and fetal movement counting are suggested practices only by Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Of note, recommendations on nutritional interventions and supplementation are offered only by Public Health Agency of Canada and World Health Organization, with some minor discrepancies in the optimal dosage. Conclusions Antenatal care remains a critical factor in achieving positive outcomes, but there are variations depending on the socioeconomic status of each country. Therefore, the establishment of consistent international protocols for optimal antenatal care is of utmost importance. This can help provide safe guidance for healthcare providers and, consequently, improve both maternal and fetal outcomes.
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Affiliation(s)
| | | | | | | | | | - Ioannis Kalogiannidis
- Associate Professor, Third Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Ota H, Yamada H, Wada S, Tanimura K, Deguchi M, Uchida A, Nishikawa A. Toxoplasma gondii IgG avidity for the diagnosis of primary infection in pregnant women: Comparison between chemiluminescent microparticle immunoassay and enzyme-linked immunosorbent assay. J Infect Chemother 2024; 30:434-438. [PMID: 38000499 DOI: 10.1016/j.jiac.2023.11.019] [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: 08/22/2023] [Revised: 11/01/2023] [Accepted: 11/19/2023] [Indexed: 11/26/2023]
Abstract
INTRODUCTION This study evaluated whether IgG avidity measured by chemiluminescent microparticle immunoassay (CMIA) compared with enzyme-linked immunosorbent assay (ELISA) was useful to detect primary T. gondii infection during pregnancy and to estimate the risk for congenital T. gondii infection. METHODS One hundred six women with positive tests for T. gondii IgG and T. gondii IgM, comprising 21 women (19.8%) with low (<30%), 6 (5.7%) with borderline (30%-35%), and 79 (74.5%) with high (>35%) IgG avidity measured by ELISA were selected. Their stored sera were used for T. gondii IgG avidity measurements by CMIA. RESULTS In CMIA, 72 (67.9%) women had low (<50%), 12 (11.3%) had borderline (50%-59.9%), and 22 (20.8%) had high (≥60%) IgG avidity. The ratio of low T. gondii IgG avidity index in CMIA was more than three-fold than that in ELISA. Eighteen (85.7%) of 21 women with ELISA low avidity also had CMIA low avidity, and 26 (96.3%) of 27 women with ELISA low or borderline avidity corresponded to CMIA low or borderline avidity, whereas 21 (26.6%) of 79 women with ELISA high avidity were diagnosed with CMIA low avidity. All three cases with congenital T. gondii infection showed coincidentally low IgG avidity in both methods. A positive correlation in IgG avidity indices was found between of ELISA and CMIA. CONCLUSIONS CMIA for T. gondii avidity measurements compared with ELISA was clinically useful to detect pregnant women at a high risk of developing congenital T. gondii infection.
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Affiliation(s)
- Hajime Ota
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Hideto Yamada
- Center for Recurrent Pregnancy Loss, Teine Keijinkai Hospital, Sapporo, Japan.
| | - Shinichiro Wada
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Kenji Tanimura
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masashi Deguchi
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akiko Uchida
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
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Zhou Y, Leahy K, Grose A, Lykins J, Siddiqui M, Leong N, Goodall P, Withers S, Ashi K, Schrantz S, Tesic V, Abeleda AP, Beavis K, Clouser F, Ismail M, Christmas M, Piarroux R, Limonne D, Chapey E, Abraham S, Baird I, Thibodeau J, Boyer KM, Torres E, Conrey S, Wang K, Staat MA, Back N, L’Ollivier C, Mahinc C, Flori P, Gomez-Marin J, Peyron F, Houzé S, Wallon M, McLeod R. Novel paradigm enables accurate monthly gestational screening to prevent congenital toxoplasmosis and more. PLoS Negl Trop Dis 2024; 18:e0011335. [PMID: 38805559 PMCID: PMC11132520 DOI: 10.1371/journal.pntd.0011335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 04/01/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Congenital toxoplasmosis is a treatable, preventable disease, but untreated causes death, prematurity, loss of sight, cognition and motor function, and substantial costs worldwide. OBJECTIVES We asked whether high performance of an Immunochromatographic-test (ICT) could enable accurate, rapid diagnosis/treatment, establishing new, improved care-paradigms at point-of-care and clinical laboratory. METHODS Data were obtained in 12 studies/analyses addressing: 1-feasibility/efficacy; 2-false-positives; 3-acceptability; 4-pink/black-line/all studies; 5-time/cost; 6-Quick-Information/Limit-of-detection; 7, 8-acute;-chronic; 9-epidemiology; 10-ADBio; 11,12-Commentary/Cases/Chronology. FINDINGS ICT was compared with gold-standard or predicate-tests. Overall, ICT performance for 1093 blood/4967 sera was 99.2%/97.5% sensitive and 99.0%/99.7% specific. However, in clinical trial, FDA-cleared-predicate tests initially caused practical, costly problems due to false-positive-IgM results. For 58 persons, 3/43 seronegative and 2/15 chronically infected persons had false positive IgM predicate tests. This caused substantial anxiety, concerns, and required costly, delayed confirmation in reference centers. Absence of false positive ICT results contributes to solutions: Lyon and Paris France and USA Reference laboratories frequently receive sera with erroneously positive local laboratory IgM results impeding patient care. Therefore, thirty-two such sera referred to Lyon's Reference laboratory were ICT-tested. We collated these with other earlier/ongoing results: 132 of 137 USA or French persons had false-positive local laboratory IgM results identified correctly as negative by ICT. Five false positive ICT results in Tunisia and Marseille, France, emphasize need to confirm positive ICT results with Sabin-Feldman-Dye-test or western blot. Separate studies demonstrated high performance in detecting acute infections, meeting FDA, CLIA, WHO REASSURED, CEMark criteria and patient and physician satisfaction with monthly-gestational-ICT-screening. CONCLUSIONS/SIGNIFICANCE This novel paradigm using ICT identifies likely false positives or raises suspicion that a result is truly positive, rapidly needing prompt follow up and treatment. Thus, ICT enables well-accepted gestational screening programs that facilitate rapid treatment saving lives, sight, cognition and motor function. This reduces anxiety, delays, work, and cost at point-of-care and clinical laboratories. TRIAL REGISTRATION NCT04474132, https://clinicaltrials.gov/study/NCT04474132 ClinicalTrials.gov.
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Affiliation(s)
- Ying Zhou
- Departments of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
| | - Karen Leahy
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, United States of America
| | - Andrew Grose
- Departments of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
- Pritzker School of Medicine, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
| | - Joseph Lykins
- Departments of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
- Pritzker School of Medicine, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
| | - Maryam Siddiqui
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, United States of America
| | - Nicole Leong
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, United States of America
| | - Perpetua Goodall
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, United States of America
| | - Shawn Withers
- Departments of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
| | - Kevin Ashi
- Departments of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
- Pritzker School of Medicine, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
| | - Stephen Schrantz
- Pritzker School of Medicine, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
- Chicago Medicine, The University of Chicago, Chicago, Illinois, United States of America
- Department of Pediatrics, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
- Department of Medicine, The University of Chicago, Chicago, Illinois, United States of America
| | - Vera Tesic
- Pritzker School of Medicine, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
- Chicago Medicine, The University of Chicago, Chicago, Illinois, United States of America
- Department of Pathology, The University of Chicago, Chicago, Illinois, United States of America
| | - Ana Precy Abeleda
- Chicago Medicine, The University of Chicago, Chicago, Illinois, United States of America
- Department of Pathology, The University of Chicago, Chicago, Illinois, United States of America
| | - Kathleen Beavis
- Pritzker School of Medicine, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
- Chicago Medicine, The University of Chicago, Chicago, Illinois, United States of America
- Department of Pathology, The University of Chicago, Chicago, Illinois, United States of America
| | - Fatima Clouser
- Departments of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
| | - Mahmoud Ismail
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, United States of America
- Pritzker School of Medicine, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
- Chicago Medicine, The University of Chicago, Chicago, Illinois, United States of America
| | - Monica Christmas
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, United States of America
- Pritzker School of Medicine, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
- Chicago Medicine, The University of Chicago, Chicago, Illinois, United States of America
| | | | | | - Emmanuelle Chapey
- Institut des agents infectieux, Hôpital de la Croix-Rousse, Lyon, France
| | - Sylvie Abraham
- Laboratory of Parasitologie, Bichat-Claude Bernard Hôpital, Paris, France
| | - Isabelle Baird
- The College, The University of Chicago, Chicago, Illinois, United States of America
- Global Health Center, The University of Chicago, Chicago, Illinois, United States of America
| | - Juliette Thibodeau
- The College, The University of Chicago, Chicago, Illinois, United States of America
- Global Health Center, The University of Chicago, Chicago, Illinois, United States of America
| | - Kenneth M. Boyer
- Department of Pediatrics, Division of Infectious Diseases, Rush Presbyterian Hospital and Medical Center, Chicago, Illinois, United States of America
| | - Elizabeth Torres
- Group of Molecular Parasitology (GEPAMOL), Center of Biomedical Research, Faculty of Health Sciences, University of Quindio, Armenia (Quindio), Colombia
| | - Shannon Conrey
- University of Cincinnati and Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, United States of America
| | - Kanix Wang
- Carl H. Lindner College of Business, The University of Cincinnati, Cincinnati, Ohio, United States of America
| | - Mary Allen Staat
- University of Cincinnati and Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, United States of America
| | - Nancy Back
- University of Cincinnati and Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, United States of America
| | - Coralie L’Ollivier
- Centre National de Référence Toxoplasmose—Pôle Sérologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- IHU-Méditerranée Infection, Assistance Publique Hôpitaux de Marseille (AP-HM), Marseille, France; Aix Marseille University, IRD, AP-HM, SSA, VITROME, IHU Méditerranée, Marseille, France
| | - Caroline Mahinc
- Parasitology and Mycology Laboratory, Pôle de Biologie-Pathologie, University Hospital of Saint Etienne, Saint Etienne, France
| | - Pierre Flori
- Parasitology and Mycology Laboratory, Pôle de Biologie-Pathologie, University Hospital of Saint Etienne, Saint Etienne, France
| | - Jorge Gomez-Marin
- Group of Molecular Parasitology (GEPAMOL), Center of Biomedical Research, Faculty of Health Sciences, University of Quindio, Armenia (Quindio), Colombia
| | - Francois Peyron
- Institut des agents infectieux, Hôpital de la Croix-Rousse, Lyon, France
| | - Sandrine Houzé
- Laboratory of Parasitologie, Bichat-Claude Bernard Hôpital, Paris, France
| | - Martine Wallon
- Institut des agents infectieux, Hôpital de la Croix-Rousse, Lyon, France
| | - Rima McLeod
- Departments of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
- Pritzker School of Medicine, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
- Department of Pediatrics, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
- Department of Medicine, The University of Chicago, Chicago, Illinois, United States of America
- The College, The University of Chicago, Chicago, Illinois, United States of America
- Global Health Center, The University of Chicago, Chicago, Illinois, United States of America
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Zhou Y, Leahy K, Grose A, Lykins J, Siddiqui M, Leong N, Goodall P, Withers S, Ashi K, Schrantz S, Tesic V, Abeleda AP, Beavis K, Clouser F, Ismail M, Christmas M, Piarroux R, Limonne D, Chapey E, Abraham S, Baird I, Thibodeau J, Boyer K, Torres E, Conrey S, Wang K, Staat MA, Back N, Gomez Marin J, Peyron F, Houze S, Wallon M, McLeod R. Novel paradigm enables accurate monthly gestational screening to prevent congenital toxoplasmosis and more. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.26.23289132. [PMID: 37162985 PMCID: PMC10168490 DOI: 10.1101/2023.04.26.23289132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Background Congenital toxoplasmosis is a treatable, preventable disease, but untreated causes death, prematurity, loss of sight, cognition and motor function, and substantial costs worldwide. Methods/Findings In our ongoing USA feasibility/efficacy clinical trial, data collated with other ongoing and earlier published results proved high performance of an Immunochromatographic-test(ICT) that enables accurate, rapid diagnosis/treatment, establishing new paradigms for care. Overall results from patient blood and/or serum samples tested with ICT compared with gold-standard-predicate-test results found ICT performance for 4606 sera/1876 blood, 99.3%/97.5% sensitive and 98.9%/99.7% specific. However, in the clinical trial the FDA-cleared-predicate test initially caused practical, costly problems due to false-positive-IgM results. For 58 persons, 3/43 seronegative and 2/15 chronically infected persons had false positive IgM predicate tests. This caused substantial anxiety, concerns, and required costly, delayed confirmation in reference centers. Absence of false positive ICT results contributes to solutions: Lyon and Paris France and USA Reference laboratories frequently receive sera with erroneously positive local laboratory IgM results impeding patient care. Therefore, thirty-two such sera referred to Lyon's Reference laboratory were ICT-tested. We collated these with other earlier/ongoing results: 132 of 137 USA or French persons had false positive local laboratory IgM results identified correctly as negative by ICT. Five false positive ICT results in Tunisia and Marseille, France, emphasize need to confirm positive ICT results with Sabin-Feldman-Dye-test or western blot. Separate studies demonstrated high performance in detecting acute infections, meeting FDA, CLIA, WHO ASSURED, CEMark criteria and patient and physician satisfaction with monthly-gestational-ICT-screening. Conclusions/Significance This novel paradigm using ICT identifies likely false positives or raises suspicion that a result is truly positive, rapidly needing prompt follow up and treatment. Thus, ICT enables well-accepted gestational screening programs that facilitate rapid treatment saving lives, sight, cognition and motor function. This reduces anxiety, delays, work, and cost at point-of-care and clinical laboratories. Author’s Summary Toxoplasmosis is a major health burden for developed and developing countries, causing damage to eyes and brain, loss of life and substantial societal costs. Prompt diagnosis in gestational screening programs enables treatment, thereby relieving suffering, and leading to > 14-fold cost savings for care. Herein, we demonstrate that using an ICT that meets WHO ASSURED-criteria identifying persons with/without antibody to Toxoplasma gondii in sera and whole blood with high sensitivity and specificity, is feasible to use in USA clinical practice. We find this new approach can help to obviate the problem of detection of false positive anti- T.gondii IgM results for those without IgG antibodies to T.gondii when this occurs in present, standard of care, predicate USA FDA cleared available assays. Thus, this accurate test facilitates gestational screening programs and a global initiative to diagnose and thereby prevent and treat T.gondii infection. This minimizes likelihood of false positives (IgG and/or IgM) while maintaining maximum sensitivity. When isolated IgM antibodies are detected, it is necessary to confirm and when indicated continue follow up testing in ∼2 weeks to establish seroconversion. Presence of a positive ICT makes it likely that IgM is truly positive and a negative ICT makes it likely that IgM will be a false positive without infection. These results create a new, enthusiastically-accepted, precise paradigm for rapid diagnosis and validation of results with a second-line test. This helps eliminate alarm and anxiety about false-positive results, while expediting needed treatment for true positive results and providing back up distinguishing false positive tests.
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Qi T, Ai J, Sun Y, Ma H, Kang M, You X, Li J. Application of Toxoplasma gondii-specific SAG1, GRA7 and BAG1 proteins in serodiagnosis of animal toxoplasmosis. Front Cell Infect Microbiol 2022; 12:1029768. [PMID: 36590582 PMCID: PMC9798413 DOI: 10.3389/fcimb.2022.1029768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
Toxoplasmosis is a zoonotic disease caused by the obligate intracellular protozoan parasite T. gondii which is widely prevalent in humans and animals worldwide. The diagnosis of toxoplasmosis and distinguishing acute or chronic T. gondii infections have utmost importance for humans and animals. The TgSAG1, TgGRA7, and TgBAG1 proteins were used in the present study to develop the serological rSAG1-ELISA, rGRA7-ELISA and rBAG1-ELISA methods for the testing of T. gondii specific IgG and IgM antibodies and differentiating acute or chronic toxoplasmosis in 3733 animals, including Tibetan sheep, yaks, pigs, cows, cattle, horses, chickens, camels and donkeys from the Qinghai-Tibetan Plateau. The ELISA tests showed that the overall positivity of IgG antibody was 21.1% (786/3733), 15.3% (570/3733) and 18.2% (680/3733) for rSAG1-, rGRA7- and rBAG1-ELISA, respectively, and the positivity of IgM antibody was 11.8% (439/3733), 13.0% (486/3733) and 11.8% (442/3733) for rSAG1-, rGRA7- and rBAG1-ELISA, respectively. A total of 241 animals (6.5%) positive for all rSAG1-, rGRA7- and rBAG1-IgG were found in this study, and the 141 animals (3.8%) tested were anti-T. gondii IgM positive in all three ELISAs. Moreover, the 338, 284 and 377 animals were IgG positive in rSAG1 + rGRA7-, rBAG1 + rGRA7- and rSAG1 + rBAG1- ELISAs respectively, and the 346, 178 and 166 animals in rSAG1 + rGRA7-, rBAG1 + rGRA7- and rSAG1 + rBAG1-ELISAs were IgM positive respectively. The results confirmed that the application of SAG1, GRA7, and BAG1 recombinant antigens could successfully be used in the detection of specific IgG and IgM antibodies for distinguishing between acute or chronic T. gondii infections. It is inferred that the forms in which current animal species in the plateau area were infected with T. gondii, and the period of infection or the clinical manifestations of the current infections may be different. The present study provides substantial clinical evidence for the differential diagnosis of toxoplasmosis, and the classification of acute and chronic T. gondii infections.
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Affiliation(s)
- Tongsheng Qi
- State Key Laboratory of Plateau Ecology and Agriculture, Qinghai University, Xining, China,College of Agriculture and Animal Husbandry, Qinghai University, Xining, China
| | - Jingkai Ai
- State Key Laboratory of Plateau Ecology and Agriculture, Qinghai University, Xining, China,College of Agriculture and Animal Husbandry, Qinghai University, Xining, China
| | - Yali Sun
- State Key Laboratory of Plateau Ecology and Agriculture, Qinghai University, Xining, China,College of Agriculture and Animal Husbandry, Qinghai University, Xining, China,Qinghai Provincial Key Laboratory of Pathogen Diagnosis for Animal Diseases and Green Technical Research for Prevention and Control, Qinghai University, Xining, China
| | - Hejia Ma
- State Key Laboratory of Plateau Ecology and Agriculture, Qinghai University, Xining, China,College of Agriculture and Animal Husbandry, Qinghai University, Xining, China
| | - Ming Kang
- State Key Laboratory of Plateau Ecology and Agriculture, Qinghai University, Xining, China,College of Agriculture and Animal Husbandry, Qinghai University, Xining, China
| | - Xiaoqian You
- Qinghai Animal Disease Control Center, Department of Agriculture and Rural Affairs of Qinghai Province, Xining, China
| | - Jixu Li
- State Key Laboratory of Plateau Ecology and Agriculture, Qinghai University, Xining, China,College of Agriculture and Animal Husbandry, Qinghai University, Xining, China,Qinghai Provincial Key Laboratory of Pathogen Diagnosis for Animal Diseases and Green Technical Research for Prevention and Control, Qinghai University, Xining, China,*Correspondence: Jixu Li,
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Vargas-Villavicencio JA, Cañedo-Solares I, Correa D. Anti-Toxoplasma gondii IgM Long Persistence: What Are the Underlying Mechanisms? Microorganisms 2022; 10:microorganisms10081659. [PMID: 36014077 PMCID: PMC9415799 DOI: 10.3390/microorganisms10081659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 11/16/2022] Open
Abstract
Diagnosis of Toxoplasma gondii acute infection was first attempted by detection of specific IgM antibodies, as for other infectious diseases. However, it was noted that this immunoglobulin declines slowly and may last for months or even years. Apart from the diagnostic problem imposed on clinical management, this phenomenon called our attention due to the underlying phenomena that may be causing it. We performed a systematic comparison of reports studying IgM antibody kinetics, and the data from the papers were used to construct comparative plots and other graph types. It became clear that this phenomenon is quite generalized, and it may also occur in animals. Moreover, this is not a technical issue, although some tests make more evident the prolonged IgM decay than others. We further investigated biological reasons for its occurrence, i.e., infection dynamics (micro-reactivation–encystment, reinfection and reactivation), parasite strain relevance, as well as host innate, natural B cell responses and Ig class-switch problems inflicted by the parasite. The outcomes of these inquiries are presented and discussed herein.
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Affiliation(s)
| | - Irma Cañedo-Solares
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Mexico City 04530, Mexico
| | - Dolores Correa
- Dirección de Investigación/Centro de Investigación en Ciencias de la Salud, FCS, Universidad Anáhuac México Campus Norte, Av Universidad Anáhuc 46, Lomas Anáhuac, Huixquilucan 52786, Mexico
- Correspondence: ; Tel.: +52-(55)-5627-0210-7637
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Holec-Gąsior L, Sołowińska K. IgG Avidity Test as a Tool for Discrimination between Recent and Distant Toxoplasma gondii Infection—Current Status of Studies. Antibodies (Basel) 2022; 11:antib11030052. [PMID: 35997346 PMCID: PMC9397011 DOI: 10.3390/antib11030052] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 07/31/2022] [Accepted: 08/11/2022] [Indexed: 11/29/2022] Open
Abstract
Toxoplasma gondii, an obligate intracellular protozoan parasite, is the causative agent of one of the most prevalent zoonoses worldwide. T. gondii infection is extremely important from a medical point of view, especially for pregnant women, newborns with congenital infections, and immunocompromised individuals. Thus, an accurate and proper diagnosis of this infection is essential. Among the available diagnostic tests, serology is commonly used. However, traditional serological techniques have certain limitations in evaluating the duration of T. gondii infection, which is problematic, especially for pregnant women. Avidity of T. gondii-specific IgG antibodies seems to be a significant tool for discrimination between recent and distant infections. This article describes the problem of diagnosis of T. gondii infection, with regard to IgG avidity tests. The IgG avidity test is a useful serological indicator of toxoplasmosis, which in many cases can confirm or exclude the active form of the disease. IgG antibodies produced in the recent primary T. gondii infection are of low avidity while IgG antibodies with high avidity are detected in the chronic phase of infection. Furthermore, this paper presents important topics of current research that concern the usage of parasite recombinant antigens that may improve the performance of IgG avidity tests.
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Alvarado-Esquivel C, Estrada-Martínez S, Pérez-Álamos AR, Ramos-Nevárez A, Botello-Calderón K, Alvarado-Félix ÁO, Vaquera-Enríquez R, Alvarado-Félix GA, Sifuentes-Álvarez A, Guido-Arreola CA, Rábago-Sánchez E, Saenz-Soto L. Toxoplasma gondii infection and insomnia: A case control seroprevalence study. PLoS One 2022; 17:e0266214. [PMID: 35679264 PMCID: PMC9182222 DOI: 10.1371/journal.pone.0266214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/24/2022] [Indexed: 11/19/2022] Open
Abstract
We determined the association between Toxoplasma gondii (T. gondii) infection and insomnia. Through an age-and gender-matched case-control study, 577 people with insomnia (cases) and 577 people without insomnia (controls) were tested for anti-T. gondii IgG and IgM antibodies using commercially available enzyme-immunoassays. Anti-T. gondii IgG antibodies were found in 71 (12.3%) of 577 individuals with insomnia and in 46 (8.0%) of 577 controls (OR = 1.62; 95% CI: 1.09–2.39; P = 0.01). Men with insomnia had a higher (16/73: 21.9%) seroprevalence of T. gondii infection than men without insomnia (5/73: 6.8%) (OR: 3.81; 95% CI: 1.31–11.06; P = 0.009). The rate of high (>150 IU/ml) anti-T. gondii IgG antibody levels in cases was higher than the one in controls (OR = 2.21; 95% CI: 1.13–4.31; P = 0.01). Men with insomnia had a higher (8/73: 11.0%) rate of high anti-T. gondii IgG antibody levels than men without insomnia (0/73: 0.0%) (P = 0.006). The rate of high anti-T. gondii IgG antibody levels in cases >50 years old (11/180: 6.1%) was higher than that (3/180: 1.7%) in controls of the same age group (OR: 3.84; 95% CI: 1.05–14.00; P = 0.05). No difference in the rate of IgM seropositivity between cases and controls was found (OR = 1.33; 95% CI: 0.57–3.11; P = 0.50). Results of this seroepidemiology study suggest that infection with T. gondii is associated with insomnia. Men older than 50 years with T. gondii exposure might be prone to insomnia. Further research to confirm the association between seropositivity and serointensity to T. gondii and insomnia is needed.
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Affiliation(s)
- Cosme Alvarado-Esquivel
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango, Mexico
- * E-mail:
| | - Sergio Estrada-Martínez
- Institute for Scientific Research “Dr. Roberto Rivera-Damm”, Juárez University of Durango State, Durango, Mexico
| | - Alma Rosa Pérez-Álamos
- Institute for Scientific Research “Dr. Roberto Rivera-Damm”, Juárez University of Durango State, Durango, Mexico
| | - Agar Ramos-Nevárez
- Clínica de Medicina Familiar, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Durango, Mexico
| | - Karina Botello-Calderón
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango, Mexico
| | - Ángel Osvaldo Alvarado-Félix
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango, Mexico
| | - Raquel Vaquera-Enríquez
- Health Center No. 2 “Dr. Carlos Santamaría”, Servicios de Salud de Durango, Durango, Durango, Mexico
| | - Gustavo Alexis Alvarado-Félix
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango, Mexico
| | - Antonio Sifuentes-Álvarez
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango, Mexico
| | - Carlos Alberto Guido-Arreola
- Clínica de Medicina Familiar, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Durango, Mexico
| | - Elizabeth Rábago-Sánchez
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango, Mexico
| | - Leandro Saenz-Soto
- Clínica de Medicina Familiar, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Durango, Mexico
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Seroprevalence and Genetic Characterization of Toxoplasma gondii among Children with Neurodevelopmental Disorders in Egypt. J Trop Med 2022; 2022:2343679. [PMID: 35669051 PMCID: PMC9166983 DOI: 10.1155/2022/2343679] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 05/09/2022] [Accepted: 05/12/2022] [Indexed: 11/25/2022] Open
Abstract
Toxoplasma gondii is a parasite with a special predilection for the central nervous system. Toxoplasmosis's contribution to the triggering of many neurodevelopmental disorders was established. This study aimed to detect the seroprevalence and genotypes of T. gondii strains in children with neurodevelopmental disorders. The study included 180 children with neurodevelopmental disorders and 180 children in the control group. Assessment of seropositivity of Toxoplasma IgM and IgG antibodies in patients and controls was carried out. Genetic characterization of T. gondii was obtained by nested polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) technique targeting dense granule gene (GRA6). Our results showed that the overall seroprevalence of T. gondii antibodies in the patient and controls was 35.6% and 11.7%, respectively. Nested PCR showed positivity in 11.1% of the patient group for T. gondii DNA. T. gondii seropositivity rate was significantly high in patients with hydrocephalus and also in patients with epilepsy. Positive nested PCR was significantly high in children with hydrocephalus only. Genotyping using nested PCR-RFLP showed genotype I (80%) followed by atypical strains (20%) with no association with any specific clinical presentation. In conclusion, among toxoplasmosis-positive children with neurodevelopmental disorders, analysis of T. gondii GRA6 locus revealed the predominance of type I genotype followed by atypical strains.
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Plazas MI, Marín JS, Torres E, Londoño JC, Celis-Giraldo D, Marín JEG. FREQUENCY OF NATURAL ANTIBODIES AND CONCORDANCE ANALYSIS FOR ANTI-TOXOPLASMA IgM TESTS IN COLOMBIAN SERA OF PREGNANT WOMEN. Diagn Microbiol Infect Dis 2022; 103:115733. [DOI: 10.1016/j.diagmicrobio.2022.115733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/13/2022] [Accepted: 05/21/2022] [Indexed: 11/03/2022]
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Contopoulos‐Ioannidis DG, Gianniki M, Ai‐Nhi Truong A, Montoya JG. Toxoplasmosis and Schizophrenia: A Systematic Review and Meta‐Analysis of Prevalence and Associations and Future Directions. PSYCHIATRIC RESEARCH AND CLINICAL PRACTICE 2022; 4:48-60. [PMID: 36254187 PMCID: PMC9558922 DOI: 10.1176/appi.prcp.20210041] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 12/15/2022] Open
Affiliation(s)
- Despina G. Contopoulos‐Ioannidis
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California, USA (D. G. Contopoulos‐Ioannidis); Department of Pediatrics, University Hospital, Athens, Greece (M. Gianniki); Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA (A. Ai‐Nhi Truong); Dr. Jack S. Remington Laboratory for Specialty Diagnostics, National Reference Center for the Study and Diagnosis of Toxoplasmosis Palo Alto Medical
| | - Maria Gianniki
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California, USA (D. G. Contopoulos‐Ioannidis); Department of Pediatrics, University Hospital, Athens, Greece (M. Gianniki); Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA (A. Ai‐Nhi Truong); Dr. Jack S. Remington Laboratory for Specialty Diagnostics, National Reference Center for the Study and Diagnosis of Toxoplasmosis Palo Alto Medical
| | - Angeline Ai‐Nhi Truong
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California, USA (D. G. Contopoulos‐Ioannidis); Department of Pediatrics, University Hospital, Athens, Greece (M. Gianniki); Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA (A. Ai‐Nhi Truong); Dr. Jack S. Remington Laboratory for Specialty Diagnostics, National Reference Center for the Study and Diagnosis of Toxoplasmosis Palo Alto Medical
| | - Jose G. Montoya
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California, USA (D. G. Contopoulos‐Ioannidis); Department of Pediatrics, University Hospital, Athens, Greece (M. Gianniki); Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA (A. Ai‐Nhi Truong); Dr. Jack S. Remington Laboratory for Specialty Diagnostics, National Reference Center for the Study and Diagnosis of Toxoplasmosis Palo Alto Medical
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Assessment of an In-House Enzyme-Linked Immunosorbent Assay and IgG Avidity Test Based on SAG1 and GRA7 Proteins for Discriminating between Acute and Chronic Toxoplasmosis in Humans. J Clin Microbiol 2021; 59:e0041621. [PMID: 34077255 DOI: 10.1128/jcm.00416-21] [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] [Indexed: 11/20/2022] Open
Abstract
To improve serodiagnostic methods for diagnosis of acute from chronic toxoplasmosis, an economical in-house enzyme-linked immunosorbent assay (ELISA) for measuring Toxoplasma-specific IgG, IgM, and IgG avidity has been developed and assessed based on use of various Toxoplasma gondii antigens, including SAG1, GRA7, and a combination of SAG1 and GRA7 (SAG1+GRA7), as well as Toxoplasma lysate antigens (TLAs). Performances of in-house IgM, IgG, and IgG avidity assays were compared to those of ELISA commercial kits and VIDAS Toxo IgG avidity. A set of 138 sera from patients with acquired T. gondii infection and seronegative people were assessed. Receiver operating characteristic (ROC) analysis revealed an area under curve (AUC) of 0.98, 0.97, 0.99, and 0.99 for IgM-TLAs, IgM-SAG1, IgM-GRA7, and IgM-SAG1+GRA7, respectively. Furthermore, AUC was calculated as 0.99, 0.99, 0.98, and 0.99 for IgG-TLAs, IgG-SAG1, IgG-GRA7, and IgG-SAG1+GRA7, respectively. The current study showed that GRA7 included 100% sensitivity for the detection of Toxo IgM, while SAG1 included 89.7% sensitivity. Furthermore, the highest specificity (97.2%) to detect Toxo IgM was achieved using SAG1+GRA7 antigen. For the detection of Toxo IgG, the highest sensitivity (100%) was recorded for SAG1+GRA7, followed by TLAs (97.9%). The SAG1+GRA7 showed the greatest potential for assessing avidity of IgG antibodies, with 97.1% sensitivity and 96.6% specificity compared to those of VIDAS Toxo IgG avidity. The preliminary results have promised better discriminations between acute and chronic infections using a combination of SAG1 and GRA7 recombinant antigens compared to those using TLAs.
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Deshmukh AS, Hebbar BK, Mitra P, Shinde S, Chaudhari S, Barbuddhe SB. Seroprevalence and risk factors of Toxoplasma gondii infection among veterinary personnel and abattoir workers in Central India. Parasitol Int 2021; 84:102402. [PMID: 34119685 DOI: 10.1016/j.parint.2021.102402] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 05/31/2021] [Accepted: 06/07/2021] [Indexed: 11/16/2022]
Abstract
Toxoplasmosis, caused by the protozoan parasite Toxoplasma gondii, is an important zoonotic infection. Veterinary personnel and abattoir workers are considered to be at a high risk of T. gondii infection owing to their occupational exposure. However, the association of T. gondii infection with occupational exposure to animals has not been determined in India. Hence, we analysed 139 and 126 blood samples of veterinary personnel and abattoir workers, respectively, for anti-T. gondii antibodies using enzyme-linked immunosorbent assay (ELISA), modified agglutination test (MAT) and indirect fluorescent antibody test (IFAT). The association of seroprevalence with sociodemographic profiles, work activities and dietary habits was determined in the study population. MAT, ELISA and IFAT results demonstrated nearly 46%, 48% and 47% seropositivity, respectively. MAT (kappa = 0.924) and IFAT (kappa = 0.962) results showed good agreement with ELISA results. Of the ELISA positive samples, 46% was copositive for IgG antibody, 1.5% for IgM antibody and 1.5% for both IgG and IgM antibodies. High IgG avidity was observed only in IgG+ IgM- and IgG+ IgM+ samples and not in IgM+ IgG- samples, indicating chronic T. gondii infection in most of the cases. Furthermore, multivariate analysis revealed that T. gondii seropositivity was associated with age > 30 years (odds ration [OR] = 1.992), cat at home (OR = 1.991), not wearing gloves (OR = 1.886), not wearing safety glasses (OR = 1.985) and contact with soil (OR = 1.695). These findings support the presence of a potentially significant association between T. gondii seropositivity and occupational exposure to animals.
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Affiliation(s)
- Abhijit S Deshmukh
- Molecular Parasitology Laboratory, DBT-National Institute of Animal Biotechnology, Hyderabad, India.
| | - Bhavana K Hebbar
- Molecular Parasitology Laboratory, DBT-National Institute of Animal Biotechnology, Hyderabad, India
| | - Pallabi Mitra
- Department of Animal Biology, School of Life Sciences, University of Hyderabad, Hyderabad, India
| | - Shilpshri Shinde
- Department of Veterinary Public Health, College of Veterinary and Animal Sciences, Nagpur, India
| | - Sandeep Chaudhari
- Department of Veterinary Public Health, College of Veterinary and Animal Sciences, Nagpur, India
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Marques BA, Carellos EVM, Silva VMN, Pereira FH, Guerra MRL, Iturra JAD, Januário JN, Andrade GMQD. Comparison between Enzyme Immunoassays Performed on Samples of Dried Blood and Serum for Toxoplasmosis Prenatal Screening: Population-based Study. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2021; 43:351-356. [PMID: 34077987 PMCID: PMC10302860 DOI: 10.1055/s-0041-1730285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE Most prenatal screening programs for toxoplasmosis use immunoassays in serum samples of pregnant women. Few studies assess the accuracy of screening tests in dried blood spots, which are of easy collection, storage, and transportation. The goals of the present study are to determine the performance and evaluate the agreement between an immunoassay of dried blood spots and a reference test in the serum of pregnant women from a population-based prenatal screening program for toxoplasmosis in Brazil. METHODS A cross-sectional study was performed to compare the immunoassays Imunoscreen Toxoplasmose IgM and Imunoscreen Toxoplasmose IgG (Mbiolog Diagnósticos, Ltda., Contagem, Minas Gerais, Brazil)in dried blood spots with the enzyme-linked fluorescent assay (ELFA, BioMérieux S.A., Lyon, France) reference standard in the serum of pregnant women from Minas Gerais Congenital Toxoplasmosis Control Program. RESULTS The dried blood spot test was able to discriminate positive and negative results of pregnant women when compared with the reference test, with an accuracy of 98.2% for immunoglobulin G (IgG), and of 95.8% for immunoglobulin M (IgM). CONCLUSION Dried blood samples are easy to collect, store, and transport, and they have a good performance, making this a promising method for prenatal toxoplasmosis screening programs in countries with continental dimensions, limited resources, and a high prevalence of toxoplasmosis, as is the case of Brazil.
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Shahighi M, Heidari A, Keshavarz H, Bairami A, Shojaee S, Sezavar M, Salimi M, Teimouri A. Seroepidemiological study of toxoplasmosis in women referred to a pre-marriage counseling center in Alborz Province, Iran. BMC Res Notes 2021; 14:163. [PMID: 33931121 PMCID: PMC8086314 DOI: 10.1186/s13104-021-05581-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 04/22/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives The aim of the current study was to assess prevalence of Toxoplasma infection and its associated risk factors in women of childbearing-age in central Iran. Results Of 400 serum samples assessed for anti-T. gondii antibodies, 81 (20.25%) samples were positive for anti-T. gondii antibodies, including 74 positive samples (91.3%) for anti-T. gondii IgG and seven positive samples (8.7%) for IgG and IgM. Of seven IgG and IgM positive samples, five and two samples were high and low in IgG avidity, respectively. Based on PCR analysis, Toxoplasma infection was detected in one sample with anti-T. gondii IgM and low IgG avidity. The Chi-square test showed significant correlations of T. gondii seropositivity with history of undercooked meat consumption and contacts with cats (p < 0.05). In the present study, 79.75% of the participants were negative for IgG against T. gondii infection. Furthermore, recently acquired Toxoplasma infection was found using IgG avidity and PCR assays among women of childbearing-age in the study area, which would increase the risk of their fetus becoming infected. Educational program and antenatal screening of childbearing-age women for T. gondii infection may be important primary prevention strategies and help reduce the risk of congenital toxoplasmosis in this population.
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Affiliation(s)
- Melica Shahighi
- Department of Medical Parasitology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Aliehsan Heidari
- Department of Medical Parasitology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
| | - Hossein Keshavarz
- Department of Medical Parasitology and Mycology, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Bairami
- Department of Medical Parasitology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Saeedeh Shojaee
- Department of Medical Parasitology and Mycology, Tehran University of Medical Sciences, Tehran, Iran
| | - Monireh Sezavar
- Department of Experimental Sciences, Faculty of Allied Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahboobeh Salimi
- Department of Medical Parasitology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Aref Teimouri
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Seroprevalence and Risk Factors of Toxoplasma gondii Infection among Pregnant Women in Kumasi: A Cross-Sectional Study at a District-Level Hospital, Ghana. Infect Dis Obstet Gynecol 2021; 2021:6670219. [PMID: 33883871 PMCID: PMC8041552 DOI: 10.1155/2021/6670219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 03/04/2021] [Accepted: 03/22/2021] [Indexed: 11/18/2022] Open
Abstract
Background This study investigated the prevalence and risk factors of Toxoplasma gondii infection among pregnant women in a district-level hospital in Ghana and compared the diagnostic performance of the rapid diagnostic test (RDT) and enzyme-linked immunosorbent assay (ELISA) for T. gondii diagnosis. Method This cross-sectional study included 400 consecutive consenting women in their first-trimester stage of pregnancy. A validated well-structured closed-ended questionnaire was used to collect sociodemographic data and possible risk factors of each participant. Blood samples were collected for analysis of T. gondii IgG and IgM using the commercial ELISA Kit and RDT. Results Seroprevalence of toxoplasmosis was 21.5% and 57.3% based on the RDT and ELISA technique, respectively. Secondary education (cOR = 1.9, 95% CI (1.1-3.1), and p = 0.020) and contact with cats (cOR = 1.7, 95% CI (1.1-2.8), and p = 0.030) were significant predictors of T. gondii infection, with the former being the only independent risk factor for T. gondii infection (aOR = 1.8, 95% CI (1.0-3.0), and p = 0.034) by the ELISA method. The sensitivity, specificity, and area under the curve (AUC) of RDT-IgM against ELISA were 42.9%, 95.9%, and 0.694, respectively, whereas those of RDT-IgG were 31.0%, 91.2%, and 0.611, respectively. The diagnostic consistency between the two methods was fair for both RDT-IgM (κ = 0.304) and RDT-IgG (κ = 0.201). Conclusion The prevalence of T. gondii infection among pregnant women at Kumasi is 21.5% and 57.3% based on the RDT and ELISA technique, respectively. Secondary education and contact with cats were the major risk factors of T. gondii infection. Using ELISA as the reference, the RDT used in this study for the diagnosis of T. gondii infection has low sensitivity, and therefore, it is unreliable. However, this finding does not invalidate all RDTs because there are several other brands of RDT with good sensitivity and specificity. Further studies to ascertain the performance of other commercially available RDT kits are needed.
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Neves ES, Espíndola OM, Curi A, Amendoeira MR, Rocha DN, Gomes LHF, Guida LC. PCR-based diagnosis is not always useful in the acute acquired toxoplasmosis in immunocompetent individuals. Parasitol Res 2021; 120:763-767. [PMID: 33415403 DOI: 10.1007/s00436-020-07022-6] [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: 03/28/2020] [Accepted: 12/14/2020] [Indexed: 10/22/2022]
Abstract
Toxoplasmosis is the most prevalent zoonosis in the world and is associated with a large spectrum of diseases. Acute acquired toxoplasmosis (AAT) is considered a benign and self-limiting disease but severe postnatal infections have been reported, particularly in South America. Laboratory diagnosis is based on the detection of anti-Toxoplasma gondii IgM, IgG, and presence of low IgG avidity. However, these assays present limitations, and therefore, PCR has been suggested as an alternative diagnostic tool. In this study, we performed real-time and nested PCR in DNA blood samples from 59 individuals with AAT lasting less than 80 days. None of the patients had parasitic DNA detected by PCR, even in the more severe cases or when blood was collected early after disease onset. These negative results indicate that the parasitemia kinetics needs investigation to determine the best time for blood sampling, especially in immunocompetent individuals. Thus, we emphasize that a negative PCR result does not exclude recent T. gondii infection, and serological criteria are still decisive for the laboratory diagnosis of AAT.
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Affiliation(s)
- Elizabeth Souza Neves
- Laboratório de Parasitologia, Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro, Brazil.
| | - Otavio Melo Espíndola
- Laboratório de Pesquisa Clínica em Neuroinfecções, Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro, Brazil.
| | - André Curi
- Laboratório de Oftalmologia, Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro, Brazil
| | | | | | | | - Letícia Cunha Guida
- Laboratório de Alta Complexidade, Instituto Fernandes Figueira, Fiocruz, Rio de Janeiro, Brazil
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Antibody kinetics and exposure to Toxoplasma gondii in cats: a seroepidemiological study. Int J Parasitol 2020; 51:291-299. [PMID: 33359204 DOI: 10.1016/j.ijpara.2020.09.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/24/2020] [Accepted: 09/27/2020] [Indexed: 02/03/2023]
Abstract
Domestic cats are the most important definitive hosts for Toxoplasma gondii, the agent of an important global zoonosis. Serial sera from cats orally inoculated either withT. gondii tissue cysts (n = 3) or sporulated oocysts (n = 3) and from 65 client-owned cats, plus sera from 1,757 client-owned cats presented to veterinarians in Switzerland were analysed for an antibody response to T. gondii by ELISA. Risk factors for seropositivity and prevalence were estimated with a generalised linear and beta regression model. The first model examined the association of an OD405 value as the dependent variable, with gender, age, and outside access as possible independent variables. In the second model, we first analysed the data assuming a bimodal distribution representing two overlapping distributions of OD405 values from positive and negative cats, enabling the assignment of a probability of true infection status to each cat. Mean probabilities of true infection status across groups represent an estimate of true prevalence. These probabilities were then regressed against age, gender and outside access. Antibody kinetics in cats orally inoculated with tissue cysts, shedding oocysts, did not differ significantly from those of cats inoculated with sporulated oocysts without detectable oocyst excretion, suggesting extraintestinal parasite invasion and exposure to tachyzoites in both situations at an early stage of infection. Analysis of serial serum samples suggested a persisting long-term humoral immune response. Of the client-owned cats, 42.4% (95% confidence interval (CI): 40.1-44.6) had a positive true infection status. This was higher (56.3% (95% CI: 53.2-59.6)) in cats with outside access than in those without (22.1% (95% CI: 18.9-25.4)). In the first model, the factors age (P < 0.0001), gender (male: P = 0.046), and outside access (P < 0.0001) were independently associated with significantly higher OD405 values. In the second model, the probability of having a positive true infection status increased with age (P < 0.0001), was higher with outside access (P < 0.0001) and in outdoor male cats (P = 0.0006).
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Saadat F, Mahmoudi MR, Rajabi E, Roshan ZA, Shad BM, Karanis P. Seroepidemiology and Associated Risk Factors of Toxoplasma gondii in Hemodialysis Patients. Acta Parasitol 2020; 65:906-912. [PMID: 32533419 DOI: 10.1007/s11686-020-00238-7] [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: 05/21/2019] [Accepted: 05/29/2020] [Indexed: 01/01/2023]
Abstract
PURPOSE Immunocompromised patients may be at risk for reactivation of the toxoplasmosis infection, because of defection in cell-mediated immunity. Therefore, early diagnosis would be highly desirable in these individuals. This case-control study was designed to increase information about toxoplasmosis in hemodialysis (HD) patients in Guilan province, Iran. METHODS The study was performed among 150 patients and 150 controls referred to hospitals of Guilan University of Medical Sciences during 2018-2019. Questionnaire forms, including demographic and epidemiological information, were completed. Peripheral blood samples were taken for serum separation and were collected into tubes and then kept at - 20 °C until use. IgG and IgM antibodies to Toxoplasma gondii were detected by a commercial ELISA kit. Accordingly, IgG absorbance levels < 9 were considered negative, 9-11 was considered borderline, and > 11 was positive; IgM absorbance levels < 0.9 were considered negative, 0.9-1.1 was assumed to be borderline, and > 1.1 was positive. RESULTS Throughout the study, 72.0% of HD patients and 64.7% of the control group were positive for anti-Toxoplasma IgG antibody subsequently. 2% of HD patients and 0.7% of the control group were positive for anti-Toxoplasma IgM antibody and these difference weren't significant between control and ones with HD (P > 0.05). There was no significant difference between dialysis duration factor and the seropositivity rate. Seroprevalence of T. gondii infection did not vary significantly with age, educational level, residence and presence of a cat at home. On the contrary, seroprevalence varied significantly with gender and consumption of raw vegetables. CONCLUSION Because of the high percentage of positivity for Toxoplasma IgG antibodies in hemodialysis patients, we suggest a periodically screening program to carry out for monitoring and evaluating the possible dissemination of toxoplasmosis during hemodialysis.
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Role of Toxoplasma gondii IgG Avidity Testing in Discriminating between Acute and Chronic Toxoplasmosis in Pregnancy. J Clin Microbiol 2020; 58:JCM.00505-20. [PMID: 32321784 DOI: 10.1128/jcm.00505-20] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Risk of mother-to-child transmission of Toxoplasma gondii during pregnancy is much greater in women who are exposed to primary T. gondii infection (toxoplasmosis) after conception compared to those who were exposed to the infection before conception. Therefore, laboratory tests that help classify recent primary toxoplasmosis are important tools for the management of pregnant women suspected to have T. gondii exposure. Detection of Toxoplasma IgM (Toxo IgM) is a sensitive indicator of primary toxoplasmosis, but the indicator specificity is low because sometimes natural IgM antibodies react with Toxoplasma antigens in the absence of the infection. Furthermore, Toxo IgM sometimes persists in blood serum for several months or years following the primary infection. In recent decades, Toxo IgG avidity assay has been used as a standard diagnostic technique for a better estimation of the infection acquisition time and identification of the primary T. gondii infection during pregnancy. Avidity is described as the aggregate strength; by which, a mixture of polyclonal IgG molecules reacts with multiple epitopes of the proteins. This parameter matures gradually within 6 months of the primary infection. A high Toxo IgG avidity index allows a recent infection (less than 4 months) to be excluded, whereas a low Toxo IgG avidity index indicates a probable recent infection with no exclusions of the older infections. This minireview is based on various aspects of T. gondii IgG avidity testing, including (i) description of avidity and basic methods used in primary studies on T. gondii IgG avidity and primary infections; (ii) importance of IgG avidity testing in pregnancy; (iii) result summary of the major studies on the use of T. gondii IgG avidity assay in pregnancy; (iv) brief explanation of the T. gondii IgG avidity values in newborns; (v) result summary of the major studies on T. gondii IgG avidity and PCR; (vi) discussion of commercially available T. gondii IgG avidity assays, including newer automated assays; and (vii) current issues and controversies in diagnosis of primary T. gondii infections in pregnancy.
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Sandoval-Carrillo AA, Vértiz-Hernández AA, Salas-Pacheco JM, González-Lugo OE, Antuna-Salcido EI, Salas-Pacheco SM, Sánchez-Anguiano LF, Méndez-Hernández EM, Hernández-Tinoco J, Castellanos-Juárez FX, La-Llave-León O, Alvarado-Esquivel C. Toxoplasma gondii infection in pregnant women: a cross-sectional study in Matehuala City, Mexico. BMJ Open 2020; 10:e033995. [PMID: 32764080 PMCID: PMC7412581 DOI: 10.1136/bmjopen-2019-033995] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES This study aimed to determine the seroprevalence of Toxoplasma gondii (T. gondii) infection in pregnant women in Matehuala City, Mexico; and the associated risk factors. DESIGN A cross-sectional study. SETTING Matehuala City, Mexico. PARTICIPANTS 311 pregnant women. PRIMARY AND SECONDARY OUTCOME MEASURES Sera of women were analysed for anti-T. gondii IgG and IgM antibodies by commercially available immunoassays. Bivariate and multivariate analyses were used to assess the association between T. gondii seroprevalence and the characteristics of the pregnant women. RESULTS Thirteen (4.2%) of the 311 pregnant women studied were positive for anti-T. gondii IgG antibodies. No anti-T. gondii IgM antibodies were found in anti-T. gondii IgG seropositive women. No association between seropositivity and history of blood transfusion, transplantation, caesarean sections, deliveries, miscarriages or number of pregnancies was found. Logistic regression analysis of sociodemographic, behavioural and housing variables showed that availability of potable water at street represented a risk factor for T. gondii infection (age-adjusted OR=2.18; 95% CI: 1.05 to 4.53; p=0.03), whereas being born in Mexico was a protective factor for infection (age-adjusted OR=0.01; 95% CI: 0.001 to 0.35; p=0.008). CONCLUSIONS In this first study on the seroepidemiology of T. gondii infection in pregnant women in Matehuala, we conclude that the seroprevalence of T. gondii infection is low and similar to those reported in pregnant women in other Mexican cities. However, the seroprevalence found is lower than those reported in pregnant women in other countries in the Americas and Europe. Two risk factors associated with T. gondii infection were identified. Results of the present study may help for the optimal planning of preventive measures against toxoplasmosis in pregnant women.
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Affiliation(s)
| | | | | | - Olga Edith González-Lugo
- Coordinación Académica Regional Altiplano, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
| | | | | | | | - Edna Madai Méndez-Hernández
- Subdirección de Auxiliares de Diagnóstico y Tratamiento, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca, Mexico
| | - Jesús Hernández-Tinoco
- Instituto de Investigación Científica, Universidad Juárez del Estado de Durango, Durango, Mexico
| | | | - Osmel La-Llave-León
- Instituto de Investigación Científica, Universidad Juárez del Estado de Durango, Durango, Mexico
| | - Cosme Alvarado-Esquivel
- Laboratorio de Investigación Biomédica, Juarez University of Durango State Faculty of Medicine and Nutrition, Durango, Mexico
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Khalil A, Sotiriadis A, Chaoui R, da Silva Costa F, D'Antonio F, Heath PT, Jones C, Malinger G, Odibo A, Prefumo F, Salomon LJ, Wood S, Ville Y. ISUOG Practice Guidelines: role of ultrasound in congenital infection. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2020; 56:128-151. [PMID: 32400006 DOI: 10.1002/uog.21991] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 01/27/2020] [Indexed: 06/11/2023]
Affiliation(s)
- A Khalil
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - A Sotiriadis
- Second Department of Obstetrics and Gynecology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - R Chaoui
- Center for Prenatal Diagnosis and Human Genetics, Berlin, Germany
| | - F da Silva Costa
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, São Paulo, Brazil
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
| | - F D'Antonio
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
- Department of Obstetrics and Gynecology, University Hospital of Northern Norway, Tromsø, Norway
| | - P T Heath
- Paediatric Infectious Diseases Research Group and Vaccine Institute, St George's University of London and St George's University Hospitals NHS Trust, London, UK
| | - C Jones
- Faculty of Medicine and Institute for Life Sciences, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - G Malinger
- Ultrasound Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Odibo
- Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - F Prefumo
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - L J Salomon
- Department of Obstetrics and Fetal Medicine, Hopital Necker-Enfants Malades, Assistance Publique-Hopitaux de Paris, Paris Descartes University, Paris, France
| | | | - Y Ville
- Department of Obstetrics and Fetal Medicine, Hopital Necker-Enfants Malades, Assistance Publique-Hopitaux de Paris, Paris Descartes University, Paris, France
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Ybañez RHD, Ybañez AP, Nishikawa Y. Review on the Current Trends of Toxoplasmosis Serodiagnosis in Humans. Front Cell Infect Microbiol 2020; 10:204. [PMID: 32457848 PMCID: PMC7227408 DOI: 10.3389/fcimb.2020.00204] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 04/16/2020] [Indexed: 12/17/2022] Open
Abstract
Toxoplasmosis is a widely distributed zoonotic infection caused by the obligate intracellular apicomplexan parasite Toxoplasma gondii. It is mainly transmitted through the ingestion of oocysts shed by an infected cat acting as its definitive host. The key to effective control and treatment of toxoplasmosis is prompt and accurate detection of T. gondii infection. Several laboratory diagnostic methods have been established, including the most commonly used serological assays such as the dye test (DT), direct or modified agglutination test (DAT/MAT), indirect hemagglutination test (IHA), latex agglutination test (LAT), indirect immunofluorescent test (IFAT), enzyme-linked immunosorbent assays (ELISA), immunochromatographic tests (ICT), and the western blot. Nonetheless, creating specific and reliable approaches for serodiagnosis of T. gondii infection, and differentiating between acute and chronic phases of infection remains a challenge. This review provides information on the current trends in the serodiagnosis of human toxoplasmosis. It highlights the advantages of the use of recombinant proteins for serological testing and provides insight into the possible future direction of these methods.
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Affiliation(s)
- Rochelle Haidee D Ybañez
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Adrian P Ybañez
- Institute of Molecular Parasitology and Protozoan Diseases at Main and College of Veterinary Medicine, Cebu Technological University, Cebu City, Philippines
| | - Yoshifumi Nishikawa
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
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Prevalence and predictors of Toxoplasma gondii infection in pregnant women from Dhamar, Yemen. BMC Infect Dis 2019; 19:1089. [PMID: 31888517 PMCID: PMC6937662 DOI: 10.1186/s12879-019-4718-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 12/22/2019] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Toxoplasmosis is a common and serious parasitic infection caused by the ubiquitous obligatory intracellular protozoan organism, Toxoplasma gondii. Although infection with T. gondii is usually asymptomatic in healthy individuals, it can lead to severe pathological effects in congenital cases and immunocompromised patients. This study aimed to determine the seroprevalence of T. gondii and its predictors among pregnant women seeking prenatal and medical care at the general maternal and child health facility in Dhamar district of Dhamar governorate, Yemen. METHODS A total of 420 pregnant women were randomly selected for this cross-sectional study. Participants were screened for anti-T. gondii antibodies (i.e. immunoglobulin M; IgM and immunoglobulin G; IgG) using electrochemiluminescence immunoassay. Demographic, socioeconomic, obstetric and behavioural data were collected using a pretested questionnaire via face-to-face interview. Univariate and multivariate analyses were used to identify the independent predictors of T. gondii seroprevalence. RESULTS The overall seroprevalence of anti-T. gondii antibodies (IgG and/or IgM) among the participants was 21.2% (89/420; 95% CI = 17.3-25.1). Anti-T. gondii IgG antibodies were detected in 20.0% (84/420) of the women of which 12.9% (54/420) were positive for only IgG and 7.1% (30/420) were positive for both IgG and IgM antibodies. Moreover, 5 women (1.2%) were reactive only for IgM antibodies. Significant associations between T. gondii seroprevalence and history of spontaneous abortion (P < 0.001), raw vegetables consumption (P = 0.036), and presence of cats in household (P = 0.049) were reported. Multivariate analysis confirmed that history of spontaneous abortion (AOR = 4.04; 95% CI = [2.46, 6.63]) and presence of cats in household (AOR = 1.77; 95% CI = [1.02, 3.07]) are significant predictors of T. gondii seroprevalence among the studied participants. CONCLUSION The study found a high seroprevalence (21.2%) of T. gondii infection during pregnancy in Dhamar district, which is significantly associated with adverse pregnancy outcomes. The provision of adequate maternal healthcare and health education pertaining to the prevention of T. gondii infection is therefore imperative to curtail the prevalence of infection among the studied population.
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Le Roux D, Djokic V, Morisse S, Chauvin C, Doré V, Lagrée AC, Voisin D, Villain Y, Grasset-Chevillot A, Boursin F, Su C, Perrot S, Vallée I, Seche E, Blaga R. Evaluation of immunogenicity and protection of the Mic1-3 knockout Toxoplasma gondii live attenuated strain in the feline host. Vaccine 2019; 38:1457-1466. [PMID: 31864855 DOI: 10.1016/j.vaccine.2019.11.076] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/18/2019] [Accepted: 11/27/2019] [Indexed: 01/12/2023]
Abstract
Toxoplasmosis is a zoonotic disease caused by the parasite Toxoplasma gondii. Up to a third of the global human population is estimated to carry a T. gondii infection, which can result in severe complications in immunocompromised individuals and pregnant women. Humans and animals can become infected by ingesting either tissue cysts containing T. gondii bradyzoites, from raw or undercooked meat, or sporulated oocysts from environmental sources. T. gondii oocysts are released in the faeces of cats and other felids, which are the parasite's definitive hosts, leading to environmental contamination. Therefore, vaccination of the feline host against T. gondii is an interesting strategy to interrupt the parasitic life cycle and subsequently limit contamination of intermediate hosts. With this goal in mind, we tested in cats, an attenuated live strain of T. gondii deleted for the Mic1 and Mic3 genes (Mic1-3KO) that was previously shown to be an efficient vaccine candidate in mouse and sheep models. Subcutaneous or oral vaccination routes induced a high specific antibody titer in the cat sera, indicating that the Mic1-3KO strain is immunogenic for cats. To assess protection induced by the vaccine candidate strain, we followed oocysts shedding by vaccinated cats, after oral challenge with a T. gondii wild-type strain. Surprisingly, a high antibody titer did not prevent cats from shedding oocysts from the challenge strain, regardless of the vaccination route. Our results show that the Mic1-3KO vaccine candidate is immunogenic in the feline host, is well tolerated and safe, but does not confer protection against oocysts shedding after natural infection with wild type T. gondii. This result highlights the particular relationship between T. gondii and its unique definitive host, which indicates the need for further investigations to improve vaccination strategies to limit environmental and livestock contaminations.
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Affiliation(s)
- Delphine Le Roux
- UMR BIPAR, INRAE, Ecole Nationale Vétérinaire d'Alfort, ANSES, Université Paris-Est, Maisons-Alfort, F-94700, France.
| | - Vitomir Djokic
- UMR BIPAR, INRAE, Ecole Nationale Vétérinaire d'Alfort, ANSES, Université Paris-Est, Maisons-Alfort, F-94700, France
| | - Solen Morisse
- Vitamféro, Université François Rabelais - UFR des Sciences Pharmaceutiques, Tours, F-37200, France
| | - Clément Chauvin
- UMR BIPAR, INRAE, Ecole Nationale Vétérinaire d'Alfort, ANSES, Université Paris-Est, Maisons-Alfort, F-94700, France
| | - Vanessa Doré
- BioPôle Alfort, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, F-94700, France
| | - Anne-Claire Lagrée
- UMR BIPAR, INRAE, Ecole Nationale Vétérinaire d'Alfort, ANSES, Université Paris-Est, Maisons-Alfort, F-94700, France
| | - Déborah Voisin
- UMR BIPAR, INRAE, Ecole Nationale Vétérinaire d'Alfort, ANSES, Université Paris-Est, Maisons-Alfort, F-94700, France
| | - Yohan Villain
- UMR BIPAR, INRAE, Ecole Nationale Vétérinaire d'Alfort, ANSES, Université Paris-Est, Maisons-Alfort, F-94700, France
| | - Aurélie Grasset-Chevillot
- UMR BIPAR, Anses, Ecole Nationale Vétérinaire d'Alfort, INRAE, Laboratoire de Santé Animale, Maisons-Alfort, F-94700, France
| | - Fanny Boursin
- Vitamféro, Université François Rabelais - UFR des Sciences Pharmaceutiques, Tours, F-37200, France
| | - Chunlei Su
- Department of Microbiology, University of Tennessee, Knoxville, United States of America
| | - Sébastien Perrot
- BioPôle Alfort, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, F-94700, France
| | - Isabelle Vallée
- UMR BIPAR, Anses, Ecole Nationale Vétérinaire d'Alfort, INRAE, Laboratoire de Santé Animale, Maisons-Alfort, F-94700, France
| | - Edouard Seche
- Vitamféro, Université François Rabelais - UFR des Sciences Pharmaceutiques, Tours, F-37200, France
| | - Radu Blaga
- UMR BIPAR, INRAE, Ecole Nationale Vétérinaire d'Alfort, ANSES, Université Paris-Est, Maisons-Alfort, F-94700, France
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Paquet C, Yudin MH. No. 285-Toxoplasmosis in Pregnancy: Prevention, Screening, and Treatment. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2019; 40:e687-e693. [PMID: 30103893 DOI: 10.1016/j.jogc.2018.05.036] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND One of the major consequences of pregnant women becoming infected by Toxoplasma gondii is vertical transmission to the fetus. Although rare, congenital toxoplasmosis can cause severe neurological or ocular disease (leading to blindness), as well as cardiac and cerebral anomalies. Prenatal care must include education about prevention of toxoplasmosis. The low prevalence of the disease in the Canadian population and limitations in diagnosis and therapy limit the effectiveness of screening strategies. Therefore, routine screening is not currently recommended. OBJECTIVE To review the prevention, diagnosis, and management of toxoplasmosis in pregnancy. OUTCOMES Outcomes evaluated include the effect of screening on diagnosis of congenital toxoplasmosis and the efficacy of prophylaxis and treatment. EVIDENCE The Cochrane Library and Medline were searched for articles published in English from 1990 to the present related to toxoplasmosis and pregnancy. Additional articles were identified through references of these articles. VALUES The quality of evidence is rated and recommendations made according to guidelines developed by the Canadian Task Force on Preventive Health Care (Table 1). BENEFITS, HARMS, AND COSTS Guideline implementation should assist the practitioner in developing an approach to screening for and treatment of toxoplasmosis in pregnancy. Patients will benefit from appropriate management of this condition. SPONSOR The Society of Obstetricians and Gynaecologists of Canada. RECOMMENDATIONS
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Prevalence of Toxoplasma gondii Infection in Healthy Volunteer Blood Donors Using Serological and Molecular Methods from Chaharmahal and Bakhtiari Province, Southwest Iran. Jundishapur J Microbiol 2019. [DOI: 10.5812/jjm.91042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Yamada H, Tanimura K, Deguchi M, Tairaku S, Morizane M, Uchida A, Ebina Y, Nishikawa A. A cohort study of maternal screening for congenital Toxoplasma gondii infection: 12 years' experience. J Infect Chemother 2019; 25:427-430. [PMID: 30824301 DOI: 10.1016/j.jiac.2019.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/11/2019] [Accepted: 01/21/2019] [Indexed: 10/27/2022]
Abstract
Primary infection with Toxoplasma gondii (T. gondii) during pregnancy may cause congenital infection of the infant. This study evaluated whether screening using IgG avidity and multiplex-nested polymerase chain reaction (PCR) methods was effective for detecting a high-risk pregnancy for congenital T. gondii infection. In a prospective cohort study serum T. gondii IgG avidity was measured in 469 pregnant women who had a positive test for T. gondii antibody plus a positive or equivocal test for IgM. Multiplex-nested PCR for T. gondii DNA on amniotic fluid, maternal blood, and neonatal blood was performed with informed consent. Low (<30%), borderline (30-35%), and high (>35%) IgG avidity indices were found in 104 (22.2%), 30 (6.4%), and 305 (71.4%), respectively. A total of 12 cases had a positive PCR test for amniotic fluids of the prenatal amniocentesis or at birth, or neonatal blood. Seven of the 12 cases were diagnosed as having congenital T. gondii infection, and they had low IgG avidity indices. Congenital T. gondii infection screening using of IgG avidity and multiplex-nested PCR methods for pregnant women with a positive test for T. gondii antibody plus a positive or equivocal test for T. gondii IgM was useful for detecting a high-risk pregnancy and diagnosing congenital T. gondii infection.
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Affiliation(s)
- Hideto Yamada
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Kenji Tanimura
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masashi Deguchi
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shinya Tairaku
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Mayumi Morizane
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akiko Uchida
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yasuhiko Ebina
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akira Nishikawa
- NTT East Sapporo Medical Center, Japan; Nishikawa Women's Health Clinic, Sapporo, Japan
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Role of Toxoplasma IgA as Part of a Reference Panel for the Diagnosis of Acute Toxoplasmosis during Pregnancy. J Clin Microbiol 2019; 57:JCM.01357-18. [PMID: 30463899 PMCID: PMC6355551 DOI: 10.1128/jcm.01357-18] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 11/19/2018] [Indexed: 01/27/2023] Open
Abstract
This study evaluated the usefulness of adding the Toxoplasma gondii IgA antibody enzyme-linked immunosorbent assay (ELISA) to the serologic panel of tests done for the diagnosis of acute toxoplasmosis in pregnant women in a reference laboratory in the United States. We conducted a retrospective study of 690 consecutive pregnant women with positive T. gondii IgG antibody test results who also had T. gondii IgA and IgM antibody tests performed. This study evaluated the usefulness of adding the Toxoplasma gondii IgA antibody enzyme-linked immunosorbent assay (ELISA) to the serologic panel of tests done for the diagnosis of acute toxoplasmosis in pregnant women in a reference laboratory in the United States. We conducted a retrospective study of 690 consecutive pregnant women with positive T. gondii IgG antibody test results who also had T. gondii IgA and IgM antibody tests performed. Patients were defined as acutely or chronically infected with T. gondii based on a panel of serologic tests performed at the Palo Alto Medical Foundation Toxoplasma Serology Laboratory (PAMF-TSL). Among the 81 women who were positive by T. gondii IgA antibody ELISA testing, 61 (75.3%) were acutely infected with T. gondii, while of the 547 who were negative by IgA testing, only 24 (4.4%) were acutely infected (P < 0.001). Among the 71 women who were positive by both IgA and IgM antibody tests, 61 (85.9%) were acutely infected, whereas 24 (19.2%) of the 125 women who were positive by only the IgM ELISA were acutely infected (P < 0.001). These results demonstrate that pregnant women with T. gondii IgA antibodies are more likely than pregnant women without T. gondii IgA antibodies to have had a recent infection with T. gondii. Toxoplasma IgA antibody testing can therefore improve the accuracy of a serologic panel for the diagnosis of acute toxoplasmosis during pregnancy. Physicians who ordered testing only for T. gondii IgG and IgM should also request additional testing for IgA and IgG avidity, if both IgG and IgM are positive. This further testing should, ideally, be performed in a reference laboratory.
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Paquet C, Yudin MH. No 285 - Toxoplasmose pendant la grossesse : Prévention, dépistage et traitement. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2018; 40:e694-e702. [DOI: 10.1016/j.jogc.2018.05.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Alvarado-Esquivel C, Sánchez-Anguiano LF, Hernández-Tinoco J, Ramos-Nevarez A, Estrada-Martínez S, Cerrillo-Soto SM, Medina-Heredia GE, Guido-Arreola CA, Soto-Quintero AA, Beristain-Garcia I. Association between Toxoplasma gondii infection and history of blood transfusion: a case-control seroprevalence study. J Int Med Res 2018; 46:1626-1633. [PMID: 29490516 PMCID: PMC6091851 DOI: 10.1177/0300060518757928] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objectives This study was performed to determine the association between seropositivity to Toxoplasma gondii and a history of blood transfusion. Methods Patients who had undergone blood transfusion (n = 410) and age- and sex-matched controls who had not undergone blood transfusion (n = 1230) were examined for anti-T. gondii IgG and IgM antibodies using enzyme-linked immunoassays. Results Anti-T. gondii IgG antibodies were detected in 57 (13.9%) patients and in 129 (10.5%) controls with a borderline difference [odds ratio (OR) = 1.37, 95% confidence interval (CI) = 0.98–1.92]. High anti-T. gondii IgG antibody levels (>150 IU/mL) were found in 27 (47.4%) of the 57 anti-T. gondii IgG-positive patients and in 37 (28.7%) of the 129 anti-T. gondii IgG positive controls with a significant difference (OR = 2.23, 95% CI = 1.17–4.26). Anti-T. gondii IgM antibodies were found in 13 (22.8%) of the 57 seropositive patients and in 37 (28.7%) of the 129 seropositive controls, but the difference was not significant (OR = 0.73, 95% CI = 0.35–1.52). Seroprevalence was significantly higher in patients aged >50 years than in controls of the same age and in female patients than in female controls. Conclusions These findings indicate that a history of blood transfusion is a risk factor for T. gondii infection.
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Affiliation(s)
- Cosme Alvarado-Esquivel
- 1 Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Avenida Universidad, Durango, Mexico
| | - Luis Francisco Sánchez-Anguiano
- 2 Institute for Scientific Research "Dr. Roberto Rivera-Damm," Juárez University of Durango State, Avenida Universidad, Durango, Mexico
| | - Jesús Hernández-Tinoco
- 2 Institute for Scientific Research "Dr. Roberto Rivera-Damm," Juárez University of Durango State, Avenida Universidad, Durango, Mexico
| | - Agar Ramos-Nevarez
- 3 Clínica de Medicina Familiar, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Predio Canoas, Durango, Mexico
| | - Sergio Estrada-Martínez
- 2 Institute for Scientific Research "Dr. Roberto Rivera-Damm," Juárez University of Durango State, Avenida Universidad, Durango, Mexico
| | - Sandra Margarita Cerrillo-Soto
- 3 Clínica de Medicina Familiar, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Predio Canoas, Durango, Mexico
| | | | - Carlos Alberto Guido-Arreola
- 3 Clínica de Medicina Familiar, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Predio Canoas, Durango, Mexico
| | | | - Isabel Beristain-Garcia
- 4 Facultad de Enfermería y Obstetricia, Juárez University of Durango State, Cuauhtémoc, Norte, Durango, Mexico
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Chan T, Shannon PT, Detsky ME. An unexpected but underestimated case of disseminated toxoplasmosis. Transpl Infect Dis 2018; 20. [PMID: 29156082 DOI: 10.1111/tid.12818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 05/24/2017] [Accepted: 08/13/2017] [Indexed: 11/28/2022]
Abstract
Toxoplasma gondii is a ubiquitous intracellular parasite that can cause disseminated infection following reactivation in immunocompromised hosts. We describe a 58-year-old man who died of refractory shock because of disseminated toxoplasmosis. The diagnosis was only made postmortem on autopsy. We discuss the importance of considering toxoplasmosis on the differential diagnosis in high-risk patients, and review the role of screening and chemoprophylaxis in preventing infection.
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Affiliation(s)
- Tiffany Chan
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Michael E Detsky
- Interdepartmental Division of Critical Care Medicine, Mount Sinai Hospital, Toronto, ON, Canada
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Rostami A, Karanis P, Fallahi S. Advances in serological, imaging techniques and molecular diagnosis of Toxoplasma gondii infection. Infection 2018; 46:303-315. [PMID: 29330674 DOI: 10.1007/s15010-017-1111-3] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 12/22/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Toxoplasmosis is worldwide distributed zoonotic infection disease with medical importance in immunocompromised patients, pregnant women and congenitally infected newborns. Having basic information on the traditional and new developed methods is essential for general physicians and infectious disease specialists for choosing a suitable diagnostic approach for rapid and accurate diagnosis of the disease and, consequently, timely and effective treatment. METHODS We conducted English literature searches in PubMed from 1989 to 2016 using relevant keywords and summarized the recent advances in diagnosis of toxoplasmosis. RESULTS Enzyme-linked immunosorbent assay (ELISA) was most used method in past century. Recently advanced ELISA-based methods including chemiluminescence assays (CLIA), enzyme-linked fluorescence assay (ELFA), immunochromatographic test (ICT), serum IgG avidity test and immunosorbent agglutination assays (ISAGA) have shown high sensitivity and specificity. Recent studies using recombinant or chimeric antigens and multiepitope peptides method demonstrated very promising results to development of new strategies capable of discriminating recently acquired infections from chronic infection. Real-time PCR and loop-mediated isothermal amplification (LAMP) are two recently developed PCR-based methods with high sensitivity and specificity and could be useful to early diagnosis of infection. Computed tomography, magnetic resonance imaging, nuclear imaging and ultrasonography could be useful, although their results might be not specific alone. CONCLUSION This review provides a summary of recent developed methods and also attempts to improve their sensitivity for diagnosis of toxoplasmosis. Serology, molecular and imaging technologies each has their own advantages and limitations which can certainly achieve definitive diagnosis of toxoplasmosis by combining these diagnostic techniques.
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Affiliation(s)
- Ali Rostami
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Panagiotis Karanis
- Qinghai Academy of Animal Science and Veterinary Medicine, Qinghai University, Xining, China
| | - Shirzad Fallahi
- Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran. .,Department of Medical Parasitology and Mycology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.
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Alvarado-Esquivel C, Rico-Almochantaf YDR, Sanchez-Anguiano LF, Quinones-Canales G, Hernandez-Tinoco J, Torres-Gonzalez J, Gonzalez-Silva MF, Ramirez-Valles EG. Toxoplasma gondii Infection and Headache: A Matched Case-Control Study in a Public Hospital in Durango City, Mexico. J Clin Med Res 2017; 10:27-31. [PMID: 29238431 PMCID: PMC5722042 DOI: 10.14740/jocmr3236w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 10/31/2017] [Indexed: 11/11/2022] Open
Abstract
Background Toxoplasma gondii (T. gondii) can disseminate to brain in infected hosts. Little is known about the magnitude of the association between this infection and headache. Therefore, we sought to determine the association of T. gondii seropositivity and headache in patients attending neurological consultations in a public hospital in Durango City, Mexico. Methods Through an age- and gender-matched case-control study, 105 patients suffering from headache and 105 subjects without headache were examined for anti-T. gondii IgG and IgM antibodies using commercially available enzyme-linked immunoassays. Seropositive cases were analyzed for detection of T. gondii DNA by polymerase chain reaction. Results Anti-T. gondii IgG antibodies were found in five (4.8%) of the 105 cases and in seven (6.7%) of the 105 controls (odds ratio (OR) = 0.70; 95% confidence interval (CI): 0.21 - 2.28; P = 0.76). The frequency of high (> 150 IU/mL) levels of anti-T. gondii IgG antibodies among anti-T. gondii IgG positive individuals was significantly (P = 0.01) higher in cases (5/5) than in controls (1/7). Anti-T. gondii IgM antibodies were found in one (20.0%) of the five IgG seropositive cases, and in three (42.9%) of the seven IgG seropositive controls (P = 0.60). T. gondii DNA was not detected in any of the five anti-T. gondii IgG positive cases. No association between T. gondii infection and specific headache types was found. Conclusions This is the first matched case-control study on the association between T. gondii infection and headache. Results suggest that high anti-T. gondii IgG antibody levels, but not T. gondii seropositivity, were associated with headache in the population studied.
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Affiliation(s)
- Cosme Alvarado-Esquivel
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Yazmin Del Rosario Rico-Almochantaf
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Luis Francisco Sanchez-Anguiano
- Institute for Scientific Research "Dr. Roberto Rivera-Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Gerardo Quinones-Canales
- Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado, Predio Canoas S/N, 34000 Durango, Mexico
| | - Jesus Hernandez-Tinoco
- Institute for Scientific Research "Dr. Roberto Rivera-Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Jorge Torres-Gonzalez
- Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado, Predio Canoas S/N, 34000 Durango, Mexico
| | - Maria Felix Gonzalez-Silva
- Faculty of Chemical Sciences, Juarez University of Durango State, Avenida Veterinaria S/N, 34120 Durango, Mexico
| | - Eda Guadalupe Ramirez-Valles
- Faculty of Chemical Sciences, Juarez University of Durango State, Avenida Veterinaria S/N, 34120 Durango, Mexico
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Iddawela D, Vithana SMP, Ratnayake C. Seroprevalence of toxoplasmosis and risk factors of Toxoplasma gondii infection among pregnant women in Sri Lanka: a cross sectional study. BMC Public Health 2017; 17:930. [PMID: 29202747 PMCID: PMC5716377 DOI: 10.1186/s12889-017-4941-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 11/22/2017] [Indexed: 02/02/2023] Open
Abstract
Background Toxoplasma gondii is an intracellular protozoan infecting humans and animals. Infection in adults usually causes mild disease but greater importance lies in preventing transplacental transmission which can cause major foetal anomalies and is vital to identify infection in pregnancy. Research on this regard in Sri Lanka is scarce and would be beneficial in developing antenatal care strategies for improved foetal outcome. Methods A random sample of 536 pregnant women attending antenatal care in Teaching Hospital Peradeniya from 2010 to 2013 was recruited for this study. Blood samples were tested for Toxoplasma gondii IgG and IgM antibodies from the participants by using a commercial ELISA kit with a cut-off OD value of >1 and a structured questionnaire was used to identify the exposure to risk. Bivariate analysis using the Chi Square test was used to calculate associations between documented risk factors and seropositivity and a p value of <0.05 was taken as significant. Results Among the participants 160 (29.9%) were positive for T. gondii IgG antibodies and 2 (0.37%) were IgM positive. The seroprevalence in the first, second and third trimesters were 30.4%, 30.6% and 26.1% respectively. Of the risk factors studied, preparation and selling raw meat (p = 0.05) and household gardening (p = 0.01) were significant whereas the presence of domesticated cats and dogs, eating locally produced meat or dairy products did not show significant associations. Conclusions Seroprevalence of T. gondii present among pregnant women attending antenatal care in Peradeniya was 29.9% indicating high level of transmission among the study population. However 70.1% of the study population were seronegative and were susceptible to primary acute infection during pregnancy and possible foetal anomalies. Therefore implementing health education especially on the aforementioned risk factors is recommended.
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Affiliation(s)
- Devika Iddawela
- Department of Parasitology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | | | - Chathura Ratnayake
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
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Knowledge and Practices of Toxoplasmosis among Clinical Laboratory Professionals: A Cross-Sectional Study in Durango, Mexico. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111413. [PMID: 29156547 PMCID: PMC5708052 DOI: 10.3390/ijerph14111413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 11/15/2017] [Accepted: 11/15/2017] [Indexed: 11/16/2022]
Abstract
Background: The aim of this study was to determine the level of knowledge and practices about toxoplasmosis in a sample of clinical laboratory professionals in Mexico. Methods: 192 clinical laboratory professionals were surveyed. They were asked about (1) Toxoplasma gondii; (2) clinical manifestations, diagnosis, treatment, and epidemiology of toxoplasmosis; and (3) their practices with respect to toxoplasmosis. Results: The range of animals infected by T. gondii was known by 44.8% of participants. Clinical aspects of toxoplasmosis were known by up to 44.3% of subjects. Correct answers about the interpretation of serological markers of T. gondii infection were provided by up to 32.8% of participants. A minority (32.2%) of participants knew about a high number of false positive results of anti-T. gondii IgM antibody tests. Most participants (90.1%) did not know what the anti-T. gondii IgG avidity test was. Up to 55.7% of participants provided incorrect answers about the interpretation of serology tests for the treatment of pregnant women. Common routes of T. gondii infection were known by <15% of participants. Most (84.4%) participants had not performed tests for detection T. gondii infection. Conclusions: Results indicate incomplete knowledge of T. gondii infection and toxoplasmosis and a limited practice of laboratory tests among the professionals surveyed.
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Evaluation of a New Immunochromatography Technology Test (LDBio Diagnostics) To Detect Toxoplasma IgG and IgM: Comparison with the Routine Architect Technique. J Clin Microbiol 2017; 55:3395-3404. [PMID: 28954897 DOI: 10.1128/jcm.01106-17] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 09/08/2017] [Indexed: 11/20/2022] Open
Abstract
A study comparing the ICT (immunochromatography technology) Toxoplasma IgG and IgM rapid diagnostic test (LDBio Diagnostics, France) with a fully automated system, Architect, was performed on samples from university hospitals of Marseille and Saint-Etienne. A total of 767 prospective sera and 235 selected sera were collected. The panels were selected to test various IgG and IgM parameters. The reference technique, Toxoplasma IgGII Western blot analysis (LDBio Diagnostics), was used to confirm the IgG results, and commercial kits Platelia Toxo IgM (Bio-Rad) and Toxo-ISAgA (bioMérieux) were used in Saint-Etienne and Marseille, respectively, as the IgM reference techniques. Sensitivity and specificity of the ICT and the Architect IgG assays were compared using a prospective panel. Sensitivity was 100% for the ICT test and 92.1% for Architect (cutoff at 1.6 IU/ml). The low-IgG-titer serum results confirmed that ICT sensitivity was superior to that of Architect. Specificity was 98.7% (ICT) and 99.8% (Architect IgG). The ICT test is also useful for detecting IgM without IgG and is both sensitive (100%) and specific (100%), as it can distinguish nonspecific IgM from specific Toxoplasma IgM. In comparison, IgM sensitivity and specificity on Architect are 96.1% and 99.6%, respectively (cutoff at 0.5 arbitrary units [AU]/ml). To conclude, this new test overcomes the limitations of automated screening techniques, which are not sensitive enough for IgG and lack specificity for IgM (rare IgM false-positive cases).
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Berredjem H, Aouras H, Benlaifa M, Becheker I, Djebar MR. Contribution of IgG avidity and PCR for the early diagnosis of toxoplasmosis in pregnant women from the North-Eastern region of Algeria. Afr Health Sci 2017; 17:647-656. [PMID: 29085392 PMCID: PMC5656190 DOI: 10.4314/ahs.v17i3.7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background Acute toxoplasmosis in pregnant women presents a high risk of Toxoplasma transmission to the fetus. Early diagnosis is difficult, especially when serological testing for IgG/IgM antibodies fail to differentiate between a recent and a past infection. In this case, we rely on IgG avidity or PCR assays. Objectives The aim of this study was to compare conventional ELISA and IgG avidity, with PCR using B1 and P30 primers for the early diagnosis of toxoplasmosis in pregnant women. Methods Sera were collected from 143 pregnant women and measured by ELISA for anti-Toxoplasma IgG, IgM, IgA and IgG avidity. DNA was extracted from 57 peripheral blood and 14 amniotic fluid samples for PCR amplification. Results A total of 57 out 143 women were seropositive: 30 (52.6%) were IgG+/IgM− and 27 (43.8%) were IgG+/IgM+; IgA antibodies were positive in 7 (12.2%) cases. IgG avidity was low in 9 women suggesting an acute infection; 3 women presented an intermediate avidity. PCR detected Toxoplasma DNA in 9 women presenting low avidity and was negative for the intermediate avidity cases. Conclusion PCR combined to avidity IgG performed better than ELISA IgG, IgM and/or IgA assays alone. PCR was useful in the case of intermediate avidity.
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Affiliation(s)
- Hajira Berredjem
- Department of Biochemistry, Faculty of Sciences, University of Badji Mokhtar, Annaba, Algeria
- Laboratory of Cellular Toxicology, Faculty of Sciences, University of Badji Mokhtar, Annaba, Algeria
| | - Hayette Aouras
- Service of Gynecology, EHS Abdallah Nouaouria Hospital, El Bouni-Annaba, Algeria
| | - Meriem Benlaifa
- Laboratory of Cellular Toxicology, Faculty of Sciences, University of Badji Mokhtar, Annaba, Algeria
| | - Imène Becheker
- Department of Biochemistry, Faculty of Sciences, University of Badji Mokhtar, Annaba, Algeria
| | - Mohamed Reda Djebar
- Laboratory of Cellular Toxicology, Faculty of Sciences, University of Badji Mokhtar, Annaba, Algeria
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Evaluation of serological and molecular tests used to identify Toxoplasma gondii infection in pregnant women attended in a public health service in São Paulo state, Brazil. Diagn Microbiol Infect Dis 2017; 89:13-19. [PMID: 28689893 DOI: 10.1016/j.diagmicrobio.2017.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 06/07/2017] [Accepted: 06/09/2017] [Indexed: 11/23/2022]
Abstract
Toxoplasmosis during pregnancy can have severe consequences. The use of sensitive and specific serological and molecular methods is extremely important for the correct diagnosis of the disease. We compared the ELISA and ELFA serological methods, conventional PCR (cPCR), Nested PCR and quantitative PCR (qPCR) in the diagnosis of Toxoplasma gondii infection in pregnant women without clinical suspicion of toxoplasmosis (G1=94) and with clinical suspicion of toxoplasmosis (G2=53). The results were compared using the Kappa index, and the sensitivity, specificity, positive predictive value and negative predictive value were calculated. The results of the serological methods showed concordance between the ELISA and ELFA methods even though ELFA identified more positive cases than ELISA. Molecular methods were discrepant with cPCR using B22/23 primers having greater sensitivity and lower specificity compared to the other molecular methods.
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Lee SH, Lee DH, Piao Y, Moon EK, Quan FS. Influenza M1 Virus-Like Particles Consisting of Toxoplasma gondii Rhoptry Protein 4. THE KOREAN JOURNAL OF PARASITOLOGY 2017; 55:143-148. [PMID: 28506036 PMCID: PMC5450957 DOI: 10.3347/kjp.2017.55.2.143] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 03/02/2017] [Accepted: 03/11/2017] [Indexed: 01/13/2023]
Abstract
Toxoplasma gondii infections occur throughout the world, and efforts are needed to develop various vaccine candidates expressing recombinant protein antigens. In this study, influenza matrix protein (M1) virus-like particles (VLPs) consisting of T. gondii rhoptry antigen 4 (ROP4 protein) were generated using baculovirus (rBV) expression system. Recombinant ROP4 protein with influenza M1 were cloned and expressed in rBV. SF9 insect cells were coinfected with recombinant rBVs expressing T. gondii ROP4 and influenza M1. As the results, influenza M1 VLPs showed spherical shapes, and T. gondii ROP4 protein exhibited as spikes on VLP surface under transmission electron microscopy (TEM). The M1 VLPs resemble virions in morphology and size. We found that M1 VLPs reacted with antibody from T. gondii-infected mice by western blot and ELISA. This study demonstrated that T. gondii ROP4 protein can be expressed on the surface of influenza M1 VLPs and the M1 VLPs containing T. gondii ROP4 reacted with T. gondii-infected sera, indicating the possibility that M1 VLPs could be used as a coating antigen for diagnostic and/or vaccine candidate against T. gondii infection.
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Affiliation(s)
- Su-Hwa Lee
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul 02447, Korea
| | - Dong-Hun Lee
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul 02447, Korea
| | - Ying Piao
- Department of Emergency, Yanbian University Hospital, Yanji City, P. R. China
| | - Eun-Kyung Moon
- Department of Medical Zoology, Kyung Hee University School of Medicine, Seoul 02447, Korea
| | - Fu-Shi Quan
- Department of Medical Zoology, Kyung Hee University School of Medicine, Seoul 02447, Korea
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Lack of association between Toxoplasma gondii exposure and depression in pregnant women: a case-control study. BMC Infect Dis 2017; 17:190. [PMID: 28264662 PMCID: PMC5340021 DOI: 10.1186/s12879-017-2292-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 02/28/2017] [Indexed: 11/10/2022] Open
Abstract
Background Very little is known about the link of T. gondii infection and depression. Through an age-, gender-, and month of pregnancy-matched case-control study, we determined the association of T. gondii infection and depression in pregnant women. Methods We studied 200 pregnant women with depression and 200 pregnant women without depression attended in a public hospital in Durango City, Mexico. Pregnant women were tested for the presence of anti-Toxoplasma IgG antibodies using an enzyme-linked immunoassay (EIA), and IgG seropositive women were further tested for the presence of IgM using an EIA. IgM positivity by EIA was further analyzed by enzyme-linked fluorescence assay (ELFA). Results Anti-T. gondii IgG antibodies were found in 9 (4.5%) of the 200 cases and in 12 (6.0%) of the 200 controls (OR = 0.73; 95% CI: 0.30–1.79; P = 0.50). The frequency of high (>150 IU/ml) anti-T. gondii IgG levels was similar in cases and in controls (OR = 1.20; 95% CI: 0.36–4.01; P = 0.75). Two women were positive for IgM by EIA but both were negative by ELFA. Conclusions We did not find serological evidence of an association between T. gondii infection and depression in pregnant women attended in a public hospital in Durango City, Mexico. Since an association of T. gondii and depression in pregnancy has been reported in the U.S. previously, further research to elucidate the role of T. gondii in prenatal depression should be conducted. Electronic supplementary material The online version of this article (doi:10.1186/s12879-017-2292-1) contains supplementary material, which is available to authorized users.
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Mahdy MAK, Alareqi LMQ, Abdul-Ghani R, Al-Eryani SMA, Al-Mikhlafy AA, Al-Mekhlafi AM, Alkarshy F, Mahmud R. A community-based survey of Toxoplasma gondii infection among pregnant women in rural areas of Taiz governorate, Yemen: the risk of waterborne transmission. Infect Dis Poverty 2017; 6:26. [PMID: 28190399 PMCID: PMC5304399 DOI: 10.1186/s40249-017-0243-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 01/13/2017] [Indexed: 11/10/2022] Open
Abstract
Background Toxoplasma gondii is a zoonotic coccidian parasite causing morbidity and mortality. In Yemen, T. gondii infection has been reported among pregnant women seeking healthcare in the main cities. However, no data are available on the prevalence of T. gondii infection and its associated risk factors among pregnant women in the rural communities of the country. Thus, the present study aimed to determine the seroprevalence of T. gondii and identify its risk factors among pregnant women in the rural communities of Taiz governorate, Yemen. Methods A total of 359 pregnant women living in the rural communities of Taiz governorate were enrolled in this study by house-to-house visits. Data were collected using a pre-designed questionnaire, and blood samples were collected and tested for the detection of anti- T. gondii IgM and IgG antibodies by enzyme-linked immunosorbent assay. Results The prevalence of T. gondii infection among pregnant women in this study was 46.2% (166/359). Bivariate analysis identified the age of ≥ 30 years (odds ratio [OR] = 1.7; 95% confidence interval [CI] = 1.09–2.65, P = 0.019) and unimproved water sources (OR = 2.2; 95% CI = 1.10–4.55, P = 0.023) as factors associated with T. gondii infection among pregnant women. The multivariable analysis, however, identified unimproved water sources as an independent risk factor (adjusted OR = 2.4; 95% CI = 1.16–5.0, P = 0.018) associated with T. gondii infection among pregnant women. Conclusions Pregnant women in the rural communities of Taiz, Yemen are at high risk of contracting T. gondii infection. Unimproved water sources (wells, water streams and water tanks) are significantly associated with T. gondii infection and should be considered in prevention and control strategies, especially among pregnant women. Electronic supplementary material The online version of this article (doi:10.1186/s40249-017-0243-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mohammed A K Mahdy
- Tropical Disease Research Center, University of Science and Technology, Sana'a, Yemen. .,Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen.
| | - Lina M Q Alareqi
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Rashad Abdul-Ghani
- Tropical Disease Research Center, University of Science and Technology, Sana'a, Yemen.,Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
| | - Samira M A Al-Eryani
- Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
| | - Abdullah A Al-Mikhlafy
- Department of Community Medicine, Faculty of Medicine, University of Science and Technology, Sana'a, Yemen
| | - Abdulsalam M Al-Mekhlafi
- Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
| | - Fawzya Alkarshy
- Yemeni-Swedish Hospital, Ministry of Public Health and Population, Taiz, Yemen
| | - Rohela Mahmud
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
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Toxoplasmose pendant la grossesse : Prévention, dépistage et traitement. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2017; 38:S189-S196. [PMID: 28063534 DOI: 10.1016/j.jogc.2016.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Anti- Toxoplasma gondii IgG avidity testing is necessary for diagnosis of acute toxoplasmosis. J Taibah Univ Med Sci 2017; 12:87-88. [PMID: 31435220 PMCID: PMC6695034 DOI: 10.1016/j.jtumed.2016.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 11/18/2016] [Accepted: 11/20/2016] [Indexed: 11/22/2022] Open
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Help in the Choice of Automated or Semiautomated Immunoassays for Serological Diagnosis of Toxoplasmosis: Evaluation of Nine Immunoassays by the French National Reference Center for Toxoplasmosis. J Clin Microbiol 2016; 54:3034-3042. [PMID: 27733631 DOI: 10.1128/jcm.01193-16] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 09/28/2016] [Indexed: 11/20/2022] Open
Abstract
Toxoplasmosis, a benign infection, is asymptomatic or paucisymptomatic in over 80% of cases, except in immunocompetent patients suffering from ocular toxoplasmosis or in immunocompromised patients with opportunistic or congenital toxoplasmosis. Diagnosis is based mainly on serology testing. Thus, we compared the performance of the nine most commonly used commercial automated or semiautomated immunoassays for IgG and IgM Toxoplasma gondii antibody detection, that is, the Advia Centaur, Architect, AxSYM, Elecsys, Enzygnost, Liaison, Platelia, VIDAS, and VIDIA assays. The assays were conducted on four panels of serum samples derived during routine testing from patients with an interfering disease and who exhibited a low IgG antibody level in one of two clinical settings, namely, acute or chronic toxoplasmosis. As a result, IgG sensitivities ranged from 97.1% to 100%, and IgG specificities ranged from 99.5% to 100%. For IgG quantification, strong differences in IgG titers (expressed in IU/ml) were noted depending on the assay used. IgM sensitivities ranged from 65% to 97.9%, and IgM specificities ranged from 92.6% to 100%. For defining the best serological strategies to be implemented, it appears crucial to compare the diagnostic performance of the different tests with respect to their specificity and sensitivity in detecting the presence of IgG and IgM antibodies.
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Zhang K, Lin G, Han Y, Li J. Serological diagnosis of toxoplasmosis and standardization. Clin Chim Acta 2016; 461:83-9. [DOI: 10.1016/j.cca.2016.07.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 07/19/2016] [Accepted: 07/23/2016] [Indexed: 11/26/2022]
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Mohammadpour N, Saki J, Rafiei A, Khodadadi A, Tavalla M, Cheraghian B. Design of Indigenous ELISA Using Tachyzoites from the RH Strain of Toxoplasma gondii and Comparison with Commercial Kits in Ahvaz, Southwest of Iran, 2015. Jundishapur J Microbiol 2016; 9:e36666. [PMID: 27942363 PMCID: PMC5136452 DOI: 10.5812/jjm.36666] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 06/07/2016] [Accepted: 09/06/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Toxoplasma gondii is one of the most common causes of latent infections in humans worldwide. Detecting anti-Toxoplasma antibodies in serum using serological tests is a common method to diagnose toxoplasmosis. OBJECTIVES In the present study, an indigenous ELISA kit was prepared using tachyzoites from the RH strain of T. gondii, and its sensitivity and specificity were compared with those of commercial kits. METHODS To produce antigens, 0.02 mL of locally isolated T. gondii RH strain parasites along with 109 tachyzoites were injected into the peritoneal cavities of 50 laboratory mice (BALB/C). Parasites were collected after 4 days. After filtering and washing, the concentration of protein in sonicated tachyzoites was calculated using the Lowry protein assay. The dilution of antigen, serum and alkaline phosphatase conjugate was assessed in designing an indigenous ELISA method; then ELISA was performed based on these dilutions, and its sensitivity was determined using 200 serum samples. In addition, the specificity of the assay was evaluated using 40 serum samples from patients with tuberculosis, leukemia or hydatid cyst. RESULTS Indigenous ELISA was used to examine 100 serum samples containing anti-T. gondii IgG, with a sensitivity of 98% (commercial kits: 100%). Another 100 serum samples containing anti-T. gondii IgM were also tested, with a sensitivity of 99% (commercial kits: 100%). When 40 serum samples from patients with leukemia, hydatid cyst or tuberculosis were examined using anti-T. gondii IgG, the specificity was 100%, identical to commercial kits. However, the specificity of a similar test with anti-T. gondii IgM was just 28.6% for serum samples from leukemia patients, 21.4% for hydatid cyst and 16.7% for tuberculosis. CONCLUSIONS We found that purified locally isolated soluble crude antigens of the RH strain of T. gondii from the peritoneal cavity of mice may be one of the most promising antigens for detection of human toxoplasmosis in routine screening.
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Affiliation(s)
- Niloofar Mohammadpour
- Department of Medical Parasitology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Jasem Saki
- Department of Medical Parasitology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Corresponding author: Jasem Saki, Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran. Tel: +98-9127166933, E-mail:
| | - Abdollah Rafiei
- Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Ali Khodadadi
- Department of Immunology, School of Medicine , Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Mehdi Tavalla
- Department of Medical Parasitology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Bahman Cheraghian
- Department of Epidemiology and Biostatistics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
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Twenty-six circulating antigens and two novel diagnostic candidate molecules identified in the serum of canines with experimental acute toxoplasmosis. Parasit Vectors 2016; 9:374. [PMID: 27357215 PMCID: PMC4928332 DOI: 10.1186/s13071-016-1643-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 06/13/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The protozoan Toxoplasma gondii is a pathogen that causes severe opportunistic disease in a wide range of hosts. Efficient methods to diagnose acute T. gondii infection are essential for the administration of appropriate treatments and to reduce economic losses. In animals with acute infections, circulating antigens (CAgs) were detected as early as two days post-infection; these CAgs were reliable diagnostic indicators of acute infection. However, only a limited number of CAgs have been identified to date. The objective of this study was to identify a broader spectrum of CAgs and to explore novel diagnostic candidates in serum. METHODS A canine model of acute toxoplasmiosis was established. For this purpose, six dogs were infected by intraperitoneal inoculation of tachyzoites. The CAgs spectrum in the serum was identified with the immunoprecipitation-shotgun approach. Two CAgs with low homology to other species, coronin protein (TgCOR) and ELMO protein (TgELMO), were heterologously expressed in Escherichia coli. Polyclonal antibodies against these two proteins were prepared, and the presence of these proteins in the serum was verified by Western blotting. The two CAgs were detected and evaluated by indirect ELISA methods. RESULTS The CAgs levels peaked between two and five days after inoculation, and twenty-six CAgs were identified. Western blotting showed the presence of the two proteins in the serum during acute infection. Based on ELISA tests, the two CAgs were detected during acute infection. CONCLUSIONS We identified twenty-six CAgs in the serum of canines with experimental acute toxoplasmosis and discovered two novel diagnostic candidates. We also provide new insights into the diagnosis of acute toxoplasmosis.
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