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Li Y, Yang HS, Klasse PJ, Zhao Z. The significance of antigen-antibody-binding avidity in clinical diagnosis. Crit Rev Clin Lab Sci 2024:1-15. [PMID: 39041650 DOI: 10.1080/10408363.2024.2379286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 07/09/2024] [Indexed: 07/24/2024]
Abstract
Immunoglobulin G (IgG) and immunoglobulin M (IgM) testing are commonly used to determine infection status. Typically, the detection of IgM indicates an acute or recent infection, while the presence of IgG alone suggests a chronic or past infection. However, relying solely on IgG and IgM antibody positivity may not be sufficient to differentiate acute from chronic infections. This limitation arises from several factors. The prolonged presence of IgM can complicate diagnostic interpretations, and false positive IgM results often arise from antibody cross-reactivity with various antigens. Additionally, IgM may remain undetectable in prematurely collected samples or in individuals who are immunocompromised, further complicating accurate diagnosis. As a result, additional diagnostic tools are required to confirm infection status. Avidity is a measure of the strength of the binding between an antigen and antibody. Avidity-based assays have been developed for various infectious agents, including toxoplasma, cytomegalovirus (CMV), SARS-CoV-2, and avian influenza, and are promising tools in clinical diagnostics. By measuring the strength of antibody binding, they offer critical insights into the maturity of the immune response. These assays are instrumental in distinguishing between acute and chronic or past infections, monitoring disease progression, and guiding treatment decisions. The development of automated platforms has optimized the testing process by enhancing efficiency and minimizing the risk of manual errors. Additionally, the recent advent of real-time biosensor immunoassays, including the label-free immunoassays (LFIA), has further amplified the capabilities of these assays. These advances have expanded the clinical applications of avidity-based assays, making them useful tools for the diagnosis and management of various infectious diseases. This review is structured around several key aspects of IgG avidity in clinical diagnosis, including: (i) a detailed exposition of the IgG affinity maturation process; (ii) a thorough discussion of the IgG avidity assays, including the recently emerged biosensor-based approaches; and (iii) an examination of the applications of IgG avidity in clinical diagnosis. This review is intended to contribute toward the development of enhanced diagnostic tools through critical assessment of the present landscape of avidity-based testing, which allows us to identify the existing knowledge gaps and highlight areas for future investigation.
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Affiliation(s)
- Yaxin Li
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - He S Yang
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - P J Klasse
- Department of Microbiology and Immunology, Weill Cornell Medicine, New York, NY, USA
| | - Zhen Zhao
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
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2
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Fadhil SH, Saheb EJ. Relationship between the serum level, polymorphism and gene expression of IL-33 in samples of recurrent miscarriage Iraqi women infected with toxoplasmosis. Exp Parasitol 2024:108799. [PMID: 39025462 DOI: 10.1016/j.exppara.2024.108799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 05/20/2024] [Accepted: 07/11/2024] [Indexed: 07/20/2024]
Abstract
One of the many warm-blooded hosts that toxoplasmosis-causing intracellular protozoan parasite Toxoplasma gondii can infect is humans. Cytokines are crucial to stimulate an effective immune response against T. gondii. Interleukin-33 (IL-33) is a unique anti-inflammatory cytokine that suppresses the immune response. The levels of cytokine gene expression are regulated by genetics, and the genetic polymorphisms of these cytokines play a functional role in this process. Single nucleotide polymorphisms (SNPs) are prognostic indicators of illnesses. This study aimed to determine whether toxoplasmosis interacts with serum levels of IL-33 and its SNP in miscarriage women as well as whether serum levels and IL-33 gene expression are related in toxoplasmosis-positive miscarriage women. Two hundred blood samples from patients and controls were collected from AL-Alawiya Maternity Teaching Hospital and AL-Yarmouk Teaching Hospital in Baghdad, Iraq from 2021 to 2022 in order to evaluate the serum level of IL-33 using ELISA test. For the SNP of IL-33, the allelic high-resolution approach was utilized, and real time-PCR was performed to assess gene expression. The results showed that compared to healthy and pregnant women, recurrent miscarriage with toxoplasmosis and recurrent miscarriage women had lower IL-33 concentrations. Additionally, there were significant differences among healthy women, pregnant women, and women with repeated miscarriage who experienced toxoplasmosis. Furthermore, no differences between patients and controls were revealed by gene expression data. The results revealed that recurrent miscarriage, pregnancy, and healthy women all had a slightly higher amount of the IL-33 gene fold. Additionally, the SNP of IL-33 data demonstrated that there was no significant genetic relationship between patients and controls. Recurrent miscarriage women with toxoplasmosis have showed significant differences from pregnant women in the genotypes GG and AA as well as the alleles A and G. There were notable variations between recurrent miscarriage with and without toxoplasmosis in terms of the genotypes AA and AC. The genotypes GG, AA, and allele A in recurrent miscarriage women with toxoplasmosis and recurrent miscarriage women is a protective factor. Taking together, there was a statistically significant negative correlation between toxoplasmosis and IL-33 gene expression, which calls for more quantitative investigation in order to fully comprehend the interaction of mRNA and protein.
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Affiliation(s)
- Sabreen Hadi Fadhil
- Department of Biology, Collage of Science, Baghdad University, Baghdad, Iraq
| | - Entsar Jabbar Saheb
- Department of Biology, Collage of Science, Baghdad University, Baghdad, Iraq.
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Fang M, Li S, Mao Z, Liu X, Wang X, Lu S. A retrospective study on intracranial mixed infection with tuberculous meningitis in Shenzhen, China. Microbiol Spectr 2024; 12:e0374723. [PMID: 38767391 PMCID: PMC11218455 DOI: 10.1128/spectrum.03747-23] [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: 10/22/2023] [Accepted: 04/24/2024] [Indexed: 05/22/2024] Open
Abstract
Tuberculous meningitis (TBM) is a prevalent global intracranial infection and the most lethal and disabling form of tuberculosis. TBM with mixed intracranial infections is clinically rare but has a higher mortality rate. To investigate the clinical characteristics of TBM with mixed intracranial infections, demographic and clinical data of TBM and pulmonary tuberculosis (PTB) patients admitted to Shenzhen Third People's Hospital between January 2015 and October 2022 were collected anonymously. A total of 207 cases of TBM were diagnosed, of which 16 cases (7.73%) were TBM with mixed intracranial infections. The overall mortality rate of TBM cases was 16.4%, while the mortality rate of TBM cases with mixed intracranial infections was as high as 35.7%. Compared to simple TBM cases, TBM cases with mixed intracranial infections had severer clinical symptoms. The percentage of human immune deficiency virus (HIV)-positive TBM cases with mixed intracranial infections reached up to 68.8%. HIV co-infection, CD4+/CD8+ T-cell counts less than 1, cranial nerve impairment, paralysis, cerebral infarction, PRO less than 450 mg/L, WBC less than 10 × 106 /L, and CL more than 120 mmol/L were risk factors for TBM cases with mixed intracranial infections. Compared to PTB, HIV co-infection, CD4+ T cell less than 550 /uL, and age less than 45 years were risk factors for TBM, and TBM was associated with higher mortality rates. Our study provides additional data to better understand single TBM and TBM with mixed intracranial infections. More than two-thirds of TBM cases with mixed intracranial infections were HIV-positive. Clinicians should consider the possibility of multiple infections in people with TBM/HIV co-infection. IMPORTANCE TBM can cause severe neurological damage and death, and TBM with mixed intracranial infections can exacerbate the damage and poor prognosis of the disease. TBM with mixed intracranial infections is a rare disease, which has led to an incomplete understanding of its clinical features. This study investigated the clinical features of TBM and its associated factors by comparing the characteristics of TBM with mixed intracranial infections, single TBM and pulmonary tuberculosis. This information will help to improve the understanding of TBM, diagnostic accuracy and treatment outcomes.
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Affiliation(s)
- Mutong Fang
- Department of Pulmonary Medicine, Shenzhen Third People’s Hospital, Shenzhen, Guangdong, China
| | - Sinian Li
- Department of Pulmonary Medicine, Shenzhen Third People’s Hospital, Shenzhen, Guangdong, China
| | - Zhi Mao
- Department of Pulmonary Medicine, Shenzhen Third People’s Hospital, Shenzhen, Guangdong, China
| | - Xuhui Liu
- Department of Pulmonary Medicine, Shenzhen Third People’s Hospital, Shenzhen, Guangdong, China
| | - Xiaomin Wang
- National Clinical Research Center for Infectious Diseases, Shenzhen Third People’s Hospital, Shenzhen, Guangdong, China
| | - Shuihua Lu
- Department of Pulmonary Medicine, Shenzhen Third People’s Hospital, Shenzhen, Guangdong, China
- National Clinical Research Center for Infectious Diseases, Shenzhen Third People’s Hospital, Shenzhen, Guangdong, China
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Romeo B, Lestra V, Martelli C, Amirouche A, Benyamina A, Hamdani N. The Modulated Role of Toxoplasma gondii on Eosinophils in Psychiatric Disorders after Cannabis Cessation. Pathogens 2023; 12:1333. [PMID: 38003797 PMCID: PMC10675363 DOI: 10.3390/pathogens12111333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/29/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
The aim of our study was to evaluate the impact of T. gondii status on eosinophils count (EOS), the eosinophil-to-lymphocyte ratio (ELR), and the eosinophil-to-neutrophil-to-lymphocytes ratio (ENLR) before and after cannabis cessation in patients with psychiatric disorders. One hundred and eighty-eight patients were included in the study. T. gondii, EOS, ELR, ENLR, and urinary cannabis were measured at baseline and after 4 weeks of cannabis cessation. Highest levels and increase of PNE (p = 0.02), ENLR levels (p = 0.031) and highest level of ELR (p = 0.03) were found in patients after cannabis cessation only in patients positive for T. gondii serology (Toxo+ group). At four weeks, significant interactions between cannabis and T. gondii status for EOS (p = 0.038), and for ENLR (p = 0.043) levels were found, as well as for the evolution between baseline and 4 weeks for ENLR level (p = 0.049). After cannabis cessation, we found a positive correlation between negative symptoms and EOS levels at 4 weeks in the Toxo+ group. This study shows that the increase of inflammation after cannabis cessation might be modulated by T. gondii seropositivity status in patients after cannabis cessation.
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Affiliation(s)
- Bruno Romeo
- Department of Psychiatry and Addictology, Paul Brousse Hospital, APHP, 94800 Villejuif, France; (V.L.); (C.M.); (A.A.); (A.B.)
- Unité de Recherche UR, Psychiatrie-Comorbidités-Addictions (PSYCOMadd), Paris Saclay University, 94800 Villejuif, France;
| | - Valentine Lestra
- Department of Psychiatry and Addictology, Paul Brousse Hospital, APHP, 94800 Villejuif, France; (V.L.); (C.M.); (A.A.); (A.B.)
| | - Catherine Martelli
- Department of Psychiatry and Addictology, Paul Brousse Hospital, APHP, 94800 Villejuif, France; (V.L.); (C.M.); (A.A.); (A.B.)
- Unité de Recherche UR, Psychiatrie-Comorbidités-Addictions (PSYCOMadd), Paris Saclay University, 94800 Villejuif, France;
- Institut National de la Santé et de la Recherche Médicale U1299, Research unit, NeuroImaging and Psychiatry, Paris Sud University-Paris Saclay University, Paris Descartes University, Digiteo Labs, 91190 Gif-sur-Yvette, France
| | - Ammar Amirouche
- Department of Psychiatry and Addictology, Paul Brousse Hospital, APHP, 94800 Villejuif, France; (V.L.); (C.M.); (A.A.); (A.B.)
- Unité de Recherche UR, Psychiatrie-Comorbidités-Addictions (PSYCOMadd), Paris Saclay University, 94800 Villejuif, France;
| | - Amine Benyamina
- Department of Psychiatry and Addictology, Paul Brousse Hospital, APHP, 94800 Villejuif, France; (V.L.); (C.M.); (A.A.); (A.B.)
- Unité de Recherche UR, Psychiatrie-Comorbidités-Addictions (PSYCOMadd), Paris Saclay University, 94800 Villejuif, France;
| | - Nora Hamdani
- Unité de Recherche UR, Psychiatrie-Comorbidités-Addictions (PSYCOMadd), Paris Saclay University, 94800 Villejuif, France;
- Cédiapsy, 75006 Paris, France
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Ikuta K, Kanno R, Bessho T, Koshizuka T, Suzutani T. Evaluation of Toxoplasma gondii IgG avidity assays through a comparison of IgM serostatus. Diagn Microbiol Infect Dis 2023; 105:115901. [PMID: 36889215 DOI: 10.1016/j.diagmicrobio.2023.115901] [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: 07/22/2022] [Revised: 12/23/2022] [Accepted: 01/13/2023] [Indexed: 01/20/2023]
Abstract
Primary Toxoplasma gondii (T. gondii) infection during pregnancy could result in congenital disease with severe clinical complications. IgM antibodies are one of the indices of primary infection. The IgG avidity index (AI) is also known to remain low for at least 3 months after primary infection. Here, we evaluated and compared the performance of T. gondii IgG avidity assays as confirmed by T. gondii IgM serostatus and number of days post-exposure. Four assays preferentially used in Japan were employed to measure the T. gondii IgG AI. Results for the T. gondii IgG AI showed good concordance, particularly in cases with a low IgG AI. This study confirms that the combination of T. gondii IgM and IgG AI tests is a reliable and suitable method for identifying T. gondii primary infections. Our study proposes the necessity of measuring the T. gondii IgG AI as an additional indicator of T. gondii primary infection.
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Affiliation(s)
- Kazufumi Ikuta
- Department of Microbiology, Fukushima Medical University School of Medicine, Fukushima , Japan; Division of Microbiology, Tohoku Medical and Pharmaceutical University School of Medicine, Miyagi, Japan
| | - Ryoko Kanno
- Department of Microbiology, Fukushima Medical University School of Medicine, Fukushima , Japan
| | - Tomoaki Bessho
- Department of Vaccine and Diagnostics, Life Innovation Center, Denka Co., Ltd, Niigata, Japan
| | - Tetsuo Koshizuka
- Department of Microbiology, Fukushima Medical University School of Medicine, Fukushima , Japan; Laboratory of Microbiology and Immunology, Gifu Pharmaceutical University, Gifu, Japan
| | - Tatsuo Suzutani
- Department of Microbiology, Fukushima Medical University School of Medicine, Fukushima , Japan.
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Souza IMFNBD, Siqueira VDS, Ribeiro IDC, Moraes LSP, Prado DPGD, Rezende SR, Costa WLGD, Rezende HHA. Molecular and serological diagnosis of toxoplasmosis: a systematic review and meta-analysis. Rev Inst Med Trop Sao Paulo 2023; 65:e19. [PMID: 36921207 PMCID: PMC10013468 DOI: 10.1590/s1678-9946202365019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 01/06/2023] [Indexed: 03/17/2023] Open
Abstract
Toxoplasmosis is an infection of vast worldwide distribution whose etiologic agent is Toxoplasma gondii. This disease can cause problems ranging from mild symptoms to serious conditions, such as encephalitis, miscarriage and blindness. Therefore, it is of utmost importance to perform a diagnosis with reproducible techniques in order to obtain a good prognosis. The aim of this review was to analyze the efficiency of toxoplasmosis diagnostic techniques based on sensitivity and specificity results. Five research platforms in English language were used (Eric, Elsevier, Google Scholar, PubMed and SciELO), which contained data on the diagnosis of toxoplasmosis. The search and selection were performed for studies published prior to June 2021. The search resulted in the inclusion of 13 articles published from 2005 to 2020. The data revealed the use of different samples in the standardization of techniques such as serum, total blood, colostrum and amniotic fluid. The flow cytometry, lateral flow immunoassay and qPCR techniques showed 100% sensitivity, whereas the ELISA, western blotting, qPCR and RE-LAMP techniques achieved 100% specificity. Significantly, the qPCR and LAMP techniques were more accurate when the likelihood ratio was assessed. The meta-analysis identified that ISAGA and western blotting have low sensitivity values and LIASON, ELFA and ELISA, using a silica bioconjugate, also have low specificity values. It was noted that a wide range of methods have high values of sensitivity and specificity. Therefore, the choice of the method will be based on the conditions and its financial viability.
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Affiliation(s)
| | - Victor da Silva Siqueira
- Universidade Federal de Jatai, Programa de Pós-Graduação em Ciências Aplicadas à Saúde, Jataí, Goiás, Brazil
| | | | | | | | | | - Webster Leonardo Guimarães da Costa
- Universidade Federal de Jatai, Programa de Pós-Graduação em Ciências Aplicadas à Saúde, Jataí, Goiás, Brazil.,Universidade Estadual de Campinas, Instituto de Biologia, Programa de Pós-Graduação em Genética e Biologia Molecular (Imunologia), Campinas, São Paulo, Brazil
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Kodym P, Kurzová Z, Berenová D, Malý M. Detection of persistent low IgG avidity-an interpretative problem in the diagnosis of acute toxoplasmosis. PLoS One 2023; 18:e0284499. [PMID: 37053239 PMCID: PMC10101438 DOI: 10.1371/journal.pone.0284499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 04/02/2023] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVES For the proper diagnosis of toxoplasmosis it is essential to determine the stage of the infection, for which the most preferred method is IgG avidity test. The avidity index (AI) should initially be low (AI≤0.3) in the acute phase and increase during the infection. However, persistent low avidity can occur in patients with latent toxoplasmosis, which can complicate the interpretation of the results. The aim of the study is to explain the causes of this phenomenon. METHODOLOGY A retrospective study was carried out with 717 serum samples collected from 442 patients from the categories of pregnant and non-pregnant women, men, and newborns + infants (age < 0.5 year). The trends of AI kinetics were evaluated in repeatedly examined patients. The frequency of cases with low avidity was compared in individual categories of patients and in groups of people with acute and non-acute toxoplasmosis. RESULTS The proportion of patients with initially low avidity was 42.1% in the acute toxoplasmosis group while it was 13.0% in the non-acute groups. In uninfected newborns with anti-Toxoplasma antibodies transmitted from the mother, a decrease in IgG avidity levels over time was observed, resulting in 29.2% of samples showing low (improper) avidity. While the dynamics of IgG avidity and the frequency of cases of improperly low avidity were similar in men and pregnant and non-pregnant women, the category of newborns and infants differed substantially for these indicators. CONCLUSIONS Due to acceptable specificity and negative predictive value, high avidity can rule out acute toxoplasmosis, but moderate sensitivity complicates the possibility of its confirmation. The results of the avidity test must be interpreted in the context of the results of other methods.
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Affiliation(s)
- Petr Kodym
- National Reference Laboratory for Toxoplasmosis, National Institute of Public Health, Prague, Czech Republic
| | - Zuzana Kurzová
- National Reference Laboratory for Toxoplasmosis, National Institute of Public Health, Prague, Czech Republic
| | - Dagmar Berenová
- National Reference Laboratory for Toxoplasmosis, National Institute of Public Health, Prague, Czech Republic
| | - Marek Malý
- National Institute of Public Health, Unit of Biostatistics, Prague, Czech Republic
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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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Trotta M, Trotta A, Spataro E, Giache S, Borchi B, Zammarchi L, Campolmi I, Galli L, Pasquini L. Primary toxoplasmosis acquired during early pregnancy: Is it currently overestimated? Eur J Obstet Gynecol Reprod Biol 2021; 267:285-289. [PMID: 34839251 DOI: 10.1016/j.ejogrb.2021.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/06/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Toxoplasmosis acquired in early pregnancy is a potentially severe complication for the fetus. Evaluating the risk of transplacental infection in pregnant women accessing the Tuscany Reference Center for Infectious Diseases in Pregnancy during the last 20 years with suspected or confirmed toxoplasmosis acquired in early pregnancy was the aim of the study. STUDY DESIGN We retrospectively enrolled all pregnant women undergoing amniocentesis for toxoplasmosis acquired in the first 16 gestational weeks in the period 1999-2019, comparing patients with certain acute infection (seroconversion occurred in pregnancy, CAIP) with those with suspected acute infection (IgG positive with low/intermediate IgG avidity index, SAIP). RESULTS 237 patients were enrolled, 187 (78.9%) with SAIP and 50 (21.1%) with CAIP. Specific IgM was detected in 47.5% and 76.7% (p-value 0.001), and the mean IgG avidity index was 22.7% and 7.1% (p-value < 0.001) in the SAIP and in the CAIP group, respectively. The mean delay from diagnosis to antibiotic initiation was 14.6 in SAIP and 11 days in CAIP group. Toxoplasma DNA was detected in the amniotic fluid in one case in a patient with CAIP. Excluding 24 newborns with not available data, prevalence of congenital infection was 0.47% [1/213 (95% CI 0.08%-2.61%)], 0% [0/178 (95% CI 0%-2.11%)] in SAIP and 2.8% [1/35 (95% CI 0.51%-14.53%)] in CAIP group. CONCLUSIONS Toxoplasmosis acquired in early pregnancy has a low risk of fetal infection. Actively discussing case-by-case amniocentesis indication with patients, especially when a recent toxoplasmosis is not properly confirmed, is desirable.
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Affiliation(s)
- Michele Trotta
- Infectious and Tropical Diseases Unit, Careggi University and Hospital, Florence, Italy; Referral Center for Infectious Diseases in Pregnancy of Tuscany, Florence, Italy.
| | - Alessandra Trotta
- School of Human Health Sciences, Degree Course in Medicine and Surgery, University of Florence, Florence, Italy
| | - Elisa Spataro
- Fetal Medicine Unit, Department for Women and Children Health, Careggi University and Hospital, Florence, Italy
| | - Susanna Giache
- Referral Center for Infectious Diseases in Pregnancy of Tuscany, Florence, Italy.
| | - Beatrice Borchi
- Infectious and Tropical Diseases Unit, Careggi University and Hospital, Florence, Italy; Referral Center for Infectious Diseases in Pregnancy of Tuscany, Florence, Italy.
| | - Lorenzo Zammarchi
- Infectious and Tropical Diseases Unit, Careggi University and Hospital, Florence, Italy; Referral Center for Infectious Diseases in Pregnancy of Tuscany, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
| | - Irene Campolmi
- Infectious and Tropical Diseases Unit, Careggi University and Hospital, Florence, Italy; Referral Center for Infectious Diseases in Pregnancy of Tuscany, Florence, Italy
| | - Luisa Galli
- Department of Health Sciences University of Florence, Paediatric Infectious Diseases Division, Anna Meyer Children's University Hospital, Florence, Italy.
| | - Lucia Pasquini
- Fetal Medicine Unit, Department for Women and Children Health, Careggi University and Hospital, Florence, Italy.
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Lam AP, de Sordi D, Müller HHO, Lam MC, Carl A, Kohse KP, Philipsen A. Aggravation of symptom severity in adult attention-deficit/hyperactivity disorder by latent Toxoplasma gondii infection: a case-control study. Sci Rep 2020; 10:14382. [PMID: 32873854 PMCID: PMC7463265 DOI: 10.1038/s41598-020-71084-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 07/06/2020] [Indexed: 11/09/2022] Open
Abstract
Toxoplasma gondii (T. gondii) has a high worldwide prevalence and an underestimated impact on neuropsychiatric disorders. Previous studies related T. gondii to disorders associated with the dysfunctional dopaminergic system. However, an association between T. gondii infection and adult attention-deficit/hyperactivity disorder (ADHD) has not yet been studied. In a sex- and age-matched case-control study, we investigated the seropositivity, serointensity, and avidity of latent T. gondii infection in adult ADHD patients and examined the influence of those variables on the symptomatology of ADHD. Of 140 participants, 20.0% were seropositive for anti-T. gondii IgG and 0% for anti-T. gondii IgM. T. gondii seropositivity was associated with 2.8-fold increase in the odds of ADHD in a confounder-adjusted multivariable analysis. Age and consumption of raw/undercooked meat were confirmed as significant predictors of T. gondii seropositivity. Multiple linear regression analysis of self-rated ADHD-related symptom severity in all participants revealed a significant association with T. gondii seropositivity, elevated IgG titers (serointensity), and stronger anti-T. gondii IgG avidity. Overall symptom severity was increased in seropositive ADHD patients compared to seronegative subjects with ADHD. In particular, hyperactivity was significantly associated with serointensity. We conclude that there is a high rate of T. gondii seropositivity in adults with ADHD. Additionally, our results suggest a clinical impact of latent T. gondii infection on ADHD-related symptoms in a serointensity- and avidity-dependent manner.
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Affiliation(s)
- Alexandra P Lam
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany. .,School of Medicine and Health Sciences, Medical Campus University of Oldenburg, Oldenburg, Germany.
| | - Dominik de Sordi
- Division of Epidemiology and Biometry, School of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Helge H O Müller
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.,School of Medicine and Health Sciences, Medical Campus University of Oldenburg, Oldenburg, Germany.,Department of Psychiatry and Psychotherapy, Chair of Integrative Psychiatry and Psychotherapy, Witten/Herdecke University, Gemeinschaftskrankenhaus Herdecke, Witten/Herdecke, Germany
| | - Martin C Lam
- School of Medicine and Health Sciences, Medical Campus University of Oldenburg, Oldenburg, Germany
| | - Angelika Carl
- Institute for Laboratory Diagnostics and Microbiology, Klinikum Oldenburg, School of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Klaus P Kohse
- Institute for Laboratory Diagnostics and Microbiology, Klinikum Oldenburg, School of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
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12
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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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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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14
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Garnaud C, Fricker-Hidalgo H, Evengård B, Álvarez-Martínez MJ, Petersen E, Kortbeek LM, Robert-Gangneux F, Villena I, Costache C, Paul M, Meroni V, Guy E, Chiodini PL, Brenier-Pinchart MP, Pelloux H. Toxoplasma gondii-specific IgG avidity testing in pregnant women. Clin Microbiol Infect 2020; 26:1155-1160. [PMID: 32334096 DOI: 10.1016/j.cmi.2020.04.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/07/2020] [Accepted: 04/14/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The parasite Toxoplasma gondii can cause congenital toxoplasmosis following primary infection in a pregnant woman. It is therefore important to distinguish between recent and past infection when both T. gondii-specific IgM and IgG are detected in a single serum in pregnant women. Toxoplasma gondii-specific IgG avidity testing is an essential tool to help to date the infection. However, interpretation of its results can be complex. OBJECTIVES To review the benefits and limitations of T. gondii-specific avidity testing in pregnant women, to help practitioners to interpret the results and adapt the patient management. SOURCES PubMed search with the keywords avidity, toxoplasmosis and Toxoplasma gondii for articles published from 1989 to 2019. CONTENT Toxoplasma gondii-specific IgG avidity testing remains a key tool for dating a T. gondii infection in immunocompetent pregnant women. Several commercial assays are available and display comparable performances. A high avidity result obtained on a first-trimester serum sample is indicative of a past infection, which occurred before pregnancy. To date, a low avidity result must still be considered as non-informative to date the infection, although some authors suggest that very low avidity results are highly suggestive of recent infections depending on the assay. Interpretation of low or grey zone avidity results on a first-trimester serum sample, as well as any avidity result on a second-trimester or third-trimester serum sample, is more complex and requires recourse to expert toxoplasmosis laboratories. IMPLICATIONS Although used for about 30 years, T. gondii-specific avidity testing has scarcely evolved. The same difficulties in interpretation have persisted over the years. Some authors have proposed additional thresholds to exclude an infection of <9 months, or in contrast to confirm a recent infection. Such thresholds would be of great interest to adapt management of pregnant women and avoid unnecessary treatment; however, they need confirmation and further studies.
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Affiliation(s)
- C Garnaud
- Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France; Parasitology-Mycology, CHU Grenoble Alpes, Grenoble, France.
| | | | - B Evengård
- Department Clinical Microbiology, Umea University, Umea, Sweden
| | - M J Álvarez-Martínez
- Microbiology Department, Hospital Clínic-ISGLOBAL, University of Barcelona, Barcelona, Spain
| | - E Petersen
- Directorate General for Disease Surveillance and Control, Ministry of Health, Oman; Institute for Clinical Medicine, Faculty of Health Science, University of Aarhus, Denmark; ESCMID Emerging Infections Task Force, ESCMID, Basel, Switzerland
| | - L M Kortbeek
- National Institute for Public Health and the Environment; Centre for Infectious Disease Control (CIb) Bilthoven, the Netherlands
| | - F Robert-Gangneux
- Université Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement et Travail)-UMR_S 1085, Rennes, France
| | - I Villena
- Université Reims Champagne-Ardenne EA 7510, CHU Reims, Centre National de Référence de La Toxoplasmose, CRB Toxoplasma, Reims, France
| | - C Costache
- Microbiology Department 'Iuliu Hatieganu', University of Medicine and Pharmacy Cluj-Napoca, Romania
| | - M Paul
- Department and Clinic of Tropical and Parasitic Diseases, University of Medical Sciences, Poznan, Poland
| | - V Meroni
- University Pavia Internal Medicine and Medical Therapy Department, Microbiology and Virology Department IRCCS, Foundation San Matteo Polyclinic, Pavia Italy
| | - E Guy
- Toxoplasma Reference Unit, Public Health Wales Microbiology, Swansea, UK
| | - P L Chiodini
- Hospital for Tropical Diseases and the London School of Hygiene and Tropical Medicine, London, UK
| | - M-P Brenier-Pinchart
- Parasitology-Mycology, CHU Grenoble Alpes, Grenoble, France; Université Grenoble Alpes, INSERM-CNRS, Institute for Advanced Biosciences, Grenoble, France
| | - H Pelloux
- Parasitology-Mycology, CHU Grenoble Alpes, Grenoble, France; Université Grenoble Alpes, INSERM-CNRS, Institute for Advanced Biosciences, Grenoble, France
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15
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Jiang N, Su R, Jian F, Su C, Zhang L, Jiang Y, Yang Y. Toxoplasma gondii in lambs of China: Heart juice serology, isolation and genotyping. Int J Food Microbiol 2020; 322:108563. [PMID: 32113068 DOI: 10.1016/j.ijfoodmicro.2020.108563] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 02/07/2020] [Accepted: 02/16/2020] [Indexed: 12/15/2022]
Abstract
Toxoplasmosis is one of the most common foodborne diseases in the world. The objective of this study was to determine Toxoplasma gondii infection in lambs from Henan province, China. A total of 166 lamb hearts were collected from 2017 to 2019. T. gondii infection was determined by the Modified Agglutination Test (MAT) using heart juice of lambs. 11 isolates (TgSheepCHn3 - TgSheepCHn13) were obtained from samples with MAT titers ≥1:100. The rate of T. gondii isolation increased with antibody titer against T. gondii (P < 0.05). No isolate was obtained from samples with titer 1:25 and 1:50, suggesting the cut-off titer for MAT is better set at 1:100. With cut-off value of 1:100, IgG antibodies to T. gondii were found in 25.3% (42/166) of the lambs by MAT. T. gondii parasite was not found in IHC and HE-stained tissue sections of lamb hearts (0/166). Sixty-seven heart tissues with ≥1:25 MAT titers were subjected to acid pepsin digestion and detected T. gondii by PCR. Only 7.5% (5/67) of DNA amplified products were found in heart tissues by the primer TOX5/TOX8. Brain tissue cysts were observed in all mice infected with the 11 isolates at day 60 post infection, suggesting these isolates are non-lethal to mice. PCR-RFLP analysis revealed that 7 isolates belonged to ToxoDB#2, 4 isolates belonged to ToxoDB#4. This is the first isolation of ToxoDB#2 and ToxoDB#4 from lambs in China. Interestingly, none of these isolates belongs to the ToxoDB#9 that is common in China. Our results suggest that the genetic diversity and population structure of T. gondii from China maybe more abundant and magical than previous speculation.
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Affiliation(s)
- Nan Jiang
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, China
| | - Ruijing Su
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, China
| | - Fuchun Jian
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, China
| | - Chunlei Su
- Department of Microbiology, University of Tennessee, Knoxville, USA.
| | - Longxian Zhang
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, China.
| | - Yibao Jiang
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, China.
| | - Yurong Yang
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, China.
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Pinto-Ferreira F, Mitsuka-Breganó R, Monica TC, Martins FDC, Matos RLND, Mareze M, Nino BDSL, Narciso SG, Freire RL, Navarro IT. Investigation and environmental analysis of samples from outbreak of toxoplasmosis at research institution in Londrina, Paraná, Brazil, 2016. ACTA ACUST UNITED AC 2019; 28:518-521. [PMID: 31482939 DOI: 10.1590/s1984-29612019044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 05/22/2019] [Indexed: 11/22/2022]
Abstract
The objective of this study was to report an outbreak of human toxoplasmosis at a research institution in Londrina, Paraná, from December 2015 to February 2016. Blood samples from 26 symptomatic individuals were collected and the microparticle chemiluminescence immunoassay was performed to detect IgM, IgG and specific IgG avidity test in the official laboratory. A total of 20 people with symptoms and serology compatible with acute toxoplasmosis (IgM positive and IgG with low avidity) were selected as cases, while 45 asymptomatic employees working in the same teams and during the same shifts were selected as controls. All the participants of the investigation answered an epidemiological questionnaire. Three samples of water and one sludge from the institution's supply cisterns, 10 soil samples, 11 plant samples, three cat fecal samples and one domestic feline cadaver were collected for analysis of the polymerase chain reaction (PCR) for T. gondii. After analyzing the epidemiological data, the consumption of vegetables in the restaurant of the institution was the only variable associated with the occurrence of the disease. In laboratory results, all the samples showed negative results to PCR. The rapid recognition of the outbreak, early notification and investigation could have broken the chain of transmission early, thus preventing the emergence of new cases. In addition, the adoption of good food handling practices could have prevented the occurrence of the outbreak.
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Affiliation(s)
- Fernanda Pinto-Ferreira
- Departamento de Medicina Veterinária Preventiva, Laboratório de Zoonoses e Saúde Pública, Universidade Estadual de Londrina - UEL, Londrina, PR, Brasil
| | - Regina Mitsuka-Breganó
- Departamento de Medicina Veterinária Preventiva, Laboratório de Parasitologia Veterinária, Universidade Estadual de Londrina - UEL, Londrina, PR, Brasil
| | - Thais Cabral Monica
- Departamento de Medicina Veterinária Preventiva, Laboratório de Zoonoses e Saúde Pública, Universidade Estadual de Londrina - UEL, Londrina, PR, Brasil
| | - Felippe Danyel Cardoso Martins
- Departamento de Medicina Veterinária Preventiva, Laboratório de Zoonoses e Saúde Pública, Universidade Estadual de Londrina - UEL, Londrina, PR, Brasil
| | - Ricardo Luís Nascimento de Matos
- Departamento de Medicina Veterinária Preventiva, Laboratório de Zoonoses e Saúde Pública, Universidade Estadual de Londrina - UEL, Londrina, PR, Brasil
| | - Marcelle Mareze
- Departamento de Medicina Veterinária Preventiva, Laboratório de Zoonoses e Saúde Pública, Universidade Estadual de Londrina - UEL, Londrina, PR, Brasil
| | - Beatriz de Souza Lima Nino
- Departamento de Medicina Veterinária Preventiva, Laboratório de Zoonoses e Saúde Pública, Universidade Estadual de Londrina - UEL, Londrina, PR, Brasil
| | | | - Roberta Lemos Freire
- Departamento de Medicina Veterinária Preventiva, Laboratório de Zoonoses e Saúde Pública, Universidade Estadual de Londrina - UEL, Londrina, PR, Brasil
| | - Italmar Teodorico Navarro
- Departamento de Medicina Veterinária Preventiva, Laboratório de Zoonoses e Saúde Pública, Universidade Estadual de Londrina - UEL, Londrina, PR, Brasil
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Immunodiagnosis and molecular validation of Toxoplasma gondii infection among patients with end-stage renal disease undergoing haemodialysis. Parasitology 2019; 146:1683-1689. [PMID: 31397237 DOI: 10.1017/s0031182019001033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Infection is a significant cause of morbidity and mortality in patients with chronic kidney disease, especially who were under dialysis due to their depressed immunity. Toxoplasma gondii is a ubiquitous parasite that causes severe manifestations in immunocompromised patients. This case-control study was conducted to the immunodiagnosis and molecular validation of T. gondii infection among patients with end-stage renal disease undergoing haemodialysis. The study population consisted of 260 haemodialysis patients and 259 healthy controls referred to the main dialysis centres of Tehran, Iran during 2016. Anti-T. gondii immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies were assessed using enzyme-linked immunosorbent assay. As well, the T. gondii genomic DNA in whole blood samples of IgM-positive patients and healthy controls was evaluated using GRA6-polymerase chain reaction (PCR) and SAG1-loop-mediated isothermal amplification (LAMP) assays. The anti-T. gondii IgG and IgM antibodies were detected in 175 (67.3%) and 18 (7%) of haemodialysis patients and 122 (47%) and 4 (1.5%) of controls, respectively. Two of the 18 blood samples from IgM-positive patients and none of the IgM-positive control subjects were positive by GRA6-PCR. Whereas, nine and two blood samples of IgM-positive patients and controls were positive for Toxoplasma DNA by a SAG1-LAMP technique respectively. The seropositivity of the Toxoplasma IgM antibody was significantly different between haemodialysis patients and healthy controls which was confirmed by PCR and LAMP. The higher prevalence of T. gondii infection in haemodialysis patients compared with the controls proposes that these patients can be a group at risk for toxoplasmosis and screening for toxoplasmosis before dialysis is necessary for the patients.
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Rahmati-Balaghaleh M, Hosseini Farash BR, Zarean M, Hatami-Pourdehno S, Mirahmadi H, Jarahi L, Sharifi Y, Ahmadi O, Shamsian SA, Moghaddas E, Hashemi Shahri SM. Diagnosis of acute toxoplasmosis by IgG avidity method in pregnant women referred to health centers in south-eastern Iran. J Parasit Dis 2019; 43:517-521. [PMID: 31406419 DOI: 10.1007/s12639-019-01120-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 04/24/2019] [Indexed: 11/25/2022] Open
Abstract
Toxoplasmosis, one of the most common parasitic infections, can cause abortions in human. The purpose of this study was to determine seroprevalence of toxoplasmosis and acute form of toxoplasmosis in pregnant women. 208 pregnant women who referred to health centers in south-eastern Iran were taken under study after signing the informed consent forms and filling out the checklists. For those with high levels of IgG or IgM antibody titers, IgG Avidity test was performed to determine the acute infection. High level of IgG anti-body were found in sera of 81 pregnant women and 7 persons had borderline titer. IgM antibody results were positive in 33 and borderline in 4 cases. Then, the samples with positive and borderline results for IgM and IgG were evaluated by IgG avidity test. In this study, approximately 60% of pregnant women were not immune to risks posed by Toxoplasma gondii. Therefore, this group are at risk of acquiring primary infection of toxoplasmosis during gestation.
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Affiliation(s)
- Mansour Rahmati-Balaghaleh
- 1Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
- 5Department of Parasitology and Mycology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Bibi Razieh Hosseini Farash
- 2Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- 3Cutaneous Leishmaniasis Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehdi Zarean
- 2Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- 3Cutaneous Leishmaniasis Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Hadi Mirahmadi
- 1Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
- 5Department of Parasitology and Mycology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Lida Jarahi
- 6Community Medicine Department, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Yousef Sharifi
- 7Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Omid Ahmadi
- 7Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Aliakbar Shamsian
- 2Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elham Moghaddas
- 2Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mohammad Hashemi Shahri
- 5Department of Parasitology and Mycology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
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Ferra BT, Holec-Gąsior L, Gatkowska J, Dziadek B, Dzitko K, Grąźlewska W, Lautenbach D. The first study on the usefulness of recombinant tetravalent chimeric proteins containing fragments of SAG2, GRA1, ROP1 and AMA1 antigens in the detection of specific anti-Toxoplasma gondii antibodies in mouse and human sera. PLoS One 2019; 14:e0217866. [PMID: 31170254 PMCID: PMC6553757 DOI: 10.1371/journal.pone.0217866] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 05/20/2019] [Indexed: 12/22/2022] Open
Abstract
This study presents an evaluation of four tetravalent recombinant chimeric proteins containing fragments of the Toxoplasma gondii antigens, SAG2, GRA1, ROP1 and AMA1, as potential replacements of a the soluble, whole-cell tachyzoite lysate (TLA) used in serological assays. Recombinant chimeric proteins (SAG2-GRA1-ROP1-AMA1N, AMA1N-SAG2-GRA1-ROP1, AMA1C-SAG2-GRA1-ROP1, and AMA1-SAG2-GRA1-ROP1) obtained by genetic engineering were tested for their reactivity with specific IgM and IgG antibodies from sera of experimentally infected mice and humans with T. gondii infection using an enzyme-linked immunosorbent assay (ELISA). In total 192 serum samples from patients with acquired T. gondii infection and 137 sera from seronegative individuals were examined. The reactivity of chimeric antigens with antibodies generated during T. gondii invasion was measured and compared to the results obtained in assays based on whole-cell Toxoplasma antigen. Chimeric proteins proved effective in differentiation between T. gondii-infected and uninfected individuals (100% sensitivity and specificity in the IgG ELISAs) which shows their potential usefulness as a replacements for TLA in standardized commercial tests for the serodiagnosis of toxoplasmosis. In addition, the chimeric proteins were tested for use in avidity determination. Obtained results were comparable to those of the corresponding commercial assays, suggesting the utility of these proteins for avidity assessment. Furthermore, this study demonstrated that the AMA1-SAG2-GRA1-ROP1 chimeric protein has the potential to distinguish specific antibodies from serum samples of individuals with the early and chronic phase of T. gondii infection.
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Affiliation(s)
- Bartłomiej Tomasz Ferra
- Department of Molecular Biotechnology and Microbiology, Faculty of Chemistry, Gdańsk University of Technology, Gdańsk, Poland
- * E-mail:
| | - Lucyna Holec-Gąsior
- Department of Molecular Biotechnology and Microbiology, Faculty of Chemistry, Gdańsk University of Technology, Gdańsk, Poland
| | - Justyna Gatkowska
- Department of Immunoparasitology, Faculty of Biology and Environmental Protection, University of Lodz, Łódź, Poland
| | - Bożena Dziadek
- Department of Immunoparasitology, Faculty of Biology and Environmental Protection, University of Lodz, Łódź, Poland
| | - Katarzyna Dzitko
- Department of Immunoparasitology, Faculty of Biology and Environmental Protection, University of Lodz, Łódź, Poland
| | - Weronika Grąźlewska
- Department of Molecular Biotechnology and Microbiology, Faculty of Chemistry, Gdańsk University of Technology, Gdańsk, Poland
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Seroprevalence of Toxoplasma gondii Infection Among Β-Thalassemia Major Pediatric Population: Implications for Transfusion Transmissible Toxoplasmosis. Pediatr Infect Dis J 2019; 38:236-240. [PMID: 29762364 DOI: 10.1097/inf.0000000000002111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Children with β-thalassemia major who regularly receive blood transfusion are at risk of developing transfusion-transmitted infection. Toxoplasmosis is a common and a serious parasitic disease with high prevalence and could be transmitted through blood transfusion from healthy asymptomatic donors. However, screening Toxoplasma gondii before blood donation has not been considered. The objective of this study was to determine the prevalence of T. gondii antibodies among thalassemia children undergoing blood transfusion. METHODS In a case-control study, serum samples from 211 thalassemia children and 100 control children were investigated for Toxoplasma IgM and IgG using the enzyme-linked immunosorbent assay. Positive serum samples for IgG antibodies to T. gondii were further subjected to IgG avidity enzyme-linked immunosorbent assay. RESULTS The seroprevalence of Toxoplasma infection among thalassemia children was 23.2% and 53.6% for IgM and IgG anti-Toxoplasma antibodies, respectively. Whereas in the control group, the prevalence was 5% and 18% for IgM and IgG anti-Toxoplasma antibodies, respectively. There is a significant statistical difference between thalassemia and control groups regarding the prevalence of toxoplasmosis. From these positive IgG samples, 65.5% have low avidity indicating recent infection while 38.73% have high avidity indicating past infection. CONCLUSION Due to the high serologic infection rate of toxoplasmosis among thalassemia pediatric population in this study with no existing effective therapies and no available T. gondii vaccine, appropriate strategies are critical for reducing the risk of that infection. Screening of blood for T. gondii antibodies should be considered before transmission to those children especially in countries with a high prevalence of toxoplasmosis.
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KHADEMI SZ, GHAFFARIFAR F, Dalimi ABDOLHOSSEIN, DAVOODIAN P, ABDOLI A. Prevalence and Risk Factors of Toxoplasma gondii Infection among Pregnant Women in Hormozgan Province, South of Iran. IRANIAN JOURNAL OF PARASITOLOGY 2019; 14:167-173. [PMID: 31123482 PMCID: PMC6511600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Toxoplasmosis can cause miscarriage or complications in the fetus. Diagnosis and treatment of this disease by anti-parasitic drugs especially in early pregnancy can help to prevent fetal infection and its complications. This study aimed to determine T. gondii infection in pregnant women, evaluate risk factors in the transmission of the disease and congenital toxoplasmosis. METHODS Overall, 360 sera of pregnant women from 5 cities in the Hormozgan Province in southern Iran with different climate were evaluated from 2015-2016 for T. gondii infection by using ELISA method and positive cases of IgM and IgG were tested again using Avidity IgG ELISA. All cases were evaluated according to climate, acute and chronic of toxoplasmosis, number of pregnancy and abortion, epidemiological factors and food habits. RESULTS Among 360 specimens T. gondii IgG + IgM antibodies were found positive in 0. 8% subjects and also 27% of samples had IgG seropositivity. A significant relationship was observed between age, sampling place, consumption of raw and half cooked meat, history of contact with cats, abortion history, number of children, and parity with IgG positive. In Avidity IgG ELISA test, 13 people with low avidity, 3 people with borderline avidity were reported. CONCLUSION 72. 2% of the population had no antibody against the disease that this could be a warning to the people and requires education of preventive and prenatal care and routine screening of women at childbearing age.
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Affiliation(s)
- Seyedeh Zahra KHADEMI
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran, Department of Biology, Payam Noor University, Tehran, Iran
| | - Fatemeh GHAFFARIFAR
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran,Correspondence:
| | - ABDOLHOSSEIN Dalimi
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Parivash DAVOODIAN
- Infectious and Tropical Disease Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Amir ABDOLI
- Department of Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran, Zoonosis Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
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Molecular and Serological Evaluation of Toxoplasmosis in AIDS Cases in Southwest Iran. Jundishapur J Microbiol 2018. [DOI: 10.5812/jjm.77044] [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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Interpretation of very low avidity indices acquired with the Liaison XL Toxo IgG avidity assay in dating toxoplasmosis infection. Eur J Clin Microbiol Infect Dis 2018; 38:253-257. [DOI: 10.1007/s10096-018-3421-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 11/02/2018] [Indexed: 10/27/2022]
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Khan K, Khan W. Congenital toxoplasmosis: An overview of the neurological and ocular manifestations. Parasitol Int 2018; 67:715-721. [PMID: 30041005 DOI: 10.1016/j.parint.2018.07.004] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 07/03/2018] [Accepted: 07/11/2018] [Indexed: 12/21/2022]
Abstract
Toxoplasma gondii is an obligate intracellular parasite which is known to infect one-third of the total world population chronically though it is asymptomatic in immunocompetent patients. However, in an immunocompromised patient or an infected fetus, it may cause devastating effects. The parasite may cross the placenta of an infected pregnant woman and probably infect the fetus congenitally. The severity of the infection depends on the gestational age at which the infection has occurred i.e., if it has occurred in the early phase, the rate of transmission is low but the severity is high if the fetus is infected and if it has occurred in the later phase then transmission rate is higher while the severity would be low. Congenital toxoplasmosis may result in non-specific consequences like abortion, intra-uterine growth restriction, jaundice, hepatosplenomegaly or even intra-uterine death. It may also result in neurological or ocular manifestations like intracranial calcifications, hydrocephalus or retinochoroiditis. The diagnosis may be done by serological screening of anti-Toxoplasma antibodies (IgM and IgG) while PCR of the amniotic fluid or the placenta is the confirmatory test. Acute or chronic infections may be differentiated by IgG avidity tests. The treatment regimens include spiramycin to prevent congenital transmission from an infected mother, pyrimethamine, sulfadoxine and folinic acid to treat the infected fetus, CSF shunting for the treatment of hydrocephalus and a combination of pyrimethamine, azithromycin, and corticosteroids for treating ocular toxoplasmosis.
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Affiliation(s)
- Khadija Khan
- Department of Zoology, Section of Parasitology, Aligarh Muslim University, India
| | - Wajihullah Khan
- Department of Zoology, Section of Parasitology, Aligarh Muslim University, India.
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Abd El Wah WM, Shaapan RM, Abd El Haf MED, Elfadaly HA, Ahmed Hamd D. Toxoplasma Gondii Infection and Associated Sociodemographic and Behavioral Risk Factors among Blood Donors. ASIAN JOURNAL OF EPIDEMIOLOGY 2018; 11:52-58. [DOI: 10.3923/aje.2018.52.58] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Detection of toxoplasma-specific immunoglobulin G in human sera: performance comparison of in house Dot-ELISA with ECLIA and ELISA. Eur J Clin Microbiol Infect Dis 2018; 37:1421-1429. [DOI: 10.1007/s10096-018-3266-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 04/23/2018] [Indexed: 10/17/2022]
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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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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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Laboudi M, Sadak A. Serodiagnosis of Toxoplasmosis: The effect of measurement of IgG avidity in pregnant women in Rabat in Morocco. Acta Trop 2017; 172:139-142. [PMID: 28433574 DOI: 10.1016/j.actatropica.2017.04.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 04/10/2017] [Accepted: 04/14/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND The diagnosis of Toxoplasmosis in pregnant women during the early first trimester of pregnancy is very important for preventing congenital infection of the fetus; it will not only prevent the risk of transmitting the infection to the fetus but it will also enable to give these women a preventive treatment. In this study, the avidity test was performed on pregnant women during their first prenatal visit at the National Institute of Hygiene in Rabat, Morocco. FINDINGS One hundred and twenty-eight sera samples were collected from 128 pregnant women between August 2015 and June 2016; these women were chosen retrospectively and were in their first four months of pregnancy. The samples were screened using the specific anti-Toxoplasma IgG and IgM antibodies and were subjected to an IgG avidity test. After the serological screening, only 54 women (42.4%) were tested positive for IgG antibodies and five women (3.9%) were tested positive for both anti-Toxoplasma IgG and IgM antibodies. Four IgM-negative women had low-avidity antibodies. However, none of the IgG-avidity test had detected low-avidity antibodies in the five IgM-positive women; three women (60%) had high-avidity antibodies, indicating that the infection was acquired in the distant past. CONCLUSION The avidity test is a helpful tool to exclude a recently acquired toxoplasmosis infection within IgM-positive serum samples in pregnant women during their first trimester of pregnancy. Thus, allowing to perform an appropriate therapeutic intervention.
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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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Armengol C, Cassaing S, Roques-Malecaze C, Chauvin P, Iriart X, Berry A, Fillaux J. Time before anti-Toxoplasma IgG seroconversion detection by 7 commercial assays in French pregnant women. Diagn Microbiol Infect Dis 2016; 87:103-107. [PMID: 27884549 DOI: 10.1016/j.diagmicrobio.2016.10.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 10/18/2016] [Accepted: 10/19/2016] [Indexed: 11/28/2022]
Abstract
We assessed the ability to early detect a toxoplasmic seroconversion between 1 immunoblot (LDBIO II®) and 6 automated assays (TGS TA®, Architect®, Vidas II®, Liaison II®, Platelia®, and Elecsys®), comparing the time before anti-Toxoplasma gondii IgG detection during infection in pregnant women. From 2007 to 2015, 620 sera of 269 women were included. The median durations before positive IgG detection with Vidas II®, Liaison II®, Platelia®, and Elecsys® were significantly longer than Architect® with differential times from 11 to 28days (P<0.001). This time was significantly shortened by the use of LDBIO®, resulting in a saving of 13days (P<0.001). The detection of a positive rate of IgG with TGS TA® was as early as Architect® (P=0.105). The ability to early detect a toxoplasmic seroconversion is not equivalent between the assays and has to be considered when selecting the reagents to reduce the time to therapeutic intervention.
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Affiliation(s)
- Catherine Armengol
- Service de Parasitologie-Mycologie, Hôpital Purpan, Toulouse, 31059, France
| | - Sophie Cassaing
- Service de Parasitologie-Mycologie, Hôpital Purpan, Toulouse, 31059, France; Pharmacochimie et Biologie Pour le Développement (PHARMA-DEV), IRD UMR 152 Université Paul Sabatier, Toulouse, 31400, France
| | | | - Pamela Chauvin
- Service de Parasitologie-Mycologie, Hôpital Purpan, Toulouse, 31059, France
| | - Xavier Iriart
- Service de Parasitologie-Mycologie, Hôpital Purpan, Toulouse, 31059, France
| | - Antoine Berry
- Service de Parasitologie-Mycologie, Hôpital Purpan, Toulouse, 31059, France
| | - Judith Fillaux
- Service de Parasitologie-Mycologie, Hôpital Purpan, Toulouse, 31059, France; Pharmacochimie et Biologie Pour le Développement (PHARMA-DEV), IRD UMR 152 Université Paul Sabatier, Toulouse, 31400, France.
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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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Multiplexed Anti-Toxoplasma IgG, IgM, and IgA Assay on Plasmonic Gold Chips: towards Making Mass Screening Possible with Dye Test Precision. J Clin Microbiol 2016; 54:1726-1733. [PMID: 27008879 DOI: 10.1128/jcm.03371-15] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 03/16/2016] [Indexed: 11/20/2022] Open
Abstract
Toxoplasmosis is an infection caused by the protozoan parasite Toxoplasma gondii that can lead to severe sequelae in the fetus during pregnancy. Definitive serologic diagnosis of the infection during gestation is made mostly by detecting T. gondii-specific antibodies, including IgG and IgM, individually in a single serum sample by using commercially available kits. The IgA test is used by some laboratories as an additional marker of acute infection. Most of the commercial tests have failed to reach 100% correlation with the reference method, the Sabin-Feldman dye test for the detection of Toxoplasma IgG antibodies. For Toxoplasma IgM and IgA antibodies, there is no reference method and their evaluation is done by comparing the results of one assay to those of another. There is a need for multiplexed assay platforms, as the serological diagnosis of T. gondii infection does not rely on the detection of a single Ig subtype. Here we describe the development of a plasmonic gold chip with vast fluorescence enhancement in the near-infrared region for simultaneous detection of IgG, IgM, and IgA antibodies against T. gondii in an ∼1-μl serum or whole-blood sample. When 168 samples were tested on this platform, IgG antibody detection sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were all 100%. IgM antibody detection achieved 97.6% sensitivity and 96.9% specificity with a 90.9% PPV and a 99.2% NPV. Thus, the nanoscience-based plasmonic gold platform enables a high-performance, low-cost, multiplexed assay requiring ultrasmall blood volumes, paving the way for the implementation of universal screening for toxoplasmosis infection during gestation.
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Stajner T, Bobic B, Klun I, Nikolic A, Srbljanovic J, Uzelac A, Rajnpreht I, Djurkovic-Djakovic O. Prenatal and Early Postnatal Diagnosis of Congenital Toxoplasmosis in a Setting With No Systematic Screening in Pregnancy. Medicine (Baltimore) 2016; 95:e2979. [PMID: 26945416 PMCID: PMC4782900 DOI: 10.1097/md.0000000000002979] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To determine the risk of congenital toxoplasmosis (CT) and provide early (pre- or postnatal) identification of cases of CT in the absence of systematic screening in pregnancy.I n the presented cross-sectional study, serological criteria were used to date Toxoplasma gondii infection versus conception in 80 pregnant women with fetal abnormalities or referred to as suspected of acute infection, and in 16 women after delivery of symptomatic neonates. A combination of serological, molecular (qPCR), and biological (bioassay) methods was used for prenatal and/or postnatal diagnosis of CT. Most (77.5%) pregnant women were examined in advanced pregnancy. Of all the examined seropositive women (n = 90), infection could not be ruled out to have occurred during pregnancy in 93.3%, of which the majority (69%) was dated to the periconceptual period. CT was diagnosed in 25 cases, of which 17 prenatally and 8 postnatally. Molecular diagnosis proved superior, but the diagnosis of CT based on bioassay in 7 instances and by Western blot in 2 neonates shows that other methods remain indispensable. In the absence of systematic screening in pregnancy, maternal infection is often diagnosed late, or even only when fetal/neonatal infection is suspected. In such situations, use of a complex algorithm involving a combination of serological, biological, and molecular methods allows for prenatal and/or early postnatal diagnosis of CT, but lacks the preventive capacity provided by early maternal treatment.
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Affiliation(s)
- Tijana Stajner
- From the National Reference Laboratory for Toxoplasmosis, Center of Excellence for Food- and Vector-Borne Zoonoses, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
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de Jesus LNNP, de Castro Zacche Tonini A, Barros GB, Coelho-dos-Reis JGA, Béla SR, do Valle Antonelli LR, Machado AS, Carneiro ACAV, Andrade GMQ, Vasconcelos-Santos DV, Januário JN, Teixeira-Carvalho A, Vitor RWA, Ferro EA, Mineo JR, Bahia-Oliveira LMG, Martins-Filho OA, Lemos EM. IgA and IgG1 reactivities assessed by flow cytometry mirror clinical aspects of infants with ocular congenital toxoplasmosis. J Immunol Methods 2016; 428:1-8. [DOI: 10.1016/j.jim.2015.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 11/11/2015] [Indexed: 11/26/2022]
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Persistent Low Toxoplasma IgG Avidity Is Common in Pregnancy: Experience from Antenatal Testing in Norway. PLoS One 2015; 10:e0145519. [PMID: 26714282 PMCID: PMC4703128 DOI: 10.1371/journal.pone.0145519] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 12/05/2015] [Indexed: 11/19/2022] Open
Abstract
The parasite Toxoplasma gondii might harm the fetus if a woman is infected during pregnancy. IgG seroconversion and significant increase in IgG antibody amount in pregnancy indicates maternal infection. Presence of toxoplasma immunoglobulin M (IgM), immunoglobulin G (IgG) and low IgG avidity in a single serum sample indicates possible maternal infection, but positive toxoplasma IgM and low IgG avidity may persist for months and even years. We aimed to evaluate avidity development during pregnancy in a retrospective study. Serial blood samples from 176 pregnant women admitted to Oslo University Hospital 1993–2013 for amniocentesis because of suspected toxoplasma infection were included. Data were obtained from journals and laboratory records. The avidity method used was based on Platelia Toxo IgG assay. Mean maternal age at first serology was 29.9 years (SD 5.2, range 18–42). In 37 (21%) women only the avidity increased from low to high in < 3 months. In 139 (79%) the IgG avidity remained below the high threshold ≥ 3 months and within this group 74 (42%) women had stable low IgG avidity during the observation period. Median gestational age at first test was 10.6 weeks (range 4.6–28.7). Fetal infection was detected in four children, but none among children whose mother had stable low IgG avidity. The first antenatal toxoplasma serology should ideally be collected in early pregnancy and if stable values of toxoplasma IgM and low IgG-avidity are detected in a second sample after three to four weeks, the need for amniocentesis can be questioned.
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Mardani M, Tavalla M. Seroepidemiology of Toxoplasma gondii IgG and IgM among butchers in southwest of Iran. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2015. [DOI: 10.1016/s2222-1808(15)60970-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Villard O, Cimon B, L'Ollivier C, Fricker-Hidalgo H, Godineau N, Houze S, Paris L, Pelloux H, Villena I, Candolfi E. Serological diagnosis of Toxoplasma gondii infection: Recommendations from the French National Reference Center for Toxoplasmosis. Diagn Microbiol Infect Dis 2015; 84:22-33. [PMID: 26458281 DOI: 10.1016/j.diagmicrobio.2015.09.009] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 09/03/2015] [Accepted: 09/09/2015] [Indexed: 11/17/2022]
Abstract
Toxoplasmosis manifests no clinical signs in 80% of cases in immunocompetent patient, causing immunization characterized by the persistence of cysts, particularly in brain, muscles, and retina. Assessing the serological status, based on testing for serum toxoplasma IgG and IgM antibodies, is essential in cases that are increasingly at risk for the more severe disease forms, such as congenital or ocular toxoplasmosis. This disease also exposes immunosuppressed patients to reactivation, which can lead to more widespread forms and increased mortality. By interpreting the serological results, we can estimate the risk of contamination or reactivation and define appropriate prophylactic and preventive measures, such as hygienic and dietetic, therapeutic, biological, and clinical follow-up, according to the clinical context. We hereby propose practical approaches based on serological data, resulting from a consensus of a group of experts from the French National Reference Center Network for Toxoplasmosis, according to both routine and specific clinical situations.
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Affiliation(s)
- O Villard
- Institut de Parasitologie et de Pathologie Tropicale de Strasbourg, Université de Strasbourg, Hôpitaux Universitaires de Strasbourg, 1-3 rue Koeberlé, F-67000 Strasbourg, France.
| | - B Cimon
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, 4 rue Larrey, F-49933 Angers Cedex 9, France
| | - C L'Ollivier
- Laboratoire de Parasitologie-Mycologie, Hôpital de la Timone, 264 rue Saint Pierre, F-13385 Marseille Cedex 05, France
| | - H Fricker-Hidalgo
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire A. Michallon et Université de Grenoble BP 217, 38043 Grenoble Cedex, France
| | - N Godineau
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier de Saint-Denis, 2 rue du Docteur Pierre Delafontaine, BP 279, F-93205 Saint-Denis Cedex, France
| | - S Houze
- Laboratoire de Parasitologie Mycologie, AP-HP Hôpital BICHAT-Claude Bernard, 46 rue Henri Huchard, F-75877 Paris Cedex 18, France
| | - L Paris
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Laboratoire de Parasitologie-Mycologie, 47-83 Boulevard de l'Hôpital, F-75651 Paris Cedex 13, France
| | - H Pelloux
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire A. Michallon et Université de Grenoble BP 217, 38043 Grenoble Cedex, France
| | - I Villena
- Laboratoire de Parasitologie-Mycologie, Hôpital Maison Blanche, Centre Hospitalier Universitaire et Université de Reims Champagne Ardennes, 45 rue Cognacq-Jay, F-51092 Reims Cedex, France
| | - E Candolfi
- Institut de Parasitologie et de Pathologie Tropicale de Strasbourg, Université de Strasbourg, Hôpitaux Universitaires de Strasbourg, 1-3 rue Koeberlé, F-67000 Strasbourg, France.
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Significance of a Positive Toxoplasma Immunoglobulin M Test Result in the United States. J Clin Microbiol 2015; 53:3601-5. [PMID: 26354818 DOI: 10.1128/jcm.01663-15] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 09/03/2015] [Indexed: 11/20/2022] Open
Abstract
A positive Toxoplasma immunoglobulin M (IgM) result is often interpreted as a marker of an acute infection. However, IgM can persist for several years, and Toxoplasma commercial IgM diagnostic test kits can yield a number of false-positive results. For these reasons, a chronic Toxoplasma infection can be erroneously classified as an acute infection, resulting in serious adverse consequences, especially in pregnant women, leading to emotional distress and unnecessary interventions, including termination of pregnancy. Interpretation of Toxoplasma serology at a reference laboratory can help differentiate a recently acquired infection from a chronic infection. Serological test results for 451 patients with positive Toxoplasma IgM and IgG test results obtained at nonreference laboratories (NRLs) that were referred to Palo Alto Medical Foundation Toxoplasma Serology Laboratory (PAMF-TSL) to determine whether the patient was acutely or chronically infected were retrospectively reviewed. PAMF-TSL results established that of the 451 patients, 335 (74%) had a chronic infection, 100 (22%) had an acute infection, and 7 (2%) were not infected, and for 9 (2%), results were indeterminate. Positive Toxoplasma IgM and IgG test results obtained at NRLs cannot accurately distinguish between acute and chronic infections. To do so, testing at reference laboratories is required, as mandated in 1997 in a letter from the Food and Drug Administration (FDA) to clinicians and laboratories in the United States.
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Meylan P, Paris L, Liesenfeld O. Multicenter evaluation of the Elecsys Toxo IgG and IgM tests for the diagnosis of infection with Toxoplasma gondii. Eur J Microbiol Immunol (Bp) 2015; 5:150-8. [PMID: 26185683 PMCID: PMC4500066 DOI: 10.1556/1886.2015.00016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 05/19/2015] [Indexed: 11/19/2022] Open
Abstract
Detection of IgG and IgM antibodies is commonly performed for the diagnosis of infection with Toxoplasma gondii. We determined the accuracy of the Elecsys Toxo IgG and IgM test at four European laboratories compared to local reference methods. Coefficients of variation for reproducibility ranged from 1.0 to 6.5% for IgG and from 0.8 to 3.2% for IgM. Seroconversion panels revealed high overall concordance with the reference tests. The Elecsys test detected IgG antibodies earlier than the Cobas Core IgG test in 19 of 47 panels; persisting IgM antibodies were observed in the VIDAS but not the Elecsys test in five of 47 panels. In 31.4% of latent stage sera with persistent IgM antibodies (positive LIASON IgM), the Elecsys IgM test gave negative results indicating increased "clinical" specificity. Sensitivity and specificity of the Elecsys IgG assay ranged from 99.45 to 100% and 87.50-99.80%, respectively, and 91.11-95.74 and 98.45-99.79% for the Elecsys IgM assay, respectively. In conclusion, excellent reproducibility and accuracy make the Elecsys Toxo G and M tests highly suitable for the detection of anti-T. gondii IgG and IgM antibodies. The lower detection rates for persistent IgM in the Elecsys IgM test increase "clinical" specificity and decrease the need for follow-up testing.
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Affiliation(s)
- Pascal Meylan
- Institute of Microbiology, Centre Hospitalier Universitaire Vaudois , Lausanne, Switzerland
| | - Luc Paris
- AP-HP, Laboratoire de Parasitologie-Mycologie, Hôpitaux Universitaires Pitié-Salpétrière - Charles Foix , Paris, France
| | - Oliver Liesenfeld
- Institute for Microbiology and Hygiene, Charité Medical School , Berlin, Germany
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Identification of Toxoplasma gondii antigens associated with different types of infection by serum antibody profiling. Parasitology 2015; 142:827-38. [PMID: 25586591 DOI: 10.1017/s0031182014001978] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Acquisition of acute toxoplasmosis during the first trimester of pregnancy can have catastrophic consequences for the foetus. Diagnosis is routinely based on the detection of maternal Toxoplasma gondii--antibodies using whole parasite extracts as detection antigen. While such assays are sensitive, they show no specificity for the stage of infection. We hypothesized diagnosis might be improved using recombinant antigens for detection, particularly if antibodies to certain antigen(s) were associated with early or late stages of infection. To address this, protein microarrays comprising 1513 T. gondii exon products were probed with well-characterized sera from seronegative ('N') controls, and acute ('A'), chronic/IgM-persisting ('C/M') and chronic ('C') toxoplasmosis cases from Turkey. Three reactive exon products recognized preferentially in A infections, and three recognized preferentially in C/M infections, were expressed in Escherichia coli and tested for discrimination in IgG ELISAs. The best discriminators were exon 1 of TGME49_086450 (GRA5) which detected C/M infections with 70.6% sensitivity and 81.8% specificity, and exon 6 of TGME49_095700 (ubiquitin transferase domain-containing protein) which detected A infections with 84.8% sensitivity and 82.4% specificity. Overall, the data support a recombinant protein approach for the development of improved serodiagnostic tests for toxoplasmosis.
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Siddiqui N, Shujatullah F, Khan HM, Rabbani T, Khan PA. IgG avidity antibodies against Toxoplasma gondii in high risk females of reproductive age group in India. THE KOREAN JOURNAL OF PARASITOLOGY 2014; 52:487-91. [PMID: 25352696 PMCID: PMC4210730 DOI: 10.3347/kjp.2014.52.5.487] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 06/15/2014] [Accepted: 06/18/2014] [Indexed: 11/23/2022]
Abstract
Toxoplasma gondii is an obligate intracellular protozoan that is distributed worldwide. Recently, several tests for avidity of Toxoplasma IgG antibodies have been introduced to help discriminate between recently acquired and distant infections. The study was conducted in Jawaharlal Nehru Medical College and Hospital, India from February 2011 to September 2012. Serum specimens were subjected to Toxoplasma IgM ELISA and IgG avidity ELISA test. Out of 48 patients with abortions, 17 (35.4%) were positive for IgM ELISA, and 8 (16.6%) had low IgG avidity antibodies. Out of 48 patients with other obstetric problems, 23 (47.9%) were positive for IgM ELISA, and 17 (35.4%) had low IgG avidity antibodies. Combining both groups on avidity test, only 25 of 40 (62.5%) IgM-positive women had low-avidity IgG antibodies suggesting a recent T. gondii infection in these women. More importantly, 15 (37.5%) of the IgM-positive women had high-avidity antibodies suggesting that the infection was acquired before gestation The relation of IgM seropositivity with the following risk factors was not found to be statistically significant; contact with cats (0.13), non-vegetarian food habits (0.05), and low socio-economic status (0.49). While, for IgG avidity ELISA, only contact with cats (0.01) was significantly associated with seropositivity. All other risk factors have P-values of >0.05 (not significant). IgG avidity test when used in combination with IgM test was a valuable assay for diagnosis of ongoing or recently acquired T. gondii infection in India.
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Affiliation(s)
- Naushaba Siddiqui
- Department of Microbiology, Jawaharlal Nehru Medical College and Hospital, AMU, Aligarh, UP, India
| | - Fatima Shujatullah
- Department of Microbiology, Jawaharlal Nehru Medical College and Hospital, AMU, Aligarh, UP, India
| | - Haris M Khan
- Department of Microbiology, Jawaharlal Nehru Medical College and Hospital, AMU, Aligarh, UP, India
| | - Tamkin Rabbani
- Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College and Hospital, AMU, Aligarh, UP, India
| | - Parvez A Khan
- Department of Microbiology, Jawaharlal Nehru Medical College and Hospital, AMU, Aligarh, UP, India
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Chaudhry SA, Gad N, Koren G. Toxoplasmosis and pregnancy. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2014; 60:334-336. [PMID: 24733322 PMCID: PMC4046541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Question Congenital toxoplasmosis is a dangerous fetal infection. Why is routine screening for Toxoplasma gondii infection during pregnancy not available for most Canadians? Answer Low prevalence of the infection, high cost associated with testing, low sensitivity of screening tests, false-positive test results, and limitations of treatment effectiveness are all cited as reasons for not routinely screening for T gondii infection in Canada. Currently, screening for the detection of T gondii is only performed in Nunavik and other parts of northern Quebec owing to the high prevalence of infection in this region. Congenital toxoplasmosis causes neurologic or ocular disease (leading to blindness), as well as cardiac and cerebral anomalies.
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Fischer S, Agmon-Levin N, Shapira Y, Porat Katz BS, Graell E, Cervera R, Stojanovich L, Gómez Puerta JA, Sanmartí R, Shoenfeld Y. Toxoplasma gondii: bystander or cofactor in rheumatoid arthritis. Immunol Res 2014; 56:287-92. [PMID: 23553228 DOI: 10.1007/s12026-013-8402-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Parasitic infections may induce variable immunomodulatory effects and control of autoimmune disease. Toxoplasma gondii (T. gondii) is a ubiquitous intracellular protozoan that was recently associated with autoimmunity. This study was undertaken to investigate the seroprevalence and clinical correlation of anti-T. gondii antibodies in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). We evaluated sera from European patients with RA (n = 125) and SLE (n = 164) for the prevalence of anti-T. gondii IgG antibodies (ATXAb), as well as other common infections such as Cytomegalovirus, Epstein-Barr, and Rubella virus. The rates of seropositivity were determined utilizing the LIAISON chemiluminescent immunoassays (DiaSorin, Italy). Our results showed a higher seroprevalence of ATXAb in RA patients, as compared with SLE patients [63 vs. 36 %, respectively (p = 0.01)]. The rates of seropositivity of IgG against other infectious agents were comparable between RA and SLE patients. ATXAb-seropositivity was associated with older age of RA patients, although it did not correlate with RA disease activity and other manifestations of the disease. In conclusion, our data suggest a possible link between exposure to T. gondii infection and RA.
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Affiliation(s)
- Svetlana Fischer
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, 52621, Tel HaShomer, Israel
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Murat JB, Fricker Hidalgo H, Brenier-Pinchart MP, Pelloux H. Human toxoplasmosis: which biological diagnostic tests are best suited to which clinical situations? Expert Rev Anti Infect Ther 2014; 11:943-56. [DOI: 10.1586/14787210.2013.825441] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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47
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Detection of Toxoplasmosis in Renal Transplant Recipients by ELISA and PCR Methods in Ahvaz, South-West of Iran. Jundishapur J Microbiol 2013. [DOI: 10.5812/jjm.7642] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Deshpande PS, Kotresha D, Noordin R, Yunus MH, Saadatnia G, Golkar M, Osman S, Karim IZA, Ghaffarifar F. IgG avidity Western blot using Toxoplasma gondii rGRA-7 cloned from nucleotides 39-711 for serodiagnosis of acute toxoplasmosis. Rev Inst Med Trop Sao Paulo 2013; 55:79-83. [PMID: 23563759 DOI: 10.1590/s0036-46652013000200003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 08/13/2012] [Indexed: 11/21/2022] Open
Abstract
Toxoplasmosis is an important cause of congenital infection. The present study was performed to evaluate the usefulness of recombinant (r) GRA-7 cloned from nucleotides (n) 39-711 in discriminating between acute and chronic toxoplasmosis. First, commercial IgM, IgG and IgG avidity ELISAs were used to determine the serological profile of the sera. Serum samples were from 20 symptomatic patients with acute infection (low IgG avidity, IgM positive), 10 with chronic infection (high IgG avidity, IgM negative) and 10 with indeterminate IgG avidity (IgM positive) which were tested for IgG avidity status with an in-house developed IgG avidity Western blot using the rGRA-7 recombinant antigen. All 20 sera from cases of probable acute infection showed bands which either faded out completely or reduced significantly in intensity after treatment with 8 M urea, whereas the band intensities of the 10 serum samples from chronic cases remained the same. Of the 10 sera with indeterminate IgG avidity status, after treatment with 8 M urea the band intensities with six sera remained the same, two sera had completely faded bands and another two sera had significantly reduced band intensities. Discrimination between acute and chronic toxoplasmosis was successfully performed by the in-house IgG avidity Western blot.
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Affiliation(s)
- Poonam S Deshpande
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, 11800 Penang, Malaysia
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Baquero-Artigao F, del Castillo Martín F, Fuentes Corripio I, Goncé Mellgren A, Fortuny Guasch C, de la Calle Fernández-Miranda M, González-Tomé M, Couceiro Gianzo J, Neth O, Ramos Amador J. Guía de la Sociedad Española de Infectología Pediátrica para el diagnóstico y tratamiento de la toxoplasmosis congénita. An Pediatr (Barc) 2013; 79:116.e1-116.e16. [DOI: 10.1016/j.anpedi.2012.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 12/03/2012] [Accepted: 12/04/2012] [Indexed: 10/27/2022] Open
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Comparison of the Vidas system and two recent fully automated assays for diagnosis and follow-up of toxoplasmosis in pregnant women and newborns. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2013; 20:1203-12. [PMID: 23740928 DOI: 10.1128/cvi.00089-13] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Serological testing to detect toxoplasmosis is of major importance to avoid the possible effects of the disease in newborns. This study assessed anti-Toxoplasma IgG and IgM with the Vidas (bioMérieux), Architect (Abbott), and Liaison (DiaSorin) systems in 631 sera from pregnant women and newborns as well as anti-Toxoplasma IgG avidity with these three systems on 54 sera from pregnant women with positive IgG and IgM. The IgG and IgM results were in agreement in, respectively, 95.2% and 98.3% (Vidas versus Architect) and 96.9% and 95.3% (Vidas versus Liaison) of the samples. Specificities were excellent for all the assays, while Vidas sensitivities ranged (depending on the classification of gray zone results) from 93.8 to 98.4% for IgG (Architect, 84.4 to 93.8%; Liaison, 93.8%) and from 81.8 to 90.9% for IgM (Architect, 63.6%; Liaison, 81.8 to 90.9%). In seroconversion sequences, IgMs were generally detected simultaneously by the three assays, while Architect was the earliest assay to detect IgG. In noninfected children, maternally transmitted IgGs were detected for a longer time with Architect than with the other systems. IgMs were positive in only one infected child with the Vidas and Liaison systems. Significantly more sera were classified in the high-avidity category with Vidas than with Architect. This evaluation shows similar performances for Vidas and more recent systems. The Vidas system adequately detects toxoplasmosis in pregnant women and newborns. This system fits the needs of laboratories working on small routine series for first-line testing as well as expert laboratories, due to a high specificity and a powerful avidity test.
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