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Yarahmadi S, Saki J, Arjmand R, Shahbazian H. Toxoplasma gondii molecular detection and phylogenetic analysis in hemodialysis patients from Khuzestan, Southwest Iran. Trop Med Health 2024; 52:19. [PMID: 38350969 PMCID: PMC10863173 DOI: 10.1186/s41182-024-00585-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 01/26/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND The diagnosis and genetic characterization of Toxoplasma gondii (T. gondii) infection can make a significant influence to the prevention of the dangerous consequences of toxoplasmosis, particularly in immunocompromised people. OBJECTIVE The aim of this investigation was to assess the frequency and genotyping of T. gondii in blood samples of patients with hemodialysis. MATERIALS AND METHODS In the current investigation, a total of 379 blood samples were taken from subjects with hemodialysis who were referred to teaching hospital of Ahvaz in the southwest of Iran. The samples were evaluated using the Nested PCR by targeting the B1 gene, and then, sequencing and phylogenetic tree were constructed. RESULTS T. gondii DNA was found in 112 (29.55%) of the blood samples by Nested PCR. Amplicons from T. gondii revealed high identity with GenBank sequences. The phylogenetic analysis revealed that all sequences were closely related to Type I of T. gondii. CONCLUSION Because of the high incidence of toxoplasmosis with type I prevalent in hemodialysis patients, we recommend a systematic screening for toxoplasmosis to carry out for monitoring the possible dissemination of toxoplasmosis during hemodialysis.
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Affiliation(s)
- Saba Yarahmadi
- Department of Medical Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, P. O. Box 6135743337, Ahvaz, 393-61155, Iran
| | - Jasem Saki
- Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, P.O. Box 6135743337, Ahvaz, 393-61155, Iran.
| | - Reza Arjmand
- Department of Medical Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, P. O. Box 6135743337, Ahvaz, 393-61155, Iran
| | - Heshmatolah Shahbazian
- Department of Nephrology, Golestan General Hospital, Diabetes and CKD Research Center, Ahvaz Jundishapur University of Medical Sciences, P.O. Box 6135743337, Ahvaz, 393-61155, Iran
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Henry B, Sibley LD, Rosenberg A. A Combination of Four Nuclear Targeted Effectors Protects Toxoplasma Against Interferon Gamma Driven Human Host Cell Death During Acute Infection. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.12.24.573224. [PMID: 38234811 PMCID: PMC10793417 DOI: 10.1101/2023.12.24.573224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
In both mice and humans, Type II interferon-gamma (IFNγ) is crucial for regulation of Toxoplasma gondii (T. gondii) infection, during acute or chronic phases. To thwart this defense, T. gondii secretes protein effectors hindering the hosťs immune response. For example, T. gondii relies on the MYR translocon complex to deploy soluble dense granule effectors (GRAs) into the host cell cytosol or nucleus. Recent genome-wide loss-of-function screens in IFNγ-primed primary human fibroblasts identified MYR translocon components as crucial for parasite resistance against IFNγ driven vacuole clearance. However, these screens did not pinpoint specific MYR-dependent GRA proteins responsible for IFNγ signaling blockade, suggesting potential functional redundancy. Our study reveals that T. gondii depends on the MYR translocon complex to prevent host cell death and parasite premature egress in human cells stimulated with IFNγ postinfection, a unique phenotype observed in various human cell lines but not in murine cells. Intriguingly, inhibiting parasite egress did not prevent host cell death, indicating this mechanism is distinct from those described previously. Genome-wide loss-of-function screens uncovered TgIST, GRA16, GRA24, and GRA28 as effectors necessary for a complete block of IFNγ response. GRA24 and GRA28 directly influenced IFNγ driven transcription, GRA24's action depended on its interaction with p38 MAPK, while GRA28 disrupted histone acetyltransferase activity of CBP/p300. Given the intricate nature of the immune response to T. gondii, it appears that the parasite has evolved equally elaborate mechanisms to subvert IFNγ signaling, extending beyond direct interference with the JAK/STAT1 pathway, to encompass other signaling pathways as well.
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Affiliation(s)
- Brittany Henry
- Department of Infectious Diseases, Center for Tropical and Emerging Infectious Diseases, University of Georgia, Athens, Georgia, USA
| | - L. David Sibley
- Department of Molecular Microbiology, Washington University School of Medicine, St Louis, Missouri, USA
| | - Alex Rosenberg
- Department of Infectious Diseases, Center for Tropical and Emerging Infectious Diseases, University of Georgia, Athens, Georgia, USA
- Department of Molecular Microbiology, Washington University School of Medicine, St Louis, Missouri, USA
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Tawfeek GM, Abou-El-Naga IF, Hassan EME, Sabry D, Meselhey RA, Younis SS. Protective efficacy of Toxoplasma gondii infected cells-derived exosomes against chronic murine toxoplasmosis. Acta Trop 2023; 248:107041. [PMID: 37858877 DOI: 10.1016/j.actatropica.2023.107041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 10/21/2023]
Abstract
Exosomes were isolated from T. gondii infected human hepatoblastoma cells using the exosome isolation kit and characterized by electron microscopy and Western blotting. Exosomes adsorbed to alum adjuvant were evaluated as a potential immunizing agent against murine chronic toxoplasmosis compared to excretory secretory antigens (ESA)-alum. Mice were immunized at days 1, 15 and 29. The levels of IgG, IFN-γ, IL-4 and IL-10, CD4+ and CD8+ T cells were determined using sandwich enzyme-linked immunosorbent assay (sandwich ELISA) at days 14, 28 and 56 of the experiment. Then mice were infected orally with 10 cysts of T. gondii. The protective efficacy of the antigens were evaluated by counting the brain cysts and measuring the aforementioned humoral and cellular parameters 60 days post infection. The results showed that alum increased the protective efficacy of the exosomes. Immunization with exosome-alum induced both humoral and mixed Th1/Th2 cellular immune responses. Exosome-alum gave higher levels of the humoral and cellular parameters, compared to ESA-alum. After challenge infection, exosome-alum significantly reduced the brain cyst burden by 75 % while ESA-alum gave 42 % reduction and evoked higher humoral and cellular immune responses. Therefore, the possibility of using T. gondii infected cells-derived exosome-alum as a vaccine is a new perspective in toxoplasmosis.
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Affiliation(s)
- Gihan M Tawfeek
- Medical Parasitology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Iman F Abou-El-Naga
- Medical Parasitology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| | | | - Dina Sabry
- Medical Biochemistry and Molecular Biology, Faculty of Medicine, Badr University in Cairo, Egypt; Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Egypt
| | | | - Salwa Sami Younis
- Medical Parasitology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Li X, Yuan W, He T, Guo R, Du X, He Y, Li X, El-Ashram S, Al-Olayan EM, Yang N, Sang X. Boosting Mouse Defense against Lethal Toxoplasma gondii Infection with Full-Length and Soluble SAG1 Recombinant Protein. Vaccines (Basel) 2023; 11:1678. [PMID: 38006011 PMCID: PMC10675489 DOI: 10.3390/vaccines11111678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/23/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023] Open
Abstract
Toxoplasmosis is a major worldwide protozoan zoonosis. The surface antigen 1 (SAG1) of Toxoplasma gondii (T. gondii) has always been recognized as an ideal vaccine candidate antigen. However, the intact and soluble SAG1 protein is usually difficult to acquire in vitro, which is unfavorable for employing the recombinant protein as a vaccine candidate antigen. In the present study, we obtained the full-length SAG1 recombinant protein in soluble form by Escherichia coli Transetta (DE3) cells under optimized expression conditions. The immunogenicity and protective ability of this recombinant protein against T. gondii acute infection were evaluated in a mouse model. Monitoring changes in serum antibody levels and types, the presence of cytokines, and the rate of lymphocyte proliferation in vaccinated mice were used to assess humoral and cellular immune responses. Additional assessments were performed to determine the protective potency of the recombinant protein in combating T. gondii RH tachyzoites. It was found that the titers of both IgG2a and IgG2b were considerably greater in the immunized mice compared to the titers of IgG1 and IgG3. The levels of Th1-type cytokines (IFN-γ, IL-12p70, IL-2, and TNF-α) and Th2-type cytokines (IL-10) significantly increased when splenocytes from immunological group mice were treated with T. gondii lysate antigen. Compared to the control group, a recombinant protein substantially increased the longevity of infected mice, with an average death time prolonged by 14.50 ± 0.34 days (p < 0.0001). These findings suggest that the full-length and soluble SAG1 recombinant protein produced potent immune responses in mice and could be a preferred subunit vaccine candidate for T. gondii, offering a feasible option for vaccination against acute toxoplasmosis.
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Affiliation(s)
- Xiang Li
- Key Laboratory of Livestock Infectious Diseases, Shenyang Agricultural University, Ministry of Education, Shenyang 110866, China; (X.L.); (W.Y.); (T.H.); (R.G.); (X.D.); (Y.H.); (X.L.)
- College of Animal Science and Veterinary Medicine, Shenyang Agricultural University, Shenyang 110866, China
| | - Wei Yuan
- Key Laboratory of Livestock Infectious Diseases, Shenyang Agricultural University, Ministry of Education, Shenyang 110866, China; (X.L.); (W.Y.); (T.H.); (R.G.); (X.D.); (Y.H.); (X.L.)
- College of Animal Science and Veterinary Medicine, Shenyang Agricultural University, Shenyang 110866, China
| | - Ting He
- Key Laboratory of Livestock Infectious Diseases, Shenyang Agricultural University, Ministry of Education, Shenyang 110866, China; (X.L.); (W.Y.); (T.H.); (R.G.); (X.D.); (Y.H.); (X.L.)
- College of Animal Science and Veterinary Medicine, Shenyang Agricultural University, Shenyang 110866, China
| | - Ruiying Guo
- Key Laboratory of Livestock Infectious Diseases, Shenyang Agricultural University, Ministry of Education, Shenyang 110866, China; (X.L.); (W.Y.); (T.H.); (R.G.); (X.D.); (Y.H.); (X.L.)
- College of Animal Science and Veterinary Medicine, Shenyang Agricultural University, Shenyang 110866, China
| | - Xiuxian Du
- Key Laboratory of Livestock Infectious Diseases, Shenyang Agricultural University, Ministry of Education, Shenyang 110866, China; (X.L.); (W.Y.); (T.H.); (R.G.); (X.D.); (Y.H.); (X.L.)
- College of Animal Science and Veterinary Medicine, Shenyang Agricultural University, Shenyang 110866, China
| | - Yanhong He
- Key Laboratory of Livestock Infectious Diseases, Shenyang Agricultural University, Ministry of Education, Shenyang 110866, China; (X.L.); (W.Y.); (T.H.); (R.G.); (X.D.); (Y.H.); (X.L.)
- College of Animal Science and Veterinary Medicine, Shenyang Agricultural University, Shenyang 110866, China
| | - Xuan Li
- Key Laboratory of Livestock Infectious Diseases, Shenyang Agricultural University, Ministry of Education, Shenyang 110866, China; (X.L.); (W.Y.); (T.H.); (R.G.); (X.D.); (Y.H.); (X.L.)
- College of Animal Science and Veterinary Medicine, Shenyang Agricultural University, Shenyang 110866, China
| | - Saeed El-Ashram
- Zoology Department, Faculty of Science, Kafrelsheikh University, Kafr El-Sheikh 33516, Egypt;
| | - Ebtesam M. Al-Olayan
- Department of Zoology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Na Yang
- Key Laboratory of Livestock Infectious Diseases, Shenyang Agricultural University, Ministry of Education, Shenyang 110866, China; (X.L.); (W.Y.); (T.H.); (R.G.); (X.D.); (Y.H.); (X.L.)
- College of Animal Science and Veterinary Medicine, Shenyang Agricultural University, Shenyang 110866, China
| | - Xiaoyu Sang
- Key Laboratory of Livestock Infectious Diseases, Shenyang Agricultural University, Ministry of Education, Shenyang 110866, China; (X.L.); (W.Y.); (T.H.); (R.G.); (X.D.); (Y.H.); (X.L.)
- College of Animal Science and Veterinary Medicine, Shenyang Agricultural University, Shenyang 110866, China
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Zouei N, Dalimi A, Pirestani M, Ghaffarifar F. Assessment of tissue levels of miR-146a and proinflammatory cytokines in experimental cerebral toxoplasmosis following atovaquone and clindamycin treatment: An in vivo study. Microb Pathog 2023; 184:106340. [PMID: 37683834 DOI: 10.1016/j.micpath.2023.106340] [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: 06/12/2023] [Revised: 07/27/2023] [Accepted: 09/05/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Despite recent advances for treating cerebral toxoplasmosis (CT), monitoring the parasite burden and treatment response is still challenging. miRNAs are small non-coding RNAs with regulatory functions that can be used in diagnosis and treatment monitoring. We investigated the changes in miR-146a, BAG-1 gene, IL-6, and IL-10 tissue levels in the brain of BALB/c mice with chronic CT caused by the PRU strain of T. gondii following anti-parasitic and antibiotic treatment. METHOD Fifty-three 6-to 8-week-old BALB/c mice were infected using intraperitoneal inoculation of cerebral cysts of T. gondii PRU strain and then divided into five groups as follows: group 1 included mice treated with 100 mg/kg/d Atovaquone (AT), group 2 included mice treated with 400 mg/kg/d clindamycin (CL), group 3 included mice treated with combination therapy (AT + CL), group 4 included infected untreated mice as a positive control (PC), and; group 5 included uninfected untreated mice as negative control (NC). After the completion of the treatment course, tissue level of mir-146a, miR-155, BAG-1 gene, IL-6, and IL-10 was investigated with real-time polymerase chain reaction. The IL-6/IL-10 ratio was calculated as an indicator of immune response. Moreover, brain cyst numbers were counted on autopsy samples. RESULTS miR-146a, IL-6, IL-10, and BAG-1 genes were expressed in PC, but not in the NC group; miR-146a, IL-6, IL-10, and BAG-1 gene expression were significantly lower in AT, CL, and AT + CL compared with PC. MiR-146a and BAG-1 levels in AT and CL were not different statistically, however, they both had lower levels compared to AT + CL (P < 0.01). There was no difference in the expression of IL-6 and IL-10 between treatment groups. BAG-1 expression was significantly lower in AT, than in CL and AT + CL (P < 0.0089 and < 0.002, respectively). The PC group showed a higher ratio of IL-6/IL-10, although this increase was not statistically significant. It is noteworthy that the treatment with AT reduced this ratio; in the inter-group comparison, this ratio showed a decrease in the AT and AT + CL compared to the PC. The number of brain tissue cysts was significantly lower in AT, CL, and AT + CL, than in PC (p < 0.0001). AT had significantly lower brain cysts than CL and AT + CL (P < 0.0001). CONCLUSION It seems that the factors studied in the current research (microRNA and cytokines) are a suitable index for evaluating the response to antiparasitic and antibiotic treatment. However, more studies should be conducted in the future to confirm our findings.
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Affiliation(s)
- Nima Zouei
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Abdolhossein Dalimi
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Majid Pirestani
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Fatemeh Ghaffarifar
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Kadkhodaei S, Jahromi ZK, Taghipour A, Rezanezhad H, Solhjoo K. A Case-Control Seroprevalence Survey of Toxoplasmosis in Hemodialysis Patients and Healthy Subjects in Kazeroon and Jahrom Districts in Fars Province, Southern Iran. J Parasitol Res 2023; 2023:8251462. [PMID: 37808168 PMCID: PMC10560106 DOI: 10.1155/2023/8251462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/05/2023] [Accepted: 09/13/2023] [Indexed: 10/10/2023] Open
Abstract
Opportunistic parasites such as Toxoplasma gondii (T. gondii) are capable of causing neurological and ocular manifestations in patients undergoing hemodialysis. By designing a matched case-control study, we conducted a seromolecular survey of T. gondii in hemodialysis patients compared to a healthy group from Jahrom and Kazeroon cities in Fars Province, Iran. For this purpose, 75 hemodialysis patients from Kazeroon city, 75 hemodialysis patients from Jahrom city, and 75 healthy individuals were recruited for the study. The serum levels of specific immunoglobulins (IgG/IgM) in the case and control groups were evaluated using the enzyme-linked immunosorbent assay (ELISA) method. Also, buffy coat samples were used to extract genomic DNA. Then, Polymerase Chain Reaction (PCR) was accomplished using the RE and GRA6 genes of T. gondii. A standard questionnaire containing demographic factors was administered. Although the seroprevalence of the anti-T. gondii IgG antibody in hemodialysis patients from Kazeroon (18.66% (14/75)) and Jahrom (25.33% (19/75)) was higher than that in the control group (13.33% (10/75)), no statistically significant difference was observed between the case and control groups (P value = 0.373 from Kazeroon and P value = 0.354 from Jahrom). Among the studied variables, only residence (urban) was significantly associated with the anti-T. gondii IgG antibody in the case group from Kazeroon. Also, no IgM antibody titers and DNA of T. gondii were detected in the case and control groups from both cities. Although high seroprevalence of anti-T. gondii IgG antibody was seen in hemodialysis patients, further epidemiological studies with larger samples need to be done in Jahrom and Kazeroon cities and in other parts of Iran. It is also necessary for health officials to establish programs for the prevention and control of T. gondii infection in hemodialysis patients.
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Affiliation(s)
- Shahin Kadkhodaei
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Ali Taghipour
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Hassan Rezanezhad
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Kavous Solhjoo
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
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Tarannum A, Rodríguez-Almonacid CC, Salazar-Bravo J, Karamysheva ZN. Molecular Mechanisms of Persistence in Protozoan Parasites. Microorganisms 2023; 11:2248. [PMID: 37764092 PMCID: PMC10534552 DOI: 10.3390/microorganisms11092248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/31/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Protozoan parasites are known for their remarkable capacity to persist within the bodies of vertebrate hosts, which frequently results in prolonged infections and the recurrence of diseases. Understanding the molecular mechanisms that underlie the event of persistence is of paramount significance to develop innovative therapeutic approaches, given that these pathways still need to be thoroughly elucidated. The present article provides a comprehensive overview of the latest developments in the investigation of protozoan persistence in vertebrate hosts. The focus is primarily on the function of persisters, their formation within the host, and the specific molecular interactions between host and parasite while they persist. Additionally, we examine the metabolomic, transcriptional, and translational changes that protozoan parasites undergo during persistence within vertebrate hosts, focusing on major parasites such as Plasmodium spp., Trypanosoma spp., Leishmania spp., and Toxoplasma spp. Key findings of our study suggest that protozoan parasites deploy several molecular and physiological strategies to evade the host immune surveillance and sustain their persistence. Furthermore, some parasites undergo stage differentiation, enabling them to acclimate to varying host environments and immune challenges. More often, stressors such as drug exposure were demonstrated to impact the formation of protozoan persisters significantly. Understanding the molecular mechanisms regulating the persistence of protozoan parasites in vertebrate hosts can reinvigorate our current insights into host-parasite interactions and facilitate the development of more efficacious disease therapeutics.
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Affiliation(s)
| | | | | | - Zemfira N. Karamysheva
- Department of Biological Sciences, Texas Tech University, Lubbock, TX 79409, USA; (A.T.); (C.C.R.-A.); (J.S.-B.)
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Reimer-Mcatee M, Ramirez D, Mcatee C, Granillo A, Hasbun R. Encephalitis in HIV-infected adults in the antiretroviral therapy era. J Neurol 2023; 270:3914-3933. [PMID: 37115358 DOI: 10.1007/s00415-023-11735-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/18/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023]
Abstract
INTRODUCTION Encephalitis presents with high morbidity and mortality in both HIV-infected and HIV-negative patients. There are currently no studies comparing HIV-infected and HIV-negative patients admitted to the hospital with acute encephalitis. METHODS We conducted a multicenter, retrospective study of adults admitted to the hospital with a diagnosis of encephalitis in Houston, Texas between 2005 and 2020. We describe the clinical manifestations, etiology, and outcomes of these patients with a focus on those infected with HIV. RESULTS We identified 260 patients with encephalitis, 40 of whom were infected with HIV. Viral etiology was identified in 18 of the 40 HIV-infected patients (45.0%); bacterial in 9 (22.5%); parasitic in 5 (12.5%); fungal in 3 (7.5%); immune-mediated in 2 (5.0%). Eleven cases had unclear etiology (27.5%). More than one disease process was identified in 12 (30.0%) patients. HIV-infected persons were more likely to have neurosyphilis (8/40 vs. 1/220; OR 55; 95%CI 6.6-450), CMV encephalitis [5/18 vs. 1/30; OR 11.2 (1.18-105)], or VZV encephalitis (8/21 vs. 10/89; OR 4.82; 1.62-14.6) compared to the HIV-negative patients. Inpatient mortality was similar in the HIV-infected and HIV-negative patients, 15.0% vs 9.5% [p = 0.4, OR 1.67 (0.63-4.44)], but one-year mortality was higher for the HIV-infected patients, 31.3% vs 16.0% [p = 0.04, OR 2.40 (1.02-5.55)]. CONCLUSION This large, multicenter study shows that HIV-infected patients with encephalitis have a distinct pattern of disease when compared with HIV-negative patients, and that this population has nearly twice the odds of mortality in the year following hospitalization.
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Affiliation(s)
- Melissa Reimer-Mcatee
- Section of Infectious Diseases, UT Health McGovern Medical School, Houston, TX, USA.
- Institute for Global Health and Infectious Diseases, University of North Carolina UNC Project Malawi, Lilongwe, Malawi.
- Washington University in St. Louis, ACHIEVE Fogarty Global Health Program, Lilongwe, Malawi.
| | - Denisse Ramirez
- Section of Infectious Diseases, UT Health McGovern Medical School, Houston, TX, USA
| | | | - Alejandro Granillo
- Section of Infectious Diseases, UT Health McGovern Medical School, Houston, TX, USA
| | - Rodrigo Hasbun
- Section of Infectious Diseases, UT Health McGovern Medical School, Houston, TX, USA.
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Ghasemikhah R, Hakimzadeh Z, Gilani A, Sarmadian H, Sarmadian R, Yousefbeigi N. An HIV-positive woman with massive brain lesion due to toxoplasmosis: A case report. Clin Case Rep 2023; 11:e7688. [PMID: 37457995 PMCID: PMC10340077 DOI: 10.1002/ccr3.7688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/07/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
Key Clinical Message Toxoplasmosis-related huge brain lesions may require decompressive craniectomy and lesion excision to avoid brain damage. In this situation, injectable cotrimoxazole is a better choice for treatment. Abstract Toxoplasma gondii is a worldly distributed obligate intracellular protozoa. Toxoplasmosis is a prevalent opportunistic infection in HIV-infected people, but it was rarely recorded prior to the identification of HIV infection. Here, we report a toxoplasmosis brain lesion in an Iranian HIV-positive patient. A 45-year-old woman with a complaint of malaise was referred to the Valiasr Hospital in Arak city. In her past clinical history, the patient had a history of anemia, deep vein thrombosis (DVT), and positive HIV. The patient was informed of the diagnosis of massive brain toxoplasmosis as a definite diagnosis. The patient was then taken to the operating room for a left decompressive craniectomy, during which the ensuing brain lesion was excised. After a few days, she was discharged from the hospital in good condition and without any complications.
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Affiliation(s)
- Reza Ghasemikhah
- Department of Parasitology & MycologyArak University of Medical SciencesArakIran
| | - Zahra Hakimzadeh
- Neurosciences Research Center (NSRC)Tabriz University of Medical SciencesEast AzerbaijanIran
| | - Abolfazl Gilani
- Sina Trauma & Surgery Research CenterTehran University of Medical SciencesTehranIran
| | - Hossein Sarmadian
- Department of Infectious DiseasesArak University of Medical SciencesArakIran
| | - Roham Sarmadian
- Infectious Diseases Research CenterArak University of Medical SciencesArakIran
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Awang Senik NIS, Halim SA, Sapiai NA. A case of cerebral toxoplasmosis: "Eccentric and concentric sign" in MRI. IDCases 2023; 33:e01824. [PMID: 37434609 PMCID: PMC10331276 DOI: 10.1016/j.idcr.2023.e01824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/11/2023] [Accepted: 06/15/2023] [Indexed: 07/13/2023] Open
Abstract
Central nervous system (CNS) toxoplasmosis is an opportunistic infection caused by the intracellular protozoan parasite Toxoplasma gondii. This organism typically causes disease in immunocompromised patients with human immunodeficiency virus (HIV). We reported a case of a 52-year-old woman with neurology symptoms and Magnetic resonance imaging (MRI) brain shows both eccentric and concentric target signs, which are typical signs in a patient with cerebral toxoplasmosis but rarely displayed in the same lesion. The MRI played a crucial role in diagnosing the patient and distinguishing CNS diseases commonly found in HIV patients. Our objective is to discuss the imaging findings that aided in the patient's diagnosis.
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Affiliation(s)
- Nur Izzati Syahirah Awang Senik
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Health Campus, Jalan Raja Perempuan Zainab 2, 16150 Kota Bharu, Kelantan, Malaysia
| | - Sanihah Abdul Halim
- Department of Internal Medicine/Neurology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Health Campus, Jalan Raja Perempuan Zainab 2, 16150 Kota Bharu, Kelantan, Malaysia
- Brain and Behaviour Cluster, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, 16150 Kota Bharu, Kelantan, Malaysia
| | - Nur Asma Sapiai
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Health Campus, Jalan Raja Perempuan Zainab 2, 16150 Kota Bharu, Kelantan, Malaysia
- Brain and Behaviour Cluster, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, 16150 Kota Bharu, Kelantan, Malaysia
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11
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Ramos MEH, Villaraza SG. The use of azithromycin and pyrimethamine for treatment of cerebral toxoplasmosis in human immunodeficiency virus-infected patients: a systematic review. ENCEPHALITIS 2023; 3:64-70. [PMID: 37469675 PMCID: PMC10295825 DOI: 10.47936/encephalitis.2022.00115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/11/2023] [Accepted: 02/14/2023] [Indexed: 07/21/2023] Open
Abstract
Purpose Toxoplasma gondii is a parasite that is widely distributed around the globe and can cause brain inflammation, particularly in immunosuppressed patients such as those diagnosed with human immunodeficiency virus (HIV). This paper reviews the efficacy of azithromycin and pyrimethamine combination therapy for cerebral toxoplasmosis in patients with HIV. Methods The scope of the studies included in this review was limited from 1992 to 2022, with studies primarily being randomized, controlled clinical trials available on online scientific journal databases. The authors screened eligible records for review, removing those that did not fit the inclusion and exclusion criteria. The risk of bias of the extracted data was analyzed through the Cochrane risk-of-bias tool for randomized trials. Results A broad search of major online databases such as PubMed, Medline, Google Scholar, and Cochrane using keywords, limit fields, and Boolean operators yielded 3,130 articles. After thoroughly screening the search results, two studies were included in this review. Results from the studies included in the review demonstrate that the combination therapy of azithromycin and pyrimethamine is favorable for cerebral toxoplasmosis. However, the net response is less effective than the standard treatment regimen (pyrimethamine and sulfadiazine). Conclusion The combination therapy of azithromycin and pyrimethamine is less effective than the standard treatment regimen for maintenance therapy for cerebral toxoplasmosis; thus, administering these medications for this indication must be met with caution.
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Affiliation(s)
- Mark Erving H. Ramos
- Department of Neurology, Jose R. Reyes Memorial Medical Center, Manila, Philippines
| | - Steven G. Villaraza
- Department of Neurology, Jose R. Reyes Memorial Medical Center, Manila, Philippines
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12
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Müller J, Hemphill A. Toxoplasma gondii infection: novel emerging therapeutic targets. Expert Opin Ther Targets 2023; 27:293-304. [PMID: 37212443 PMCID: PMC10330558 DOI: 10.1080/14728222.2023.2217353] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 04/24/2023] [Indexed: 05/23/2023]
Abstract
INTRODUCTION Toxoplasmosis constitutes a challenge for public health, animal production, and welfare. So far, only a limited panel of drugs has been marketed for clinical applications. In addition to classical screening, the investigation of unique targets of the parasite may lead to the identification of novel drugs. AREAS COVERED Herein, the authors describe the methodology to identify novel drug targets in Toxoplasma gondii and review the literature with a focus on the last two decades. EXPERT OPINION Over the last two decades, the investigation of essential proteins of T. gondii as potential drug targets has fostered the hope of identifying novel compounds for the treatment of toxoplasmosis. Despite good efficacies in vitro, only a few classes of these compounds are effective in suitable rodent models, and none has cleared the hurdle to applications in humans. This shows that target-based drug discovery is in no way better than classical screening approaches. In both cases, off-target effects and adverse side effects in the hosts must be considered. Proteomics-driven analyses of parasite- and host-derived proteins that physically bind drug candidates may constitute a suitable tool to characterize drug targets, irrespectively of the drug discovery methods.
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Affiliation(s)
- Joachim Müller
- Department of Infectious Diseases and Pathobiology, Institute of Parasitology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Andrew Hemphill
- Department of Infectious Diseases and Pathobiology, Institute of Parasitology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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Khalid S, Memon SF, Jumani L, Memon SA, Siddiqui MS. Neurotoxoplasmosis in the Immunocompetent: A Rare Occurrence. Cureus 2023; 15:e36782. [PMID: 37123766 PMCID: PMC10134001 DOI: 10.7759/cureus.36782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2023] [Indexed: 03/30/2023] Open
Abstract
Cerebral toxoplasmosis is a rare condition that predominantly affects immunocompromised people and is relatively uncommon in immunocompetent individuals. Acute toxoplasmosis primarily presents with focal and diffuse neurological signs and symptoms depending on the site of the lesion, the degree of local damage, and the severity of inflammation. In this report, we present a case of cerebral toxoplasmosis in an immunocompetent adult female who presented with an altered level of consciousness, fever, headache, and shortness of breath. This case highlights the diagnostic challenges that may arise when dealing with patients who have a wide range of clinical manifestations.
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14
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Zafar A, Khan MK, Abbas RZ, Saqib M, Javed H. Molecular evidence of toxoplasmosis in people living with HIV in Pakistan. Int J STD AIDS 2023; 34:346-352. [PMID: 36708244 DOI: 10.1177/09564624231152791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Toxoplasma gondii is a zoonotically important parasite infecting almost all vertebrates. The parasite can easily infect humans through the fecal-oral route, particularly immunocompromised individuals, and children. Due to lack of epidemiological data regarding the occurrence of Toxoplasma gondii in people living with HIV in Pakistan, the present study was designed to estimate the prevalence of Toxoplasma gondii in people living with HIV. METHODS Briefly, 384 blood samples were randomly collected from people living with HIV registered under Punjab AIDS Control Program. DNA of all samples was extracted and the 18S rRNA gene of T. gondii was amplified through polymerase chain reaction (PCR) by using genus-specific primers. The amplicons were spread on 1.5% agar rose gel and visualized under gel documentation system. Then the amplicons were purified from the gel and subjected to sequence and phylogenetic analysis. RESULTS Overall prevalence of T. gondii was observed as 23.96%. The prevalence of T. gondii was significantly (p <0.05) higher in females and in middle age group (26-40 years). Similarly, the prevalence was significantly (p <0.05) higher in people with poor socioeconomic status, symptomatic patients, drugs users and people using unfiltered water for drinking. Furthermore, bodyweight (46-70 kg) and dry seasons also significantly (p <0.05) affected the prevalence of T. gondii. CONCLUSIONS Our findings illustrated a high infection rate of toxoplasmosis in people living with HIV which could be a significant cause of mortality. More studies need to be conducted for other opportunistic infections caused by parasites and other pathogens.
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Affiliation(s)
- Arsalan Zafar
- Department of Parasitology, 66724University of Agriculture, Faisalabad, Punjab, Pakistan
| | - Muhammad Kasib Khan
- Department of Parasitology, 66724University of Agriculture, Faisalabad, Punjab, Pakistan
| | - Rao Zahid Abbas
- Department of Parasitology, 66724University of Agriculture, Faisalabad, Punjab, Pakistan
| | - Muhammad Saqib
- Department of Clinical Medicine and Surgery, 66724University of Agriculture, Faisalabad, Punjab, Pakistan
| | - Hasnain Javed
- Provincial Public Health Reference Lab, 484008Punjab AIDS Control Program, Lahore, Punjab, Pakistan
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15
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Yan X, Sun Y, Yu X, Gao J, Wang H, Liang R, Han W, Jin X, Guo W, Liu P, Chen J. Study on the effect of koumiss on reactivation of Toxoplasma gondii infection. Front Nutr 2022; 9:1032271. [PMID: 36337653 PMCID: PMC9630357 DOI: 10.3389/fnut.2022.1032271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
Toxoplasma gondii is an obligate intracellular parasite that infects nucleated cells of all warm-blooded animals, and most patients have latent infections. The latent infection will be reactivated in the immunocompromised or immunocompromised individuals, which will lead to severe toxoplasmosis. At present, less research has been focused on the reactivation of T. gondii infection. Koumiss is a kind of fermented milk made from fresh mare’s milk through natural fermentation that can be applied to clinical and rehabilitation medicine to mitigate the development of various diseases due to its unique functional characteristics. In this study, we explored the antagonistic effect of koumiss on reactivation of T. gondii infection. Mice were treated with dexamethasone to establish a reactivation model after infection with T. gondii and then treated with koumiss. The survival rate, SHIRPA test, serum cytokine levels, organ parasite burden and intestinal microbiota were measured, respectively. Our results showed that koumiss treatment improved the clinical symptoms of mice, significantly reduced the organ parasite burden of mice, and improved the composition and structure of intestinal flora. This study provides new evidence for the alleviation and treatment of toxoplasmosis and provides a novel idea for the development and utilization of koumiss.
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Affiliation(s)
- Xinlei Yan
- College of Food Science and Engineering, Inner Mongolia Agricultural University, Hohhot, China
- *Correspondence: Xinlei Yan,
| | - Yufei Sun
- College of Food Science and Engineering, Inner Mongolia Agricultural University, Hohhot, China
| | - Xiuli Yu
- College of Food Science and Engineering, Inner Mongolia Agricultural University, Hohhot, China
| | - Jialu Gao
- College of Food Science and Engineering, Inner Mongolia Agricultural University, Hohhot, China
| | - Hejing Wang
- College of Food Science and Engineering, Northwest Agriculture and Forestry University, Xianyang, Shaanxi, China
| | - Ru Liang
- Department of Pediatrics, Inner Mongolia Maternal, Child Health Hospital, Hohhot, China
| | - Wenying Han
- College of Food Science and Engineering, Inner Mongolia Agricultural University, Hohhot, China
| | - Xindong Jin
- College of Food Science and Engineering, Inner Mongolia Agricultural University, Hohhot, China
| | - Wenhui Guo
- College of Food Science and Engineering, Inner Mongolia Agricultural University, Hohhot, China
| | - Pufang Liu
- College of Food Science and Engineering, Inner Mongolia Agricultural University, Hohhot, China
| | - Jia Chen
- College of Food Science and Engineering, Inner Mongolia Agricultural University, Hohhot, China
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Cerebral Toxoplasmosis as an Uncommon Complication of Biologic Therapy for Rheumatoid Arthritis: Case Report and Review of the Literature. Brain Sci 2022; 12:brainsci12081050. [PMID: 36009113 PMCID: PMC9405725 DOI: 10.3390/brainsci12081050] [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: 07/21/2022] [Revised: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 11/24/2022] Open
Abstract
Toxoplasmosis is one of the most common opportunistic infections, mainly reported in patients with acquired immunodeficiency syndrome (AIDS). Patients with rheumatoid arthritis (RA) have also been linked to reactivation of toxoplasmosis due to immunosuppressive treatment, although biologic drugs have seldom been implicated. We present a case of cerebral toxoplasmosis in a 62-year-old female patient with RA after initiation of biologic therapy (adalimumab). The patient had detectable serum IgG antibodies to toxoplasma gondii, was also on chronic treatment with other non-biologic drugs and presented with worsening disorientation, unsteady gait and left hemiparesis. Imaging studies showed a space-occupying lesion in the right basal ganglia with ring-enhancement. Brain biopsy confirmed the diagnosis of toxoplasmosis and the patient was treated with pyrimethamine and sulfadiazine for 6 weeks, showing complete recovery on follow-up. A review of the literature yielded other four case reports of cerebral toxoplasmosis implying biologic drugs; however, data concerning toxoplasmosis serologic testing, prophylaxis and treatment in these patients are lacking. Each case must be carefully evaluated prior to treatment and a high-index of suspicion in seropositive patients is warranted. Since the use of biologic drugs is increasing, further research is needed to establish practical guidelines for seropositive patients receiving immunosuppressive treatment.
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de Barros RAM, Torrecilhas AC, Marciano MAM, Mazuz ML, Pereira-Chioccola VL, Fux B. Toxoplasmosis in Human and Animals Around the World. Diagnosis and Perspectives in the One Health Approach. Acta Trop 2022; 231:106432. [PMID: 35390311 DOI: 10.1016/j.actatropica.2022.106432] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/25/2022] [Accepted: 03/27/2022] [Indexed: 12/12/2022]
Abstract
Toxoplasmosis is a unique health disease that significantly affects the health of humans, domestic animals, wildlife and is present in ecosystems, including water, soil and food. Toxoplasma gondii is one of the best-adapted parasites in the word. This parasite is able to persist for long periods in its hosts, in different geographic regions of the word. This review summarizes the current literature of these themes, focusing on: (1) toxoplasmosis, a zoonotic infection; (2) One health approach and toxoplasmosis; (3) human toxoplasmosis; (4) animal toxoplasmosis; (5) toxoplasmosis diagnosis, as immunological, parasitological and molecular diagnosis; (6) T. gondii outbreaks caused by infected meat, milk and dairy products, as well as, vegetables and water consume; (7) studies in experimental models; (8) genetic characterization of T. gondii strains; (9) extracellular vesicles and miRNA; and (10) future perspectives on T. gondii and toxoplasmosis. The vast prevalence of toxoplasmosis in both humans and animals and the dispersion and resistence of T. gondii parasites in environment highlight the importance of the one health approach in diagnostic and control of the disease. Here the different aspects of the one health approach are presented and discussed.
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Affiliation(s)
- Rosangela Aparecida Müller de Barros
- Unidade de Medicina Tropical, Departamento de Patologia, Universidade Federal do Espirito Santo, Vitoria, ES, Brazil.; Programa em Doenças Infecciosas, Centro de Doenças Infecciosas, Universidade Federal do Espirito Santo, Vitoria, ES, Brazil..
| | - Ana Claudia Torrecilhas
- Laboratório de Imunologia Celular e Bioquímica de Fungos e Protozoários, Departamento de Ciências Farmacêuticas, Universidade Federal de São Paulo (UNIFESP), Campus Diadema, Sao Paulo, SP, Brazil..
| | | | - Monica Leszkowicz Mazuz
- Parasitology Division, Kimron Veterinary Institute, Israeli Veterinary Service and Animal Health, Ministry of Agriculture and Rural Development Beit Dagan, 5025000, Israel..
| | | | - Blima Fux
- Unidade de Medicina Tropical, Departamento de Patologia, Universidade Federal do Espirito Santo, Vitoria, ES, Brazil.; Programa em Doenças Infecciosas, Centro de Doenças Infecciosas, Universidade Federal do Espirito Santo, Vitoria, ES, Brazil..
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18
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Puchalska M, Wiśniewski J, Klich D, Gołąb E, Jańczak D, Sokołowska J, Urbańska K, Anusz K. A serological survey of Toxoplasma gondii in polish pigs from organic farms, other housing systems and in pigs of different age groups. Acta Vet Scand 2022; 64:3. [PMID: 35130949 PMCID: PMC8822955 DOI: 10.1186/s13028-022-00623-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 01/26/2022] [Indexed: 11/10/2022] Open
Abstract
Background The consumption of raw or undercooked meat, especially pork, and offal containing infective tissue cysts is suspected to be a significant route of infection with Toxoplasma gondii. Although the use of “animal-friendly pig production systems” ensuring direct contact with the natural environment offers ethical benefits, it limits the ability to ensure animal health; it may also increase the probability of infections by pathogens such as T. gondii, and thus their entry into the food chain. This study determines the seroprevalence of T. gondii in pigs from different housing systems and farms with different hygiene standards in Poland, as well as among pigs of different age groups from farms with high hygiene standards. In total 760 pig serum samples were examined for the presence of specific antibodies using the PrioCHECK® Toxoplasma Ab porcine commercial ELISA test (Prionics, Switzerland). Results Test results with PP ≥ 20% were regarded as positive, as indicated by the manufacturer. Antibodies to T. gondii were found in 193 of 760 (25.4%) tested sera. Regarding different housing systems, antibodies were found in 117 pigs: of these, 52.6% (61/116) were from organic farms, 40.9% (47/115) from farms with low hygiene standards, 5.4% (9/167) from farms with high hygiene standards and 0% (0/40) from a farm with a high level of biosecurity. Regarding age groups, antibodies were found in 76 animals on farms with high hygiene standards: 11.1% (7/63) were pigs younger than 3 months, 0% (0/60) aged 3–4 months, 12.3% (7/57) aged 5–6 months (final fattening stage) and 43.7% (62/142) were sows aged 9 months and older. Conclusions Antibodies to T. gondii were most often found in pigs from organic and low-hygiene farms, as well as in pigs aged 9 months and older. Meat derived from seropositive animals can pose a potential source of infection for humans. As maternal antibodies to T. gondii can be present in the blood of piglets aged up to 3–4 months, serological examination is unjustified in piglets up to this age.
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19
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Sharifzadeh M, Rezanezhad H, Solhjoo K, Kargar Jahromi Z, Shadmand E, Shahabi S, Taghipour A. Sero-molecular survey on Toxoplasma gondii infection among drug addicted and non-addicted individuals: a case-control study. BMC Infect Dis 2022; 22:19. [PMID: 34983410 PMCID: PMC8725485 DOI: 10.1186/s12879-021-06979-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 12/14/2021] [Indexed: 11/23/2022] Open
Abstract
Background Up to now, epidemiological studies on the prevalence of Toxoplasma gondii infection among drug addicted individuals have been rarely performed. By designing an age and sex matched case–control study, we sought to determine the prevalence and associated factors with T. gondii infection in these population using serological and molecular techniques. Methods One hundred and thirty-seven drug addicted individuals and 141 healthy subjects were enrolled in this study. Informed consent as well as a standard questionnaire were obtained from all subjects participating. Blood samples were collected from each participant and the serum was screened for anti-Toxoplasma antibodies (IgG and IgM). PCR assay was performed using the primer pair targeting the RE and GRA6 genes of T. gondii. Then, PCR products were sequenced to determine genotype. Results The seroprevalence of T. gondii infection based on IgG titer was 34.3% in case and 9.9% in the control groups, revealing a statistically significant difference (OR = 4.37; 95% CI = 2.46–9.12; P = 0.001). After analyzing the variables studied through the questionnaire, age was the only significantly factor associated with the anti-T. gondii IgG antibody in case group. Considering PCR assays with RE genomic target, the prevalence of T. gondii infection was 5.1% in the case and 3.5% in control groups which the difference was no statistically significant (OR = 1.46; 95% CI = 0.45–4.73; P = 0.521). Subsequently, all sequenced samples were genotype #1 using the GRA6 genomic target. Conclusions T. gondii exposure is relatively high among drug addicted individuals in Iran, and there is a need for health policymakers and researchers to establish enlightenment and prevention programs for these population at risk of infection. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06979-8.
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Affiliation(s)
- Majid Sharifzadeh
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Hassan Rezanezhad
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran. .,Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran.
| | - Kavous Solhjoo
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Enayatollah Shadmand
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Saeed Shahabi
- Department of Medical Entomology and Vector Control, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Taghipour
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
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20
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Csep A, Vaida LL, Negruțiu BM, Todor BI, Judea-Pusta CT, Buhaș C, Sava C. Research on demographic, clinical and paraclinical aspects in pregnant women infected with Toxoplasma gondii. Exp Ther Med 2022; 23:123. [PMID: 34970346 PMCID: PMC8713168 DOI: 10.3892/etm.2021.11046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 10/11/2021] [Indexed: 11/29/2022] Open
Abstract
Toxoplasmosis is a zoonotic disease caused by the Toxoplasma gondii protozoan parasite. The aim of this study was to determine the frequency of acute toxoplasmosis or its presence in the medical history of 240 pregnant women, depending on age and geographical background. The second purpose was to analyze several medical aspects (clinical and paraclinical) in pregnant women with acute toxoplasmosis. The study identified several serological changes including positive toxoplasma IgM, IgG, and IgA antibodies. The chemiluminescence immunoassay (CLIA) method was used to detect T. gondii-specific IgM and IgG antibodies and the enzyme immunoassay (EIA) method to detect T. gondii-specific IgA antibodies. Of the 96 pregnant women (40%) infected with T. gondii, approximately 1/3 had acquired acute infection and 2/3 had a history of prior acute infection (P<0.0001). No statistically significant differences according to age groups (P=0.9384) were found in terms of serological profile. The number of patients with negative serology was significantly higher in urban areas than in rural areas (P<0.0001). The highest incidence among the pregnant women with acute toxoplasmosis with a single chain of ganglia affected was represented by those with the involvement of cervical lymph nodes (75%), the difference compared to the involvement of other chains of ganglia being statistically significant (P=0.0087). All 35 pregnant women with acute toxoplasmosis tested positive for T. gondii-specific IgM antibodies. Most pregnant women with acute T. gondii infection (57.1%) tested negative for T. gondii-specific IgM antibody serum titres within 3-6 months of presentation. The difference compared to other intervals from the moment pregnant women sought care was statistically significant (P=00002). Only 80% of all pregnant women with acute toxoplasmosis tested positive for T. gondii-specific IgA antibodies. Pregnant women with acute toxoplasmosis have a 3.3 times higher risk of pregnancy loss.
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Affiliation(s)
- Andrei Csep
- Department of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Luminița Ligia Vaida
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Bianca-Maria Negruțiu
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Bianca Ioana Todor
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Claudia Teodora Judea-Pusta
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Camelia Buhaș
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Cristian Sava
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
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21
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Oya Y, Futami H, Nakazawa T, Ishijima K, Umemiya K, Takizawa F, Imai N, Kitamura H, Matsumura R. Tubulointerstitial nephritis and uveitis syndrome following meningitis and systemic lymphadenopathy with persistent Toxoplasma immunoglobulin M: a case report. J Med Case Rep 2021; 15:482. [PMID: 34556154 PMCID: PMC8461971 DOI: 10.1186/s13256-021-02909-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 05/17/2021] [Indexed: 01/04/2023] Open
Abstract
Background Tubulointerstitial nephritis and uveitis syndrome is a rare lymphocyte-related oculorenal inflammatory disease presumed to be associated with drug use and infectious agents. Toxoplasma gondii is one of such pathogens that could exhibit encephalitis, meningitis, and uveitis in immunocompromised or in some immunocompetent individuals. If the immunoglobulin M of Toxoplasma is positive on screening, the interpretation of the result is not simple, especially when immunoglobulin M stays positive persistently. Case presentation A 34-year-old Asian male developed fever, headache, and lymphadenopathy with tenderness, which was initially diagnosed as meningitis. Antibiotics were started, and diclofenac sodium was used for the fever. Although his symptoms were alleviated in a week by the treatment, gradual decline in renal function was noted, prompting a renal biopsy that indicated acute granulomatous interstitial nephritis. A week later, tenderness in both eyes with blurred vision appeared and revealed iritis and keratic precipitations in both eyes; hence, the diagnosis of acute tubulointerstitial nephritis and bilateral uveitis syndrome was made. Toxoplasma gondii-specific immunoglobulin G and immunoglobulin M titers were both positive. Although we could not rule out recent infection of Toxoplasma gondii, which may cause uveitis initially, Toxoplasma immunoglobulin G avidity test indicated a distant infection, which allowed us to rule out meningitis and uveitis as responsible for the complication of recent Toxoplasma gondii infection. Drug-induced lymphocyte stimulation test, or lymphocyte transformation test of diclofenac sodium, was solely positive among the tested drugs. Uveitis was alleviated only with ophthalmic steroid, and renal function returned to normal without administration of systemic steroid. Conclusions We experienced a case of diclofenac-induced tubulointerstitial nephritis and uveitis syndrome. In ruling out infections, Toxoplasma immunoglobulin M was persistently positive, and Toxoplasma immunoglobulin G avidity test indicated a “distant” infection. From these two results, we ruled out recent infection. However, it should be noted that “distant” infection indicated by commercial immunoglobulin G avidity is still a multiplex profile consisting of reinfection, reactivation, and latent infection. Narrowing down the infection profile of Toxoplasma is challenging in some cases. Therefore, careful diagnosis and extended follow-up of such patients are needed.
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Affiliation(s)
- Yoshihiro Oya
- Department of Rheumatology, Allergy and Clinical Immunology, National Hospital Organization Chibahigashi National Hospital, 673 Nitona-cho, Chuou-ku, Chiba City, Chiba, 260-8712, Japan. .,Laboratory of Autoimmune diseases, Department of Clinical Research, National Hospital Organization Chibahigashi National Hospital, Chiba City, Chiba, 260-8712, Japan.
| | - Hidekazu Futami
- Department of Rheumatology, Allergy and Clinical Immunology, National Hospital Organization Chibahigashi National Hospital, 673 Nitona-cho, Chuou-ku, Chiba City, Chiba, 260-8712, Japan
| | - Takuya Nakazawa
- Department of Rheumatology, Allergy and Clinical Immunology, National Hospital Organization Chibahigashi National Hospital, 673 Nitona-cho, Chuou-ku, Chiba City, Chiba, 260-8712, Japan
| | - Kazuyuki Ishijima
- Department of Rheumatology, Allergy and Clinical Immunology, National Hospital Organization Chibahigashi National Hospital, 673 Nitona-cho, Chuou-ku, Chiba City, Chiba, 260-8712, Japan
| | - Keiko Umemiya
- Department of Rheumatology, Allergy and Clinical Immunology, National Hospital Organization Chibahigashi National Hospital, 673 Nitona-cho, Chuou-ku, Chiba City, Chiba, 260-8712, Japan
| | - Fumiyoshi Takizawa
- Department of Internal Medicine, Seikeikai Chiba Medical Center, Chiba City, Chiba, 260-0842, Japan
| | - Naoki Imai
- Department of Ophthalmology, National Hospital Organization Chibahigashi National Hospital, Chiba City, Chiba, 260-8712, Japan
| | - Hiroshi Kitamura
- Department of Pathology, National Hospital Organization Chibahigashi National Hospital, Chiba City, Chiba, 260-8712, Japan
| | - Ryutaro Matsumura
- Department of Rheumatology, Allergy and Clinical Immunology, National Hospital Organization Chibahigashi National Hospital, 673 Nitona-cho, Chuou-ku, Chiba City, Chiba, 260-8712, Japan
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22
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Abou-El-Naga IF, Gomaa MM, ElAchy SN. Effect of HIV aspartyl protease inhibitors on experimental infection with a cystogenic Me49 strain of Toxoplasma gondii. Pathog Glob Health 2021; 116:107-118. [PMID: 34420500 DOI: 10.1080/20477724.2021.1967628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Toxoplasmosis is a zoonotic disease of major significant perspectives in public health and veterinary medicine. So far, the available drugs control only the active infection, once the parasite encysts in the tissues, they lose their efficacy. Cytokines; IFN-γ and IL-10, play a critical role in the modulation of toxoplasmic encephalitis and neuro-inflammation in chronic toxoplasmosis. Antiretroviral protease inhibitors applied in the treatment of acquired immunodeficiency syndrome, revealed activity against multiple parasites. Aluvia (lopinavir/ritonavir) (L/R); an aspartyl protease inhibitor, had efficiently treated T. gondii RH strain infection. We investigated the potential activity of L/R against experimental T. gondii infection with a cystogenic Me49 strain in mice, considering the role of IFN-γ and IL-10 in the neuropathology versus pyrimethamine-sulfadiazine combination therapy. Three aluvia regimens were applied; starting on the day of infection (acute phase), 2-week PI (early chronic phase) and eight weeks PI (late chronic phase). L/R reduced the brain-tissue cyst burden significantly in all treatment regimens. It impaired the parasite infectivity markedly in the late chronic phase. Ultrastructural changes were detected in Toxoplasma cyst membrane and wall, bradyzoite membrane and nuclear envelope. The signs of bradyzoite paraptosis and cytoplasmic lipid droplets were observed. L/R had significantly reduced the brain-homogenate levels of IFN-γ and IL-10 in its three regimens however, they could not reach the normal level in chronic phases. Cerebral hypercellularity, perivascular inflammatory response, lymphoplasmacytic infiltrates and glial cellular reaction were ameliorated by L/R treatment. Herein, L/R was proved to possess promising preventive and therapeutic perspectives in chronic cerebral toxoplasmosis.
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Affiliation(s)
- Iman Fathy Abou-El-Naga
- Department Of Medical Parasitology, Faculty Of Medicine, Alexandria University, Alexandria, Egypt
| | - Maha Mohamed Gomaa
- Department Of Medical Parasitology, Faculty Of Medicine, Alexandria University, Alexandria, Egypt
| | - Samar Nabil ElAchy
- Department Of Pathology, Faculty Of Medicine, Alexandria University, Alexandria, Egypt
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Abstract
PURPOSE OF REVIEW This article reviews how parasites affect the human nervous system, with a focus on four parasitic infections of major public health importance worldwide, two caused by protozoa (malaria and toxoplasmosis) and two by helminths (neurocysticercosis and schistosomiasis). RECENT FINDINGS Parasitic infections in humans are common, and many can affect the central nervous system where they may survive unnoticed or may cause significant pathology that can even lead to the death of the host. Neuroparasitoses should be considered in the differential diagnosis of neurologic lesions, particularly in individuals from endemic regions or those with a history of travel to endemic regions. SUMMARY Cerebral malaria is a significant cause of mortality, particularly in African children, in whom infected red blood cells affect the cerebral vessels, causing severe encephalopathy. Neurocysticercosis is the most common cause of acquired epilepsy worldwide and has varied clinical presentations, depending on the number, size, and location of the parasites in the nervous system as well as on the host's inflammatory response. Toxoplasmosis is distributed worldwide, affecting a significant proportion of the population, and may reactivate in patients who are immunosuppressed, causing encephalitis and focal abscesses. Schistosomiasis causes granulomatous lesions in the brain or the spinal cord.
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Rosenberg A, Sibley LD. Toxoplasma gondii secreted effectors co-opt host repressor complexes to inhibit necroptosis. Cell Host Microbe 2021; 29:1186-1198.e8. [PMID: 34043960 PMCID: PMC8711274 DOI: 10.1016/j.chom.2021.04.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/22/2021] [Accepted: 04/28/2021] [Indexed: 02/06/2023]
Abstract
Toxoplasma gondii translocates effector proteins into its host cell to subvert various host pathways. T. gondii effector TgIST blocks the transcription of interferon-stimulated genes to reduce immune defense. Interferons upregulate numerous genes, including protein kinase R (PKR), which induce necrosome formation to activate mixed-lineage-kinase-domain-like (MLKL) pseudokinase and induce necroptosis. Whether these interferon functions are targeted by Toxoplasma is unknown. Here, we examine secreted effectors that localize to the host cell nucleus and find that the chronic bradyzoite stage secretes effector TgNSM that targets the NCoR/SMRT complex, a repressor for various transcription factors, to inhibit interferon-regulated genes involved in cell death. TgNSM acts with TgIST to block IFN-driven expression of PKR and MLKL, thus preventing host cell necroptotic death and protecting the parasite's intracellular niche. The mechanism of action of TgNSM uncovers a role of NCoR/SMRT in necroptosis, assuring survival of intracellular cysts and chronic infection.
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Affiliation(s)
- Alex Rosenberg
- Department of Molecular Microbiology, Washington University School of Medicine in St. Louis, St. Louis, MO 63130, USA
| | - L David Sibley
- Department of Molecular Microbiology, Washington University School of Medicine in St. Louis, St. Louis, MO 63130, USA.
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Quiarim TM, Maia MM, da Cruz AB, Taniwaki NN, Namiyama GM, Pereira-Chioccola VL. Characterization of extracellular vesicles isolated from types I, II and III strains of Toxoplasma gondii. Acta Trop 2021; 219:105915. [PMID: 33861971 DOI: 10.1016/j.actatropica.2021.105915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/15/2021] [Accepted: 03/27/2021] [Indexed: 12/31/2022]
Abstract
This study investigated the participation extracellular vesicles (EVs) in Toxoplasma gondii-host interaction. EVs of three T. gondii strains (RH, ME-49 and VEG) were purified by chromatography and ELISA. Results of "nanoparticle tracking analysis" and scanning electron microscopy showed that RH strain released more EVs than other strains. Images of transmission electron microscopy showed that in beginning of incubation (culture medium), EVs were inside of tachyzoites preparing to be released. After 24 hours, they were largely produced inside tachyzoites and were released through plasma membrane. The parasite burden of mice infected with RH strain plus EVs was increased and with early death of 1-2 days compared of those that received only parasites. EV proteins of ME-49 and VEG strains were poorly reactive to sera of infected patients in imunoblot. However, those from RH strain were reactive against sera of patients with cerebral toxoplasmosis. EVs stimulated murine splenocytes caused similar production of IFN-γ and IL-10 levels. RH strain derived EVs stimulated more TNF-α than those stimulated by other strains. T. gondii and infected hosts can express the same miRNAs (miR-155-5p, miR-125b-5p, miR-423-3p). In conclusion, T. gondii derived EVs promote host-parasite interactions, modulate host immune responses, carry virulent factors and cause an imbalance in cellular immune response.
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Affiliation(s)
- Talita Motta Quiarim
- Laboratório de Biologia Molecular de Parasitas e Fungos, Instituto Adolfo Lutz, Sao Paulo, Brazil.
| | - Marta Marques Maia
- Laboratório de Biologia Molecular de Parasitas e Fungos, Instituto Adolfo Lutz, Sao Paulo, Brazil.
| | - Allecineia Bispo da Cruz
- Laboratório de Biologia Molecular de Parasitas e Fungos, Instituto Adolfo Lutz, Sao Paulo, Brazil.
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Maia MM, da Cruz AB, Pereira IDS, Taniwaki NN, Namiyama GM, Pereira-Chioccola VL. Characterization of murine extracellular vesicles and Toxoplasma gondii infection. Parasite Immunol 2021; 43:e12869. [PMID: 34028833 DOI: 10.1111/pim.12869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 02/03/2023]
Abstract
This study characterized extracellular vesicles (EVs) of sera from mice infected with Toxoplasma gondii or immunized with EVs derived T gondii. EVs were purified of sera from four groups (5 A/Sn mice/group). EV-IM: Mice immunized with T gondii-released EVs; ACT: mice in acute infection; CHR: mice in chronic infection; and NI: normal mice. EVs were purified by ultracentrifugation. Concentration of serum-derived EVs from NI group was smaller than EV-IM, ACT and CHR groups. Most of the EVs from ACT and CHR groups were microvesicles, and they were bigger than the NI group. The same results were shown by Transmission Electron Microscopy. The presence of exosomes was shown in immunoblotting by tetraspanin (CD63 and CD9) evidence. Splenocytes of EV-IM, CHR and NI groups were stimulated with T. gondii derived EVs. EV-IM and CHR groups up-expressed IFN-γ; TNF-α and IL-17, when compared with the NI group. IL-10 was up-expressed only in the EV-IM group. EV-IM, ACT and CHR groups expressed more miR-155-5p, miR-29c-3p and miR-125b-5p than the NI group. Host-T gondii interaction can occur, also, via EVs. miRNAs participate in the modulation of cellular immune response against T gondii. These data give subsidies to propose the differentiation between infect or noninfect hosts by concentration of EVs.
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Affiliation(s)
- Marta Marques Maia
- Centro de Parasitologia e Micologia, Instituto Adolfo Lutz, Sao Paulo, Brazil
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First isolation and genotyping of Toxoplasma gondii strains from domestic animals in Tunisia. Sci Rep 2021; 11:9328. [PMID: 33927299 PMCID: PMC8085010 DOI: 10.1038/s41598-021-88751-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 04/09/2021] [Indexed: 02/06/2023] Open
Abstract
The isolation and molecular typing of Toxoplasma gondii strains provide an essential basis for a better understanding of the parasite’s genetic diversity, determinants of its geographical distribution and associated risks to human health. In this study, we isolated and genetically characterized T. gondii strains from domestic animals in Southern and coastal area of Tunisia. Blood, hearts and/or brains were collected from 766 domestic animals (630 sheep and 136 free-range chickens). Strain isolation from these samples was performed using mouse bioassay and genotyping was carried out with a multiplex PCR technique using 15 microsatellite markers. Thirty viable strains of T. gondii were successfully isolated from tissues of sheep (19/142) and chickens (11/33). In addition, 3 strains could be successfully genotyped from animal tissues for which mouse bioassay was unsuccessful. A large predominance of type II strains (n = 29) was found in the sampled regions, followed by type III (n = 3) and, for the first time in Tunisia, a single isolate of Africa 4 lineage from a sheep. Analyses of population genetics showed the presence of a divergent population of type II lineage in Tunisia, supporting limited recent migrations of strains between Tunisia and other countries of the world.
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Maia MM, da Cruz AB, Taniwaki NN, Namiyama GM, Gava R, Gomes AHS, Kanamura CT, Barbo MLP, Pereira-Chioccola VL. Immunization with extracellular vesicles excreted by Toxoplasma gondii confers protection in murine infection, activating cellular and humoral responses. Int J Parasitol 2021; 51:559-569. [PMID: 33713649 DOI: 10.1016/j.ijpara.2020.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/19/2020] [Accepted: 11/23/2020] [Indexed: 12/11/2022]
Abstract
The study aim was to analyze whether microvesicles and exosomes, named extracellular vesicles (EVs), purified from Toxoplasma gondii are able to stimulate the protective immunity of experimental mice when administered, as challenge, a highly virulent strain. EVs excreted from T. gondii tachyzoites (RH strain) were purified by chromatography and used for immunization assays in inbred mouse groups (EV-IM). Chronic infected (CHR) and naive (NI) mice were used as control groups, since the immune response is well known. After immunizations, experimental groups were challenged with 100 tachyzoites. Next, parasitemias were determined by real-time PCR (qPCR), and survival levels were evaluated daily. The humoral response was analyzed by detection of IgM, IgG, IgG1 and IgG2a, and opsonization experiments. The cellular response was evaluated in situ by immunohistochemistry on IFN-γ, IL-10, TNF-α and IL-17 expression in cells of five organs (brain, heart, liver, spleen and skeletal muscles). EV immunization reduced parasitemia and increased the survival index in two mouse lineages (A/Sn and BALB/c) infected with a lethal T. gondii strain. EV-IM mice had higher IgG1 levels than IgM or IgG2a. IgGs purified from sera of EV-IM mice were able to opsonize tachyzoites (RH strain), and mice that received these parasites had lower parasitemias, and mortality was delayed 48 h, compared with the same results from those receiving parasites opsonized with IgG purified from NI mice. Brain and spleen cells from EV-IM mice more highly expressed IFN-γ, IL-10 and TNF-α. In conclusion, EV-immunization was capable of inducing immune protection, eliciting high production of IgG1, IFN-γ, IL-10 and TNF-α.
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Affiliation(s)
- Marta Marques Maia
- Centro de Parasitologia e Micologia, Instituto Adolfo Lutz, Sao Paulo, Brazil
| | | | | | | | - Ricardo Gava
- Centro de Parasitologia e Micologia, Instituto Adolfo Lutz, Sao Paulo, Brazil
| | | | | | - Maria Lourdes Peris Barbo
- Departamento de Morfologia e Patologia, Faculdade de Ciências Médicas e Saúde, Pontifícia Universidade Católica, São Paulo, Brazil
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Machado DMR, de Barros LD, de Souza Lima Nino B, de Souza Pollo A, Dos Santos Silva AC, Perles L, André MR, Zacarias Machado R, Garcia JL, Lux Hoppe EG. Toxoplasma gondii infection in wild boars (Sus scrofa) from the State of São Paulo, Brazil: Serology, molecular characterization, and hunter's perception on toxoplasmosis. VETERINARY PARASITOLOGY- REGIONAL STUDIES AND REPORTS 2021; 23:100534. [PMID: 33678387 DOI: 10.1016/j.vprsr.2021.100534] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 01/04/2021] [Accepted: 01/11/2021] [Indexed: 10/22/2022]
Abstract
The consumption of wild boar meat, common in many countries, became popular in Brazil after the hunting of these animals was authorized in 2013. The meat of these animals is often consumed by hunters and their social groups, and their offal is occasionally used as supplemental food in the diet of hunting dogs. Given the high frequency of foodborne diseases related to wild boar meat consumption in other countries, including toxoplasmosis, knowledge on these diseases is essential for risk assessment and elaboration of education campaigns for the exposed public. Thus, this study aimed diagnosing, isolating, and genotyping Toxoplasma gondii in hunted wild boars. For that, we obtained samples of serum and tissues (brain, tongue, diaphragm, and heart) from 26 wild boar hunted in three areas in São Paulo State, Brazil, based on convenience sampling strategy. The serum samples were submitted to the indirect immunofluorescence reaction test (IFAT) test while the tissue samples (n = 22) were used to perform a bioassay in mice to isolate the parasite. The isolated samples were genetically characterized by PCR-RFLP with SAG1, 5' and 3' SAG2, alt.SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, and Apico markers. Questionnaires were also formulated and applied to wildlife hunters to assess knowledge about toxoplasmosis. The seroprevalence of T. gondii was 76.9% (20/26), with titers ranging from 16 to 1024. Viable parasites accounted for 4.5% (1/22) of the samples. The ToxoDB #6 genotype of TgJava1 alone was detected. Most interviewed hunters, 84.2% (16/19) consume game meat and a few of them (15.7%; 3/19) prefer undercooked meat. Also, 15.7% (3/19) of the hunters reported supplementing their hunting dogs' diet with wild boar meat and/or offal. As antibodies to T. gondii were detected in 76.9% (20/26) of the studied wild boars, we concluded that infection by T. gondii is frequent in wild boars used for human and animal consumption in the studied areas. Although genotype #6 is commonly found in Brazil in domestic animals, wild animals, and humans, causing everything from mild clinical symptoms to death, this study found, for the first time, the detection of this genotype in wild boars. These results also reaffirm the importance of these animals as a possible source of T. gondii infection for humans and domestic animals.
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Affiliation(s)
- Dália Monique Ribeiro Machado
- Universidade Estadual Paulista - Unesp, Faculdade de Ciências Agrárias e Veterinárias de Jaboticabal, Departamento de Patologia, Reprodução Animal e Saúde Única, Rodovia Professor Paulo Donato Castelane, s/n, Zona Rural, CEP 14887-900, Jaboticabal, São Paulo, Brazil
| | - Luiz Daniel de Barros
- Universidade Estadual de Londrina (UEL), Centro de Ciências Agrárias, Departamento de Medicina Veterinária Preventiva, Rodovia Celso Garcia Cid, Jardim Portal de Versalhes 1, 86057-970 Londrina, Paraná, Brazil
| | - Beatriz de Souza Lima Nino
- Universidade Estadual de Londrina (UEL), Centro de Ciências Agrárias, Departamento de Medicina Veterinária Preventiva, Rodovia Celso Garcia Cid, Jardim Portal de Versalhes 1, 86057-970 Londrina, Paraná, Brazil
| | - Andressa de Souza Pollo
- Universidade Estadual Paulista - Unesp, Faculdade de Ciências Agrárias e Veterinárias de Jaboticabal, Departamento de Patologia, Reprodução Animal e Saúde Única, Rodovia Professor Paulo Donato Castelane, s/n, Zona Rural, CEP 14887-900, Jaboticabal, São Paulo, Brazil
| | - Ana Clécia Dos Santos Silva
- Universidade Estadual de Londrina (UEL), Centro de Ciências Agrárias, Departamento de Medicina Veterinária Preventiva, Rodovia Celso Garcia Cid, Jardim Portal de Versalhes 1, 86057-970 Londrina, Paraná, Brazil
| | - Lívia Perles
- Universidade Estadual Paulista - Unesp, Faculdade de Ciências Agrárias e Veterinárias de Jaboticabal, Departamento de Patologia, Reprodução Animal e Saúde Única, Rodovia Professor Paulo Donato Castelane, s/n, Zona Rural, CEP 14887-900, Jaboticabal, São Paulo, Brazil
| | - Marcos Rogério André
- Universidade Estadual Paulista - Unesp, Faculdade de Ciências Agrárias e Veterinárias de Jaboticabal, Departamento de Patologia, Reprodução Animal e Saúde Única, Rodovia Professor Paulo Donato Castelane, s/n, Zona Rural, CEP 14887-900, Jaboticabal, São Paulo, Brazil
| | - Rosângela Zacarias Machado
- Universidade Estadual Paulista - Unesp, Faculdade de Ciências Agrárias e Veterinárias de Jaboticabal, Departamento de Patologia, Reprodução Animal e Saúde Única, Rodovia Professor Paulo Donato Castelane, s/n, Zona Rural, CEP 14887-900, Jaboticabal, São Paulo, Brazil
| | - João Luis Garcia
- Universidade Estadual de Londrina (UEL), Centro de Ciências Agrárias, Departamento de Medicina Veterinária Preventiva, Rodovia Celso Garcia Cid, Jardim Portal de Versalhes 1, 86057-970 Londrina, Paraná, Brazil
| | - Estevam Guilherme Lux Hoppe
- Universidade Estadual Paulista - Unesp, Faculdade de Ciências Agrárias e Veterinárias de Jaboticabal, Departamento de Patologia, Reprodução Animal e Saúde Única, Rodovia Professor Paulo Donato Castelane, s/n, Zona Rural, CEP 14887-900, Jaboticabal, São Paulo, Brazil.
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Ka'e AC, Sosso SM, Fokam J, Simo RK, Essama SR, Nka AD, Yagai B, Dzukou CJN, Tchouaket MCT, Chenwi C, Abba A, Fainguem N, Zam MKN, Yimga JF, Colizzi V, Ndjolo A. Anti-Toxoplasmic Immunoglobulin G Quantitation Correlates with Immunovirological Parameters of HIV-Infected Cameroonians. Curr HIV Res 2021; 19:73-83. [PMID: 32885755 DOI: 10.2174/1570162x18666200903172523] [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: 05/06/2020] [Revised: 07/14/2020] [Accepted: 08/05/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Toxoplasmosis is still a neglected common opportunistic infection in immunocompromised individuals, who are mainly people living with HIV (PLHIV) in whom reactivation of toxoplasmosis may occur with advanced HIV conditions in resource-limited settings (RLS). OBJECTIVE The objective was to assess the correlation between anti-toxoplasmic immunoglobulin G (anti-Toxo IgG) concentration and the immuno-virological status of PLHIV. METHODS A cross-sectional study was conducted in the year 2018 among 100 PLHIV aged ≥18 years in Yaounde-Cameroon. For each participant, anti-Toxo IgG, CD4-T lymphocytes, and plasma viral load (PVL) were measured using ELISA, flow cytometry, and real-time PCR, respectively. RESULTS Overall, 56% of the participants were seropositive for anti-Toxo IgG, while 33% were negative and 11% were equivocal. All (n=19) those with PVL>1000 copies/mL were seropositive to anti-Toxo IgG versus 52.85% (37/70) with PVL<1000 copies/mL; p<0.0001. Interestingly, all (n=11) those with severe immunodeficiency (T-CD4<200 cells/μL) were positive to anti-Toxo IgG versus 57.69% (45/78) with T-CD4>200 cells/μL; p<0.0001. Most importantly, PVL and anti- Toxo IgG concentration were positively correlated (r = 0.54; p<0.0001), while T-CD4 and anti- Toxo IgG concentration were negatively correlated (r = - 0.70; p<0.0001). Adjusting age, gender, immune status, and virological profile in logistic regression shows that only immune status was independently associated with the serological status of toxoplasmosis (p=0.0004). CONCLUSION In Cameroon, about half of PLHIV might be seropositive to anti-Toxo IgG, with decreasing immunity appearing as a risk of toxoplasmosis relapse. Thus, in the context of immunodeficiency, routine quantification of anti-Toxo IgG would alleviate the programmatic burden of this opportunistic infection in RLS with the generalized HIV epidemic.
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Affiliation(s)
- Aude Christelle Ka'e
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Samuel Martin Sosso
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Joseph Fokam
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Rachel Kamgaing Simo
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Sara Riwom Essama
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - Alex Durand Nka
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Bouba Yagai
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | | | - Michel Carlos Tommo Tchouaket
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Collins Chenwi
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Aissatou Abba
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Nadine Fainguem
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Marie Krystel Nnomo Zam
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Junie Flore Yimga
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | | | - Alexis Ndjolo
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
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Dunphy L, Palmer B, Chen F, Kitchen J. Fulminant diffuse cerebral toxoplasmosis as the first manifestation of HIV infection. BMJ Case Rep 2021; 14:14/1/e237120. [PMID: 33462006 PMCID: PMC7813373 DOI: 10.1136/bcr-2020-237120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Individuals with HIV may present to the emergency department with HIV-related or HIV-unrelated conditions, toxicity associated with antiretroviral therapy or primary HIV infection (seroconversion). In individuals with HIV infection, central nervous system toxoplasmosis occurs from reactivation of disease, especially when the CD4+ count is <100 cells/μL, whereas in those taking immunosuppressive therapy, this can be either due to newly acquired or reactivated latent infection. It is a rare occurrence in immune-competent patients. Vertical transmission during pregnancy can manifest as congenital toxoplasmosis in the neonate and is often asymptomatic until the second or third decade of life when ocular lesions develop. Toxoplasmosis is an infection caused by the intracellular protozoan parasite Toxoplasma gondii and causes zoonotic infection. It can cause focal or disseminated brain lesions leading to neurological deficit, coma and death. Typical radiological findings are multiple ring-enhancing lesions. Histopathological examination demonstrating tachyzoites of T. gondii and the presence of nucleic material in the spinal cerebrospinal fluid (CSF) confirms the diagnosis. The authors present the case of a 52-year-old male UK resident, born in sub-Saharan Africa, with a 3-week history of visual hallucinations. He attended the emergency department on three occasions. Laboratory investigations and a CT head were unremarkable. He was referred to psychological medicine for further evaluation. On his third presentation, 2 months later, a CT head showed widespread lesions suggestive of cerebral metastasis. Dexamethasone was initiated and he developed rigours. An MRI head showed multiple ring-enhancing lesions disseminated throughout his brain parenchyma. CSF analysis and serology confirmed the diagnosis of HIV and toxoplasmosis, respectively. His CD4 count was 10 and his viral load (VL) was 1 245 003. He was then initiated on Biktarvy 50 mg/200 mg/25 mg, one tablet daily, which contains 50 mg of bictegravir, 200 mg of emtricitabine and tenofovir alafenamide fumarate equivalent to 25 mg of tenofovir alafenamide. After 3 months of antiretroviral therapy, his HIV VL reduced to 42. However, his abbreviated mental test remained at 2/10. Despite presenting with neurocognitive impairment and being born in a HIV prevalent region, an HIV test was not offered. This case highlights missed opportunities to request HIV serology and raises awareness that cerebral toxoplasmosis can occur as the first manifestation of HIV. Prompt diagnosis and early initiation of antiretroviral therapy reduces morbidity and mortality in this patient cohort.
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Affiliation(s)
- Louise Dunphy
- Department of Acute Medicine, Royal Berkshire NHS Foundation Trust, Reading, UK
| | - Bret Palmer
- Department of HIV Medicine, Royal Berkshire Hospital, Reading, UK
| | - Fabian Chen
- Department of HIV Medicine, The Royal Berkshire NHS Foundation Trust, Reading, UK
| | - Joanne Kitchen
- Department of Rheumatology, The Royal Berkshire NHS Foundation Trust, Reading, UK
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Gundamraj S, Hasbun R. The Use of Adjunctive Steroids in Central Nervous Infections. Front Cell Infect Microbiol 2020; 10:592017. [PMID: 33330135 PMCID: PMC7719626 DOI: 10.3389/fcimb.2020.592017] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 10/23/2020] [Indexed: 01/02/2023] Open
Abstract
Central nervous system (CNS) infections continue to be associated with significant neurological morbidity and mortality despite various existing therapies. Adjunctive steroid therapy has been employed clinically to reduce inflammation in the treatment of CNS infections across various causative pathogens. Steroid therapy can potentially improve clinical outcomes including reducing mortality rates, provide no significant benefit, or cause worsened outcomes, based on the causative agent of infection. The data on benefits or harms of adjunctive steroid therapy is not consistent in outcome or density through CNS infections, and varies based on the disease diagnosis and pathogen. We summarize the existing literature on the effects of adjunctive steroid therapy on outcome for a number of CNS infections, including bacterial meningitis, herpes simplex virus, West Nile virus, tuberculosis meningitis, cryptococcal meningitis, Angiostrongylus cantonensis, neurocysticercosis, autoimmune encephalitis, toxoplasmosis, and bacterial brain abscess. We describe that while steroid therapy is beneficial and supported in pathogens such as pneumococcal meningitis and tuberculosis, for other diseases, like Listeria monocytogenes and Cryptococcus neoformans they are associated with worse outcomes. We highlight areas of consistent and proven findings and those which need more evidence for supported beneficial clinical use of adjunctive steroid therapy.
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Affiliation(s)
| | - Rodrigo Hasbun
- Department of Internal Medicine, UT Health McGovern Medical School, Houston, TX, United States
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Manuel L, Santos-Gomes G, Noormahomed EV. Human toxoplasmosis in Mozambique: gaps in knowledge and research opportunities. Parasit Vectors 2020; 13:571. [PMID: 33176884 PMCID: PMC7659051 DOI: 10.1186/s13071-020-04441-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/30/2020] [Indexed: 01/01/2023] Open
Abstract
Toxoplasmosis is a parasitic zoonotic disease caused by Toxoplasma gondii that afflicts humans worldwide and wild and domestic warm-blooded animals. In immunocompetent individuals, the acute phase of infection presents transient low or mild symptoms that remain unnoticed. In immunocompromised patients, T. gondii is a life-threatening opportunistic infection, which can result from the reactivation of latent infection or primary infection. Moreover, congenital toxoplasmosis, which results from the transplacental passage of tachyzoites into the fetus during a pregnant primary infection, can lead to miscarriage, stillbirth, or ocular and neurologic disease, and neurocognitive deficits in the newborns. Thus, the present review aims to address the current knowledge of T. gondii infection and toxoplasmosis in Africa and especially in Mozambique, stressing the importance of identifying risk factors and promote awareness among the health care providers and population, assessing the gaps in knowledge and define research priorities. In Mozambique, and in general in southern African countries, clinical disease and epidemiological data have not yet been entirely addressed in addition to the implications of T. gondii infection in immunocompetent individuals, in pregnant women, and its relation with neuropsychiatric disorders. The main gaps in knowledge in Mozambique include lack of awareness of the disease, lack of diagnostic methods in health facilities, lack of genetic data, and lack of control strategies.![]()
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Affiliation(s)
- Leonardo Manuel
- Faculty of Health Sciences, Universidade Lurio, Nampula, Mozambique
| | - Gabriela Santos-Gomes
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal
| | - Emilia V Noormahomed
- Department of Microbiology, Faculty of Medicine, Universidade Eduardo Mondlane (UEM), Maputo, Mozambique. .,Department of Medicine, Infectious Disease Division, University of California, San Diego, USA. .,Mozambique Institute for Health Education and Research (MIHER), Maputo, Mozambique.
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Marciano MAM, Silva RA, Barbosa ML, Ferreira ARS, Pereira-Chioccola VL. Determination of the viability of Toxoplasma gondii oocysts by PCR real-time after treatment with propidium monoazide. Rev Inst Med Trop Sao Paulo 2020; 62:e84. [PMID: 33146312 PMCID: PMC7608075 DOI: 10.1590/s1678-9946202062084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 10/01/2020] [Indexed: 11/23/2022] Open
Abstract
This study aimed to investigate a methodology for discriminating viable and non-viable T. gondii oocysts in water. Analyses included two steps: (i) microscopic investigation with vital dyes; (ii) molecular investigation, using a real time PCR (qPCR), after parasite treatment (or not) with propidium monoazide (PMA). The method was called qPCR-PMA. Oocyst aliquots were incubated (15 min) at 25 ºC or 100 ºC and analyzed by microscopy, after trypan blue and neutral red staining. Microscopic investigation determined viable and non-viable oocysts. For the molecular investigation, both aliquots of oocysts were treated with PMA. Non-viable oocysts, after PMA treatment, exhibited an inhibition of DNA amplification by qPCR. Although analyses were carried out with oocysts treated experimentally, these results suggest that qPCR-PMA can be a useful strategy to distinguish viable and non-viable T. gondii oocysts in water safety testing, showing if water is safe to drink.
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Affiliation(s)
| | | | - Maria Luisa Barbosa
- Instituto Adolfo Lutz , Núcleo de Morfologia e Microscopia , São Paulo , São Paulo , Brazil
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Dupont D, Fricker-Hidalgo H, Brenier-Pinchart MP, Garnaud C, Wallon M, Pelloux H. Serology for Toxoplasma in Immunocompromised Patients: Still Useful? Trends Parasitol 2020; 37:205-213. [PMID: 33046380 DOI: 10.1016/j.pt.2020.09.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/11/2020] [Accepted: 09/15/2020] [Indexed: 12/22/2022]
Abstract
Toxoplasmosis represents one of the most common comorbidity factors in solid organ or hematopoietic stem cell transplant recipients as well as in other immunocompromised patients. In the past decades, availability and performance of molecular tools for the diagnosis or the exclusion of toxoplasmosis in these patients have greatly improved. However, if accurately used, serology remains a complementary and essential diagnostic tool for physicians and medical parasitologists for the prevention and management of toxoplasmosis in immunocompromised patients as well. It is required for determination of the immunological status of patients against Toxoplasma. It also helps diagnose and monitor complex cases of opportunistic Toxoplasma infection in immunocompromised patients. New perspectives are available to further enhance their yield and ease of use.
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Affiliation(s)
- Damien Dupont
- Institut des Agents Infectieux, Service de Parasitologie Mycologie Médicale, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, 69004, France; Physiologie intégrée du système d'éveil, Centre de Recherche en Neurosciences de Lyon, INSERM U1028-CNRS UMR 5292, Faculté de Médecine, Université Claude Bernard Lyon 1, Bron, 69500, France.
| | - Hélène Fricker-Hidalgo
- Laboratoire de Parasitologie-Mycologie, CHU Grenoble Alpes, Grenoble, 38000, France; Institut pour l'Avancée des Biosciences (IAB), INSERM U1209-CNRS UMR 5309, Université Grenoble Alpes, Grenoble, 38000, France
| | - Marie-Pierre Brenier-Pinchart
- Laboratoire de Parasitologie-Mycologie, CHU Grenoble Alpes, Grenoble, 38000, France; Institut pour l'Avancée des Biosciences (IAB), INSERM U1209-CNRS UMR 5309, Université Grenoble Alpes, Grenoble, 38000, France
| | - Cécile Garnaud
- Laboratoire de Parasitologie-Mycologie, CHU Grenoble Alpes, Grenoble, 38000, France; Université Grenoble Alpes, CNRS, CHU Grenoble Alpes, Grenoble INP, TIMC-IMAG, Grenoble, 38000, France
| | - Martine Wallon
- Institut des Agents Infectieux, Service de Parasitologie Mycologie Médicale, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, 69004, France; Physiologie intégrée du système d'éveil, Centre de Recherche en Neurosciences de Lyon, INSERM U1028-CNRS UMR 5292, Faculté de Médecine, Université Claude Bernard Lyon 1, Bron, 69500, France
| | - Hervé Pelloux
- Laboratoire de Parasitologie-Mycologie, CHU Grenoble Alpes, Grenoble, 38000, France; Institut pour l'Avancée des Biosciences (IAB), INSERM U1209-CNRS UMR 5309, Université Grenoble Alpes, Grenoble, 38000, France
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The prevalence of latent and acute toxoplasmosis in HIV-infected pregnant women: A systematic review and meta-analysis. Microb Pathog 2020; 149:104549. [PMID: 33010362 DOI: 10.1016/j.micpath.2020.104549] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/20/2020] [Accepted: 09/25/2020] [Indexed: 01/29/2023]
Abstract
OBJECTIVE HIV in pregnancy is not only important for mother-to-child HIV transmission, but also it assumes additional importance because HIV increases susceptibility to opportunistic infections, leading to increased morbidity and mortality in mothers and neonates. Toxoplasmosis is one of the most important opportunistic infections in HIV-infected pregnant women. The present study was undertaken to assess the prevalence of latent toxoplasmosis (LT) and acute toxoplasmosis (AT) infection in HIV-infected pregnant women. METHODS PubMed/MEDLINE, Scopus, Web of Science, EMBASE and SciELO were searched to identify relevant studies. A random-effects model was used to estimate the overall and subgroup-pooled prevalences across studies. Heterogeneity between studies was assessed via the I2 test. RESULTS A total of 14 articles that included 3256 subjects in nine countries met the inclusion criteria. The overall prevalence rates of LT and AT in HIV-infected pregnant women were 45.7% (95% CI, 32.3-59.7%) and 1.1% (95% CI, 0.4-3.2%), respectively. The findings indicate that, worldwide, approximately 559,000 and 13,450 HIV-infected pregnant women are affected by LT and AT, respectively. From this review, it is estimated that approximately 3432 babies annually could be born with congenital toxoplasmosis (CT) from HIV-infected pregnant mothers. CONCLUSIONS The present study indicates that a large number of HIV-infected mothers are affected by LT and AT. This can lead to adverse complications such toxoplasmic encephalitis in mothers and CT in neonates. Our results suggest a need for screening programs using well-validated diagnostic platforms for both LT and AT for all HIV-infected pregnant women.
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Zeng YM, Li Y, He XQ, Huang YQ, Liu M, Yuan J, Bai Y, Lu YQ, Li H, Chen YK. A study for precision diagnosing and treatment strategies in difficult-to-treat AIDS cases and HIV-infected patients with highly fatal or highly disabling opportunistic infections: Study protocol for antiretroviral therapy timing in AIDS patients with toxoplasma encephalitis. Medicine (Baltimore) 2020; 99:e21141. [PMID: 32702867 PMCID: PMC7373539 DOI: 10.1097/md.0000000000021141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Toxoplasma encephalitis (TE) is one of the main opportunistic infections in acquired immunodeficiency syndrome (AIDS) patients, and represents a social burden due to its high prevalence and morbidity. Concomitant antiretroviral therapy (ART), together with effective anti- toxoplasma combination therapy, is an effective strategy to treat AIDS-associated TE (AIDS/TE) patients. However, the timing for the initiation of ART after diagnosis of TE remains controversial. We therefore designed the present study to determine the optimal timing for ART initiation in AIDS/TE patients. METHODS/DESIGN This trial is a 17-center, randomized, prospective clinical study with 2 parallel arms. A total of 200 participants will be randomized at a 1:1 ratio into the 2 arms: the early ART initiation (≤14 days after TE diagnosis) arm and the deferred ART (>14 days after TE diagnosis) arm. The primary outcome will be the difference of mortality between the 2 arms at 48 weeks. The secondary outcomes will be the differences between the 2 arms in the changes of CD4+ counts from baseline to week 48, the rate of virologic suppression (HIV ribonucleic acid <50 copies/mL) from baseline to week 48, the incidence of TE-associated immune reconstitution inflammatory syndrome during the study period, and the incidence of adverse effects during the study period. DISCUSSION This present trial aims to evaluate the optimal timing for ART initiation in AIDS/TE patients, and will provide strong evidence for AIDS/TE treatment should it be successful. TRIAL REGISTRATION This trial was registered as one of the 12 trials under the name of a general project at the chictr.gov (http://www.chictr.org.cn/showproj.aspx?proj=35362) on February 1, 2019, and the registration number of the general project is ChiCTR1900021195.
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Gohari O, Dalimi A, Pirestani M. Toxoplasma infection in patients with myocardial infarction. Wien Klin Wochenschr 2020; 132:736-741. [DOI: 10.1007/s00508-020-01682-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 05/17/2020] [Indexed: 10/24/2022]
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Vidal JE, Cunha MA, Kassab MJ, Dauar RF, Vasconcelos DDM. First case report of eosinophilic meningitis associated with cerebral toxoplasmosis in an HIV-positive patient. Int J STD AIDS 2020; 31:596-599. [PMID: 32264778 DOI: 10.1177/0956462419840121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cerebral toxoplasmosis is the most common cause of focal brain lesion in people living with HIV (PLWH) and usually causes multifocal encephalitis with little or no meningeal involvement. Classically, only subtle cerebrospinal fluid (CSF) abnormalities are described. There are no prior case reports in the literature on eosinophilic meningitis associated with cerebral toxoplasmosis in PLWH. We report on an HIV-positive man from Brazil who presented to the emergency department with headache, nausea, vomiting, and hemiparesis. He had a T-CD4+ lymphocyte count of 145 cells/mm3, and antiretroviral failure was identified. Brain computed tomography showed a contrast-enhancing lesion with mild mass effect and trimethoprim–sulfamethoxazole and dexamethasone were started. Examination of CSF showed 194 cells/mm3 (74% eosinophils, 18% lymphocytes, 4% monocytes, and 2% neutrophils), protein = 83 mg/dL, and glucose = 49 mg/dL. Detection of Toxoplasma gondii on CSF by polymerase chain reaction confirmed the diagnosis of cerebral toxoplasmosis. An exhaustive laboratorial investigation excluded other possible etiologies. After 14 days, the patient showed complete resolution of neurological and CSF alterations and substantial improvement in the brain lesion and was discharged home. We suggest that eosinophilic meningitis should be included in the spectrum of manifestations of HIV-related cerebral toxoplasmosis, especially in countries with high prevalence of toxoplasmosis in the general population.
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Affiliation(s)
- José E Vidal
- Department of Neurology, Instituto de Infectologia Emílio Ribas, São Paulo, Brazil.,Department of Infectious Diseases, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Medical Investigation, Unit 49, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Mirella Alves Cunha
- Department of Infectious Diseases, Instituto de Infectologia Emílio Ribas, São Paulo, Brazil
| | - Maria J Kassab
- Department of Infectious Diseases, Instituto de Infectologia Emílio Ribas, São Paulo, Brazil
| | - Rafi F Dauar
- Department of Instituto de Infectologia Emílio Ribas, São Paulo, Brazil
| | - Dewton de Moraes Vasconcelos
- Laboratory of Medical Investigation, Unit 56, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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de-la-Torre A, Gómez-Marín J. Disease of the Year 2019: Ocular Toxoplasmosis in HIV-infected Patients. Ocul Immunol Inflamm 2020; 28:1031-1039. [PMID: 32162993 DOI: 10.1080/09273948.2020.1735450] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Ocular toxoplasmosis (OT) may be an initial manifestation of acquired immunodeficiency syndrome (AIDS) in human immunodeficiency virus (HIV)-infected patients. OT has different clinical manifestations and can mimic other intraocular infections. Clinical findings may show single or multifocal retinochoroidal lesions or panuveitis. Atypical presentations are associated with extensive uni- or bilateral areas of retinal necrosis. OT lesions not associated with preexisting retinochoroidal scars are usually due to acquired rather than congenital infection. When CD4+ T cell counts are <100 c/uL, vitritis is frequently mild. Isolated anterior uveitis has been reported in single cases. Positive immunoglobulin M (IgM) antibodies are rare but their presence can support the diagnosis. As atypical presentations of OT are common, anterior chamber puncture for multiplex polymerase chain reaction amplification of infectious DNA should be considered, as early diagnosis and treatment can prevent massive tissue destruction and preserve vision. This review provides an overview of OT in HIV-infected patients.
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Affiliation(s)
- Alejandra de-la-Torre
- Grupo de Investigación en Neurociencia (Neuros), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario , Bogotá, Colombia
| | - Jorge Gómez-Marín
- Gepamol. Centro de Investigaciones Biomédicas, Universidad del Quindío , Armenia, Q, Colombia
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Human extracellular vesicles and correlation with two clinical forms of toxoplasmosis. PLoS One 2020; 15:e0229602. [PMID: 32126572 PMCID: PMC7054008 DOI: 10.1371/journal.pone.0229602] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 02/10/2020] [Indexed: 01/28/2023] Open
Abstract
Aim This study analyzed microvesicles and exosomes, called as extracellular vesicles (EVs) excreted in serum and cerebrospinal fluid (CSF) from patients with cerebral or gestational toxoplasmosis. Methods Clinical samples from 83 individuals were divided into four groups. Group I, 20 sera from healthy individuals and pregnant women (seronegative for toxoplasmosis); group II, 21 sera from seropositive patients for toxoplasmosis (cerebral or gestational forms); group III, 26 CSF samples from patients with cerebral toxoplasmosis/HIV co-infection (CT/HIV) (seropositive for toxoplasmosis); and group IV, 16 CSF samples from seronegative patients for toxoplasmosis, but with HIV infection and other opportunistic infections (OI/HIV). Serum and CSF samples were ultracentrifuged to recover EVs. Next, vesicle size and concentration were characterized by Nanoparticle Tracking Analysis (NTA). Results Concentrations of serum-derived EVs from toxoplasmosis patients (mean: 2.4 x 1010 EVs/mL) were statically higher than of non-infected individuals (mean: 5.9 x 109 EVs/mL). Concentrations of CSF-derived EVs were almost similar in both groups. CT/HIV (mean: 2.9 x 109 EVs/mL) and OI/HIV (mean: 4.8 x 109 EVs/mL). Analyses by NTA confirmed that CSF-derived EVs and serum-derived EVs had size and shape similar to microvesicles and exosomes. The mean size of EVs was similar in serum and CSF. Thus, the concentration, and not size was able distinguish patients with toxoplasmosis than healthy individuals. Presence of exosomes was also confirmed by transmission electron microscopy and evidence of tetraspanins CD63 and CD9 in immunoblotting. Relative expressions of miR-146a-5p, miR-155-5p, miR-21-5p, miR-29c-3p and miR-125b-5p were estimated in exosomal miRNA extracted of EVs. Serum-derived EVs from group II (cerebral and gestational toxoplasmosis) up-expressed miR-125b-5p and miR-146a-5p. CSF-derived EVs from CT/HIV patients) up-expressed miR-155-5p and miR-21-5p and were unable to express miR-29c-3p. Conclusion These data suggest the participation of EVs and exosomal miRNAs in unbalance of immune response as elevation of TNF-α, IL-6; and downregulation of IFN-γ in cerebral and gestational forms of toxoplasmosis.
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Global status of Toxoplasma gondii infection and associated risk factors in people living with HIV. AIDS 2020; 34:469-474. [PMID: 31714356 DOI: 10.1097/qad.0000000000002424] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Toxoplasma infection remains as the most common cause of focal brain lesions among people living with HIV (PLHIV) despite the decline in opportunistic infections with the introduction of antiretroviral treatment. This study was conducted to provide a summary of evidence about the seroprevalence of Toxoplasma gondii and prevalence of active T. gondii infection and associated risk factors among PLHIV. DESIGN Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Scopus, PubMed, Science Direct and EMBASE were searched from 1997 to July 2018. All peer-reviewed original research articles describing T. gondii infection among PLHIV with different diagnostic methods were included. METHODS Incoherence and heterogeneity between studies were quantified by I index and Cochran's Q test. Publication and population bias were assessed with funnel plots and Egger's regression asymmetry test. All statistical analyses were performed using StatsDirect. RESULTS In total, 111 studies from 37 countries assessing 66 139 blood samples were included in this study. The pooled prevalence of T. gondii infection among PLHIV was 3.24% by IgM and 26.22% by molecular methods using the random-effects model. Pooled seroprevalence of T. gondii by IgG was 44.22%. There was a relationship between Toxoplasma prevalence and sex, raw meat consumption, contact with cat and knowledge about toxoplasmosis. CONCLUSION High Toxoplasma seroprevalence among PLHIV observed in this study emphasizes the need for implementing screening and prophylaxis tailored to the local context. Owing to the serious and significant clinical manifestations of the parasite in case of reactivation, early identification of seropositivity for initiating prophylaxis among those with a CD4 cell count of less than 200 cells/ml is recommended.
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Pereira IDS, Maia MM, da Cruz AB, Telles JPM, Vidal JE, Gava R, Meira-Strejevitch CS, Pereira-Chioccola VL. Plasma extracellular microRNAs are related to AIDS/cerebral toxoplasmosis co-infection. Parasite Immunol 2020; 42:e12696. [PMID: 31945196 DOI: 10.1111/pim.12696] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/06/2020] [Accepted: 01/08/2020] [Indexed: 12/21/2022]
Abstract
This study investigated the potential of five miRNA candidates for cerebral toxoplasmosis/HIV co-infection (CT/HIV) biomarkers. miR-155-5p, miR-146a-5p, miR-21-5p, miR-125b-5p and miR-29c-3p were tested in 79 plasma divided into groups: 32 CT/HIV patients; 27 individuals with asymptomatic toxoplasmosis (AT); and 20 individuals seronegative for toxoplasmosis (NC). From each was collected peripheral blood/EDTA for laboratory diagnosis. Blood cells for DNA extractions (molecular diagnosis), plasma for RNA extractions (gene expression) and ELISA (serological diagnosis). miRNA expression was performed by qPCR, and values were expressed in Relative Quantification (RQ). Among the five miRNAs, miR-21-5p and miR-146a-5p were up-expressed in CT/HIV group when compared with AT and NC groups. RQ means for miR-21-5p and miR-146a-5p in CT/HIV group were 3.829 and 2.500, while in AT group, were 1.815 and 1.661, respectively. Differences between 3 groups were statistically significant (Kruskal-Wallis ANOVA test), as well as CT/HIV and AT groups (Mann-Whitney test). Plasma of CT/HIV and AT groups expressed similar levels of miR-29c-3p, miR-155-5p and miR-125b-5p. As NC group was different of CT/HIV and AT groups, differences between three groups were statistically significant (Kruskal-Wallis ANOVA test). No difference was shown between CT/HIV and AT groups (Mann-Whitney test). These results suggest the host miRNAs modulation by Toxoplasma gondii.
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Affiliation(s)
| | - Marta Marques Maia
- Laboratório de Biologia Molecular de Parasitas e Fungos, Instituto Adolfo Lutz, Sao Paulo, Brazil
| | - Allecineia Bispo da Cruz
- Laboratório de Biologia Molecular de Parasitas e Fungos, Instituto Adolfo Lutz, Sao Paulo, Brazil
| | | | - Jose Ernesto Vidal
- Instituto de Infectologia Emilio Ribas, São Paulo, Brazil.,Faculdade de Medicina, Hospital das Clínicas, da Universidade de São Paulo, São Paulo, Brazil.,Laboratório de Investigação Médica (LIM) 49, Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo, Brazil
| | - Ricardo Gava
- Laboratório de Biologia Molecular de Parasitas e Fungos, Instituto Adolfo Lutz, Sao Paulo, Brazil
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Meira-Strejevitch CS, Pereira IDS, Hippólito DDC, Maia MM, Cruz AB, Gava R, Brandão de Mattos CC, Frederico FB, Siqueira RC, Mattos LC, Pereira-Chioccola VL. Ocular toxoplasmosis associated with up-regulation of miR-155-5p/miR-29c-3p and down-regulation of miR-21-5p/miR-125b-5p. Cytokine 2020; 127:154990. [PMID: 31945658 DOI: 10.1016/j.cyto.2020.154990] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/30/2019] [Accepted: 01/07/2020] [Indexed: 12/19/2022]
Abstract
Ocular toxoplasmosis (OT) is one of the most common manifestations of Toxoplasma gondii infection and can be related with congenital or acquired infections. OT cause posterior uveitis that cause serious sequelae as complete loss of vision. microRNAs (miRNAs) are small non-coding RNAs, which have regulatory roles in cells by silencing messenger RNA. This study evaluated gene expression of miR-155-5p, miR-146a-5p, miR-21-5p, miR-29c-3p and miR-125b-5p in plasma of 51 patients with ocular toxoplasmosis (OT Group), 26 individuals with asymptomatic toxoplasmosis (AT Group), and 25 healthy individuals seronegative for toxoplasmosis (NC Group). Peripherical blood samples were collected in tube with EDTA for plasma isolation, laboratorial diagnosis for toxoplasmosis and RNA extraction. miRNA expression of each sample was performed by qPCR and values were expressed in Relative Quantification (RQ). Results showed that miR-155-5p and miR-29c-3p were up-expressed in OT patients than AT individuals. On the other hand, miR-21-5p and miR-125b-5p were down-expressed in OT patients. Differences were statistically significant. miR-146a-5p expression was similar in OT patients and AT individuals, without significant difference. In addition, comparative analysis for miRNA levels between AT and OT groups confirms these results. So far, this is the first study to evaluate circulating miRNA levels in ocular toxoplasmosis. These findings may contribute to further studies evaluating the exact role of these miRNAs in the course of infection, which may help in understanding the complex parasite-host interaction and future use in diagnosis, prognosis and therapeutic control in ocular toxoplasmosis.
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Affiliation(s)
| | | | | | - Marta Marques Maia
- Centro de Parasitologia e Micologia, Instituto Adolfo Lutz, Sao Paulo, Brazil.
| | | | - Ricardo Gava
- Centro de Parasitologia e Micologia, Instituto Adolfo Lutz, Sao Paulo, Brazil.
| | | | - Fábio Batista Frederico
- Ambulatório de Oftalmologia, Fundação Faculdade Regional de Medicina-Hospital de Base, São José do Rio Preto, Brazil.
| | - Rubens Camargo Siqueira
- Ambulatório de Oftalmologia, Fundação Faculdade Regional de Medicina-Hospital de Base, São José do Rio Preto, Brazil.
| | - Luiz Carlos Mattos
- Laboratório de Imunogenética, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, Brazil.
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Pirani V, Pelliccioni P, De Turris S, Rosati A, Franceschi A, Cesari C, Nicolai M, Mariotti C. The Eye as a Window to Systemic Infectious Diseases: Old Enemies, New Imaging. J Clin Med 2019; 8:E1392. [PMID: 31492008 PMCID: PMC6780210 DOI: 10.3390/jcm8091392] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 08/29/2019] [Accepted: 09/02/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Syphilis, tuberculosis and toxoplasmosis are major infectious diseases worldwide; all of them are multisystem pathologies and share a possible ocular involvement. In this context, a fundamental help for the definitive diagnosis is provided by the ophthalmologist, through clinical evaluation and with the aid of a multimodal imaging examination. METHODS We hereby describe selected cases who came to our attention and were visited in our eye clinic. In all clinics, the use of retinal and optic disc multimodal imaging during ophthalmological evaluation allowed to make a diagnosis of an infectious disease. RESULTS In our tertiary referral center more than 60 patients with syphilis, tuberculosis and toxoplasmosis have been evaluated in the last two years: In 60% of cases the ophthalmological evaluation was secondary to a previous diagnosis of an infectious disease, while in the remaining cases the ophthalmologist, with the help of a multimodal imaging examination and clinical evaluation, represented the physician who leads to the diagnosis. CONCLUSION Our results confirm how in these life-threatening pathologies a prompt diagnosis is mandatory and may benefit from a multidisciplinary and multimodal imaging approach, especially during ophthalmological evaluation.
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Affiliation(s)
- Vittorio Pirani
- Eye Clinic, Polytechnic University of Marche, 60126 Ancona, Italy.
| | | | - Serena De Turris
- Eye Clinic, Polytechnic University of Marche, 60126 Ancona, Italy.
| | | | | | - Claudia Cesari
- Eye Clinic, Polytechnic University of Marche, 60126 Ancona, Italy.
| | - Michele Nicolai
- Eye Clinic, Polytechnic University of Marche, 60126 Ancona, Italy.
| | - Cesare Mariotti
- Eye Clinic, Polytechnic University of Marche, 60126 Ancona, Italy
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46
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Mavi SA, Modarressi MH, Mohebali M, Shojaee S, Zeraati H, Teimouri A, Keshavarz H. Assessment of the immunogenicity and protective efficiency of a novel dual-promoter DNA vaccine, harboring SAG1 and GRA7 genes, from RH strain of Toxoplasma gondii in BALB/c mice. Infect Drug Resist 2019; 12:2519-2530. [PMID: 31616167 PMCID: PMC6699518 DOI: 10.2147/idr.s209270] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 07/26/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Toxoplasmosis, a protozoan parasitic disease caused by Toxoplasma gondii, has been a serious human and veterinary medicine problem with global distribution. In the current study, we assessed immunogenicity and protective efficiency of a novel dual-promoter DNA vaccine, harboring SAG1 and GRA7 genes, from RH strain of Toxoplasma gondii (T. gondii) with or without CpG-ODN as adjuvant in a murine model. METHODS BALB/c mice were immunized intramuscularly with pVitro-SAG1-GRA7 alone and pVitro-SAG1-GRA7 with CpG-ODN three times at three-week intervals. Enzyme-linked immunosorbent assay (ELISA) was used to assess total IgG, IgG1 and IgG2a antibodies and gamma interferon (IFN-γ) and interleukin-10 (IL-10) cytokines in mice sera. Four weeks post final vaccination, MTT assay and lethal challenge-infection with 1×103 tachyzoites of T. gondii RH strain were carried out to assess stimulation index (SI) and mice survival time, respectively. RESULTS The IgG levels in mice immunized with multicomponent vaccines, including pVitro-SAG1-GRA7 alone and pVitro-SAG1-GRA7 with CpG-ODN, were significantly higher than those in control mice or single-gene DNA-vaccinated ones (P<0.05). Furthermore, level of IgG2a in mice receiving pVitro-SAG1-GRA7 with CpG-ODN was significantly higher than that in mice receiving pVitro-SAG1-GRA7 alone (P<0.05). The Toxoplasma lysate antigen (TLA)-stimulated lymphocytes from pVitro-SAG1-GRA7 with CpG-ODN group responded more dramatically than those from control groups or single-gene DNA-vaccinated groups (P<0.001). The pVitro-SAG1-GRA7 with CpG-ODN-vaccinated mice developed high levels of IgG2a and IFN-γ (P<0.001) and low levels of IgG1 and IL-10, compared to control groups, suggesting a modulated immune response type Th1. In addition, survival time of the mice immunized with pVitro-SAG1-GRA7 with CpG-ODN was significantly extended, compared to controls (P<0.05); however, all mice died. CONCLUSION The multivalent pVitro-SAG1-GRA7 DNA vaccine with CpG-ODN adjuvant is a promising vaccine candidate against toxoplasmosis.
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Affiliation(s)
- Sara Ayazian Mavi
- Department of Medical Parasitology and Mycology, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mehdi Mohebali
- Department of Medical Parasitology and Mycology, Tehran University of Medical Sciences, Tehran, Iran
- Center for Research of Endemic Parasites of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeedeh Shojaee
- Department of Medical Parasitology and Mycology, Tehran University of Medical Sciences, Tehran, Iran
| | - Hojjat Zeraati
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Aref Teimouri
- Department of Medical Parasitology and Mycology, Tehran University of Medical Sciences, Tehran, Iran
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Keshavarz
- Department of Medical Parasitology and Mycology, Tehran University of Medical Sciences, Tehran, Iran
- Center for Research of Endemic Parasites of Iran, Tehran University of Medical Sciences, Tehran, Iran
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47
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Coupe A, Howe L, Shapiro K, Roe WD. Comparison of PCR assays to detect Toxoplasma gondii oocysts in green-lipped mussels (Perna canaliculus). Parasitol Res 2019; 118:2389-2398. [PMID: 31197544 DOI: 10.1007/s00436-019-06357-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 05/16/2019] [Indexed: 12/17/2022]
Abstract
Toxoplasma gondii is recognised as an important pathogen in the marine environment, with oocysts carried to coastal waters in overland runoff. Currently, there are no standardised methods to detect T. gondii directly in seawater to assess the extent of marine ecosystem contamination, but filter-feeding shellfish may serve as biosentinels. A variety of PCR-based methods have been used to confirm presence of T. gondii DNA in marine shellfish; however, systematic investigations comparing molecular methods are scarce. The primary objective of this study was to evaluate analytical sensitivity and specificity of two nested-PCR (nPCR) assays targeting dhps and B1 genes and two real-time (qPCR) assays targeting the B1 gene and a 529-bp repetitive element (rep529), for detection of T. gondii. These assays were subsequently validated for T. gondii detection in green-lipped mussel (Perna canaliculus) haemolymph using oocyst spiking experiments. All assays could reliably detect 50 oocysts spiked into mussel haemolymph. The lowest limit of detection was 5 oocysts using qPCR assays, with the rep529 primers performing best, with good correlation between oocyst concentrations and Cq values, and acceptable efficiency. Assay specificity was evaluated by testing DNA from closely related protozoans, Hammondia hammondi, Neospora caninum, and Sarcocystis spp. Both nPCR assays were specific to T. gondii. Both qPCR assays cross-reacted with Sarcocystis spp. DNA, and the rep529 primers also cross-reacted with N. caninum DNA. These studies suggest that the rep529 qPCR assay may be preferable for future mussel studies, but direct sequencing is required for definitive confirmation of T. gondii DNA detection.
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Affiliation(s)
- Alicia Coupe
- Institute of Veterinary, Animal and Biomedical Sciences, College of Sciences, Massey University, Private Bag 11 - 222, Palmerston North, 4442, New Zealand. .,EpiCentre, Wool Building, University Avenue, Massey University Manawatū Campus, Palmerston North, New Zealand.
| | - Laryssa Howe
- Institute of Veterinary, Animal and Biomedical Sciences, College of Sciences, Massey University, Private Bag 11 - 222, Palmerston North, 4442, New Zealand
| | - Karen Shapiro
- One Health Institute and School of Veterinary Medicine, University of California, Davis, CA, USA.,Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Wendi D Roe
- Institute of Veterinary, Animal and Biomedical Sciences, College of Sciences, Massey University, Private Bag 11 - 222, Palmerston North, 4442, New Zealand
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48
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Pellegrino D, de Lima PP, de Oliveira ACP, Vidal JE. Hemorrhagic brain lesions in a newly diagnosed HIV-1 infected patient. Int J STD AIDS 2019; 30:930-933. [PMID: 31159716 DOI: 10.1177/0956462419845965] [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] [Indexed: 01/26/2023]
Abstract
We report the case of a previously healthy 29-year-old man who has sex with men who was admitted with sub-acute onset of headache, seizures and altered mental status. Physical examination revealed oral thrush, mental confusion and right hemiparesis. An unenhanced computed tomography of the brain revealed multiple rounded hemorrhages associated with perilesional edema and no enhancement was seen after contrast infusion. A rapid test for HIV-1 was positive and the CD4 T-lymphocyte count was 120 cells/mm3. Pyrimethamine, sulfadiazine plus folinic acid and dexamethasome were started. After two weeks of treatment, the clinical condition and neuroimaging of the patient remained unaltered. A stereotactic brain biopsy was performed and the histopathologic examination confirmed the diagnosis of hemorrhagic toxoplasmosis. After a longer course of anti-Toxoplasma treatment due to an incomplete clinical and radiological response, the patient was discharged home. Hemorrhagic toxoplasmosis is a rare presentation of cerebral toxoplasmosis and should be considered in the differential diagnosis of hemorrhagic cerebral lesions in HIV-infected patients in order to initiate specific treatment promptly.
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Affiliation(s)
- D Pellegrino
- 1 Department of Infectious Diseases, Instituto Medicina, Infectologia Emílio Ribas, São Paulo, Brazil
| | - Patricia Picciarelli de Lima
- 2 Department of Pathology, Faculdade de Medicina, Hospital das Clinicas, Universidade de São Paulo, São Paulo, Brazil
| | | | - José E Vidal
- 3 Department of Neurology, Instituto Medicina, Infectologia Emílio Ribas, São Paulo, Brazil.,4 Department of Infectious Diseases, Faculdade de Medicina, Hospital das Clinicas, Universidade de São Paulo, São Paulo, Brazil
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49
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Deigendesch N, Schlüter D, Siebert E, Stenzel W. [Infections of the central nervous system by protozoa, helminths and fungi]. DER NERVENARZT 2019; 90:623-641. [PMID: 31073673 DOI: 10.1007/s00115-019-0719-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A plethora of different parasites and fungi can lead to infections of the central nervous system (CNS) and cause different clinical symptoms and outcomes depending on the pathogen and the anatomic location of the infection. The diagnosis and treatment of these eukaryotic infections is challenging. The prevalence of CNS infections depends on many factors, including geographical location, living conditions, genetic background and the immune status of the individual. In Germany, infections of the CNS by fungi and parasites are rare but can lead to considerable morbidity. Some parasitic and fungal CNS infections are becoming increasingly more prevalent and clinically relevant due to the increasing number of immunocompromised people. Case fatality rates of these infections, which are difficult to diagnose and to treat, are high. This article provides an overview of a subjective selection of parasitic and fungal infections of the CNS relevant to clinical practice in Germany and presents the diagnostic and therapeutic options.
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Affiliation(s)
- Nikolaus Deigendesch
- Institut für Medizinische Genetik und Pathologie, Universitätsspital Basel, Schönbeinstraße 40, 4031, Basel, Schweiz.
| | - Dirk Schlüter
- Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland
| | - Eberhard Siebert
- Institut für Neuroradiologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Werner Stenzel
- Institut für Neuropathologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
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50
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Mustafa M, Fathy F, Mirghani A, Mohamed MA, Muneer MS, Ahmed AE, Ali MS, Omer RA, Siddig EE, Mohamed NS, Abd Elkareem AM. Prevalence and risk factors profile of seropositive Toxoplasmosis gondii infection among apparently immunocompetent Sudanese women. BMC Res Notes 2019; 12:279. [PMID: 31097016 PMCID: PMC6524216 DOI: 10.1186/s13104-019-4314-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 05/11/2019] [Indexed: 12/29/2022] Open
Abstract
Objectives Toxoplasma gondii is an opportunistic parasite that causes a clinical manifestation known as toxoplasmosis. We investigated the prevalence and potential risk factors of T. gondii infection among women in Khartoum, Sudan. A sero-parasitological cross-sectional study included 100 women aging between 15 and 50 years old was conducted between January and November 2018. Serum samples were collected and investigated for the presence of anti-T. gondii immunoglobulins. Results Mean age of the women population included was 26.75 ± 8.25 with a range between 15 and 50 years. Sero-prevalence of T. gondii antibodies was 27% (27/100) with a 95% confidence interval (CI) of 18.6–36.8%. Among seropositive population 81% (22/27), 15% (4/27) and 4% (1/27) were seropositive for IgG antibodies, IgM antibodies and both antibodies respectively. Age group 21–30 years old had the highest frequency of detected IgG (10/45) and IgM (3/45). Married women had the highest frequency of detected IgG or IgM, 18/79 and 3/79, respectively. Risk factors analysis showed a total of 37/100 participants were having direct contact with cats and 66/100 have a frequent raw meat consumption, neither direct cats contact nor raw meat consumption had a statistically significant association with seropositivity to T. gondii (P value = 0.052 and 0.565, respectively). Electronic supplementary material The online version of this article (10.1186/s13104-019-4314-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Madinna Mustafa
- Department of Parasitology and Medical Entomology, Faculty of Medical Laboratory Sciences, Nile College, Khartoum, Sudan
| | - Fatima Fathy
- Department of Parasitology and Medical Entomology, Faculty of Medical Laboratory Sciences, Nile College, Khartoum, Sudan
| | - Abubaker Mirghani
- Department of Parasitology and Medical Entomology, Faculty of Medical Laboratory Sciences, Nile College, Khartoum, Sudan
| | - Mona A Mohamed
- Department of Parasitology and Medical Entomology, Faculty of Medical Laboratory Sciences, Nile College, Khartoum, Sudan
| | - Mohamed S Muneer
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA.,Department of Radiology, Mayo Clinic, Jacksonville, FL, USA.,Department of Internal Medicine, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Abdallah E Ahmed
- Department of Molecular Biology, National University Biomedical Research Institute, National University, Khartoum, Sudan
| | - Mohamed Siralkhatim Ali
- Department of Molecular Biology, National University Biomedical Research Institute, National University, Khartoum, Sudan.,Faculty of Medicine, Neelain University, Khartoum, Sudan
| | - Rihab A Omer
- Department of Molecular Biology, National University Biomedical Research Institute, National University, Khartoum, Sudan
| | | | - Nouh S Mohamed
- Department of Parasitology and Medical Entomology, Faculty of Medical Laboratory Sciences, Nile College, Khartoum, Sudan. .,Department of Molecular Biology, National University Biomedical Research Institute, National University, Khartoum, Sudan. .,Department of Parasitology and Medical Entomology, Faculty of Medical Laboratory Sciences, Sinnar University, Sinnar, Sudan.
| | - Amjed M Abd Elkareem
- Department of Parasitology and Medical Entomology, Faculty of Medical Laboratory Sciences, Nile College, Khartoum, Sudan.,Parasitology Department, College of Medical Laboratory Sciences, Sudan University of Science and Technology, Khartoum, Sudan
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