Toxoplasma gondii

弓形虫
  • 文章类型: Journal Article
    在人畜共患寄生虫弓形虫的潜在动物库中,鸟类受到的关注相对较少。本系统综述和荟萃分析旨在评估全球状况,并概述鸟类弓形虫感染的流行病学。遵循系统评价和荟萃分析(PRISMA)指南的首选报告项目的标准协议。Scopus,PubMed,WebofScience,科学直接,ProQuest,从1990年1月到2024年3月,谷歌学者被搜索相关出版物。包括所有经过同行评审的原始研究文章,这些文章描述了弓形虫在鸟类中的患病率。采用纳入和排除标准,并考虑了直接和间接检测。使用R(版本3.6.1)中的元包计算点估计和95%置信区间。研究之间的差异(异质性)通过I2指数量化。最后,258篇文章(包括380个数据集)符合纳入系统评价和荟萃分析的条件。全球合并患病率为24%(21-26%)。弓形虫的患病率最高的是秃鹰(52%,34-70%),火鸡(31%,17-46%),和鸡(30%,26-34%)。本研究提供了全球弓形虫在鸟类中流行的全面视图。
    Among the potential animal reservoirs of the zoonotic parasite T. gondii, birds have received relatively little attention. This systematic review and meta-analysis aimed to assess the global status and to provide an overview of the epidemiology of T. gondii infection in birds. The standard protocol of preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed. Scopus, PubMed, Web of Science, Science Direct, ProQuest, and Google Scholar were searched for relevant publications from January 1990, to March 2024. All peer-reviewed original research articles describing the prevalence of T. gondii in birds were included. Inclusion and exclusion criteria were applied, and both direct and indirect detection were considered. The point estimates and 95% confidence intervals were calculated using the meta-package in R (version 3.6.1). The variance between studies (heterogeneity) was quantified by the I2 index. Finally, 258 articles (including 380 datasets) were eligible for inclusion in the systematic review and meta-analysis. The global pooled prevalence was 24% (21 - 26%). The highest prevalence of T. gondii was observed in buzzards (52%, 34 - 70%), turkeys (31%, 17 - 46%), and chickens (30%, 26 - 34%). The present study provides a comprehensive view of the global prevalence of T. gondii in birds.
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  • 文章类型: Meta-Analysis
    进行了系统评价和荟萃分析,以确定野生鸟类弓形虫感染的全球患病率和相关因素。六个书目数据库(中国国家知识基础设施,VIP中国期刊数据库,万方数据,PubMed,Webofscience和ScienceDirect)从成立之初到2023年2月进行了搜索。搜索产生了1220条记录,其中659篇文章进行了全文评估,该研究确定了纳入荟萃分析的49篇合格文章和16,030份野鸟样本。估计全球野生鸟类弓形虫感染的汇总患病率为16.6%。在测试的变量中,2020年以后发表,气候类型与弓形虫感染显着相关(P<0.01)。我们的数据表明,野生鸟类中弓形虫的患病率可能受到流行病学变量的影响。需要进一步的研究来确定生物,环境,人为的,以及影响野生鸟类弓形虫生态和流行的地理风险因素。
    A systematic review and meta-analysis were performed to identify the global prevalence and factors associated with Toxoplasma gondii infection in wild birds. Six bibliographic databases (Chinese National Knowledge Infrastructure, VIP Chinese Journal Database, Wanfang Data, PubMed, Web of science and ScienceDirect) were searched from inception to February 2023. The search yielded 1220 records of which 659 articles underwent full-text evaluation, which identified 49 eligible articles and 16,030 wild bird samples that were included in the meta-analysis. The estimated pooled global prevalence of T. gondii infection in wild birds was 16.6%. Out of the variables tested, publication year after 2020 and climate type were significantly associated with T. gondii infection (P<0.01). Our data indicate that the prevalence of T. gondii in wild birds can be influenced by epidemiological variables. Further research is needed to identify the biological, environmental, anthropogenic, and geographical risk factors which impact the ecology and prevalence of T. gondii in wild birds.
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  • 文章类型: Journal Article
    从“一个健康”的角度来看,弓形虫是一种典型的人畜共患寄生虫,因为它分布广泛,几乎感染所有温血物种。已经开发了多种血清学技术来检测人和动物中的弓形虫感染。我们的目的是描述和比较这些血清学测试和验证过程的主要特征,并严格分析这些测试是否符合确保准确血清学诊断所需的标准。目前的系统评价和荟萃分析包括2013年至2023年发表的134项研究。采用QUADAS2工具评价纳入研究的质量。研究了与技术特征以及分析和诊断验证参数相关的总共52个变量。为人类开发了更广泛的测试小组,包括专门为人类开发的技术,涉及昂贵的设备和不同的Ig同种型的测量,被认为是先天性弓形虫病的生物标志物。在人类中进行的研究经常采用商业技术作为参考测试,测量不同的免疫球蛋白同种型,IgG占优势(>50%),并区分急性和慢性感染。在动物中,最常用的参考技术是内部测试,几乎只检测到IgG。在大量研究中发现的常见限制是对术语“金标准”和“参考测试”的一些误解,以及缺乏有关所用阴性和阳性对照血清或所用确切截止值的信息。这与研究的质量无关。缺乏分析验证,很少评估与其他病原体的交叉反应性。诊断比值比值表明,基于天然或嵌合抗原的间接ELISA比其他测试表现更好。由于缺乏相关信息和分析验证,无法保证人和动物的血清学测试结果的可重复性。因此,今后应该考虑几个关键问题,包括实验室间环形试验。
    Toxoplasma gondii is a paradigmatic zoonotic parasite from the One Health perspective, since it is broadly distributed and virtually infects all warm-blooded species. A wide variety of serological techniques have been developed to detect T. gondii infection in humans and animals. Our aim was to describe and compare the main characteristics of these serological tests and validation processes and to critically analyze whether these tests meet the standards required to ensure an accurate serological diagnosis. The current systematic review and meta-analysis included 134 studies that were published from 2013 to 2023. QUADAS 2 tool was used to evaluate the quality of the included studies. A total of 52 variables related to the characteristics of the techniques and analytical and diagnostic validation parameters were studied. A wider panel of tests was developed for humans, including techniques exclusively developed for humans that involve costly equipment and the measurement of different Ig isotypes that are considered biomarkers of congenital toxoplasmosis. Studies conducted in humans frequently employed commercial techniques as reference tests, measured different immunoglobulin isotypes with a predominance for IgG (>50%) and discriminated between acute and chronic infections. In animals, the most commonly used reference techniques were in-house tests, which almost exclusively detected IgG. Common limitations identified in a large number of studies were some misunderstandings of the terms \"gold standard\" and \"reference test\" and the absence of information about the negative and positive control sera used or the exact cutoff employed, which were independent of the quality of the study. There is a lack of analytical validation, with few evaluations of cross-reactivity with other pathogens. Diagnostic odds ratio values showed that indirect ELISA based on native or chimeric antigens performed better than other tests. The reproducibility of serological test results in both humans and animals is not guaranteed due to a lack of relevant information and analytical validation. Thus, several key issues should be considered in the future, including interlaboratory ring trials.
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  • 文章类型: Journal Article
    本系统评价和荟萃分析是为了评估弓形虫(T.gondii)伊朗健康献血者中的暴露。
    我们搜索了四个英文(PubMed,Scopus,WebofScience,和ScienceDirect)和两个波斯语数据库(Magiran和SID)以及GoogleScholar作为专门的文章搜索引擎,从成立之初到2023年11月30日,使用相关论文的特定关键字。
    总共,19项研究招募8226名明显健康的献血者,对弓形虫特异性IgG和/或IgM抗体进行了检查。其中2666[32.9%(95%CI:25.3%-41.6%)],168[1.4%(95%CI:0.9%-2.1%)],和83[1.7%(95%CI:1.3%-2.1%)]受试者的IgG血清呈阳性,IgM,和IgG/IgM抗体,分别。五个危险因素与弓形虫血清阳性率显著相关,包括性别(OR=1.98;95%CI:1.52-2.58;P<0.001),与猫接触(OR=2.41;95%CI:1.70-3.41;P<0.001),与土壤接触(OR=2.83;95%CI:1.07-7.45;P=0.035),食用生/未煮熟的肉(OR=1.95;95%CI:1.03-3.70;P=0.039),生菜/未清洗蔬菜(OR=1.70;95%CI:1.25-2.31;P=0.001)。
    在伊朗献血者中发现了适度的弓形虫暴露率,与几个危险因素的联系,包括性别,与猫接触,与土壤接触,食用未清洗的蔬菜和/或未煮熟的肉。尽管如此,建议对伊朗献血者中弓形虫暴露进行更多研究。
    UNASSIGNED: The present systematic review and meta-analysis was done to assess the rate of Toxoplasma gondii (T. gondii) exposure among Iranian healthy blood donors.
    UNASSIGNED: We searched four English (PubMed, Scopus, Web of Science, and Science Direct) and two Persian databases (Magiran and SID) as well as Google Scholar as a specialized article search engine using specific keywords for relevant papers from the inception up to November 30, 2023.
    UNASSIGNED: In total, 19 studies enrolling 8226 apparently healthy blood donors were examined regarding T. gondii-specific IgG and/or IgM antibodies, among which 2666 [32.9% (95% CI: 25.3%-41.6%)], 168 [1.4% (95% CI: 0.9%-2.1%)], and 83 [1.7% (95% CI: 1.3%-2.1%)] subjects were seropositive regarding IgG, IgM, and both IgG/IgM antibodies, respectively. Five risk factors were significantly associated with T. gondii seroprevalence, including gender (OR = 1.98; 95% CI: 1.52-2.58; P < 0.001), contact with cat (OR = 2.41; 95% CI: 1.70-3.41; P < 0.001), contact with soil (OR = 2.83; 95% CI: 1.07-7.45; P = 0.035), consuming raw/undercooked meat (OR = 1.95; 95% CI: 1.03-3.70; P = 0.039), and raw/unwashed vegetables (OR = 1.70; 95% CI: 1.25-2.31; P = 0.001).
    UNASSIGNED: A moderate rate of T. gondii exposure was found in the Iranian blood donors, with the association of several risk factors, including gender, contact with cat, contact with soil, consumption of unwashed vegetables and/or undercooked meat. Still, more studies are recommended regarding T. gondii exposure among blood donors in Iran.
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  • 文章类型: Systematic Review
    目的:通过系统评价和荟萃分析,确定HIV感染者中眼弓形虫病的患病率。材料与方法:进行了文献检索,估计合并患病率并进行质量评估,离群值,有影响力和荟萃回归分析。结果:29项研究纳入分析,结果显示,HIV感染者的眼弓形虫病率为0.37%(95%CI:0.2-0.6).在研究中观察到显著的异质性。尽管分析了连续变量,包括出版年份,男性的比例,接受抗逆转录病毒治疗的患者的平均年龄和比例,没有发现有统计学意义的关联.结论:本研究概述了HIV感染者眼弓形虫病的患病率,强调需要进一步研究以发现促成其发展的因素。
    这项研究观察了常见的眼部弓形虫病,一种寄生虫感染,是艾滋病毒携带者中的一员。我们通过回顾其他研究来做到这一点,结合他们的结果并评估每个研究的质量。我们还寻找了可能影响眼弓形虫病患病率的任何异常发现和其他因素。在分析了29项研究后,我们发现大约0.37%的艾滋病毒感染者患有眼部弓形虫病,0.2%至0.6%不等。研究结果之间存在显着差异。我们的研究概述了HIV感染者中眼部弓形虫病的患病率,强调需要进一步研究,以确定有助于其发展的因素。
    Aim: To determine the prevalence of ocular toxoplasmosis among people living with HIV through a systematic review and meta-analysis. Materials & methods: A literature search was conducted, estimating pooled prevalence and performing quality assessment, outlier, influential and meta-regression analyses. Results: Twenty-nine studies were included in the analysis, revealing that the rate of ocular toxoplasmosis among people living with HIV was 0.37% (95% CI: 0.2-0.6). Substantial heterogeneity was observed among the studies. Despite analyzing continuous variables, including year of publication, proportion of males, mean age and proportion of patients receiving antiretroviral therapy, no statistically significant associations were found. Conclusion: This study provides an overview of the prevalence of ocular toxoplasmosis in people living with HIV, emphasizing the need for further research to uncover factors contributing to its development.
    This study looked at how common ocular toxoplasmosis, a type of parasitic infection, is among people living with HIV. We did this by reviewing other studies, combining their results and evaluating the quality of each study. We also looked for any unusual findings and other factors that might affect the prevalence of ocular toxoplasmosis. After analyzing 29 studies, we found that approximately 0.37% of people living with HIV had ocular toxoplasmosis, ranging from 0.2% to 0.6%. There was a significant variation in the results among the studies. Our study provides an overview of the prevalence of ocular toxoplasmosis in people living with HIV, highlighting the need for further research to identify the factors contributing to its development.
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  • 文章类型: Journal Article
    弓形虫病是由原生动物弓形虫感染引起的寄生虫病。2018年,报告了首例具有急性发热综合征临床体征的患者,同年,报道了文献中描述的最大的人类弓形虫病暴发。在这个意义上,目前的工作试图描述圣玛丽亚市爆发病例的演变,南里奥格兰德州,巴西,以及在该市爆发期间和之后(2018年至2023年之间)进行和发表的研究。此外,在这次疫情通知后,讨论公共政策及其修改。作为这项研究的结果,核实通报和确诊病例的演变,弓形虫的检测和基因型表征的可能性以及共感染的可能性和体液反应的评估是可能的。关于公共政策,通过脚跟点刺测试检测病原体的重要性,并加强对水质的监测以防止疫情爆发。
    Toxoplasmosis is a parasitic disease caused by infection with the protozoan Toxoplasma gondii. In 2018, the first cases of people with clinical signs of acute febrile syndrome were reported, and in the same year, the largest outbreak of human toxoplasmosis ever described in the literature was reported. In this sense, the present work sought to describe the evolution of the outbreak cases in the municipality of Santa Maria, Rio Grande do Sul State, Brazil, as well as the studies conducted and published during and after the outbreak in the municipality (the period between 2018 and 2023). In addition, the discussion of public policies and their modifications after the notification of this outbreak. As a result of this research, verifying the evolution of notified and confirmed cases, the possibility of detection and genotypic characterization of T. gondii and the possibility of co-infections and evaluation of the humoral response is possible. With regard to public policies, the importance of detecting the agent through the heel prick test and increasing the monitoring of water quality to prevent outbreaks.
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  • 文章类型: Journal Article
    弓形虫病对动物和公共卫生有重大影响。迄今为止,尚未从欧洲角度收集有关人类弓形虫感染血清阳性率的信息。因此,本审查总结了2000-2020年期间的现有居民数据。抗T.gondiiIgG为32.1%,国家之间差异很大(n=30)。亚组分析根据地理区域确定了不同的合并患病率数据(p<0.0001),目标人群(p=0.0147),和血清学诊断试验(p=0.0059)。高度异质性(I2=100%,p<0.001;Q=3.5e+05,d.f.=135,p<0.001)和发表偏倚程度(Egger检验=6.14,p<0.001)在所考虑的134项研究中观察到。反T的发生弓形虫IgM,64.7%的研究报告,达到0.6%的合并血清阳性率。此外,在确定的八个主要风险因素中,“与土壤接触”,“食用未煮熟的牛肉”,和“未清洗蔬菜的摄入量”与感染最显著相关。欧洲三分之一的人口暴露于弓形虫这一事实证明,需要付出额外的努力来协调监测系统,并根据详细的来源归因评估制定额外的风险因素分析。
    Toxoplasmosis has a major impact on animal and public health. Information regarding the seroprevalence of human Toxoplasma gondii infections from a European perspective has not yet been compiled to date. Thus, the present review summarized available resident data from the period 2000-2020. The overall seroprevalence of anti-T. gondii IgG was 32.1%, with great variability between countries (n = 30). The subgroup analysis identified different pooled prevalence data depending on the geographic area (p < 0.0001), target population (p = 0.0147), and serological diagnosis assays used (p = 0.0059). A high heterogeneity (I2 = 100%, p < 0.001; Q = 3.5e+05, d.f. = 135, p < 0.001) and degree of publication bias (Egger\'s test = 6.14, p < 0.001) were observed among the 134 studies considered. The occurrence of anti-T. gondii IgM, which was reported in 64.7% of studies, reached a pooled seroprevalence of 0.6%. In addition, among the eight main risk factors identified, \"contact with soil\", \"consumption of undercooked beef\", and \"intake of unwashed vegetables\" were the most significantly associated with infections. The fact that one-third of the European population has been exposed to T. gondii justifies extra efforts to harmonize surveillance systems and develop additional risk-factor analyses based on detailed source attribution assessment.
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  • 文章类型: Journal Article
    原生动物寄生虫隐孢子虫,cayetanensis环孢菌,弓形虫和弓形虫是全球水传播和食源性疾病的主要原因。在水处理和食品加工过程中对其去除或失活的评估仍然具有挑战性,部分原因是对这些寄生虫的研究受到各种经济因素的阻碍,伦理,方法论,和生物约束。为了解决公共卫生问题并获得新知识,研究人员越来越多地寻求使用这种致病性寄生虫的替代品。在过去的几十年里,一些非致病性微生物和人造微粒已被评估为水和食源性原生动物寄生虫的潜在替代品。这里,我们回顾了已报道的C.parvum的代孕,C.cayetanensis,还有弓形虫卵囊,并讨论它们的使用和相关性,以评估运输,移除,以及食物和水基质中这些寄生虫的失活。生物替代品,包括非人致病性艾美球虫寄生虫,在水源中发现的微生物(厌氧和好氧孢子形成细菌,藻类),和非生物替代物(即制造的微粒)已经被鉴定。我们强调,必须根据寄生虫和目标应用仔细选择和实施此类替代品。艾美球虫卵囊似乎是将来研究最具挑战性的致病性球虫寄生虫C.cayetanensis和T.gondii的有希望的替代品。
    The protozoan parasites Cryptosporidium parvum, Cyclospora cayetanensis, and Toxoplasma gondii are major causes of waterborne and foodborne diseases worldwide. The assessment of their removal or inactivation during water treatment and food processing remains challenging, partly because research on these parasites is hindered by various economical, ethical, methodological, and biological constraints. To address public health concerns and gain new knowledge, researchers are increasingly seeking alternatives to the use of such pathogenic parasites. Over the past few decades, several non-pathogenic microorganisms and manufactured microparticles have been evaluated as potential surrogates of waterborne and foodborne protozoan parasites. Here, we review the surrogates that have been reported for C. parvum, C. cayetanensis, and T. gondii oocysts, and discuss their use and relevance to assess the transport, removal, and inactivation of these parasites in food and water matrices. Biological surrogates including non-human pathogenic Eimeria parasites, microorganisms found in water sources (anaerobic and aerobic spore-forming bacteria, algae), and non-biological surrogates (i.e. manufactured microparticles) have been identified. We emphasize that such surrogates have to be carefully selected and implemented depending on the parasite and the targeted application. Eimeria oocysts appear as promising surrogates to investigate in the future the pathogenic coccidian parasites C. cayetanensis and T. gondii that are the most challenging to work with.
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  • 文章类型: Meta-Analysis
    背景:弓形虫是一种专性的细胞内原生动物,可以感染几乎所有的温血动物,包括人类。弓形虫病和HIV共同感染的患者患弓形虫病脑炎的风险为30-40%。这项研究旨在描述伊朗艾滋病毒感染者弓形虫的流行病学和负担。
    方法:我们搜索了五个英文数据库(ScienceDirect,PubMed,Scopus,奥维德,Embase,和Cochrane)和四个波斯语数据库(科学信息数据库(SID),伊朗Medex,伊朗医生,和Magiran)的术语为(弓形虫或“弓形虫病”)和(HIV或“AIDS”或免疫缺陷或获得性免疫缺陷综合征)以及(血清流行病学)和(血清流行病学研究)以及(Elisa或IgG)和(PCR)和(伊朗)由两位作者提供,直到2021年2月。如果他们调查了HIV感染者,并提供了使我们能够确定伊朗弓形虫感染患病率的数据,则包括研究。
    结果:根据纳入/排除标准,选择了15项研究。从2005年到2018年,在伊朗不同地区对2275名艾滋病毒感染者进行了弓形虫病检测和评估。使用随机效应模型获得了HIV感染的Elisa个体弓形虫病的加权总体患病率,估计为47%(95%CI=31%-62%)。此外,使用随机效应模型,通过PCR获得HIV感染个体弓形虫病的加权总体患病率,估计为7%(95%CI=3%-12%)。
    结论:根据本研究的结果,可以清楚地理解,生活在伊朗的大量艾滋病毒患者患有弓形虫病。因此,由于这些群体对弓形虫病的高度易感性,医疗保健专业人员必须考虑采取措施,例如在传播和预防感染到这一高危人群的方式方面进行培训,以降低感染风险。
    Toxoplasma gondii is an obligate intracellular protozoan that can infect almost all warm-blooded animals, including humans. Patients with co-infection with toxoplasmosis and HIV have a 30-40% risk of developing toxoplasmosis encephalitis. This study aimed to describe the epidemiology and burden of Toxoplasma gondii in HIV-infected individuals in Iran.
    We searched the five English databases (Science Direct, PubMed, Scopus, Ovid, Embase, and Cochrane) and four Persian databases (Scientific Information Database (SID), Iran Medex, Iran Doc, and Magiran) with the terms of (Toxoplasma gondii OR \"toxoplasmosis\") AND (HIV OR \"AIDS\" OR immunodeficiency OR acquired immune deficiency syndrome) AND (Seroprevalence) AND (Seroepidemiologic Studies) AND (Elisa OR IgG) AND (PCR) AND (Iran) by two authors up to Feb 2021. Studies were included if they investigated people with HIV infection and presented data that allowed us to establish the prevalence of Toxoplasma gondii infection in Iran.
    According to the inclusion/exclusion criteria, 15 studies were selected. A total number of 2275 HIV-infected individuals were tested and evaluated for toxoplasmosis from 2005 up to 2018 in different regions of Iran. The weighted overall prevalence of toxoplasmosis in HIV-infected individuals with Elisa was obtained using a random-effects model, which was estimated at 47% (95% CI = 31% - 62%). Also, the Weighted overall prevalence of toxoplasmosis in HIV-infected individuals with PCR was obtained using a random-effects model, which was estimated at 7% (95% CI = 3% - 12%).
    According to the results of this study, it can be clearly understood that a large population of HIV patients living in Iran have toxoplasmosis. Therefore, due to the high susceptibility of these groups to toxoplasmosis, healthcare professionals must consider measures such as training in the ways of transmission and prevention of the infection to this high-risk group in order to reduce the risk of infection.
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  • 文章类型: Journal Article
    机会性的尖丛寄生虫弓形虫是弓形虫病的病原体,可以感染广泛的宿主,特别是人类和温血动物。目前用于治疗或预防弓形虫病的化学疗法是缺乏的,并且基于多种药物,例如atovaquone,甲氧苄啶,螺旋霉素,对急性弓形虫病有效。因此,弓形虫病需要安全的化疗,T.刚地,引起孕妇和免疫缺陷患者的严重疾病和死亡。可用治疗的某些缺点是缺乏对寄生虫组织囊肿的有效性。对抗弓形虫病的安全化疗应基于寄生虫和哺乳动物宿主之间的代谢差异。本文涵盖了对抗这种疾病的不同相关分子靶标,包括类异戊二烯途径(法尼基二磷酸合酶,角鲨烯合酶),二氢叶酸还原酶,钙依赖性蛋白激酶,组蛋白脱乙酰酶,线粒体电子传递链,等。
    The opportunistic apicomplexan parasite Toxoplasma gondii is the etiologic agent for toxoplasmosis, which can infect a widespread range of hosts, particularly humans and warm-blooded animals. The present chemotherapy to treat or prevent toxoplasmosis is deficient and is based on diverse drugs such as atovaquone, trimethoprim, spiramycine, which are effective in acute toxoplasmosis. Therefore, a safe chemotherapy is required for toxoplasmosis considering that its responsible agent, T. gondii, provokes severe illness and death in pregnant women and immunodeficient patients. A certain disadvantage of the available treatments is the lack of effectiveness against the tissue cyst of the parasite. A safe chemotherapy to combat toxoplasmosis should be based on the metabolic differences between the parasite and the mammalian host. This article covers different relevant molecular targets to combat this disease including the isoprenoid pathway (farnesyl diphosphate synthase, squalene synthase), dihydrofolate reductase, calcium-dependent protein kinases, histone deacetylase, mitochondrial electron transport chain, etc.
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