Toxoplasma gondii infection

  • 文章类型: Journal Article
    弓形虫是一种嗜神经原生动物寄生虫,会影响大脑中的神经元处理。本研究旨在调查精神疾病患者弓形虫感染的患病率。我们还调查了社会人口统计学之间的潜在关联,临床表现,以及患有精神疾病的弓形虫血清反应阳性患者的行为。商业ELISA(IgG,IgM,和IgG亲和力)使用血清和使用血沉棕黄层的PCR对来自以下每组的54名个体的样本进行:诊断患有抑郁症的患者,双相情感障碍,和精神分裂症,以及精神健康受试者(对照组)。他们是从吉兰丹的马来西亚Sains大学医院招募的,马来西亚。在54名抑郁症患者中,24/54(44.4%)IgG血清阳性,4例(16.7%)为IgG+/IgM+。在后者中,在一半的样本中观察到表明过去感染的高亲合力指数(50.0%),另一半(50.0%)显示低亲和力指数,表明最近可能感染。同时,30/54(55.6%)双相情感障碍患者IgG+血清阳性,5例(16.7%)为IgG+/IgM+,其中四个人有很高的亲和力指数,其中一人的亲合力指数较低。精神分裂症患者显示29/54(53.7%)IgG血清阳性,其中2例(6.9%)为IgG/IgM;后者之一具有较高的亲和力指数,其中一人的亲合力指数较低。在对照组的54人中,37.0%(20/54)的弓形虫IgG抗体血清阳性。然而,对照组和每个患者组的血清阳性率无显著差异.没有记录PCR阳性结果。卡方和多元逻辑回归显示,年龄(p=0.031),与猫/宠物的密切接触(p=0.033)和与土壤的接触(p=0.012)与精神疾病患者的弓形虫血清阳性显着相关。需要进一步的研究来阐明因果关系和潜在机制。
    Toxoplasma gondii is a neurotropic protozoan parasite that affects neuronal processing in the brain. This study aimed to investigate the prevalence of T. gondii infection in psychiatric disorder patients. We also investigated the potential association between sociodemographic, clinical manifestation, and behavior of Toxoplasma-seropositive patients with psychiatric disorders. Commercial ELISAs (IgG, IgM, and IgG avidity) using serum and PCR using buffy coat were performed on samples from 54 individuals in each of the following groups: patients diagnosed with depressive disorder, bipolar disorder, and schizophrenia, as well as psychiatrically healthy subjects (control group). They were recruited from the Hospital Universiti Sains Malaysia in Kelantan, Malaysia. Of 54 patients with depressive disorder, 24/54 (44.4 %) were seropositive for IgG, and four (16.7 %) were IgG+/IgM+. Among the latter, a high avidity index indicating a past infection was observed in half of the samples (50.0 %), and the other half (50.0 %) showed a low avidity index, indicating a possible recent infection. Meanwhile, 30/54 (55.6 %) patients with bipolar disorder were seropositive for IgG+, five (16.7 %) were IgG+/IgM+, and four of them had a high avidity index, and one had a low avidity index. Patients with schizophrenia showed 29/54 (53.7 %) seropositive for IgG, two of them (6.9 %) were IgG+/IgM+; one of latter had a high avidity index, and one had a low avidity index. Of 54 people in the control group, 37.0 % (20/54) were seropositive for T. gondii IgG antibodies. However, no significant difference was observed in seroprevalence between the control group and each patient group. No PCR-positive results were documented. A Chi-Square and multiple logistic regression showed that age (p = 0.031), close contact with cats/pets (p = 0.033) and contact with soil (p = 0.012) were significantly associated with Toxoplasma seropositivity in patients with psychiatric disorders. Additional research is needed to elucidate the causal relationships and underlying mechanisms.
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  • 文章类型: Journal Article
    背景:目前,西班牙孕妇弓形虫病的血清学筛查状况未知,也没有官方建议。这项研究的目的是显示西班牙先天性弓形虫病研究网络(REIV-TOXO)所属医院中弓形虫病的妊娠筛查方法。
    方法:在2021年4月至2021年9月之间,向REIV-TOXO的118家医院的调查人员发送了一项电子调查,代表所有西班牙地区。收集了与弓形虫病妊娠筛查相关的9个项目。将此信息与REIV-TOXO中鉴定的先天性弓形虫病(CT)病例进行比较,以确定是否在进行妊娠筛查的情况下被诊断出。
    结果:在研究期间,53.3%(63/118)的医院进行了血清学筛查,地区之间甚至同一地区内医院之间的差异。在每三个月进行的测试是最常见的做法(57.7%),其次是一次测定(24.4%)。2015年1月至2021年9月,89.4%的CT病例被诊断为妊娠筛查。
    结论:在西班牙进行弓形虫病妊娠筛查的决定是高度异质性的,具有显著的局部和区域差异。尽管如此,筛查仍然可以诊断大多数CT病例。迫切需要当前的流行病学数据来为公共卫生决策提供信息。
    BACKGROUND: Currently, the status of serological screening for toxoplasmosis in pregnant women in Spain is unknown, and there is no official recommendation. The objective of this study is to show the current practice of gestational screening for toxoplasmosis in hospitals belonging to the Spanish Network for Research on Congenital Toxoplasmosis (REIV-TOXO).
    METHODS: An electronic survey was sent between April 2021 and September 2021 to investigators from 118 hospitals of REIV-TOXO, representing all Spanish regions. Nine items related to gestational screening for toxoplasmosis were collected. This information was compared with cases of congenital toxoplasmosis (CT) identified in REIV-TOXO to determine if these were diagnosed in the presence of gestational screening.
    RESULTS: During the study period, serological screening was performed in 53.3% (63/118) hospitals, with variations between regions and even among hospitals within the same region. Testing performed in each trimester was the most common practice (57.7%), followed by a single determination (24.4%). 89.4% of CT cases between January 2015 and September 2021 were diagnosed due to gestational screening.
    CONCLUSIONS: The decision to perform gestational screening for toxoplasmosis in Spain is highly heterogeneous, with significant local and regional differences. Despite this, screening still allows the diagnosis of most CT cases. It is urgent to have current epidemiological data to inform decision-making in public health.
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  • 文章类型: Journal Article
    背景:弓形虫感染被认为是HIV患者最重要的机会性感染和死亡原因之一。
    方法:在这项横断面研究中,纳入334名HIV阳性患者。通过限制性片段长度多态性-聚合酶链反应方法进行分子测试。等位基因频率,单倍型分析,并计算了连锁不平衡。计算了比值比。采用线性回归模型分析白细胞介素(IL)-17A,IL-17F,有和没有弓形虫病的HIV患者的IL-6单核苷酸多态性基因型。
    结果:总计,95名受检患者(28.4%)弓形虫病阳性。本研究中弓形虫感染的风险与IL-17和IL-6多态性无关,并且本研究中弓形虫感染的风险也没有显着相关。在IL-17单倍型分析中,等位基因频率与弓形虫感染风险之间没有关联。
    结论:这项研究的结果表明,IL-6和IL-17A的血清水平存在显着差异,但不是IL-17F,在各种遗传模型中的病例组和对照组之间。然而,在HIV阳性患者中,这些多态性与弓形虫感染没有显著关系.这项研究是伊朗首次研究IL-6和IL-17多态性在HIV阳性患者弓形虫感染中的作用。
    BACKGROUND: Toxoplasma gondii infection is considered as one of the most important opportunistic infections and cause of death in HIV patients.
    METHODS: In this cross-sectional study, 334 HIV positive patients were included. The molecular test was performed by the restriction fragment length polymorphism-polymerase chain reaction method. Allelic frequency, haplotype analyses, and linkage disequilibrium were calculated. The odds ratio was calculated. The linear regression model was used to analysis of interleukin (IL)-17A, IL-17F, and IL-6 single-nucleotide polymorphism genotypes in HIV patients with and without toxoplasmosis.
    RESULTS: In total, 95 tested\'patients (28.4%) were positive for toxoplasmosis. The risk of toxoplasma infection in the current study did not correlate with IL-17 and IL-6 polymorphism and the risk of contracting toxoplasma was also not significantly correlated in this study. There was no association between the frequency of alleles and the risk of toxoplasma infection in IL-17 haplotype analysis.
    CONCLUSIONS: The findings of this study revealed that there were significant differences in the serum levels of IL-6 and IL-17A, but not IL-17F, between the case and control groups in various genetic models. However, these polymorphisms did not show a significant relationship with toxoplasma infection in HIV-positive patients. This study represents the first investigation in Iran to explore the role of IL-6 and IL-17 polymorphisms in toxoplasma infection among HIV-positive patients.
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  • 文章类型: Journal Article
    介绍兽医和其他专业人员谁与动物在日常基础上遇到暴露于已知和尚未发现的微生物剂的高风险。此外,他们也暴露在身体上,化学,和环境危害。在这方面加强职业健康和安全具有重大的全球意义。方法本研究旨在全面识别和概述各种生物,物理,化学,以及沙特阿拉伯兽医遇到的环境健康威胁。为了实现这一点,我们为529名参与者设计了一份自填问卷.调查包括潜在的职业危害,如微生物疾病,动物咬伤和抓伤造成的伤害,过敏,以及中暑和沙尘暴等环境风险。结果529名参与的兽医中,45.9%(243人)在过去五年内报告了人畜共患疾病。值得注意的是,潜在的病毒病原体包括中东呼吸综合征冠状病毒,禽流感,和口蹄疫病毒。细菌疾病也经常被记录下来,布鲁氏菌病(18.7%)和沙门氏菌病(7.9%)是显著的病原体。原虫感染是由利什曼病导致的,构成最常见的原生动物(29/529,5.5%)。有趣的是,345(65.2%)的个体报告说他们经历过动物咬伤和抓伤。针刺伤也是常见的职业危害,发病率为19.1%。此外,化学品暴露很普遍,特别是消毒剂(57.5%)和兽药(23.4%)。研究参与者还报告了他们暴露于各种环境危害的情况,包括中暑,灰尘,沙尘暴,和大雨。结论本研究的发现引起了人们对沙特阿拉伯兽医的关注趋势的关注。他们的人身健康和安全似乎没有得到足够的重视,可能会增加与职业相关的健康危害的风险。这些结果强调了在兽医行业内重新评估安全方案和感染控制实践的必要性。这项研究的影响可能为制定旨在减轻沙特阿拉伯兽医职业相关健康危害的政策和举措提供信息。
    Introduction Veterinarians and other professionals who interact with animals on a daily basis encounter an elevated risk of exposure to both known and as-yet-undiscovered microbial agents. Additionally, they are also exposed to physical, chemical, and environmental hazards. Enhancing occupational health and safety in this context carries significant global significance. Methods This study aimed to comprehensively identify and outline the various biological, physical, chemical, and environmental health threats that were encountered by veterinarians in Saudi Arabia. To achieve this, we designed a self-completed questionnaire for 529 participants. The survey encompassed potential occupational hazards such as microbial diseases, injuries resulting from animal bites and scratches, allergies, and environmental risks like sunstroke and dust storms. Results Among the 529 participating veterinarians, 45.9% (243 individuals) reported instances of zoonotic diseases within the past five years. Notably, potential viral agents included Middle East respiratory syndrome coronavirus, avian influenza, and foot-and-mouth disease virus. Bacterial diseases were also frequently documented, with brucellosis (18.7%) and salmonellosis (7.9%) being notable pathogens. Protozoal infections were led by Leishmaniosis, constituting the most commonly detected protozoa (29 /529, 5.5%). Interestingly, 345 (65.2%) of the individuals reported that they have experienced animal bites and scratches. Needle stick injuries were also a common occupational hazard, with an incidence rate of 19.1%. Additionally, chemical exposure was prevalent, particularly to disinfectants (57.5%) and veterinary drugs (23.4%). The study participants also reported their exposure to various environmental hazards, including sunstroke, dust, sandstorms, and heavy rains. Conclusion The findings of this study draw attention to a concerning trend among veterinarians in Saudi Arabia. Their personal health and safety appear to receive inadequate attention, potentially heightening the risk of occupationally related health hazards. These outcomes highlight the need for a reevaluation of safety protocols and infection control practices within the veterinary profession. The implications of this study can potentially inform the development of policies and initiatives aimed at mitigating occupationally related health hazards among veterinarians in Saudi Arabia.
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  • 文章类型: Journal Article
    相当多的证据表明炎症在肿瘤病理学中起主导作用。弓形虫作为一种常见的嗜脑寄生虫可以触发免疫系统的生物反应。这项研究的目的是研究弓形虫感染与脑肿瘤之间的关系。这项病例对照研究是对伊朗南部脑肿瘤患者(n=124)以及年龄和性别匹配的对照受试者(n=124)的血清进行的。在样品收集期间收集与肿瘤部位和类型相关的数据。通过酶联免疫吸附测定(ELISA)评估抗弓形虫IgG。脑肿瘤患者中抗弓形虫IgG血清阳性率明显高于30.6%(38/124),而健康对照组为12.1%(15/124)(OR3.211;95%CI1.658至6.219;p=0.001)。在室管膜瘤患者中检测到最高的血清阳性率(100%),其次是胶质母细胞瘤(83%),垂体腺瘤(47.3%),星形细胞瘤(27.2%),神经鞘瘤(23%),和脑膜瘤(22.6%)。寄生虫感染与脑肿瘤的位置相关,即,额叶和鞍区肿瘤患者的血清阳性率高于其他患者(P<0.05)。与对照组相比,脑肿瘤患者弓形虫感染率较高,表明感染与脑肿瘤之间可能存在关联。
    Considerable evidence points to a dominant role of inflammation in tumor pathology. The biological response of the immune system can be triggered by Toxoplasma gondii as a common brain-tropic parasite. The aim of this study was to investigate an association between Toxoplasma infection and brain tumors. This case-control study was performed on sera of brain tumor patients (n = 124) and age- and sex-matched control subjects (n = 124) in Southern Iran. Data related to tumor site and type were collected during sample collection. Anti-Toxoplasma IgG was assessed by enzyme-linked immunosorbent assay (ELISA). Seroprevalence anti-Toxoplasma IgG was significantly higher in brain tumor patients 30.6% (38/124) compared with 12.1% (15/124) of the healthy controls (OR 3.211; 95% CI 1.658 to 6.219; p = 0.001). The highest seroprevalence was detected in patients with ependymoma (100%), followed by glioblastoma (83%), pituitary adenoma (47.3%), astrocytoma (27.2%), schwannoma (23%), and meningioma (22.6%). The parasite infection was correlated to brain tumor\'s location i.e., the patients with frontal lobe and sella region tumors had higher seropositivity compared with others (P < 0.05). The higher prevalence of Toxoplasma infection among patients with brain tumor compared with the control group indicates a probable association between the infection and brain tumors.
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  • 文章类型: Journal Article
    背景:感染是人类生殖健康的主要威胁,因为它们会导致妊娠失败,包括复发性流产,死产,和早产。弓形虫(T.gondii)感染可通过影响某些免疫分子和细胞因子而导致不良妊娠结局。然而,弓形虫导致妊娠失败的详细机制尚不清楚.
    方法:建立弓形虫感染的野生型(WT)妊娠小鼠和2B4敲除(2B4-/-)妊娠小鼠进行体内研究。培养人蜕膜自然杀伤(dNK)细胞进行体外研究。观察异常妊娠结局,和2B4的表达,功能分子(CD69,CD107a,肿瘤坏死因子α[TNF-α],干扰素γ[IFN-γ]),和信号分子(SHP-2,Fyn,p-ERK,通过流式细胞术检测dNK细胞中的p-P38),蛋白质印迹,逆转录聚合酶链反应(RT-PCR),和/或免疫荧光。通过NK-92细胞中的共免疫沉淀(co-IP)验证了直接相互作用(2B4与SHP-2和Fyn相互作用;SHP-2与p-P38和2B4相互作用;Fyn与p-ERK和2B4相互作用)。
    结果:这里,结果表明,弓形虫感染后2B4显著下调。随后,与感染的WT妊娠小鼠相比,感染的2B4-/-妊娠小鼠表现出更差的妊娠结局。此外,在弓形虫感染期间,在2B4-/-妊娠小鼠中发现TNF-α和IFN-γ表达增加以及dNK细胞毒性升高。相比之下,在弓形虫感染期间2B4激活后,发现TNF-α和IFN-γ表达降低,人dNK细胞活性降低。有趣的是,结果表明,2B4与接头SHP-2或Fyn结合,然后在弓形虫感染期间触发不同的信号通路来调节dNK细胞中TNF-α和IFN-γ的表达。Further,SHP-2在2B4激活后直接结合2B4和p-P38,在NK-92细胞中产生TNF-α和IFN-γ的抑制信号。此外,在弓形虫感染后,Fyn可以与2B4和p-ERK结合,从而抑制NK-92细胞中TNF-α和IFN-γ的表达。
    结论:这些数据表明,2B4可能是一种新的危险信号分子,与弓形虫感染期间妊娠失败有关。解开2B4调节dNK细胞活性的机制将提供新的见解,以帮助我们理解弓形虫诱导的不良妊娠结局。
    BACKGROUND: Infections are a major threat to human reproductive health because they can induce pregnancy failure, including recurrent abortion, stillbirth, and preterm birth. Toxoplasma gondii (T. gondii) infection can result in adverse pregnancy outcomes by affecting certain immune molecules and cytokines. However, the detailed mechanisms behind T. gondii-induced pregnancy failure are poorly understood.
    METHODS: Toxoplasma gondii-infected wild-type (WT) pregnant mice and 2B4 knockout (2B4-/-) pregnant mice were established for in vivo study. Human decidual natural killer (dNK) cells were cultured for in vitro study. Abnormal pregnancy outcomes were observed, and the expression of 2B4, functional molecules (CD69, CD107a, tumor necrosis factor alpha [TNF-α], interferon gamma [IFN-γ]), and signaling molecules (SHP-2, Fyn, p-ERK, p-P38) in dNK cells were detected by flow cytometry, Western blot, reverse transcriptase polymerase chain reaction (RT-PCR), and/or immunofluorescence. The direct interactions (2B4 interacts with SHP-2 and Fyn; SHP-2 interacts with p-P38 and 2B4; Fyn interacts with p-ERK and 2B4) were verified by co-immunoprecipitation (co-IP) in NK-92 cells.
    RESULTS: Here, results showed that 2B4 was significantly downregulated after T. gondii infection. Subsequently, infected 2B4-/- pregnant mice displayed worse pregnancy outcomes compared with infected WT pregnant mice. Also, increased TNF-α and IFN-γ expression and elevated dNK cell cytotoxicity were found in 2B4-/- pregnant mice during T. gondii infection. In contrast, reduced TNF-α and IFN-γ expression and decreased human dNK cell activity were found following 2B4 activation during T. gondii infection. Interestingly, results showed that 2B4 binds to adaptor SHP-2 or Fyn, which then triggers different signaling pathways to regulate TNF-α and IFN-γ expression in dNK cells during T. gondii infection. Further, SHP-2 binds 2B4 and p-P38 directly after 2B4 activation, which generates an inhibitory signal for TNF-α and IFN-γ in NK-92 cells. In addition, Fyn can bind to 2B4 and p-ERK after activation of 2B4, thereby inhibiting TNF-α and IFN-γ expression in NK-92 cells following T. gondii infection.
    CONCLUSIONS: These data suggest that 2B4 may be a novel danger-signaling molecule that is implicated in pregnancy failure during T. gondii infection. Unraveling the mechanism by which 2B4 regulates dNK cell activity will provide novel insights to aid our understanding of T. gondii-induced adverse pregnancy outcomes.
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    文章类型: Journal Article
    OBJECTIVE: Toxoplasmosis is a systemic infectious disease. Infection is acquired by ingestion of Toxoplasma gondii cysts or by vertical transmission mother-to-child during pregnancy (congenital toxoplasmosis). In Spain, the prevalence shows wide variability depending on the region and the study. The incidence in other European countries evidences a decline in recent years. The aim of this study was to characterize the presence and the epidemiological patterns of the disease in the Spanish population with information obtained of hospitalized cases with a diagnosis of toxoplasmosis at discharge.
    METHODS: The interactive platform of the Specialized Registry (RAE-MBD) of the Ministry of Health was used to obtain data on hospital discharges with \"toxoplasmosis\" diagnosis. Frequencies and rates of hospital discharges were calculated according to sex, age groups, region and diagnosis at discharge. Sequence graphs were generated to analysed the temporal evolution of the number of hospitalizations. The trends and slopes of the RHs were analyzed using \"joinpoint\" regression models, estimating the mean annual percentage change (PCAM) in the RHs and its 95% confidence interval.
    RESULTS: There were 13,704 cases with toxoplasmosis diagnosis at discharge, (58%) were men. The highest hospitalization rate (RH) was in the 15-44-year-old men group (5,804 discharges and HT=2.52). During the period studied a decrease in the number of discharges was observed, it was progressive and affected all the autonomous regions, being more pronounced in men (81.9% vs 63.9%).
    CONCLUSIONS: The number of hospitalizations in Spain decreased substantially during the studied period (1997-2018), similar to other European studies reported. The decrease was progressive and mainly affected men between 15-44 years.
    OBJECTIVE: La toxoplasmosis es una enfermedad infecciosa sistémica. Se contrae principalmente por ingestión de quistes y ooquistes de Toxoplasma gondii o por afectación fetal tras la primoinfección de la madre embarazada (toxoplasmosis congénita). La prevalencia en España presenta una gran variabilidad, dependiendo de la región y el estudio. La incidencia en otros países europeos refleja un descenso en los últimos años. El objetivo de este estudio fue caracterizar la presencia y el patrón epidemiológico de la enfermedad en la población española a partir de los casos hospitalizados con un diagnóstico de toxoplasmosis al alta.
    METHODS: A través de la plataforma interactiva del Registro de Atención Sanitaria Especializada (RAE-CMBD) del Ministerio de Sanidad se obtuvieron los datos de altas hospitalarias con diagnóstico “toxoplasmosis”. Se calcularon frecuencias y tasas de altas hospitalarias (TH) según sexo, grupos de edad, comunidad autónoma y diagnóstico al alta. Se analizó la evolución temporal del número de hospitalizaciones a través de gráficos de secuencia. Las tendencias y las pendientes de las TH se analizaron mediante modelos de regresión “joinpoint”, estimándose el porcentaje de cambio anual medio (PCAM) en las TH y su intervalo de confianza al 95%.
    RESULTS: Se contabilizaron 13.704 casos con diagnóstico toxoplasmosis al alta, el 58% hombres. La tasa de hospitalización (TH) más elevada se dio en hombres, en el grupo de 15-44 años (5.804 altas y TH=2,52). Se observa un descenso del 76,8% en el número de altas a lo largo del periodo estudiado, éste fue progresivo y afectó a todas las comunidades autónomas; siendo más acusado en hombres (81,9% vs 63,9%).
    CONCLUSIONS: El número de hospitalizaciones por toxoplasmosis en España se redujo notablemente a lo largo del periodo estudiado (1997-2018), mostrando una tendencia similar a la referida en otros estudios europeos. El descenso en los ingresos fue progresivo y afectó fundamentalmente a hombres de 15 a 44 años.
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  • 文章类型: Journal Article
    UNASSIGNED: Toxoplasmosis is one of the main preventable congenital infections in Brazil. This manuscript aims to describe antenatal factors possibly associated with congenital toxoplasmosis (CT).
    UNASSIGNED: This is a case-control study, with data collected from medical records, from infants admitted under one year of age at the Infectious Diseases Clinic of Instituto de Puericultura e Pediatria Martagão Gesteira, reference center from Rio de Janeiro, exposed to toxoplasmosis during their antenatal period. Patients diagnosed with CT were classified as cases and those exposed without infection as controls.
    UNASSIGNED: A total of 289 patients were followed up in 10 years. CT was confirmed in 43 (14.9%) of which six (14%) were asymptomatic, five (12%) had the classic triad (retinochoroiditis, hydrocephalus and intracranial calcifications), 27/42 (64.3%) had reactive IgM. Even after adjusted for prematurity, cases were born with lower weight (OR 0.49 - IC95% 0.33-0.73). There was a 13% increase in chance of CT per gestational week of the maternal diagnosis. Maternal fever, consumption of poorly washed vegetables during pregnancy, and diagnosis in the third trimester were associated with CT (OR: 6.43, 6.55, and 2.16, respectively).
    UNASSIGNED: Fever during pregnancy, consumption of poorly washed vegetables and diagnosis in the third trimester were associated with CT. Infants with diagnosis of CT were born with lower weight than the controls.
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  • 文章类型: Journal Article
    Toxoplasma gondii infection was one of the most frequent AIDS-defining conditions in HIV-infected individuals until the advent of combination antiretroviral therapy. We aimed to assess the clinical load, coinfection, and mortality, as well as time trends for people living with HIV and hospitalized with Toxoplasma gondii infection, in Spain from 1997 to 2015. Retrospective observational analysis using the Spanish National Registry of Hospital Discharges. Information was retrieved for the study period using the International Classification of Diseases, 9th revision. There were 66,451,094 hospital admissions in Spain from 1997 to 2015, including 472,269 (0.71%) in people living with HIV. Toxoplasma gondii infection was registered in 9006 of these (overall prevalence 1.91%), making it the fifth most common opportunistic infection in hospitalized HIV-positive patients. Prevalence of Toxoplasma gondii infection declined in this group from 4.2% in 1997 to 0.8% in 2015 (p < 0.001), while mean age increased, from 35 years in 1997 to 44 years in 2015. The overall in-hospital mortality rate declined from 13.5% in 1997 to 8.9% in 2015, and it was higher in the concomitant presence of bacterial pneumonia (28.9% vs. 10.2%, p < 0.001), cryptosporidiosis (26.9% vs. 11.5%; p = 0.03), cytomegalovirus disease (18.2% vs. 11.2%, p < 0.001), Pneumocystis jiroveci pneumonia (31.5% vs. 10.5%, p < 0.001), leukoencephalopathy (19.8% vs. 11.78% p < 0.001), and wasting syndrome (29.3% vs 10.9%; p < 0.001). Toxoplasma gondii infection prevalence has significantly declined among hospitalized HIV-infected patients in Spain during the last two decades, coinciding with the widespread use of combination antiretroviral therapy.
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  • 文章类型: Journal Article
    实验性自身免疫性脑脊髓炎(EAE)是多发性硬化症(MS)的小鼠模型,由有害的自身反应性Th1和Th17细胞浸润引起的脱髓鞘性自身免疫性疾病。为了缓解MS,仅仅用药物是不可能治愈的,防止Th17细胞活化的免疫调节干预措施是理想的。本研究的目的是分析弓形虫感染对EAE发作的影响。我们的研究结果发现,弓形虫在脑内感染增加SOCS3的表达,降低STAT3的磷酸化,导致IL-17A和IL-23的减少,从而抑制致病性Th17细胞的分化和扩增,MS发展的一个重要因素。这些免疫应答导致髓磷脂少突胶质细胞糖蛋白35-55免疫诱导的EAE的临床评分降低。在弓形虫感染的EAE组中(TgEAE组),与EAE组相比,加剧EAE发作的Th17相关免疫应答减少。这项研究表明,弓形虫感染后EAE的缓解以SOCS3/STAT3/IL-17A/血脑屏障完整性依赖性方式受到调节。尽管MS治疗不允许寄生虫感染,这项使用弓形虫感染的研究确定了有助于疾病减弱的潜在靶标。
    Experimental autoimmune encephalomyelitis (EAE) is a mouse model of multiple sclerosis (MS), a demyelinating autoimmune disease caused by the infiltration of a harmful autoreactive Th1 and Th17 cells. To mitigate MS, which is impossible to cure with medication only, immunomodulatory interventions that prevent Th17 cell activation are ideal. The objective of the present study was to analyze the effect of Toxoplasma gondii infection on the onset of EAE. Our results found that Toxoplasma gondii infection in the brain increases SOCS3 expression and decreases the phosphorylation of STAT3, resulting in reducing IL-17A and IL-23, which suppress the differentiation and expansion of pathogenic Th17 cells, an important factor in MS development. These immune responses resulted in a reduction in the clinical scoring of EAE induced by myelin oligodendrocyte glycoprotein 35-55 immunization. In the EAE group with T. gondii infection (Tg + EAE group), Th17-related immune responses that exacerbate the onset of EAE were reduced compared to those in the EAE group. This study suggests that the alleviation of EAE after T. gondii infection is regulated in a SOCS3/STAT3/IL-17A/blood-brain barrier integrity-dependent manner. Although parasite infection would not be permitted for MS treatment, this study using T. gondii infection identified potential targets that contribute to disease attenuation.
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