Understanding mechanisms and the role of differentiation in pathogenesis of Toxoplasma gondii: a review

Parasite differentiation from proliferating tachyzoites into latent bradyzoites is central to pathogenesis and transmission of the intracellular protozoan pathogen Toxoplasma gondii. The presence of bradyzoite-containing cysts in human hosts and their subsequent rupture can cause life-threatening recrudescence of acute infection in the immunocompromised and cyst formation in other animals contributes to zoonotic transmission and widespread dissemination of the parasite. In this review, we discuss the evidence showing how the clinically relevant process of bradyzoite differentiation is regulated at both transcriptional and post-transcriptional levels. Specific regulatory factors implicated in modulating bradyzoite differentiation include promoter-based cis-elements, epigenetic modifications and protein translation control through eukaryotic initiation factor -2 (eIF2). In addition to a summary of the current state of knowledge in these areas we discuss the pharmacological ramifications and pose some questions for future research.

Toxoplasma gondii infection induces lipid metabolism alterations in the murine host

Host lipids have been implicated in the pathogenesis of Toxoplasma gondiiinfection. To determine if Toxoplasmainfection influences the lipid status in the normal host, we assessed serum lipids of Swiss-Webster mice during infection with the BGD-1 strain (type-2) at a series of time points. Mice were bled at days zero and 42 post-infection, and subgroups were additionally bled on alternating weeks (model 1), or sacrificed at days zero, 14 and 42 (model 2) for the measurement of total cholesterol (Chl), high density lipoproteins (HDL), low density lipoproteins (LDL) and triglycerides and adiponectin. At day 42, brains were harvested for cyst enumeration. A significant decrease (p = 0.02) in HDL and total Chl was first noted in infected vs. control mice at day 14 and persisted to day 42 (p = 0.013). Conversely, LDL was unaltered until day 42, when it increased (p = 0.043). Serum LDL levels at day 42 correlated only with cyst counts of above 300 (found in 44% mice), while the change in HDL between days zero and 42 correlated with both the overall mean cyst count (p = 0.041) and cyst counts above 300 (p = 0.044). Calculated per cyst, this decrease in HDL in individual animals ranged from 0.1-17 µmol/L, with a mean of 2.43 ± 4.14 µmol/L. Serum adiponectin levels remained similar between infected and control mice throughout the experiment.

Host immune response to Toxoplasma gondii and Ascaris lumbricoides in a highly endemic area: evidence of parasite co-immunomodulation properties influencing the outcome of both infections

Toxoplasmosis and ascaridiasis evoke polar Th-1 and Th-2 host immune responses, respectively. A study to investigate the specific cytokine profile production by in vitro cultures of peripheral blood mononuclear cells from individuals living under precarious sanitary conditions in a highly endemic area for the parasites Toxoplasma gondii and Ascaris lumbricoides was conducted. High levels of both IFN-³ (Th-1) and IL-13 (Th-2) were observed in groups of co-infected individuals presenting toxoplasmic ocular lesions. Significantly lower IL-10 and TGF-² levels were produced by co-infected individuals in comparison with groups of individuals not infected with A. lumbricoides and either positive or negative for T. gondii living under good sanitary conditions (control groups). The possible influence of co-parasitism on the clinical presentation of ocular toxoplasmosis is discussed.

Congenital toxoplasmosis: evaluation of serological methods for the detection of anti-Toxoplasma gondii IgM and IgA antibodies

A study was carried out to evaluate the presence of serological markers for the immunodiagnosis of the vertical transmission of toxoplasmosis. We tested the sensitivity, specificity and predictive values (positive and negative) of different serological methods for the early diagnosis of congenital toxoplasmosis. In a prospective longitudinal study, 50 infants with suspected congenital toxoplasmosis were followed up in the ambulatory care centre of Congenital Infections at University Hospital in Goiânia, Goiás, Brazil, from 1 January 2004-30 September 2005. Microparticle Enzyme Immunoassay (MEIA), Enzyme-Linked Fluorescent Assay (ELFA) and Immune-Fluorescent Antibody Technique (IFAT) were used to detect specific IgM anti-Toxoplasma gondii antibodies and a capture ELISA was used to detect specific IgA antibodies. The results showed that 28/50 infants were infected. During the neonatal period, IgM was detected in 39.3% (11/28) of those infected infants and IgA was detected in 21.4% (6/28). The sensitivity, specificity and predictive values (positive and negative) of each assay were, respectively: MEIA and ELFA: 60.9%, 100%, 100%, 55.0%; IFAT: 59.6%, 91.7%, 93.3%, 53.7%; IgA capture ELISA: 57.1%, 100%, 100%, 51.2%. The presence of specific IgM and IgA antibodies during the neonatal period was not frequent, although it was correlated with the most severe cases of congenital transmission. The results indicate that the absence of congenital disease markers (IgM and IgA) in newborns, even after confirming the absence with several techniques, does not constitute an exclusion criterion for toxoplasmosis.

Primary culture of intestinal epithelial cells as a potential model for Toxoplasma gondii enteric cycle studies

The primary culture of intestinal epithelial cells from domestic cats is an efficient cellular model to study the enteric cycle of Toxoplasma gondii in a definitive host. The parasite-host cell ratio can be pointed out as a decisive factor that determines the intracellular fate of bradyzoites forms. The development of the syncytial-like forms of T. gondii was observed using the 1:20 bradyzoite-host cell ratio, resulting in similar forms described in in vivo systems. This alternative study potentially opens up the field for investigation into the molecular aspects of this interaction. This can contribute to the development of new strategies for intervention of a main route by which toxoplasmosis spreads.

Single nucleotide polymorphisms in the interferon gamma gene are associated with distinct types of retinochoroidal scar lesions presumably caused by Toxoplasma gondii infection

The association of single nucleotide polymorphisms (SNPs) in the interferon (IFN)-γ gene ( IFNG ) with different types of retinal scar lesions presumably caused by toxoplasmosis were investigated in a cross-sectional population-based genetic study. Ten SNPs were investigated and after Bonferroni correction, only the associations between SNPs rs2069718 and rs3181035 with retinal/retinochoroidal scar lesions type A (most severe scar lesions) and C (least severe scar lesions), respectively, remained significant. The associations of two different IFNG SNPs with two different types of retinal lesions attributable to toxoplasmosis support the hypothesis that different inflammatory mechanisms underlie the development of these lesions. The in vitro analysis of IFN-γ secretion by peripheral blood mononuclear cells stimulated with Toxoplasma gondii antigens was also investigated. The association between SNP rs2069718 and type A scar lesions revealed that differential IFN-γ levels are correlated with distinct genotypes. However, no correlation was observed with IFN-γ secretion levels and the SNP rs3181035 , which was significantly associated with type C scar lesions. Our findings strongly suggest that immunogenetic studies of individuals with congenital or postnatally acquired infection are needed to better understand the role of IFN-γ and its polymorphisms in the pathogenesis of ocular toxoplasmosis.

Perdas reprodutivas associadas com infecção por Toxoplasma gondii em caprinos no sul do Brasil

Infecção por Toxoplasma gondii foi associada com perdas reprodutivas em um rebanho caprino no Rio Grande do Sul, Brasil. Lesões macroscópicas foram observadas em dois de seis produtos caprinos enviados para diagnóstico e incluíram linfonodos mesentéricos pálidos e aumentados e pulmões com consistência firme e áreas claras intercaladas com vermelhas. Lesões histológicas, especialmente caracterizadas por infiltrados linfoplasmocitários no cérebro e pulmões, foram observadas em todos os fetos. Nefrite intersticial linfoplasmocitária, linfadenite necrosante e hepatite periportal linfoplasmocitária também foram observadas. Enquanto tanto o exame bacteriológico quanto o teste de imunofluorescência direta para Leptospira sp. foram negativos em todos os casos, a PCR e a imunoistoquímica resultaram positivamente para T. gondii em quase todas as amostras testadas. Anticorpos anti-T.gondii, em titulações de 1:512 a 1:2048, foram detectados nas amostras de soro sangüíneo das cabras que pariram natimortos (3), abortaram (1) ou cujos neonatos morreram (2). Este trabalho descreve os achados clínicos, patológicos, sorológicos, imunoistoquímicos e de PCR observados em um rebanho caprino infectado por T. gondii.

Toxoplasma gondii in semen of experimentally infected swine

Eight reproductive boars were divided into three groups and inoculated with Toxoplasma gondii [GI (n=3) 1.5x10(4) oocysts strain P; GII (n=3) 1.0x10(6) tachyzoites strain RH; and GIII (n=2) non-inoculated control]. Clinical, hematological, parasitemia and serological tests and studies of the parasite in the semen through bioassay and PCR, and in reproductive organs (Bioassay and immunohistochemical analyses) were conducted to evaluate the toxoplasmic infection. Blood and semen were collected on day -2, -1, 1, 3, 5, 7, 9, 11, 14 and weekly up to 84 days post-inoculation (DPI). No clinical or hematimetric alteration was observed in the boars. Parasitemia was detected in one boar inoculated with oocysts at the 7th DPI and in another boar infected with tachyzoites (GII) at the 3rd and 49th DPI. Serological tests revealed antibodies against T. gondii in animals inoculated with oocysts or tachyzoites at the 7th DPI with dilutions of 1:256 and 1:64, which reached peaks of 1:4096 at day 11 and 9, respectively. The bioassays revealed the presence of the parasite in semen samples of a boar inoculated with oocysts (GI) at 3, 49 and 56 DPI and from two boars infected with tachyzoites (GII), one animal at 5 and two animals at 49 days DPI. Mice inoculated with semen from the control group (GIII) remained serologically negative. PCR analysis showed T. gondii DNA in the semen of Boar 1 and Boar 3 inoculated with tachyzoites and oocysts, respectively. The immuno-histochemical tests showed T. gondii in the reproductive organs of Boar 1 and Boar 2, inoculated with tachyzoites and oocysts, respectively. These findings suggest the possible occurrence of venereal transmission of T. gondii in swine.

Toxoplasma gondii in experimentally infected Bos taurus and Bos indicus semen and tissues

Eighteen young steers were inoculated with Toxoplasma gondii and randomly distributed into three groups of six animals each: GI, 2.5x10(5) "P" strain oocysts, GII, 5.0x10(6) "RH" strain tachyzoites, and GIII (Control). Clinical, serological and parasitemia exams were realized. Parasite investigation by bioassay and PCR was realized on semen and fragments of skeletal musculature, lymph nodes, brain, retina, spleen, liver, lung, testicle, epididymis and seminal vesicle. Blood and semen samples were collected on days -2, -1, 1, 3, 5, 7, 14 and weekly thereafter, up to postinfection day (PID) 84. The inoculated steers (GI and GII) presented hyperthermia from PID 3 to 16. Antibodies against T. gondii were detected through the indirect fluorescence antibody test (IFAT) on PID 5 (1:16) in both inoculated groups (oocysts and tachyzoites), reaching peaks of 1:4096 on PID 7. Parasitemia outbursts occurred in all infected bovines, principally from PID 7 to 28, independent of the strain and inoculate used. Bioassays revealed the presence of parasites in semen samples of animals infected with oocysts (GI) and tachyzoites (GII) on several experimental days between PID 7 and 84. Tissue parasitism by T. gondii was diagnosed by bioassay and the PCR technique in several organ and tissue fragments. These findings suggest the possibility of sexual transmission of T. gondii in the bovine species.

Risk factors and presence of antibodies to Toxoplasma gondii in dogs from the coast of São Paulo State, Brazil

Toxoplasmosis is caused by the obligate intracellular protozoan parasite Toxoplasma gondii and affects warm-blooded vertebrates, including pets and man. Dogs are epidemio-logically important since they act as sentinels for the infection in humans. The present study aimed to determine the presence of antibodies to T. gondii in 205 serum samples from dogs in Ubatuba, Sao Paulo state, Brazil, through indirect immunofluorescence reaction (IFAT), as well as the risk factors related to toxoplasmosis in the animals such as breed, age, sex, access to outdoors, homemade food ingestion, access to untreated water, and contact with rodents. Toxoplasmosis-positive samples accounted for 52/205 (25.4%), with titers ranging from 16 to 256. The serological results presented significant association (P<0.05) with homemade food ingestion (45/118; 38.1%; CI95% 29.9%-47.2%) (OR=7.0; CI95% 3.0-16.6), and with access to outdoors where those that do not have access to the street were prevalent (37/121; 30.6%; CI95% 23.1%-39.3%) (OR=0.5; CI95% 0.2-1.0). These results show that toxoplasmosis in this region is related to problems of sanitary education, mainly concerning the appropriate cooking of foods, since most positive animals did not show significant association with the presence of rodents or untreated water consumption but showed, instead association with ingestion of homemade food. Thus, toxoplasmosis is a public health problem in the studied region, and sanitary measures are needed to control the infection due to the strict relationship between man and dog and the presented risk factors

Anticorpos IgG anti-Neospora caninum e Toxoplasma gondii em búfalas (Bubalus bubalis) criadas no estado do Pará

Para determinar a ocorrência de anticorpos IgG anti-Neospora caninum e Toxoplasma gondii em 14 unidades produtivas de búfalos, situadas em 13 municípios no estado do Pará, foram coletadas amostras de soro sanguíneo de 374 fêmeas adultas. Os soros foram submetidos à reação de imunofluorescência indireta (RIFI), utilizando-se os títulos 200 e 64, respectivamente como ponto de corte para N. caninum e T. gondii. Obteve-se 153 (40,9%) de animais soropositivos para N. caninum com 100% das propriedades com focos da infecção, enquanto que quatro búfalas (1,1%) foram soropositivas em quatro fazendas para T. gondii e uma búfala (0,27%) foi soropositiva para ambos parasitos. A presença de anticorpos é um indicativo da circulação desses protozoários em búfalos das propriedades estudadas, representando uma fonte de infecção para outros animais, assim como o possível envolvimento em distúrbios reprodutivos nessa espécie.

Fatores associados a soroprevalência de Neospora caninum e Toxoplasma gondii em rebanhos caprinos na região sul de Minas Gerais

Este estudo estabelece a soroprevalência de Neospora caninum e Toxoplasma gondii em rebanhos caprinos no Sul de Minas Gerais e verifica a sua associação com o desempenho reprodutivo dos rebanhos analisados, uma vez que não há dados sobre neosporose em caprinos neste Estado. Amostras de soro de 401 caprinos provenientes de 11 propriedades foram submetidas à reação de imunofluorescência indireta anti-N. caninum e T. gondii. A prevalência média de animais positivos foi de 10,7% e 21,4%, respectivamente. Houve diferença significativa entre as faixas etárias. Neste quesito os maiores índices de positividade, para ambos os parasitas, foram observados nos caprinos acima de três anos de idade. Estes apresentaram uma probabilidade 2,6 e 4,8 maior, em relação aos animais de até um ano de idade, para N. caninum e T. gondii, respectivamente. No teste T não houve associação positiva entre as médias de prevalência de N. caninum (p=0,553) e T. gondii (p=0,098) com a ocorrência de problema reprodutivo nos rebanhos. Porém, propriedades com histórico de problemas reprodutivos apresentaram uma média de reagentes para N. caninum de 18,64%, se comparadas a 13,97% de criatórios que não relataram essas alterações. Quando os problemas reprodutivos foram separados em categorias a relação entre a ocorrência de aborto e a soroprevalência de N. caninum e de T. gondii foi significativa (p<0,05) por meio dos testes Exato de Fisher e Qui-quadrado. Não houve diferença (p>0,05) entre as médias de prevalência de T. gondii e o acesso de gatos ao rebanho no teste T. Entretanto, a média de prevalência nas propriedades em que os gatos tinham acesso foi de 31,01%, se comparada a 17,34% em criatórios onde não existiam gatos. Foi constatado o acesso de cães em 100% das propriedades. Os resultados obtidos neste estudo demonstram que N. caninum e T. gondii infectam caprinos no Sul de Minas Gerais e que estes parasitas podem estar associados à ocorrência de abortos nessa espécie animal.

Prevalência e fatores de risco associados à infecção por Toxoplasma gondii em granjas suinícolas tecnificadas no Estado de Alagoas

Objetivou-se com este estudo calcular a prevalência e identificar os fatores de risco associados à infecção por Toxoplasma gondii em suínos criados em granjas tecnificadas no Estado de Alagoas, Brasil. Para compor a amostra do estudo de prevalência foram utilizados 342 suínos, sendo 312 matrizes e 30 varrões, oriundos de sete granjas de ciclo completo e distribuídas em cinco municípios do Estado de Alagoas. O exame sorológico para a pesquisa de anticorpos anti-Toxoplasma gondii foi realizado através da técnica de Imunofluorescência Indireta (RIFI), utilizando-se anticorpos anti-IgG-suíno conjugado ao isotiocianato de fluoresceína. A análise dos fatores de risco foi realizada por meio da aplicação de questionários constituídos por perguntas objetivas referentes ao criador, às características gerais da propriedade, ao manejo produtivo, reprodutivo e sanitário. Determinou-se uma prevalência de 26,9% (92/342) de suínos soropositivos. O fator associado à infecção foi a introdução de reprodutores nas granjas nos últimos cinco anos (p=0,014; OR=1,83; IC=1,13-2,96). Concluiu-se que a infecção por Toxoplasma gondii encontra-se disseminada em suínos criados em granjas tecnificadas no Estado de Alagoas, Brasil. Recomenda-se o controle da população de gatos, a realização de práticas de limpeza e higienização das instalações e realização de testes laboratoriais para diagnóstico da infecção por T. gondii nos animais a serem introduzidos no plantel como medidas de redução dos índices de infecção na região estudada.

Sparrows (Passer domesticus L.) as intermediary hosts of Toxoplasma gondii in poultry farms from the "agreste" region of Pernambuco, Brazil

This paper aimed to identify Toxoplasma gondii infection in house sparrows (Passer domesticus, Linneaus 1758) coming from poultry farms in the "agreste" region of the Brazilian state of Pernambuco. 151 sparrows (Passer domesticus) captured in eight broiler, egg layer and commercial laying poultry farms, were used. Indirect hemagglutination test was used to research anti-T. gondii antibodies. Animals that presented titration of 1:16 were destined to DNA research through Polymerase Chain Reaction (PCR) technique, followed by Nested-PCR. It was observed that, from 151 analyzed samples. 91 (60.3%) were reagents and 60 (39.7%) were not reagents. It was verified, through analysis of the distribution of infected animals frequency per farm, that in only one farm (12.5%) no animal reagent to T. gondii was captured. It was also observed that three (30.00%) of the ten samples destined to DNA research for T. gondii were positive to PCR and four (40.00%) were positive to Nested-PCR. Anti-T gondii antibodies occurrence and the molecular identification of the agent confirmed natural T. gondii infection in sparrows from poultry farms in Brazil. Other studies must be carried out to highlight the real importance of these animals in the epidemiological chain and their efficiency in the transmission of the parasite to felines. Therefore, researches that use parasite isolation and molecular techniques to determine genomic profile of the agent present in these poultry farms are needed.

Risk factors associated with Toxoplasma gondii infection in dairy cattle, state of Rio de Janeiro

Toxoplasmosis is one of the most common parasitic zoonoses throughout the world. Infection in man and animals varies in different geographical areas influenced by many environmental conditions. Seroprevalence of Toxoplasma gondii infection in cattle in Brazil ranges from 1.03 to 71%. A cross-sectional survey was carried out in 58 out of 453 farms in the South Fluminense Paraiba Valley, State of Rio de Janeiro, Brazil. Over 3-year-old cattle (n=589) from dairy herds were selected for blood collection and detection of anti-T. gondii antibodies by indirect immunofluorescence reaction (IFA) with initial titration of 1:16; titers > 64 were considered positive. Univariate analysis of risk factors showed that cats in contact with cattle, cats in contact with drinking water, and number of cats were associated with T. gondii seroprevalence. Logistic regression revealed a two-fold increased risk for infection of cattle (p=0.0138) through larger number of cats (>3) compared with low numbers of cats (1-2) on the farm. In contrast, the presence of chickens was considered a protective factor (p=0.025).