Does Toxoplasma gondii infection impact liver transplantation outcomes? A systematic review

Galván-Ramírez, María de la Luz; Sánchez-Orozco, Laura V.; Gutiérrez-Maldonado, Adrián Fernando; Pérez, Laura Rocío Rodríguez

doi:10.1099/jmm.0.000694

Cited by 16 publications

(13 citation statements)

References 33 publications

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“…Using clinically isolated Type II strains, Toxoplasma cysts were found in the livers of infected Swiss-Webster mice as late as 33 weeks post-infection, indicating that the liver may be a reservoir for chronic infection (Autier et al, 2018). This is consistent with clinical reports of Toxoplasma -negative transplant recipients who have developed toxoplasmosis after receiving livers from sera positive donors (Assi et al, 2007; Galván-Ramírez et al, 2018). While there are no studies directly implicating Toxoplasma in the development of liver disease, approximately 30% of patients with chronic liver disease test sera-positive for Toxoplasma B1 compared to 6% in control populations (El-Sayed et al, 2016).…”

Section: Host Metabolic Dysregulation In Toxoplasma Infectionsupporting

confidence: 90%

Disease Tolerance in Toxoplasma Infection

Melchor

Ewald

2019

Front. Cell. Infect. Microbiol.

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Toxoplasma gondii is a successful protozoan parasite that cycles between definitive felid hosts and a broad range of intermediate hosts, including rodents and humans. Within intermediate hosts, this obligate intracellular parasite invades the small intestine, inducing an inflammatory response. Toxoplasma infects infiltrating immune cells, using them to spread systemically and reach tissues amenable to chronic infection. An intact immune system is necessary to control life-long chronic infection. Chronic infection is characterized by formation of parasite cysts, which are necessary for survival through the gastrointestinal tract of the next host. Thus, Toxoplasma must evade sterilizing immunity, but still rely on the host's immune response for survival and transmission. To do this, Toxoplasma exploits a central cost-benefit tradeoff in immunity: the need to escalate inflammation for pathogen clearance vs. the need to limit inflammation-induced bystander damage. What are the consequences of sustained inflammation on host biology? Many studies have focused on aspects of the immune response that directly target Toxoplasma growth and survival, commonly referred to as “resistance mechanisms.” However, it is becoming clear that a parallel arm of the immune response has evolved to mitigate damage caused by the parasite directly (for example, egress-induced cell death) or bystander damage due to the inflammatory response (for example, reactive nitrogen species, degranulation). These so-called “disease tolerance” mechanisms promote tissue function and host survival without directly targeting the pathogen. Here we review changes to host metabolism, tissue structure, and immune function that point to disease tolerance mechanisms during Toxoplasma infection. We explore the impact tolerance programs have on the health of the host and parasite biology.

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Section: Host Metabolic Dysregulation In Toxoplasma Infectionsupporting

confidence: 90%

Disease Tolerance in Toxoplasma Infection

Melchor

Ewald

2019

Front. Cell. Infect. Microbiol.

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“…Contracting T. gondii during pregnancy can be lethal to the fetus, which also has a minimal immune system (19). Tissues that were not classically considered "immune privileged" also harbor parasites, based on the observation that transplant recipients of kidney, liver, heart, or lung have contracted toxoplasmosis from an infected donor (20)(21)(22)(23)(24). However, chronic infection in these tissues is almost unstudied, as parasite frequency is incredibly low.…”

Section: Introductionmentioning

confidence: 99%

The molecular biology and immune control of chronic Toxoplasma gondii infection

Zhao¹,

Ewald²

2020

Journal of Clinical Investigation

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“…The most common transmission routes of toxoplasmosis are by oral means, either by eating undercooked contaminated meat that contains cysts or by ingesting water and uncooked foods contaminated with sporulated oocysts, and the congenital pathway, mother-to-child transmission during pregnancy. Less frequent transmission occurs through blood transfusion and organ transplant [1,[4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Serological prevalence of toxoplasmosis in pregnant women in Luanda (Angola): Geospatial distribution and its association with socio-demographic and clinical-obstetric determinants

et al. 2020

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We report a study on toxoplasmosis in pregnant women in Luanda, Angola, determining the seroprevalence, geospatial distribution and its association with socio-economic features, dietary habits and hygiene and health conditions. Anti-Toxoplasma gondii IgG and IgM were quantified in serum samples of women attended at the Lucrecia Paim Maternity Hospital between May 2016 and August 2017. The IgG avidity test and qPCR assay were used for dating the primary infection. Data were collected by questionnaire after written consent, and spatial distribution was assessed through a Kernel Density Function. The potential risk factors associated with Toxoplasma infection were evaluated using bivariate and multivariate binomial logistic regression analysis. Anti-T. gondii antibodies were quantified in 878 pregnant women, and 346 (39.4%) samples were IgG positive, 2 (0.2%) positive for IgM and IgG, and 530 (60.4%) negative for both immunoglobulins. The longitudinal study showed that none of the seronegative women seroconverted during the survey. Regarding other infections, 226 (25.7%) were positive for hepatitis B, while 118 (13.4%) were HIV-positive. The seroprevalence of toxoplasmosis was similar in most municipalities: 43.8% in Cazenga (28 of 64); 42.5% in Viana (88 of 207); 42.3% in Cacuaco (22 of 52); and 41.1% in Luanda ((179 of 435). In contrast, the seroprevalence in municipality of Belas was lower (25.8%; 31 of 120) and bivariate and multivariate analysis has shown a lower risk for toxoplasmosis in this area (OR 0.479, CI: 0.305–0.737; OR 0.471, CI: 0.299–0.728). The multivariate analysis has shown a significant increased risk for toxoplasmosis in women in the last trimester of pregnancy (OR 1.457, CI: 1.011–2.102), suffering spontaneous abortion (OR 1.863, CI: 1.014–3.465) and having pets at home (OR 1.658, CI: 1.212–2.269). Also, women who tested positive for hepatitis B (OR 1.375, CI: 1.008–1.874) and HIV (OR 1.833, CI: 1.233–2.730) had a significant increased risk for T. gondii infection. In conclusion, our study showed that a large number of pregnant women are not immunized for toxoplasmosis and identified the risk factors for this infection in Luanda. It is crucial to establish the diagnosis of primary maternal infection as well as the diagnosis of congenital toxoplasmosis. Our results underlined the need for diagnostic and clinical follow-up of toxoplasmosis, HIV and hepatitis B during pregnancy.

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Does Toxoplasma gondii infection impact liver transplantation outcomes? A systematic review

Abstract: Although we review Toxoplasma infection and liver transplantation cases, problems associated with the parasite may be greater than identified. Hence, follow-up studies on Toxoplasma infection in liver transplantation patients are recommended.

Cited by 16 publications

References 33 publications

Disease Tolerance in Toxoplasma Infection

Disease Tolerance in Toxoplasma Infection

The molecular biology and immune control of chronic Toxoplasma gondii infection

Serological prevalence of toxoplasmosis in pregnant women in Luanda (Angola): Geospatial distribution and its association with socio-demographic and clinical-obstetric determinants

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