<i>Toxoplasma</i> infection in kidney donors and transplant recipients from Western Mexico: A one‐year follow‐up

Galván-Ramírez, María de la Luz; Sánchez-Orozco, Laura V.; Andrade‐Sierra, Jorge; Mendoza-Cabrera, Salvador; Evangelista-Carrillo, Luis Alberto; Pérez, Laura Rocío Rodríguez; Chiquete, Erwin; Armendáriz‐Borunda, Juan

doi:10.1111/tid.13139

Cited by 5 publications

(6 citation statements)

References 26 publications

(50 reference statements)

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“…Most transplant recipients, 88.4%, received TAC (3–11 mg/d) adjusted by clinicians based on the patient's serum levels (9–15 ng/ml in the first 30 days and 8–10 ng/ml during follow-up). [ 34 ]…”

Section: Resultsmentioning

confidence: 99%

“…The maintenance immunosuppression consisted of prednisone (starting with a dose of 1 mg/kg/day with reduction doses until reaching 5 mg/day a month after transplantation) and mycophenolate mofetil (1–2 g/24 h), plus a calcineurin inhibitor. Most transplant recipients, 88.4%, received TAC (3–11 mg/d) adjusted by clinicians based on the patient's serum levels (9–15 ng/ml in the first 30 days and 8–10 ng/ml during follow-up) [34] …”

Section: Resultsmentioning

confidence: 99%

“…). [34] We then assessed changes in biochemical parameters and NETosis markers 4.0 ± 1.6 months after the transplant surgery in this subset of patients. As shown in Table 3, the Hb concentration increased after transplantation (10.2 ± 2.2 g/dL to 13.0 ± 1.7 g/ dL, P < .0001) as expected due to improved renal function in our cohort.…”

Section: Characteristics Of Esrd Patients In Relation To Circulating ...mentioning

confidence: 99%

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Impact of transplantation on neutrophil extracellular trap formation in patients with end-stage renal disease

et al. 2021

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Increased neutrophil extracellular trap (NET) formation associates with high cardiovascular risk and mortality in patients with end-stage renal disease (ESRD). However, the effect of transplantation on NETs and its associated markers remains unclear. This study aimed to characterize circulating citrullinated Histone H3 (H3cit) and Peptidyl Arginase Deiminase 4 (PAD4) in ESRD patients undergoing transplantation and evaluate the ability of their neutrophils to release NETs. This prospective cohort study included 80 healthy donors and 105 ESRD patients, out of which 95 received a transplant. H3cit and PAD4 circulating concentration was determined by enzyme-linked immunosorbent assay in healthy donors and ESRD patients at the time of enrollment. An additional measurement was carried out within the first 6 months after transplant surgery. In vitro NET formation assays were performed in neutrophils isolated from healthy donors, ESRD patients, and transplant recipients. H3cit and PAD4 levels were significantly higher in ESRD patients (H3cit, 14.38 ng/mL [5.78–27.13]; PAD4, 3.22 ng/mL [1.21–6.82]) than healthy donors (H3cit, 6.45 ng/mL [3.30–11.65], P < .0001; PAD4, 2.0 ng/mL [0.90–3.18], P = .0076). H3cit, but not PAD4, increased after transplantation, with 44.2% of post-transplant patients exhibiting high levels (≥ 27.1 ng/mL). In contrast, NET release triggered by phorbol 12-myristate 13-acetate was higher in neutrophils from ESRD patients (70.0% [52.7–94.6]) than healthy donors (32.2% [24.9–54.9], P < .001) and transplant recipients (19.5% [3.5–65.7], P < .05). The restoration of renal function due to transplantation could not reduce circulating levels of H3cit and PAD4 in ESRD patients. Furthermore, circulating H3cit levels were significantly increased after transplantation. Neutrophils from transplant recipients exhibit a reduced ability to form NETs.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Characteristics Of Esrd Patients In Relation To Circulating ...mentioning

confidence: 99%

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Impact of transplantation on neutrophil extracellular trap formation in patients with end-stage renal disease

et al. 2021

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“…gondii infection is common in humans with its prevalence varying according to region with values being higher in countries with lower socioeconomic development [25,26]. In this context, organ recipients are not exempt from infection by this apicomplexan parasite as it can be acquired through transplantation [21,27]. In their review article, Galván-Ramirez et al report that a large proportion of donors are infected and that T. gondii cysts present in the graft, when transmitted to recipients, can constitute a significant problem.…”

Section: Discussionmentioning

confidence: 99%

Toxoplasma gondii Infection in Patients Submitted to Liver Transplantation

Pintos,

Pires,

Silva

et al. 2023

Preprint

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Background: The liver has emerged as a frequent transplanted organ which can transmit T. gondii between seropositive donors and seronegative recipients. Associated with the immunosuppressive therapy of recipients, the presence of cysts in donor livers elevate the risk of severe toxoplasmosis in recipients. Objectives: The objective of the study was to verify the frequencies of positive serology in liver graft donors and their respective recipients, as well as to verify whether their clinical signs presented post-transplant are associated with the serological status of recipients. Patients and methods: All data on liver transplant recipients from 2008 to 2018 were obtained from the MVPeP electronic medical records of the Liver Transplant Service of FUNFARME/FAMERP. IgM and IgG anti-T. gondii antibody serology was investigated by chemiluminescence. According to the serological profile, four groups of recipients were assessed (G1: IgG-/IgM-; G2: IgG+/IgM-; G3: IgG+/IgM+, G4: IgG-/IgM+). Results: The numbers of recipients according to the serological profile groups were: G1: 20 (41.7%), G2: 26 (54.1%; G3: 2 (4.2%). No cases were found for G4. Post-transplant clinical manifestations such as fever without defined cause, lung nodules, headache, hepatosplenomegaly, encephalopathy and hepatitis (A, B and C) were reported in all groups. Conclusions: This study demonstrates that there is a high prevalence of T. gondii infection in liver recipients and, therefore, screening should be intensified. Furthermore, a high incidence of co-infection with hepatitis A was identified especially in patients who died in the post-transplant period.

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“…[39,40] Immunosuppressive therapy has been shown to affect parasite load times in toxoplasma infected mice. [41] In recent years, most cases of toxoplasma infection have been reported in organ transplant patients, [42][43][44] while reports of IBD patients infected with hormones and immunosuppressive agents are very rare. According to the key words "Inflammatory bowel disease," "azathioprine," and "Toxoplasma," only 1 relevant article was found in the database.…”

Section: Discussionmentioning

confidence: 99%

Azathioprine-induced toxoplasma gondii infection in a patient with Crohn's disease with NUDT15 variation

Tan

Da-lian

et al. 2021

Medicine

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Introduction: Azathioprine (AZA) has been widely used for the treatment of various immune-related diseases and has become a mainstay in the treatment of inflammatory bowel disease. However, patients with genetic mutations may experience severe adverse events when treated with azathioprine. Most of the previous literature focused on the TPMP gene-related adverse reactions, herein, we report a case of Crohn's disease patient with nucleoside diphosphate-linked moiety X motif 15 gene (NUDT15) variation and wild-type TPMP gene who developed toxoplasma gondii infection after azathioprine treatment. Patient concerns: A 56-year-old Crohn's disease patient developed toxoplasma gondii infection within 2 months after the administration of azathioprine; however, he had no relevant high-risk factors. Diagnosis: Subsequent genetic testing revealed that the patient was heterozygous for NUDT15. Therefore, it was reasonable to consider that the patient's genetic mutation resulted in reduced tolerance to azathioprine, leading to low immunity and eventually toxoplasma infection. Interventions: AZA was then discontinued; after anti-infection, antipyretic and other supportive treatments were administered, the patient's condition gradually improved. Outcomes: The patient was followed up at 1, 3, and 6 months after discharge; fortunately, he was in good health. Conclusion: We report a case of Crohn's disease in a patient who developed severe pneumonia caused by toxoplasma gondii infection due to the administration of AZA, with normal TPMP gene but NUDT15 gene mutation. This indicates that NUDT15 variation may contribute to severe adverse events in patients treated with azathioprine, and we suggest that NUDT15 genotype be detected before the use of azathioprine in order to provide personalized therapy and reduce side effects.

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Toxoplasma infection in kidney donors and transplant recipients from Western Mexico: A one‐year follow‐up

Cited by 5 publications

References 26 publications

Impact of transplantation on neutrophil extracellular trap formation in patients with end-stage renal disease

Impact of transplantation on neutrophil extracellular trap formation in patients with end-stage renal disease

Toxoplasma gondii Infection in Patients Submitted to Liver Transplantation

Azathioprine-induced toxoplasma gondii infection in a patient with Crohn's disease with NUDT15 variation

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