The Association of Toxoplasma gondii IgG and Liver Injury in US Adults

Abstract

Background: Toxoplasma gondii (T. gondii) is a ubiquitous obligatory intracellular parasite which infects over 40 million Americans and causes toxoplasmosis. Inside the human body, T. gondii can damage tissues and invade vital organs. Methods: This study evaluated the association of T. gondii infection and liver disease using data from the National Health and Nutrition Examination Survey (NHANES) 2009–2010, with a sample size of 3371 participants (age 20–80 years). Toxoplasma infection was determined by the level of T. gondii IgG antibody in serum samples. Liver disease was assessed by liver injury biomarkers and the Fatty Liver Index (US-FLI). The evaluation of the association between T. gondii infection and liver disease included the calculation of the Mantel–Haenszel risk ratio (RRMH), Rho-Scott chi-square bivariate analyses, design-based t-tests, and linear and logistic regression models which were adjusted for demographic and anthropometric covariates. Results: Mean levels of aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were significantly more elevated in the T. gondii IgG-positive (IgG+) participants as compared to T. gondii-negative (IgG−) participants, p = 0.0435 and 0.0310, respectively. In linear regression analysis, exposure to T. gondii IgG+ had statistically significant positive associations with AST (p = 0.0211), alanine aminotransferase (ALT) (p = 0.0221), and gamma-glutamyl transferase (GGT) (p = 0.0258) after adjusting for BMI, age, gender, and race. T. gondii exposure was associated with an elevated relative risk of chronic liver disease (CLD) (RRMH = 1.26, 95% CI: 1.05–1.51). This association was more pronounced in certain occupations, such as construction, agriculture, forestry, and fishing, where Toxoplasma infection is more common (p = 0.0477). Moreover, Toxoplasma infection increased the odds of nonalcoholic fatty liver disease (NAFLD) (OR = 6.99, 95% CI = 1.85–26.32, p = 0.0237). Conclusion: T. gondii IgG+ antibody was significantly associated with liver injury biomarkers (ALT, AST, GGT, and ALP) and an increased risk of CLD and NAFLD. Moreover, the association of Toxoplasma with CLD was more evident in specific occupations where the prevalence of Toxoplasma was high. The findings of this study provide insight into utilizing liver biomarkers and US-FLI to assess the health complications of Toxoplasma when imaging tests are not accessible.

The Association of Toxoplasma gondii with the Combination of Cardiovascular Disease, Chronic Kidney Disease, or Chronic Liver Disease: A Preliminary Study

“…This study hypothesized that exposure to Toxoplasma gondii infection has a negative effect on the cardiovascular system, renal system, and hepatic system simultaneously by causing inflammation, oxidative stress, and tissue damage, leading to an increased risk of cardiovascular disease, chronic kidney disease, and chronic liver disease. To test this hypothesis, we examined the effect of T. gondii on an overall cardiovascular biomarker index (OCBI) developed in our prior work [ 5 ], a chronic liver disease index, and a chronic kidney disease index used in our prior work [ 11 , 13 ].…”

“…In this study, cardiovascular, kidney, and liver health were evaluated using biomarker indexes developed in our previous studies [ 5 , 11 , 13 ].…”

“…It can be caused by a range of factors, including alcohol abuse, viral infections, and autoimmune disorders [ 12 ]. Some studies have suggested that T. gondii may contribute to liver damage in individuals [ 13 ]. For example, one study found that those infected with T. gondii may have higher odds of nonalcoholic fatty liver disease (NAFLD) [ 14 ] with age serving as a critical factor in this association.…”

Recurrent ocular toxoplasmosis infection in a patient with a selective deficiency of NK T-cells and cytotoxic СD8+ T-cells associated with a genetic folate cycle deficiency

“…Borges and co-authors [11] compared the detection of immunoglobulin isotypes and subclasses against Toxoplasma gondii soluble antigen in serum and colostrum samples from puerperal women, and reported that serum and colostrum immunoglobulins of different classes and subclasses provide a wealth of information about exposure to toxoplasmosis. A recent case-control study by Babekir and colleagues [12] evaluated the association of T. gondii infection and liver disease, and found serum T. gondii IgG+ antibody to be significantly associated with liver injury biomarkers and an increased risk of chronic liver disease and nonalcoholic fatty liver disease, demonstrating the value of serological tests in toxoplasmosis.…”

Association between Urinary Haloacetic Acid Concentrations and Liver Injury among Women: Results from the Tongji Reproductive and Environmental (TREE) Study

“…Nonalcoholic fatty liver disease (NAFLD), whose pathogenesis is linked with liver injury commonly measured by alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT), is the most common chronic liver disease worldwide. 1 – 3 Globally, the estimated prevalence of NAFLD in the general adult population is 32.4% and has increased from 25.5% in 2005 to 37.8% in 2016. 4 In China, the prevalence of NAFLD is nearly 30% and has increased by 10% from 2008 to 2018.…”