Congenital Toxoplasmosis: A Review of its Pathology, Immune Response and Current Treatment Options

Wellington A Oyibo, Oladipo O Oladosu, Chimere O Agomo, Oladele T Ojuromi, Charles C Anunobi, Kofo Soyebi

Abstract


Toxoplasmosis, caused by the protozoan parasite Toxoplasma gondii, is one of the most common parasites of man and other warm-blooded animals. Humans are infected through contaminated food, water, and blood transfusion, organ transplantation or from mother to foetus through the placenta. Severe congenital infections occur as a result of primary T. gondii infection in early pregnancy. Transmission of T.gondii to the foetus can result in serious health problems, including mental retardation, seizures, blindness and death. Frequency of foetal infection is higher when maternal infection occurs later in pregnancy and sequelae are more severe when maternal infections occur early in the first trimester of pregnancy. The ability of the parasite to survive intracellularly largely depends on the blocking of different proapoptotic signaling cascades of the host cells. During pregnancy, however, alterations in the incidence of apoptosis are associated with abnormal placental morphology and function. Both cellular and humoral immune responses control T.gondii infection. Toxoplasma is asymptomatic, infected women can only be detected by serological testing. In many instances, congenital toxoplasmosis can be prevented by educating pregnant women and women of childbearing age about the route of transmission. The need for screening suspected cases of T. gondii will help reduce transmission to the foetus

Full Text:

Untitled

References


REFERENCES

Angeloni MB, Silva NM, Castro AS, Gomes AO,

Silva DA, Mineo JR and Ferro EA (2009). Apoptosis and S phase of the Cell Cycle in BeWo

Trophoblastic and HeLa Cells is Differentially Modulated by Toxoplasma gondii Strain Types.

Placenta. July 28. [Epub ahead of print] doi:10.1016/j.placenta.2009.07.002. In Press

Aramini JJ, Stephen C and Dubey JP (1999). Potential contamination of drinking water with

Toxoplasma gondii oocyst. Epidemiol. Infect.

:305-315.

Black MW and Boothroyd JC (2000). Lytic Cycle of Toxoplasma gondii. Microbiol. Mol. Biol. Rev.

: 607–623

Channon JY, Seguin RM and Kasper LH (2000). Differential infectivity and division of Toxoplasma

gondii in human peripheral blood leukocytes. Infect. Immunol. 68: 4822-4826.

Choi WY, Nam HW, Kwak NH, Huh W, Kim JR, Kang MW, Cho SY and Dubey JP (1997). Foodborne outbreaks

of human toxoplasmosis J. Infect. Dis. 175: 1280-1282.

Cook AJ, Gilbert RE, Buffano W, Zuffrey J, Petersen E, Jenum PA, Foulon W, Semprini AE, Dunn DT

(2000). Sources of toxoplasma infection in pregnant women: European multicenter case- control

study. European Research Network on congenital Toxoplasmosis. BMJ. 321: 142-147

Daffos F, Foresstier F, Capella – Pavlovsky M,

Thulliez A, Aufrant C, and Valenti D (1988). Prenatal management of 746 pregnancies at risk for

congenital toxoplasmosis. N. Engl. J. Med.

: 271-275.

de Albuquerque MC, Aleixo AL, Benchimol EI, Leandro AC, das Neves LB, Vicente RT,

Bonecini-Almeida Mda G, Amendoeira MR (2009). The IFN-gamma +874T/A gene polymorphism is

associated with retinochoroiditis toxoplasmosis susceptibility. Mem Inst Oswaldo Cruz. 104: 451-455

Del Rio I, Bennouna S, Salinas J and Denkers EY (2001). CXCR2 deficiency confers impaired

neutrophils recruitment and increased susceptibility during Toxoplasma gondii infection J. Immunol.

: 6503-6509.

Dubey JP (1988). Refirement of pepsin digestion method for isolation of Toxoplasma gondii from

infected tissues. Vet. Parastiol. 74:75-77.

Dubey JP and Beattie CP (1988). Toxoplasmosis of Animals and Man Boca Raton, FL: CRC Press.

Dubey JP (1994). Toxoplasmosis. J. Am. Vet. Med. Assoc. 205: 1593-1598.

Dubey JP and Odening K (1995). Toxoplasmosis and related infections: In: Samuel WM, Pybus MJ,

Kocan AA eds. Parasitic Diseases of Wild mammals. Ames IA: Iowa State University Press:

-519.

Dubey JP (1997). Bradyzoite – Induced murine toxoplasmosis: Stage conversion pathogenesis, and

tissue cyst formation in mice fed brazyzoites of different strains of Toxoplasma gondii. J.

Eukaryot. Microbiol. 44: 592-602.

Dubey JP, Speer CA, Shen SK, Knok OCH and Blixt JA (1997). Oocyst induced murine toxoplasmosis:

life cycle, pathogenicity and stage conversion in mice fed. Toxoplasmosis gondii

oocysts. J. Parasitol. 83: 870-882

Dubey JP (2001). Oocyst shedding by cats fed isolated bradyzoites and comparison of infectivity

of bradyzoites of the VEG strain. Toxoplasma gondii to cat and mice. J. Parasitol. 87: 215-219. Dunn D, Wallon M, Peyron F, Peterson E, Dubey JP (2001). Oocyst shedding by cats fed isolated bradyzoites and comparison of infectivity

of bradyzoites of the VEG strain. Toxoplasma gondii to cat and mice. J. Parasitol. 87: 215-219. Dunn D, Wallon M, Peyron F, Peterson E,

Elbez-Rubinstein A, Ajzenberg E, Dardé M,

Cohen R, Dumètre A, Year H, Gondon E, Janaud J, Thulliez P (2009). Congenital toxoplasmosis

and re-infection during pregnancy: case report, strain characterization, experimental model of re-

infection, and Review. J. Infect. Dis. 199: 280-285

Evengard B, Lilja G, Capraru T, Malm G, Kussofsky E, Oman H, and Forsgren MA (1999). Retrospective

study of seroconversion against T. gondii during 3,000 pregnancies in Stockholm. Scand. J. Infect.

Dis. 31: 127-137.

Ferreira Ade M, Vitor RW, Gazzinelli RT and Melo MN (2006). Genetic analysis of natural

recombinant Brazilian Toxoplasma gondii strains by multilocus PCR-RFLP. Infect. Genet. Evol.

:22-31

Gagne SS (2001). Toxoplasmosis. Prim Care

Update Obstet. Gynecol. 8: 122-126.

Guerina NG, Hsu HW, Meissner HC, Maguire JH, Lynfield R and Stenchenberg B (1994). Neonatal

serologic screening and early treatment for congenital Toxoplasma gondii infection. The new England

Regional Toxoplasma Working Group. New Engl. J. Med. 330: 1858-1863

Hayashi S, Chan CC, Gazinelli R and Roberge FG (1996). Contribution of nitric oxide to the host

parasite equilibrium in toxoplasmosis. J. Immunol.

: 1476-1481.

Hill D and Dubey J P (2000). Toxoplasma gondii: transmission, diagnosis and prevention. Clin.

Microbiol. Infect. 8: 634-640.

Hoeprich PD, Jordan MC and Ronald AR (1994). Infectious Diseases: A treatise of infections

processes. Lippin colf-Raven publishers. Pp:

-1213.

Howe DK and Sibley LD (1995). Toxoplasma gondii comprises three clonal lineages: correlation of

parasite genotype with human disease. J. Infect. Dis. 172: 1561-1566.

Hunter CA and Remington JS (1994).

Immunopathogenesis of Toxoplasmic encephalitis. J. Infect. Dis. 179:1057-1067.

Isaac – Renton J, Bowie WR and King A (1998). Detection of Toxoplasma gondii oocysts in drinking

water. Appl. Environ. 64: 2278-2280.

Jones J, Lopez A and Wilson M (2003). Congenital Toxoplasmosis. J. Am. Family Phy.

: 2131-2138.

Jones BL, Torrey EF, and Yolken R (2003). Drugs in the treatment of schizophrenia and bipolar

disorder inhibit the replication of Toxoplasma gondii. Schizophr. Res. 62: 237-244.

Kahn IA, Matsurra T and Kasper LH (1996). IL-12 enhances murine survival against acute

toxoplasmosis. Infect. Immun. 611:1976-1980.

Kahn IA, Smith KA, and Kasper LH (1990). Induction of antigen specific human cytotoxic T cells by

Toxoplasma gondii. J. Clin. Invest.

:1879-1885

Kasper LH and Mineo JR (1994). Attachment and invention of host cell by Toxoplasma gondii

Parasitol. Today. 10: 82-85.

Kur J, Holec-Gasior L, Hiszczyńska-Sawicka E (2009). Current status of toxoplasmosis vaccine

development. Expert Rev. Vaccines. 8: 791-808

Lynfield R and Guerina NG (1997). Toxoplasmosis. Pediatr. Rev. 18: 75

Manger LD, Hehl AB and Boothroyd JC (1998). The surface of Toxoplasma tachyzoite is dominated by a

family of glycosyphosphati- dylinositol-anchored antigens related to SAG-I. Infect. Immun. 66:

-2244.

Martin F (2000). Congenital toxoplasmosis: Value of antenatal screening and current prenatal

treatment. TSMJ. 1:46-51

Matowicka-Karna J, Dymicka-Piekarska V, Kemona H (2009). Does Toxoplasma gondii infection affect

the levels of IgE and cytokines (IL-

, IL-6, IL-10, IL-12, and TNF-alpha)? Clin. Dev.

Immunol. 37: 46-96

Mordue DG, Monroy F, La-Regina M, Dinardlo CA

and Sibley LD (2001). Acute toxoplasmosis leads to lethal overproduction of Th I cytokines. J.

Immunol. 167:4574-4584.

Mosmann TR and Moore KW (1991). The role of IL-10 in cross regulation at Th1 and Th2 responses.

Immunol. Parasitol. Today. 12: 49-53

Okoh AEJ, Agbonlahor DE, Momoh M (1981). Toxoplasmosis in Nigeria: A serological survey Trop.

Anim. Health Prod. 13:137-143

Onadeko MO, Joynson DH, Payne RA, Francis J (1996). The prevalence of toxoplasma antibodies in

pregnant Nigerian women and the occurrence of stillbirth and congenital malformation. Afr. J. Med.

Medic. Sci. 25:331-334

Pedrol E, Gonzalez Clement JM, Gantell JM, Mallolas J, Miro M and Graus F (1990). Central nervous

system toxoplasmosis in AIDS patients: efficacy of intermittent maintenance therapy. AIDS.

: 511-517

Peyron F, Wallon M, and Bernadoux C. (1996). Long term follow up of patients with congenital ocular

toxoplasmosis. N. Engl. J. Med. 334: 993-

Peyron F, Lobry J, Muret K, Ferrandiz J, Gomez- Marin JE and Petersen E (2006). Serotyping of

Toxoplasma gondii in pregnant women. Predominance of type II in the old world and type I and III in

the new world. Microb. Infect. 8: 2333-

Pinon JM, Dumon G and Chemla C (2001). Strategy for diagnosis of congenital toxoplasmosis:

evaluation of methods comparing mothers and newborns and standard methods of post-natal detection

of immunoglobulin G, M and IgA antibodies J. Clin. Microbiol. 39: 2267-2271.

Prášil P (2009). Current options for the diagnosis and therapy of toxoplasmosis in HIV-negative

patients. Klin. Mikrobiol. Infekc. Lek. 15 : 83-90

Remington JS, Mcleod R and Desmonts G (1995). Toxoplasmosis. In: Remington J. S and Klein J.

O. eds. Infectious disease of the foetus and newborn. Infant Philadelphia: W. B. Saunders Company.

Pp: 140-267.

Roberts F and Mcleod R (1999). Pathogenesis of

toxoplasmic retinochoroiditis. Parasitol. Today.

: 51-57.

Robert F, Gavnet MF, Anelle T, Raymond J, Tourte CT, and Dupouy CJ (1999). Value of prenatal

diagnosis of congenital toxoplasmosis; retrospective study of 110 cases. J. Clin. Microbiol.

: 2893-2898.

Rosso F, Les JT, Agudelo A, Villalobos C, Chaves JA, Tunubala GA, Messa A, Remington JS and Montoya

JG (2008). Prevalence of Infection with Toxoplasma gondii among Pregnant Women in Cali, Colombia,

South America. Am. J. Trop. Med. Hyg. 78: 504-508.

Robert-Gangneux F, Yera H, D'Herve D, Guiguen C (2009). Congenital toxoplasmosis after a

preconceptional or periconceptional maternal infection. Pediatr Infect. Dis. J. 28:660-661

Rusiňáková Z, Raida L, Faber E, Tomková J, Bednaříková J, Indrák K, Novotný D (2009). Toxoplasmosis

after immunossuppressive therapy

- our experience. Klin. Mikrobiol. Infekc. Lek. 15:

-98.

Safadi MAP, Berezin EN, Farhat EK and Carvalho ES (2003). Clinical presentation and follow up of

children with congenital toxoplasmosis in Brazil. Brazilian J Infect Dis 7:325-331

Shaw SK, Hermanowski – Vosatka A, Shibahara T, McCommick BA, Parkos CA, Carlson SL, Ebert EA,

Brenner MB and Madara JL (1998). Migration of intestinal intraepithelial lymphocytes into a

polarized epithelial monolayer. Am. J. Physiol.

: 584-591

Sher A, Denkers EY and Gazzinelli RT (1995). Induction and regulation of host cell mediated

immunity by Toxoplasma gondii. Ciba Found Symp. 195: 95-104.

Shrittematter C, Lang W, Wiestter OD, Kleihues P (1992). The changing pattern of HIV associated

cerebral toxoplasmosis. Acta. Neuropathol. 8:

-481.

Silveira C, Belfort R. Jr, Muccioli C, Abreu M. T. Martins M. C and Victoria C (2001). A follow upstudy of Toxoplasma gondii infection in southern

Brazil. Am. J. Opthamol. 13:351-354.

Singh S, Lodha R, Passi G. R and Bhan MK. (1998). Cholangitis due to congenital Toxoplasma gondii

infection in an infant. Indian J. Paediatr.

:77-80.

Singh S (2003). Mother to child transmission and diagnosis of Toxoplasma gondii infection during

pregnancy. Indian J. Med. Microbiol. 21: 69-76.

Suzuki IA, Rosha RJ and Rossi CL (2001). Evaluation of serological markers for the immunodiagnosis

of acute acquire toxoplasmosis. J. Med. Microbiol. 50: 62-70.

Torrey FE and Robert YH (2003). Toxoplasma gondii and Schizophrenia. Emerg. Infect. Dis.

:1375-1380.

Varella IS, Canti IC, Santos BR, Coppini AZ, Argondizzo LC, Tonin C, Wagner MB (2009). Prevalence

of acute toxoplasmosis infection among 41,112 pregnant women and the mother- to-child transmission

rate in a public hospital in

South Brazil. Mem Inst Oswaldo Cruz. 104: 383-

Villena I, Chemla C, Quereux C, Dupony D, Leroux B, Foudrinier F and Pirion JM (1998).

Prenatal diagnosis of congenital toxoplasmosis transmitted by an immunocompetent woman infected

before conception. Reims Toxoplasmosis group. Prenat. Diagn. 18 :1079-1081.

Wan KL, Carrathers VB, Sibley LD and Ajoka JN (1997). Molecular characterization of an

expressed sequence tag locus of Toxoplasma gondii Mic-2. Mol. Biochem. Parasitol. 84: 203-




Copyright © 2018. Sierra Leone Journal of Biomedical Research