Prevalence of anti-toxoplasma Gondii antibodies in Turkish blood donors

OBJECTIVE: Toxoplasmosis is caused by an obligate intracellular protozoan parasite, Toxoplasma gondii. Most of these infections are asymptomatic or benign, but may cause severe or fatal consequences in immunodeficient patients, transplant recipients, and in the fetus. Transmission may occur by eating uncooked meat, contaminated vegetables, blood transfusion, organ transplantation, and across the placenta from the mother to the fetus. IgG antibodies to T. gondii may persist in the serum at high titers for years. In the present study, our aim was to determine prevalence of anti- T. gondii IgG and IgM antibodies in Turkish blood donors. METHODS: A total samples from 385 healthy blood donors from Kayseri, Turkey were examined for anti- T. gondii antibodies by indirect fluorescent antibody test (IFAT) and enzyme-linked immunosorbent assay (ELISA). RESULTS: The seroprevalence of the anti- T. gondii IgG and IgM antibodies was 19.5%, 2.33% respectively by IFAT and 20.25%, 2.33% by ELISA. CONCLUSION: It is suggested that all blood donors should be screened for toxoplasmosis before transfusion     

Prevalence and genotyping of Toxoplasma gondii among Saudi pregnant women in Saudi Arabia

Introduction: Toxoplasma gondii (T. gondii) is an intracellular protozoan that can infect all mammals, who serve as intermediate host. It causes congenital, neurological, eyes complications and mild or asymptomatic infections in humans. Purpose of this study: To investigate not only the prevalence of T. gondii, but also to find out its genotyping using multiple sequential molecular methods to predict exactly the precise genotyping of T. gondii among Saudi pregnant women. Methods: A cross-sectional study was conducted using multi-stage methods. Initial stage involved enrolment of 250 Saudi pregnant women from multi-centre healthcare and community based settings in the capital of Saudi Arabia Riyadh. The second stage was embracement of the laboratory investigation that included Enzyme immunoassay (ELISA), DNA extraction, PCR, nested-PCR assay, and genotyping of the seropositive cases. Results: 203 women agreed to take part in our study with a response rate of 81.2% (203/250). Using ELISA, we found that the prevalence of Toxoplasma gondii IgG and IgM antibodies was 32.5% and 6.4%, respectively. We found that 29 samples (80.6%) were of genotype II; however 7 samples (19.4%) were of genotype III. Conclusion: Defining the population structure of T. gondii from Saudi Arabia has important implications for transmission, immunogenicity, pathogenesis, and in planning preventive strategies. Relationship between such variation in structure and disease manifestation in pregnant women is still difficult to assess due to the role of host immune status and genetic background on the control of infection, and of other parasitic features such as the infecting dose or parasite stage. Our finding of the genotyping of T. gondii might facilitate and inform future studies on comparative genomics and identification of genes that control important biological phenotypes including pathogenesis and transmission among Saudi women.     

弓形体SAG1基因DNA诱导小鼠体液免疫应答及保护性研究

目的 :用重组真核表达质粒 pc DNA3- SAG1直接免疫 BAL B/ c小鼠 ,观察其 DNA免疫所诱导的小鼠体液免疫反应和保护性作用。方法 :大量制备重组质粒 pc DNA3- SAG1,然后将其导入 BAL B/ c小鼠体内。抗体滴度用 EL ISA法进行测定 :采用 PCR方法对小鼠的血液组织外源基因进行检测 ;对试验组及对照组进行 RH株攻击感染 ,并对其进行分析。结果 :用 EL ISA法检测的抗体 Ig G滴度为 1∶ 2 5 6 0 ;免疫后三周、六个月从免疫鼠的血液组织中用 PCR仍可检测到特异的SAG1基因的存在 :体外弓形虫攻击感染实验组和对照组 ,可见实验组的存活时间较对照组时间延长 (P<0 .0 5 )。结论 :重组质粒 pc DNA3- SAG1免疫 BAL B/ c小鼠可诱导一定的体液免疫应答和一定的保护性作用     

弓形虫IgM抗体检测试剂临床研究要点

目的详细解析弓形虫IgM抗体检测试剂临床试验方法及注意事项。方法参照我国现行相关法规要求,在充分考虑本类试剂自身的特点的前提下,对其临床试验中应注意的法规问题和关键点进行了阐述。结果与结论弓形虫IgM抗体定性检测试剂在临床研究中应注意样本选择、试验方法等方面的特殊性,紧扣其临床预期用途进行充分的临床验证。     

Usage of penicillinase as an enzyme marker in enzyme linked immunosorbent assay for the detection of IgG antibodies to Toxoplasma gondii.

An Enzyme linked immunosorbent assay system has been developed using penicillinase as an enzyme marker for the detection of IgG antibodies to Toxoplasma gondii. This system is simple (end result assessed visually) reliable (the results are matching with other available commercial ELISA based kit), sensitive (detection of antitoxoplasma IgG antibodies to a level of 15 IU/ml) and reproducible (4.3 & 6.7% intra and inter coefficient of variation respectively). Experimental results with human serum samples using our system has shown consistent results and were in total agreement with other commercially available diagnostic kits. It is therefore suggested that ELISA system using penicillinase can be a simple, sensitive and reliable method for the diagnosis of toxoplasmosis in human.     

无锡地区62141例育龄期妇女TORCH检测结果与季节性变化的相关性分析

目的 通过化学发光免疫分析法检测无锡地区育龄期妇女血清TORCH抗体,并对结果按季节进行统计分析,了解无锡地区育龄妇女TORCH感染情况及其流行特点,为本地区育龄期妇女保健提供一定的参考依据.方法 选择产前检查的62 141例育龄期妇女为研究对象,对TORCH病毒原体弓形虫(TOX)、风疹病毒(RV)、巨细胞病毒(CMV)、单纯疱疹病毒(HSV)进行检测.结果 TORCH四种病原体TOX、RV、CMV以及HSV的免疫球蛋白M(IgM)抗体阳性率依次为1.25‰(77/61 452)、2.66‰(163/61 381)、0.37‰(23/61 387)、129.41‰(7 872/60 829),anti-HSV IgM抗体阳性率远高于其他三种IgM抗体阳性率;anti-CMV IgM、anti-RV IgM、anti-TOX IgM、anti-HSV IgM抗体阳性率总体呈现逐年上升的趋势;统计结果显示,秋、冬季为巨细胞病毒感染高发期(anti-CMV IgM阳性检出率分别为39％、35％),而TOX、RV、HSV的感染率并无明显的季节性变化.结论 育龄期妇女和医疗人员需提高对TORCH感染的季节性认识,同时有针对性的按季节性对孕妇进行TORCH检测,可及时了解孕妇TORCH感染情况,尽早采取方法和措施,对人口的优生优育具有重要意义.     

弓形虫STAg免疫小鼠后血清抗体水平的动态检测

目的 观察弓形虫可溶性速殖子抗原(STAg)免疫小鼠后,小鼠血清IgG抗体水平的动态变化,探索STAg抗原的最佳免疫次数.方法 5～6周龄BALB/c小鼠20只,随机分成对照组和实验组,其中对照组头背部皮下注射生理盐水,实验组头背部皮下注射20 μg STAg,免疫5次,每次免疫1周后取5只小鼠,采血并分离血清,通过ELISA法测定IgG抗体;通过Western Blot方法检测血清中产生的IgG和IgM抗体条带.结果 第二次免疫后小鼠血清IgG值明显高于初次免疫小鼠的血清IgG值,差异有统计学意义;但是.Western Blot检测的IgG抗体条带颜色未明显增强.第四次免疫后小鼠血清IgG再次增高并达到峰值,同时第四次免疫后小鼠血清中的IgG抗体条带的反应颜色也明显变深.结论 利用STAg免疫小鼠,免疫2次就会产生明显的免疫效果,但是免疫4次可进一步有效提高小鼠的免疫力.     

Screening for small molecule inhibitors of Toxoplasma gondii

Introduction: Toxoplasma gondii, the agent that causes toxoplasmosis, is an opportunistic parasite that infects many mammalian species. It is an obligate intracellular parasite that causes severe congenital neurological and ocular disease mostly in immunocompromised humans. The current regimen of therapy includes only a few medications that often lead to hypersensitivity and toxicity. In addition, there are no vaccines available to prevent the transmission of this agent. Therefore, safer and more effective medicines to treat toxoplasmosis are urgently needed.

Areas covered: The author presents in silico and in vitro strategies that are currently used to screen for novel targets and unique chemotypes against T. gondii. Furthermore, this review highlights the screening technologies and characterization of some novel targets and new chemical entities that could be developed into highly efficacious treatments for toxoplasmosis.

Expert opinion: A number of diverse methods are being used to design inhibitors against T. gondii. These include ligand-based methods, in which drugs that have been shown to be efficacious against other Apicomplexa parasites can be repurposed to identify lead molecules against T. gondii. In addition, structure-based methods use currently available repertoire of structural information in various databases to rationally design small-molecule inhibitors of T. gondii. Whereas the screening methods have their advantages and limitations, a combination of methods is ideally suited to design small-molecule inhibitors of complex parasites such as T. gondii.     

Cell-host-parasite interactions: biodiversity, pathogenesis, environment

The apicomplexan Toxoplasma gondii, an obligate intracellular parasite, can infect humans and a wide range of vertebrates leading to toxoplasmosis. This generally benign affection can causes severe life-threatening disease, particularly in immunocompromised patients and in children with congenital toxoplasmosis. Our research team works on cell-host-parasite interactions by studying biodiversity, pathogenic mechanisms and environment. We search to identify prognostic factors of disease and markers of resistance. This project is an integral part of our Research Institute (IFR53) which receives support from the Toxoplasma Biological Resource Center for constituting a bank of well characterized toxoplasma isolates for genotyping, clinical and epidemiological data. The involvement of metalloproteinases implicated during monocytic cell invasion and identification of ABC transporter proteins in T. gondii, factors implicated in resistance, need to be explored.     

广东省8615例不孕症和捐精人群TORCH感染情况分析

目的了解广东省不孕症和捐精人群TORCH感染情况。方法采用酶联免疫法对8615例来我院就诊不孕症患者和捐精人群进行弓形虫（TOX）、风疹病毒（RUV）、巨细胞病毒（CMV）、单纯疱疹病毒（HSV）IgM抗体检测。结果 8035例不孕症患者弓形虫、风疹病毒、巨细胞病毒、单纯疱疹病毒IgM抗体阳性率分别为0.91%、1.85%、2.66%、1.80%,总阳性率为7.22%;580例捐精人群抗体阳性率分别为0.69%、0.34%、1.38%、0.86%,总阳性率为3.28%。结论 TORCH感染是引起不良妊娠结局和导致不孕原因的重要危险因素,应重视TORCH病原体感染的早期筛查。     

A seroepidemiological study of toxoplasma gondii infection in children of northern Greece

The aims of this study were to determine the incidence of toxoplasmosis in children ofthe northern Greece region through the evaluation of serologic examination. Sera of 486 children, aged between 6 months and 15 years, suffering from different clinical entities, were tested for anti-Toxoplasma gondii specific IgG antibodies, using an ELISA (enzyme linked immunosorbent assay) technique. In this survey, a high percentage (11.1 percent) of the hospitalized children reacted positively to this method. Males and females had equal prevalence, 11 percent and 11.2 percent, respectively. Seropositivity rate was higher in children aged between 6 and 10 years old. In conclusion, our results indicate toxoplasma infection is an important public health problem affecting children and adolescents in northern Greece. We believe that the study described here could be considered for inclusion in existing national screening programs for hospitalized children.     

Antiseizure medications use during pregnancy and congenital malformations: A retrospective study in Saudi Arabia

AimTo evaluate the incidence of congenital malformations in children exposed prenatally to antiseizure medications (ASMs), to assess other perinatal and fetal complications, and to determine the potential predictors for these complications.MethodA retrospective review of pregnancy outcomes of women with epilepsy. Patients were followed up at the King Faisal Specialist Hospital and Research Centre, Riyadh and Jeddah, Saudi Arabia, between Dec 1993 and Oct 2020.ResultsOf 162 pregnancies included, 10 (6.17%) congenital malformations were observed, 6.82% in ASM-exposed babies versus 3.33% in babies of epilepsy-untreated mothers (P = 0.69). The overall incidence of perinatal and fetal complications was 53%; most frequent were low birth weight (24%), preterm birth (19%), transfer to neonatal intensive care unit (18%) and abortion (8%). These complications were higher in the untreated group (66.67%) than in the ASM group (50%). The use of other non-antiseizure medications during pregnancy was the only factor that significantly increased the risk of complications.ConclusionPrenatal exposure to ASMs was associated with increased risk of congenital malformations. However, overall perinatal and fetal complications were higher in the untreated group than in the ASM group, which could be explained by maternal seizures. Therefore, taking ASMs to control epilepsy and prevent perinatal complications may outweigh the risks of teratogenicity.     

Congenital toxoplasmosis—prenatal aspects of Toxoplasma gondii infection

Toxoplasma gondii (T. gondii) is the cause of toxoplasmosis. Primary infection in an immunocompetent person is usually asymptomatic. Serological surveys demonstrate that world-wide exposure to T. gondii is high (30% in US and 50–80% in Europe). Vertical transmission from a recently infected pregnant woman to her fetus may lead to congenital toxoplasmosis. The risk of such transmission increases as primary maternal infection occurs later in pregnancy. However, consequences for the fetus are more severe with transmission closer to conception. The timing of maternal primary infection is, therefore, critically linked to the clinical manifestations of the infection. Fetal infection may result in natural abortion. Often, no apparent symptoms are observed at birth and complications develop only later in life. The laboratory methods of assessing fetal risk of T. gondii infection are serology and direct tests.Screening programs for women at childbearing age or of the newborn, as well as education of the public regarding infection prevention, proved to be cost-effective and reduce the rate of infection.The impact of antiparasytic therapy on vertical transmission from mother to fetus is still controversial. However, specific therapy is recommended to be initiated as soon as infection is diagnosed.     

178名新生儿单纯疱疹病毒1型和巨细胞病毒血清抗体检测分析

目的  了解新生儿单纯疱疹病毒1型（herpes simplex virus type 1,HSV-1）和人巨细胞病毒（human cytomegalovirus,HCMV）血清抗体阳性情况及其与早产儿临床表现的关系。方法  收集新生儿血清共178份（其中健康产妇顺产新生儿脐带血血清114份,早产儿外周血血清64份）,分别用HSV-1和HCMV IgG、IgM ELISA试剂盒进行检测。采用χ2检验对结果进行比较。结果  178名新生儿中,血清HSV-1 IgG阳性率为83.70%,IgM为阴性;HCMV IgG和IgM阳性率分别为94.38%和0.56%。其中114名顺产新生儿中,HSV-1 IgG和IgM阳性率分别为78.07%和0.00%,HCMV IgG和IgM阳性率分别为94.74%和0.88%,HSV-1 IgG和HCMV IgG共阳性率为73.68%。在64名早产儿中,HSV-1 IgG和IgM阳性率分别为93.75%和0.00%,HCMV IgG和IgM阳性率分别为93.75%和0.00%,HSV-1 IgG和HCMV IgG共阳性率为87.50%。早产儿与顺产儿的HCMV IgG阳性率差异无统计学意义（χ2=0.07,P>0.05）;但早产儿HSV-1 IgG阳性率以及HSV-1 IgG和HCMV IgG共阳性率均高于顺产儿,且差异有统计学意义（χ2值分别为7.38和4.65,P值均<0.05）。HSV-1 IgG和HCMV IgG阳性早产儿出现胎膜早破、胎盘早剥、羊水过少、羊水污染和皮肤异常的几率明显高于阴性早产儿。结论  本次检测的新生儿HSV-1 IgG和HCMV IgG阳性率较高,且两者阳性的早产儿可能伴随胎膜早破等临床表现。     

抗心磷脂抗体和抗β2-GP1抗体与子痫前期的相关性研究

目的 探讨抗心磷脂抗体和抗β2-GP1抗体与子痫前期发病的关系.方法 对30例子瘸患者及30例同期住院分娩的正常孕妇,用ELISA法定量检测其母血血清抗心磷脂抗体和抗β2-GP1抗体的滴度值.结果 子痫前期患者ACA-IgG、IgM和抗β2-GP1抗体的阳性率显著高于正常对照组(P<0.05),正常对照及轻、重子痫前期三组孕妇血清ACA-IgG、IgM和抗β2-GP1抗体的滴度值差异有统计学意义(P<0.05).结论 子痫前期患者母血ACA-Igc、IgM和抗β2-GP1抗体的阳性率、滴度值显著高于正常对照组,提示抗心磷脂抗体和抗β2-GP1抗体可能参与了子痫前期的发生发展过程,与子痫前期的.发病具有相关性,孕期检测抗心磷脂抗体和抗β2-GP1抗体对预测子痫前期患者疾病发展有重要价值,为子痫前期的诊断与治疗提供了新的途径.     

孕妇产前不规则抗体筛查在新生儿溶血病预防中的意义

目的检测孕妇产前IgG抗A／B抗体效价,探讨孕妇产前不规则抗体筛查在新生儿溶血病预防中的意义。方法对317例夫妻血型不合的孕妇进行产前抗A／B IgG抗体效价测定,并对IgG类抗A／B效价≥1：64的孕妇给予临床干预,观察产后婴儿是否发生溶血,溶血出现的时间及程度;同时随机选择317例夫妻血型不合,产前未做不规则抗体筛查的产妇,调查其婴儿是否发生溶血,溶血出现的时间及程度。结果①试验组,新生儿溶血发生13例（4．10％）,其中24h内发生者1例,48h发生者3例,72h发生者3例,〉72h发生者6例;对照组,新生儿溶血发生49例（15．46％）,其中24h内发生者14例,48h发生者17例,72h发生者15例,〉72h发生者3例;两组比较有统计学意义（P〈0．05）;②对照组新生儿黄疸平均出现时间（53．39±26．95）h;试验组（77．54±29．64）h,试验组新生儿黄疸出现时间较对照组晚;③对照组黄疸程度较试验组严重的,两组比较差异有统计学意义（P〈0．05）。结论孕妇产前ABO血清IgG抗A／B抗体效价测定可作为判断胎儿出生后是否发生新生儿溶血病的筛查指标。对降低新生儿母婴血型不合引起的新生儿溶血病具有积极作用。     

An investigation into the incidence of toxoplasmosis in pregnancy in New Zealand

AIM: To estimate the incidence of toxoplasmosis in pregnancy in New Zealand and consider whether there is a case for screening women in pregnancy. METHODS: The risk of maternal and fetal infection with toxoplasmosis was derived by first determining the rate of maternal seroconversion based on seroprevalence studies. The age-specific number of seroconversions in pregnancy was then estimated from the birth rate. Using reported fetal infection rates after primary maternal infection, the expected number of congenitally infected infants in one year was estimated. These incidences were compared with the number of recognised cases of toxoplasmosis infection in pregnancy and the actual number of positive IgM results at the Wellington Hospital laboratory. Using national births data, this incidence was extrapolated to estimate the number of expected cases in New Zealand. RESULTS: The annual seroconversion rate was 0.62% (95% confidence interval 0.39-0.86). On this basis, 164 primary maternal infections are expected annually with 66 fetuses being infected. Ten patients tested positive for IgM in Wellington, which averaged only one case per year being identified over the time examined in this study. CONCLUSIONS: Very few of the expected cases in pregnancy are diagnosed. Reporting rates were low when toxoplasmosis was a notifiable disease. Other means of improving detection, reporting and the avoidance of infection are discussed. More information is required before screening can be recommended in New Zealand.     

Nurses’ readiness to prescribe under supervision in Saudi Arabia: A cross-sectional study

AimTo explore nurses’ readiness to prescribe medications under supervision and identify associations between prescribing practices under supervision and demographic characteristics in Saudi Arabia.DesignA cross-sectional study.MethodsUsing convenience sampling, this study used a 32-item survey to collect data on nurses prescribing medications under supervision between December 2022 and March 2023.ResultsA total of 379 nurses were recruited from different regions in Saudi Arabia. Approximately 7% (n = 30) of the participants were prescribing medications independently, and 70% (n = 267) expressed their likelihood of becoming prescribers. The highest motivating factors to become prescribers were improvement of patient care (52.2%) and contribution to the multidisciplinary team (52.0%). Most participants (60%–81%) agreed that prescribing medications under supervision would improve potential outcomes at the system, nurse, and patient levels. Availability of appropriate mentors or supervisors (72.9%) was the highest rated facilitating factor, followed by support of nursing colleagues (72%). Based on demographic characteristics, findings revealed significant differences in the: a) likelihood and motivators of becoming prescribers; b) required minimum qualification, years of experience, and continuing professional education hours to become prescribers; and c) type of organizations delivering educational programs for nurse prescribing.ConclusionMajority of nurses in Saudi Arabia favored becoming prescribers, and motivating factors were mostly relevant to optimizing patient care outcomes. Having the proper supervision was rated as the most facilitating factor for nurse prescribing. Nurses’ views on potential outcomes, facilitating factors, and possible motivators varied based on nurses’ demographical characteristics.Implications for the professional and/or patient careNurses favored prescribing under supervision to improve patient care outcomes, which is an opportunity to expand the benefits of health services, including easy access to healthcare.ImpactResults revealed that nurses support the implementation of prescribing practice under supervision. Thus, the findings may inform practice change in Saudi Arabia to allow prescribing under supervision, which was perceived to have a positive impact on patient care outcomes.Reporting MethodThis study adhered to STROBE guidelines.     

New antibacterials for the treatment of toxoplasmosis; a patent review

INTRODUCTION: Toxoplasma gondii is an opportunistic protozoan parasite responsible for toxoplasmosis. T. gondii is able to infect a wide range of hosts, particularly humans and warm-blooded animals. Toxoplasmosis can be considered as one of the most prevalent parasitic diseases affecting close to one billion people worldwide, but its current chemotherapy is still deficient and is only effective in the acute phase of the disease. AREAS COVERED: This review covers different approaches to toxoplasmosis chemotherapy focused on the metabolic differences between the host and the parasite. Selective action on different targets such as the isoprenoid pathway, dihydrofolate reductase, T. gondii adenosine kinase, different antibacterials, T. gondii histone deacetylase and calcium-dependent protein kinases is discussed. EXPERT OPINION: A new and safe chemotherapy is needed, as T. gondii causes serious morbidity and mortality in pregnant women and immunodeficient patients undergoing chemotherapy. A particular drawback of the available treatments is the lack of efficacy against the tissue cyst of the parasite. During this review a broad scope of several attractive targets for drug design have been presented. In this context, the isoprenoid pathway, dihydrofolate reductase, T. gondii histone deacetylase are promising molecular targets.