Congenital and acquired toxoplasmosis: diversity and role of antibodies in different compartments of the host

Congenital parasitic infections: a review

This review defines the concepts of maternal-fetal (congenital) and vertical transmissions (mother-to-child) of pathogens and specifies the human parasites susceptible to be congenitally transferred. It highlights the epidemiological features of this transmission mode for the three main congenital parasitic infections due to Toxoplasma gondii, Trypanosoma cruzi and Plasmodium sp. Information on the possible maternal-fetal routes of transmission, the placental responses to infection and timing of parasite transmission are synthesized and compared. The factors susceptible to be involved in parasite transmission and development of congenital parasitic diseases, such as the parasite genotypes, the maternal co-infections and parasitic load, the immunological features of pregnant women and the capacity of some fetuses/neonates to overcome their immunological immaturity to mount an immune response against the transmitted parasites are also discussed and compared. Analysis of clinical data indicates that parasitic congenital infections are often asymptomatic, whereas symptomatic newborns generally display non-specific symptoms. The long-term consequences of congenital infections are also mentioned, such as the imprinting of neonatal immune system and the possible trans-generational transmission. The detection of infection in pregnant women is mainly based on standard serological or parasitological investigations. Amniocentesis and cordocentesis can be used for the detection of some fetal infections. The neonatal infection can be assessed using parasitological, molecular or immunological methods; the place of PCR in such neonatal diagnosis is discussed. When such laboratory diagnosis is not possible at birth or in the first weeks of life, standard serological investigations can also be performed 8-10 months after birth, to avoid detection of maternal transmitted antibodies. The specific aspects of treatment of T. gondii, T. cruzi and Plasmodium congenital infections are mentioned. The possibilities of primary and secondary prophylaxes, as well as the available WHO corresponding recommendations are also presented.

Molecular cloning and characterization of mitogen-activated protein kinase 2 in Toxoplasma gondii

Mitogen-activated protein kinase (MAPK) pathways are major signal transduction systems by which eukaryotic cells convert environmental cues to intracellular events, such as cell proliferation and differentiation. Toxoplasma gondii is an obligate intracellular protozoan that is both a human and animal pathogen. This Apicomplexan causes significant morbidity and mortality in immune-competent and immune-compromised hosts. In humans, the most common manifestations of T. gondii infections are chorioretinitis in congenital infection and encephalitis in immune-compromised patients, such as patients with advanced AIDS. We have identified a T. gondii homolog of the MAPK family that we have called TgMAPK2. Sequence analyses demonstrated that TgMAPK2 has homology with lower eukaryotic ERK2 but has significant differences from mammalian ERK2. TgMAPK2 has an open reading frame of 2,037 bp, 678 amino acids, and its molecular weight is 73.1 kDa. It contains the typical 12 subdomains of a MAPK and has a TDY motif in the dual phosphorylation and activation subdomains. This suggests that TgMAPK2 may play an important role in stress response. recombinant TgMAPK2 was catalytically active and was not inhibited by a human ERK2 inhibitor, FR180204. A partial TgMAPK2 lacking the ATP-binding motifs GxGxxGxV was successfully regulated by a ligand-controlled destabilization domain (ddFKBP) expression vector system in T. gondii. Since TgMAPK2 is significantly different from its mammalian counterpart, it may be useful as a drug target. This work establishes a foundation for further study for this unique kinase.

Oral administration of a probiotic Lactobacillus modulates cytokine production and TLR expression improving the immune response against Salmonella enterica serovar Typhimurium infection in mice

Background

Diarrheal infections caused by Salmonella, are one of the major causes of childhood morbidity and mortality in developing countries. Salmonella causes various diseases that range from mild gastroenteritis to enteric fever, depending on the serovar involved, infective dose, species, age and immune status of the host. Probiotics are proposed as an attractive alternative possibility in the prevention against this pathogen infection. Previously we demonstrated that continuous Lactobacillus casei CRL 431 administration to BALB/c mice before and after challenge with Salmonella enterica serovar Typhimurium (S. Typhimurium) decreased the severity of Salmonella infection. The aim of the present work was to deep into the knowledge about how this probiotic bacterium exerts its effect, by assessing its impact on the expression and secretion of pro-inflammatory (TNFα, IFNγ) and anti-inflammatory (IL-10) cytokines in the inductor and effector sites of the gut immune response, and analyzing toll-like receptor (TLR2, TLR4, TLR5 and TLR9) expressions in both healthy and infected mice.

Results

Probiotic administration to healthy mice increased the expression of TLR2, TLR4 and TLR9 and improved the production and secretion of TNFα, IFNγ and IL-10 in the inductor sites of the gut immune response (Peyer's patches). Post infection, the continuous probiotic administration, before and after Salmonella challenge, protected the host by modulating the inflammatory response, mainly in the immune effector site of the gut, decreasing TNFα and increasing IFNγ, IL-6 and IL-10 production in the lamina propria of the small intestine.

Conclusions

The oral administration of L. casei CRL 431 induces variations in the cytokine profile and in the TLRs expression previous and also after the challenge with S. Typhimurium. These changes show some of the immune mechanisms implicated in the protective effect of this probiotic strain against S. Typhimurium, providing an alternative way to reduce the severity of the infection.

Comprehensive proteomic analysis of membrane proteins in Toxoplasma gondii

Toxoplasma gondii (T. gondii) is an obligate intracellular protozoan parasite that is an important human and animal pathogen. Experimental information on T. gondii membrane proteins is limited, and the majority of gene predictions with predicted transmembrane motifs are of unknown function. A systematic analysis of the membrane proteome of T. gondii is important not only for understanding this parasite's invasion mechanism(s), but also for the discovery of potential drug targets and new preventative and therapeutic strategies. Here we report a comprehensive analysis of the membrane proteome of T. gondii, employing three proteomics strategies: one-dimensional gel liquid chromatography-tandem MS analysis (one-dimensional gel electrophoresis LC-MS/MS), biotin labeling in conjunction with one-dimensional gel LC-MS/MS analysis, and a novel strategy that combines three-layer "sandwich" gel electrophoresis with multidimensional protein identification technology. A total of 2241 T. gondii proteins with at least one predicted transmembrane segment were identified and grouped into 841 sequentially nonredundant protein clusters, which account for 21.8% of the predicted transmembrane protein clusters in the T. gondii genome. A large portion (42%) of the identified T. gondii membrane proteins are hypothetical proteins. Furthermore, many of the membrane proteins validated by mass spectrometry are unique to T. gondii or to the Apicomplexa, providing a set of gene predictions ripe for experimental investigation, and potentially suitable targets for the development of therapeutic strategies.

Diagnosis of systemic toxoplasmosis with HIV infection using DNA extracted from paraffin-embedded tissue for polymerase chain reaction: a case report

Introduction

Toxoplasmosis can be a life-threatening disease when it occurs in patients with HIV infection. In particular, meningioencephalitis has been regarded as the most common toxoplasmic complication in such patients. However, toxoplasmic meningitis in a patient with HIV infection is extremely rare and purulent or tuberculous meningitis should be considered initially as a disease for differential diagnosis in Japan.

Case presentation

Toxoplasmic meningitis in a patient with HIV infection is reported. A 36-year-old Japanese man presented with fever, pulsating headache, lumbago, nausea, and vomiting. No examinations suggested toxoplasmosis including cerebrospinal fluid examinations, images, and serological tests. The result of a polymerase chain reaction assay using paraffin-embedded section was regarded as the conclusive evidence for the diagnosis.

Conclusions

We wish to emphasize the usefulness of polymerase chain reaction assays with nucleic acid extracted from paraffin-embedded tissue sections processed for routine histopathological examination, if the section shows the infectious agents or findings suggesting some infectious diseases.

Congenital toxoplasmosis: candidate host immune genes relevant for vertical transmission and pathogenesis

Toxoplasma gondii infects a variety of vertebrate hosts, including humans. Transplacental passage of the parasite leads to congenital toxoplasmosis. A primary infection during the first weeks of gestation causes vertical transmission at low rate, although it causes major damage to the embryo. Transmission frequency increases to near 80% by the end of pregnancy, but the proportion of ill newborns is low. For transmission and pathogenesis, the parasite genetics is certainly important. Several host innate and adaptative immune response genes are induced during infection in adults, which control the rapidly replicating tachyzoite. The T helper 1 (Th1) response is protective, although it has to be modulated to avoid inflammatory damage. Paradoxical observations on this response pattern in congenital toxoplasmosis have been reported, as it may be protective or deleterious, inducing sterile abortion or favoring parasite transplacental passage. Regarding pregnancy, an early Th1 microenvironment is important for control of infectious diseases and successful implantation, although it has to be regulated to support trophoblast survival. Polymorphism of genes involved in these parallel phenomena, such as Toll-like receptors (TLRs), adhesins, cytokines, chemokines or their receptors, immunoglobulins or Fc receptors (FcRs), might be important in susceptibility for T. gondii vertical transmission, abortion or fetal pathology. In this study some examples are presented and discussed.

In utero and at birth diagnosis of congenital toxoplasmosis: use of likelihood ratios for clinical management

BACKGROUND

The results of the ante- and neonatal diagnostic tests for congenital toxoplasmosis influence the decision to treat the newborn immediately after birth. Here, we estimate the positive and negative likelihood ratios (LRs) and the probabilities of congenital infection according to PCR and IgM-IgA tests results.

METHODS

The study concerned 767 children born between 1996 and 2002 and followed-up for 1-year at Croix-Rousse hospital, Lyon, France. The LRs and the post-test probabilities were estimated conditionally on gestational age at maternal infection using a logistic regression approach.

RESULTS

For the PCR and the IgM-IgA tests, the positive LRs were high. In children with one positive test when only one test was done, the probability of infection reached 90% when the maternal infection occurred at 18-weeks gestation or later. This probability was close to 100% when the 2 tests were positive, whatever the gestational age. The negative LRs of the 2 tests moved closer to 0 at later gestational ages. However, when the tests were negative, the probability of infection remained greater or equal to 10%, except in early maternal infection. When the 2 tests were discordant, the probability of infection was about 50% in early maternal infection.

CONCLUSION

Providing reliable probabilities of congenital infection, the PCR and IgM-IgA tests guide clinical management and counseling of parents.

Induction of mitotic S-phase of host and neighboring cells by Toxoplasma gondii enhances parasite invasion

The intracellular parasite Toxoplasma gondii extensively modifies its host cell so as to efficiently grow and divide. Among these cellular changes, T. gondii alters the cell cycle of host cells it has invaded. We found that T. gondii affects the cell cycle of not only the cells it directly invades, but neighboring cells as well. Both direct invasion by T. gondii and exposure to filtered medium from cultures of T. gondii-infected cells (conditioned medium) caused normally quiescent fibroblasts to enter S-phase. T. gondii has been shown to attach to and invade S-phase host cells more readily, and we found that conditioned medium increased the rate of invasion of T. gondii into new host cells. Thus it appears that T. gondii directly releases, or induces parasitized host cells to release, a factor that induces neighboring cells to enter S-phase, allowing more rapid invasion by extracellular T. gondii and providing a possible selective advantage for the parasite.

Altered endochondral ossification in collagen X mouse models leads to impaired immune responses

Disruption of collagen X function in hypertrophic cartilage undergoing endochondral ossification was previously linked to altered hematopoiesis in collagen X transgenic (Tg) and null (KO) mice (Jacenko et al., [2002] Am J Pathol 160:2019-2034). Mice displayed altered growth plates, diminished trabecular bone, and marrow hypoplasia with an aberrant lymphocyte profile throughout life. This study identifies altered B220+, CD4+, and CD8+ lymphocyte numbers, as well as CD4+/fox3P+ T regulatory cells in the collagen X mice. Additionally, diminished in vitro splenocyte responses to mitogens and an inability of mice to survive a challenge with Toxoplasma gondii, confirm impaired immune responses. In concert, ELISA and protein arrays identify aberrant levels of inflammatory, chemo-attractant, and matrix binding cytokines in collagen X mouse sera. These data link the disruption of collagen X function in the chondro-osseous junction to an altered hematopoietic stem cell niche in the marrow, resulting in impaired immune function.

Mexican immunoparasitology: what is done and has to be done

In this special issue of Parasite Immunology, the reader will find reviewed some of the hottest topics in immunoparasitology, with emphasis on the most studied parasite species in Mexico. For instance, the immunological conditions that appear favorable for the survival or destruction of the parasite in the intermediate and definitive hosts in cysticercosis, as well as the use of immunodiagnostic tests in epidemiological/intervention studies are discussed in two different articles. The role that alternatively activated macrophages plays in modulating host immunity is also discussed, while in the field of Leishmaniasis, the reader will find reviewed the role that CD8+ T cells play in the host defense during the human infection. The role that antibodies may play as biomarkers of protective or pathological cellular immune events in Toxoplasma gondii infections, as well as the new insights about the regulation of the inflammatory immune response by the cytokine/chemokine network in amebiasis, are topics reviewed. The use that TSL-1 antigens may have in the development of more sensitive and specific diagnosis of human and animal trichinellosis as well as the role that the neuroimmunoendocrine network plays during schistosomiasis are also presented. We hope that our readers will find fascinating and enticing, the first ever Special Issue devoted to Mexican Immunoparasitology.