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Sutterland AL, Fond G, Kuin A, Koeter MWJ, Lutter R, van Gool T, Yolken R, Szoke A, Leboyer M, de Haan L. Beyond the association. Toxoplasma gondii in schizophrenia, bipolar disorder, and addiction: systematic review and meta-analysis. Acta Psychiatr Scand 2015; 132:161-79. [PMID: 25877655 DOI: 10.1111/acps.12423] [Citation(s) in RCA: 286] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To perform a meta-analysis on studies reporting prevalence of Toxoplasma gondii (T. gondii) infection in any psychiatric disorder compared with healthy controls. Our secondary objective was to analyze factors possibly moderating heterogeneity. METHOD A systematic search was performed to identify studies into T. gondii infection for all major psychiatric disorders versus healthy controls. Methodological quality, publication bias, and possible moderators were assessed. RESULTS A total of 2866 citations were retrieved and 50 studies finally included. Significant odds ratios (ORs) with IgG antibodies were found in schizophrenia (OR 1.81, P < 0.00001), bipolar disorder (OR 1.52, P = 0.02), obsessive-compulsive disorder (OR 3.4, P < 0.001), and addiction (OR 1.91, P < 0.00001), but not for major depression (OR 1.21, P = 0.28). Exploration of the association between T. gondii and schizophrenia yielded a significant effect of seropositivity before onset and serointensity, but not IgM antibodies or gender. The amplitude of the OR was influenced by region and general seroprevalence. Moderators together accounted for 56% of the observed variance in study effects. After controlling for publication bias, the adjusted OR (1.43) in schizophrenia remained significant. CONCLUSION These findings suggest that T. gondii infection is associated with several psychiatric disorders and that in schizophrenia reactivation of latent T. gondii infection may occur.
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Affiliation(s)
- A L Sutterland
- Department of Psychiatry, Academic Medical Centre (AMC), Amsterdam, the Netherlands
| | - G Fond
- AP-HP, DHU Pe-PSY, Pôle de Psychiatrie et d'addictologie des Hôpitaux Universitaires H Mondor, INSERM U955, Eq 15 Psychiatrie Translationnelle, Université Paris Est-Créteil, Créteil, France.,Fondation Fondamental, Créteil, France
| | - A Kuin
- Department of Psychiatry, Academic Medical Centre (AMC), Amsterdam, the Netherlands
| | - M W J Koeter
- Department of Psychiatry, Academic Medical Centre (AMC), Amsterdam, the Netherlands
| | - R Lutter
- Departments of Experimental Immunology and Respiratory Medicine, Academic Medical Centre (AMC), Amsterdam, the Netherlands
| | - T van Gool
- Department of Parasitology, Academic Medical Centre (AMC), Amsterdam, the Netherlands
| | - R Yolken
- Stanley Neurovirology Laboratory, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - A Szoke
- AP-HP, DHU Pe-PSY, Pôle de Psychiatrie et d'addictologie des Hôpitaux Universitaires H Mondor, INSERM U955, Eq 15 Psychiatrie Translationnelle, Université Paris Est-Créteil, Créteil, France.,Fondation Fondamental, Créteil, France
| | - M Leboyer
- AP-HP, DHU Pe-PSY, Pôle de Psychiatrie et d'addictologie des Hôpitaux Universitaires H Mondor, INSERM U955, Eq 15 Psychiatrie Translationnelle, Université Paris Est-Créteil, Créteil, France.,Fondation Fondamental, Créteil, France
| | - L de Haan
- Department of Psychiatry, Academic Medical Centre (AMC), Amsterdam, the Netherlands
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Gutiérrez-Fernández J, Luna Del Castillo JDD, Mañanes-González S, Carrillo-Ávila JA, Gutiérrez B, Cervilla JA, Sorlózano-Puerto A. Different presence of Chlamydia pneumoniae, herpes simplex virus type 1, human herpes virus 6, and Toxoplasma gondii in schizophrenia: meta-analysis and analytical study. Neuropsychiatr Dis Treat 2015; 11:843-52. [PMID: 25848282 PMCID: PMC4384747 DOI: 10.2147/ndt.s79285] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
In the present study we have performed both a meta-analysis and an analytical study exploring the presence of Chlamydia pneumoniae, herpes simplex virus type 1, human herpes virus 6, and Toxoplasma gondii antibodies in a sample of 143 schizophrenic patients and 143 control subjects. The meta-analysis was performed on papers published up to April 2014. The presence of serum immunoglobulin G and immunoglobulin A was performed by enzyme-linked immunosorbent assay test. The detection of microbial DNA in total peripheral blood was performed by nested polymerase chain reaction. The meta-analysis showed that: 1) C. pneumoniae DNA in blood and brain are more common in schizophrenic patients; 2) there is association with parasitism by T. gondii, despite the existence of publication bias; and 3) herpes viruses were not more common in schizophrenic patients. In our sample only anti-Toxoplasma immunoglobulin G was more prevalent and may be a risk factor related to schizophrenia, with potential value for prevention.
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Affiliation(s)
| | | | | | | | - Blanca Gutiérrez
- Department of Psychiatry, Institute of Neurosciences and CIBERSAM, School of Medicine and Biohealth Research Institute (Instituto de Investigación Biosanitaria) IBS-Granada, University of Granada, Granada, Spain
| | - Jorge A Cervilla
- Department of Psychiatry, Institute of Neurosciences and CIBERSAM, School of Medicine and Biohealth Research Institute (Instituto de Investigación Biosanitaria) IBS-Granada, University of Granada, Granada, Spain
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Gender identity disorder and schizophrenia: neurodevelopmental disorders with common causal mechanisms? SCHIZOPHRENIA RESEARCH AND TREATMENT 2014; 2014:463757. [PMID: 25548672 PMCID: PMC4274821 DOI: 10.1155/2014/463757] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 11/20/2014] [Indexed: 12/15/2022]
Abstract
Gender identity disorder (GID), recently renamed gender dysphoria (GD), is a rare condition characterized by an incongruity between gender identity and biological sex. Clinical evidence suggests that schizophrenia occurs in patients with GID at rates higher than in the general population and that patients with GID may have schizophrenia-like personality traits. Conversely, patients with schizophrenia may experience alterations in gender identity and gender role perception. Neurobiological research, including brain imaging and studies of finger length ratio and handedness, suggests that both these disorders are associated with altered cerebral sexual dimorphism and changes in cerebral lateralization. Various mechanisms, such as Toxoplasma infection, reduced levels of brain-derived neurotrophic factor (BDNF), early childhood adversity, and links with autism spectrum disorders, may account for some of this overlap. The implications of this association for further research are discussed.
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Bosman L. Toxoplasmosis and Vision Impairment. INTERNATIONAL JOURNAL OF ORIENTATION & MOBILITY 2013. [DOI: 10.21307/ijom-2013-006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Herberth M, Schwarz E, Bahn S. Problems and promise of immunological factors as biomarkers for schizophrenia. Biomark Med 2008; 2:385-95. [DOI: 10.2217/17520363.2.4.385] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The complex and multifactorial etiology of psychiatric disorders, and in particular that of schizophrenia, has made it difficult to identify biomarkers suitable for clinical diagnosis. In schizophrenia research, the investigation of immune-related factors has been of central importance in the quest to unravel the disease etiology. However, immunological findings have been controversial, and the importance of an underlying immunopathology in schizophrenia remains to be irrevocably established. Here we review those findings that have been most consistently reported. We further address their potential utility for clinical diagnosis and drug development. We also discuss problems connected to sample collection and preparation, with special focus on their effects on immune-derived parameters. In light of recent findings, we highlight the potential of combining functional cell-based assays with high-throughput multiomics experiments for the discovery of novel biomarkers.
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Affiliation(s)
- M Herberth
- Institute of Biotechnology, University of Cambridge, Cambridge, UK
| | - E Schwarz
- Institute of Biotechnology, University of Cambridge, Cambridge, UK
| | - Sabine Bahn
- Institute of Biotechnology, University of Cambridge, Cambridge, UK
- Institute of Biotechnology, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QT, UK
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Tamer GS, Dundar D, Yalug I, Caliskan S, Yazar S, Aker A. The schizophrenia and Toxoplasma gondii connection: infectious, immune or both? Adv Ther 2008; 25:703-9. [PMID: 18563312 DOI: 10.1007/s12325-008-0063-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Recent research has suggested a possible link between toxoplasmic agents and schizophrenia. We aimed to assess this by measuring Toxoplasma gondii-associated antibodies in schizophrenia patients and controls METHODS We used a commercially available enzyme-linked immunosorbent assay (ELISA) kit to measure the level of immunoglobulin G (IgG) and IgM antibodies in serum samples from schizophrenia patients (n=40) and from a group of non-schizophrenic control subjects (n=37) RESULTS Among schizophrenic patients, 16 (40%) showed IgG seropositivity and two (5%) showed IgM seropositivity. Among the control group, five (13.5%) were found have IgG seropositivity and one (2.7%) showed IgM seropositivity. In our study we found that IgG T gondii antibodies were significantly higher in schizophrenia patients compared with controls CONCLUSIONS This study supports the theory that toxoplasmic agents may have a role in the aetiology of schizophrenia.
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Affiliation(s)
- Gulden Sonmez Tamer
- Kocaeli University, Medical Faculty, Department of Clinical Microbiology, Kocaeli, Turkey.
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