Evaluation of Apoptosis, Proliferation, and Adhesion Molecule Expression in Trophoblastic Tissue of Women With Recurrent Spontaneous Abortion and Infected With Toxoplasma gondii.

Recurrent spontaneous abortion is an obstetric complication with undefined causes. Apoptosis, proliferation, and adhesion are considered important factors in the pathogenesis of abortion. This work aimed to determine Bax and Bcl-2 as a proapoptotic and antiapoptotic protein, Ki67 and P27kip as proliferative and antiproliferative proteins, and E-cadherin and CD44 as adhesion molecules in the trophoblastic tissues in cases with recurrent miscarriage. Immunohistochemistry and quantitative polymerase chain reaction analysis of Bax, Bcl-2, Ki67, P27kip, E-cadherin, and CD44 in paraffin-embedded sections of placental tissues obtained from 108 women were divided into 3 categories: 66 Toxoplasma gondii-positive women with recurrent abortion, 22 T. gondii-negative women with recurrent abortion, and 20 women with no history of abortion as a control group. The mean ratio of the expression of Bax and P27kip proteins was 35.3% and 36.1%, which is significantly higher than that of the second group (19.88 and 20.02%), and the third group (12.3% and 10.98%), while the mean ratio of the expression of Bcl-2, Ki67, E-cadherin, and CD44 proteins was 12.35%, 11.23%, 10.32%, and 9.97%, which is significantly lower than that of the second group (33.75%, 13.18%, 21.88%, and 23.29%) and that of the third group (38.58%, 39.27%, 37.98%, and 35.79%). The presence of proapoptotic protein (Bax) and antiproliferative protein (P27kip) at high levels and the presence of antiapoptotic protein (Bcl-2), proliferative protein (Ki67), and adhesion molecules (E-cadherin and CD44) in lower levels in the T. gondii-positive group clarify the mechanism involved in the induction of abortion and loss of pregnancy.

A case of congenital toxoplasmosis-associated miscarriage with maternal infection four months prior to conception.

BACKGROUND: We report a case of fatal congenital toxoplasmosis with maternal infection dated four months before pregnancy in the absence of any specific immunosuppressive condition. CASE: Ms. D. experienced submaxillary lymphadenitis in February 2018. The medical workup performed revealed an acute T. gondii infection. She became pregnant in June 2018 while she still had adenopathy. The second obstetrical ultrasound, performed at 16 weeks of pregnancy, revealed a fetal death. The research for T. gondii by PCR was positive in the products of conception. CONCLUSION: Diagnosis of toxoplasmosis should be discussed in case of miscarriage with lymphadenitis. As lymph nodes in T. gondii infection could be responsible for iterative release of parasites and fetal death, symptomatic toxoplasmosis should be treated in women of childbearing age.

A cross sectional study of leptospirosis and fetal death in Yucatan, Mexico / Estudio transversal de leptospirosis y muerte fetal en Yucatán, México

Introduction: Leptospirosis is a zoonotic disease affecting mainly to low income human population. Acute leptospiral infection during pregnancy has been associated with spontaneous abortion and fetal death during the first trimester and the abortion may occur as consequence of systemic failure. Objective: To estimate the frequency of Leptospira interrogans infection in women with spontaneous abortion in the state of Yucatan, Mexico. Methods: A cross sectional study on women with spontaneous abortion was conducted. Serum samples were tested for Leptospirosis by the microaglutination test, to estimate the frequency of the infecting serovar. The indirect ELISA IgM was used to detect recent infection by L. interrogans. DNA was extracted from paraffin-embedded tissue of placenta for PCR detection of L. interrogans. Results: Overall frequency of infection with L. interrogans in the 81 women with abortion was 13.6%. Five of the 12 serovars evaluated were found and included. Two of the 11 women with abortion and positive to microaglutination test were also positive to the ELISA IgM test. None samples were positive for PCR Leptospira diagnosis. Conclusion: two women could be associated with spontaneous abortion due to leptospirosis, because they showed antibodies against L. interrogans in the microaglutination test and ELISA IgM assays. Differences between regions were found with respect to the prevalences of lesptospirosis.

Introducción: Leptospirosis es una enfermedad zoonótica que afecta principalmente la población humana de bajos recursos. Infección aguda por leptospirosis durante el embarazo se ha asociado con aborto espontáneo y muerte fetal durante el primer trimestre del embarazo. Objetivo: Estimar la frecuencia de infección por Leptospira interrogans en mujeres con aborto espontáneo en el estado de Yucatán, México. Métodos: Se efectuó un estudio trasversal en 81 mujeres con aborto espontáneo. La prueba de referencia para Leptospirosis, prueba de microaglutinación, se utilizó para estimar la frecuencia de la serovar infectante. El ELISA IgM indirecto se utilizó para detectar infección reciente por L. interrogans. Se extrajo ADN a partir de tejido embebido en parafina de placenta para la detección de L. interrogans por PCR. Resultados: La frecuencia global de la infección con L. interrogans en 81 mujeres con aborto, fue del 13.6%. Se encontró cinco de 12 serovares de Leptospira. Dos de las 11 mujeres con aborto espontáneo y positivo a microaglutinación también fueron positivas a la prueba ELISA IgM. Ninguna muestra fue positiva hacia el diagnóstico PCR de Leptospira. Conclusion: Dos mujeres podrían estar asociados con el aborto espontáneo debido a la leptospirosis, porque mostraron anticuerpos contra L. interrogans en la microaglutinación y ensayos de ELISA IgM. Diferencias entre regiones fueron encontradas con respecto a las prevalencias de leptospirosis.

Differential roles of inflammation and apoptosis in initiation of mid-gestational abortion in malaria-infected C57BL/6 and A/J mice.

INTRODUCTION: Plasmodium chabaudi AS-infection in pregnant A/J and C57BL/6J mice results in mid-gestational pregnancy loss. Although associated with increased systemic and placental pro-inflammatory responses and coagulopathy, the molecular mechanisms that underlie poor pregnancy outcomes in these mice are not yet fully understood. This study investigates the relationships between inflammation, apoptosis and malaria-induced pregnancy loss. METHODS: Infection with P. chabaudi AS in early murine pregnancy and term human placental tissues from an endemic setting were assessed by histology, immunohistochemistry, TUNEL staining, real-time PCR, flow cytometry, western blot, and ELISA. RESULTS: Quantitative PCR reveals accumulation of lymphocytes and monocytes and upregulation of chemokines that attract these cell types in malaria-exposed mid-gestational A/J conceptuses. Monocyte accumulation is confirmed by flow cytometry and placental immunohistochemistry. Concurrent with initiation of malaria-induced abortion, markers of apoptosis are evident in the junctional zone, but not the labyrinth, of A/J placentae. In contrast, mid-gestation conceptuses in infected C57BL/6J lack evidence for monocyte accumulation, exhibiting low or no in situ placental staining despite trophoblast immunoreactivity for the monokine, CCL2. Additionally, placental apoptosis is not consistently observed, and when evident, appears after malaria-induced abortion typically initiates. Similarly, trophoblast apoptosis in term human placental malaria is not observed. Of those studied, a sole common feature of malaria-induced abortion in A/J and C57BL/6J mice is elevation of plasma tumor necrosis factor. DISCUSSION: Consistent with our previous observations, tumor necrosis factor is likely to be a central driver of malaria-induced pregnancy loss in both strains, but likely operates through mechanisms distinct from placental apoptosis in C57BL/6J mice.

Infeccoes de transmissao vertical em material abortivo e sangue com enfase em Toxoplasmose gondii / Vertical transmission from abortive material and blood with emphasis on Toxoplasma gondii

OBJETIVO: Analisar os resultados sorológicos, anatomopatológicos e parasitológicos de material abortivo para infecções com risco de transmissão vertical, com ênfase na toxoplasmose. MÉTODOS: Foi realizado um estudo coorte-transversal tratando da prevalência das doenças infectoparasitárias. Participaram da pesquisa 105 mulheres que sofreram aborto espontâneo completo e/ou incompleto; elas foram entrevistadas por meio de um questionário, e foram coletadas amostras de sangue e material abortivo. Foram realizados testes imunológicos para toxoplasmose, doença de Chagas, rubéola, citomegalovírus e sífilis e análise anatomopatológica nos restos ovulares. RESULTADOS: 55% das mulheres tinham entre 20 e 30 anos de idade. A maioria (68%) apresentou idade gestacional entre a 7ª e a 14ª semanas. 54,3% das mulheres tinham o ensino médio completo ou incompleto. Pela análise da sorologia, a infecção com risco de transmissão vertical mais frequente foi o citomegalovírus (CMV) com 97,1% de positividade, e em seguida a rubéola, com 95,2%. A toxoplasmose teve um percentual de 54,3%, a doença de Chagas, de 1,9% e a sífilis, de 0,95%. A análise dos laudos de biópsia demonstrou que 63,1% apresentaram inflamação e 34%, ausência de inflamação. Das análises sorológica, anatomopatológica e parasitológica das 105 mulheres, 57 foram soropositivas para T. gondii, e nenhuma teve resultado positivo para a Reação em Cadeia da Polimerase (PCR) e para inoculação em camundongos. CONCLUSÕES: A prevalência de doenças com risco de transmissão congênita nas mulheres com abortamento espontâneo é importante, sendo necessárias pesquisas visando esclarecer a etiologia do aborto. .

PURPOSE: To analyze the serological, anatomopathological and parasitological results obtained from abortive material in order to detect infections with the risk of vertical transmission, with emphasis on toxoplasmosis. METHODS: A cross-sectional cohort study was conducted in order to determine the prevalence of infectoparasitic diseases. A total of 105 women who suffered spontaneous complete or incomplete abortion participated in the study. The women were interviewed, answered a questionnaire and had their blood and abortive material collected. Immunological tests were carried out in order to detect toxoplasmosis, Chagas disease, rubeola, cytomegalovirus and syphilis, and anatomopathological analysis of the ovular remains was performed. RESULTS: 55% of the women studied were 20 to 30 years old. Most of them (68%) presented a gestational age between the 7th and 14th week. 54.3% of the women had complete or incomplete high school education. Serological analysis showed cytomegalovirus (CMV) as the most common vertically transmitted infection with 97.1% positivity, followed by rubeola with 95.2%. Toxoplasmosis showed 54.3% positivity, Chagas disease 1.9% and syphilis 0.95%. Anatomopathological analysis showed inflammation in 63.1% of the cases and absence of inflammation in 34%. The results of the serological, anatomopathological and parasitological analysis of the 105 participants showed that 57 women were T. gondii positive. However, none showed positivity in the polymerase chain reaction (PCR) or in mouse inoculation. CONCLUSIONS: The prevalence of diseases with the risk of vertical transmission is important in women with spontaneous abortion, indicating the need for more research in order to investigate the etiology of abortion. .

Seroprevalencia contra agentes ToRCH en mujeres indígenas en edad fértil, estado Zulia, Venezuela / Prevalence of infectious agents in indigenous women of childbearing age in Venezuela

Introducción. El termino ToRCH comprende a los patógenos Toxoplasma gondii, virus de la rubéola, citomegalovirus y virus herpes simple 1 y 2. En mujeres embarazadas expuestas pueden ser causa de abortos y malformaciones congénitas en el neonato. Objetivo. Determinar la seroprevalencia de infección por los agentes causantes del síndrome ToRCH en mujeres en edad fértil de algunas comunidades indígenas yukpa de Venezuela. Materiales y métodos. En el año 2007 fueron seleccionadas 109 muestras de 151 mujeres, en edades comprendidas entre 14 y 40 años. La detección de anticuerpos se hizo por el método de inmunoensayo enzimático indirecto o ELISA de Smartest Diagnostics™. Resultados. El 85,5 % presentó anticuerpos contra T. gondii, el 95,4 % para rubéola, el 75,2 % para citomegalovirus y el 97,2 % para el virus herpes simple 1 y 2. Se observa que el 21,1 % y el 30,2 % presentaron relación entre la variable aborto y las infecciones por citomegalovirus y virus herpes simple 1 y 2, respectivamente. Conclusiones. Existe alta seroprevalencia de infecciones por los agentes causantes del síndrome ToRCH en mujeres en edad fértil de la etnia indígena yukpa. Las condiciones sanitarias precarias y el consumo de agua contaminada con ooquistes, favorecen la adquisición de la infección por T. gondii. El hacinamiento, el inicio a temprana de edad de la actividad sexual y el número de parejas, pueden incidir en la presencia de citomegalovirus y virus herpes simple 1 y 2.

Introduction. The ToRCH syndrome includes the following infectious pathogens: Toxoplasma gondii, rubella, cytomegalovirus and herpes simplex virus 1 and 2. In susceptible pregnant women, these pathogens can cause abortions and congenital malformation in the newborn babies. Objective. The seroprevalence of infection by ToRCH agents was determined in women of childbearing age in several Venezuelan Yukpa indigenous communities. Material and methods. In 2007, 109 samples were selected from 151 women with an age range of 14 to 40 years old. The determination of antibodies against ToRCH agents was carried out through the indirect enzyme immunoassay technique by ELISA´s technique of Smartest Diagnostics. Results. Of the 109 samples, 85.5% presented antibodies against T. gondii, 95.4% for rubella, 75.2% for cytomegalovirus and 97.2% for and herpes simplex virus 1 and 2. A relationship between abortion and infection by cytomegalovirus and herpes simplex virus 1and 2 was noted in 21.1% and 30.2% of women presented, respectively. Conclusions. The findings show a high prevalence of ToRCH agents in women in childbearing age in Yukpa indigenous communities in Venezuela. Poor sanitary conditions and consumption of water contaminated with oocysts may be an important way of transmission of T. gondii. Overcrowding in the communities, sexual activity at an early age and number of partners and may be related to the presence of cytomegalovirus and herpes simplex virus HSV-1 and 2.

Sheep abortion associated with Neospora caninum in Mato Grosso do Sul, Brazil / Abortos por Neospora caninum em ovinos em Mato Grosso do Sul

Canids are the main hosts of Neospora caninum, but cattle, (sheep, goats and horses may serve as intermediary hosts. N. caninum infection of pregnant intermediary hosts may provoke abortion and neonatal infections. This study is the first to report lamb abortion associated with N. caninum in Mato Grosso do Sul. Epidemiological data were obtained from interviews with sheep producers. For microscopic examination, fragments of different organs removed from 4 sheep fetuses, aborted and necropsied, were fixed in 10% formaldehyde, embedded in paraffin and subjected to the hematoxylin-eosin staining protocol and immunohistochemistry (IHC) to test for N. caninum and Toxoplasma gondii. The abortion outbreak studied was reported from a herd of 268 Santa Inês sheep (including 186 pregnant ewes), with 10 abortion cases in the last third of gestation. Four fetuses were examined, 3 from a same ewe. At necropsy, one fetus exhibited crackling in the lung and all its organs were reddish. Histological findings detected mononuclear cell infiltrates among myocardium fibers and around blood vessels, in addition to circular structures with basophilic points resembling protozoans. IHC tests revealed strongly positive staining for N. caninum and weakly positive for T. gondii, characterizing N. caninum infection.

Neospora caninum é um protozoário que tem o cão como hospedeiro defiinitivo e, bovinos, ovinos, caprinos e equinos como hospedeiros intermediários. Nestas últimas espécies pode provocar abortos e infecções neonatais. Este trabalho é o primeiro relato de aborto em ovinos associado com N. caninum no Mato Grosso do Sul. Os dados epidemiológicos foram obtidos através de entrevistas com o proprietário dos animais. Quatro fetos foram necropsiados, dos quais foram colhidos fragmentos de diversos órgãos fiixados em formol a 10%, incluídos em parafiina, processados pela técnica usual de hematoxilina e eosina e também foi realizada imuno-histoquímica para N. caninum e Toxoplasma gondii. O surto ocorreu em um rebanho constituído por 268 ovinos da raça Santa Inês, destes 186 eram fêmeas prenhes, no terço fiinal de gestação e 10 abortaram. Dos quatro fetos analisados, três eram da mesma fêmea, sendo um de menor tamanho. À necropsia o pulmão de um dos fetos estava crepitante e todos os órgãos estavam avermelhados. Os achados histológicos foi infiiltrado mononuclear entre as fiibras do miocárdio e ao redor dos vasos, além de estruturas circulares compostas por pontilhados basofiílicos semelhantes a protozoários. A IHQ revelou marcação fortemente positiva para N. caninum e fracamente positiva para T. gondii, caracterizando infecção por N. caninum.

An insight into the salivary transcriptome and proteome of the soft tick and vector of epizootic bovine abortion, Ornithodoros coriaceus.

The salivary glands of blood-sucking arthropods contain a redundant 'magic potion' that counteracts their vertebrate host's hemostasis, inflammation, and immunity. We here describe the salivary transcriptome and proteomics (sialome) of the soft tick Ornithodoros coriaceus. The resulting analysis helps to consolidate the classification of common proteins found in both soft and hard ticks, such as the lipocalins, Kunitz, cystatin, basic tail, hebraein, defensin, TIL domain, metalloprotease, 5'-nucleotidase/apyrase, and phospholipase families, and also to identify protein families uniquely found in the Argasidae, such as the adrenomedullin/CGRP peptides, 7DB, 7 kDa, and the RGD-containing single-Kunitz proteins. Additionally, we found a protein belonging to the cytotoxin protein family that has so far only been identified in hard ticks. Three other unique families common only to the Ornithodoros genus were discovered. Edman degradation, 2D and 1D-PAGE of salivary gland homogenates followed by tryptic digestion and HPLC MS/MS of results confirms the presence of several proteins. These results indicate that each genus of hematophagous arthropods studied to date evolved unique protein families that assist blood feeding, thus characterizing potentially new pharmacologically active components or antimicrobial agents.

Toxoplasmosis y aborto en evolución / Toxoplasmosis and abortion in evolution

Para conocer la prevalencia de toxoplasmosis en población abierta de Comitán Chiapas, se realizó estudio serológico por inmunofluorescncia indirecta en voluntarios sanos. Además se identifico la presencia de anticuerpos anti Toxoplasma gondii en 50 mujeres con aborto en evolución. Los resultados mostraron que alrededor de 5 por ciento de la población general tiene títulos positivos de anticuerpos anti Toxoplasma gondii, y el 18 por ciento en el caso de las mujeres con aborto en volución. Se concluyó que la seropositividad para esta parasitosis estadísticamente es signficativa en los casos de aborto que entre la población general (P<0.006) y también, es significativamente mayor a las mujeres con aborto, que con respecto a la mujeres de la población general de Comitán Chiapas (P<0.01)

Descripción de un caso de aborto bovino asociado a infección por Neospora sp en México / Description of a case of bovine abortion associated to Neospora sp infection in México

En el siguiente informe se describe un caso de aborto bovino asociado a neosporosis en México. El feto fue remitido para su estudio al Departamento de Patología de la Facultad de Medicina Veterinaria y Zootecnia de la Universidad Nacional Autónoma de México. El feto fue expulsado al quinto mes de gestación, siendo macho y de raza Holstein. En el estudio microscópico se encontró encefalitis no supurativa con múltiples focos de necrosis y gliosis, además de un quiste parasitario oval de pared gruesa de 21 x 22 mm. Varias secciones de tejido nervioso desparafinadas se examinaron para estudio inmunohistoquímico, utilizando anticuerpos anti Neospora caninum encontrándose grupos de taquizoitos extracelulares asociados a las áreas de gliosis. También se encontró miocarditis y hepatitis no supurativa discreta. Se cree que este es el primer caso descrito en México de aborto bovino asociado a lesiones características y a la presencia de estructuras parasitarias correspondientes a Neospora sp. Sin embargo, es necesario realizar más estudios anatomopatológicos e inmunológicos para poder determinar la prevalencia y la significancia de aborto bovino asociado a neosporosis en México

[Schistosoma intercalatum bilharziasis: clinical and epidemiological considerations]. / La bilharziose à Schistosoma intercalatum: considèrations cliniques et èpidèmiologiques.

Schistosoma intercalatum bilharziasis continues to raise numerous questions regarding pathogenicity and gravity. The parasite was identified recently and the last fully described outbreak occurred 10 years ago in the city of Bata, Equatorial Guinea. Geographically Schistosoma intercalatum biharziasis is limited to one part of the African continent but has shown a tendency to spread. Hybridization of Schistosoma intercalatum and Schistosoma haematobium has been observed. The main clinical manifestation of Schistosoma intercalatum is rectal bleeding. The endoscopic appearance of lesions is variable and non-specific ranging from granulomas or polyps to ulcerations. Complications include severe rectitis or genital involvement such as salpingitis with secondary sterility. Spontaneous abortion has also been reported. Association with salmonella and klebsiella infection has been confirmed and can lead to life-threatening situations. Few studies have been performed to assess the value of diagnostic tests. The sensitivity of stool smears and urinary sedimentation testing is 81.7% and 56.3% respectively using the two examinations as references for one another. The sensitivity of immunological tests is generally good but varies depending on the reference technique used. Specificity can be affected by cross-reaction with other schistosomas or trematodes and even with nematodes and hematozoons. Treatment with a single dose of Biltricide has proven to be effective. Prevention requires education of the population at risk and use of molluscacides. The control strategy must be adapted in function of the epidemiology of the disease, diagnostic data, cost and effectiveness of screening and treatment.

[Pulmonary echinococcosis, hepatic opisthorchiasis and generalized trichinelliasis combined with pregnancy]. / Ekhinokokk legkikh, opistorkhoz pecheni, generalizovannyi trikhinellez v sochetanii s beremennost'iu.

A case is reported of a spontaneous abortion (25 weeks of gestation) in a Nenets woman resulting in thrombohemorrhagic syndrome and profuse uterine bleeding. The abortion is attributed to drastic allergization by three parasites: Echinococcus granulosus, Opisthorchis felineus, Trichinella spiralis.