Potential Association Between Latent Toxoplasma gondii Infection and Suicide Attempts: A Case-Control Registry-Based Study.

Toxoplasma gondii is a ubiquitous parasitic protozoan that may be an important cause of neurological and psychiatric diseases. The purpose of this case-control registry-based study was to evaluate the prevalence of T. gondii infection and related risk factors among subjects who attempted suicide by drug use and a control group at the Iranian National Registry Center for Toxoplasmosis in Mazandaran Province, northern Iran. Baseline data were collected from participants using a questionnaire, and a blood sample was taken from each individual. The plasma was prepared for serological analysis, whereas the buffy coat was used for molecular analysis. Out of 282 individuals (147 cases with suicide attempters [SA] and 135 controls), 42.9% of patients and 16.3% of control subjects were positive for anti-Toxoplasma immunoglobin G (IgG), but all participants were negative for T. gondii DNA and anti-Toxoplasma immunoglobin M. Based on multiple logistic regressions, IgG seropositivity in SA in the age group of 20-30 years was 3.22 times higher than that in the control group (p < 0.001). These findings suggest that latent T. gondii infection among SA is significantly higher than that in healthy individuals, indicating a potential association between latent toxoplasmosis and SA at least in the studied area. Further research is needed to shed light on the potential association between T. gondii and suicide among different populations and areas of the world.

Phylogenetic analysis and antimony resistance of Leishmania major isolated from humans and rodents.

Cutaneous Leishmaniasis (CL) is one of the world's neglected diseases which is caused by Leishmania spp. The aim of this study was to assess molecular profile and antimony resistance of Leishmania isolated from human and rodent hosts. Samples were collected from suspected CL patients referred to health centres and wild rodent's traps in Gonbad-e-Qabus region, north-eastern Iran. Smears were subjected to PCR-RFLP to identify Leishmania species. In addition, ITS1-PCR products were sequenced for phylogenetic analysis. Clinical isolates and rodent samples were subjected to MTT assay to determine IC50 values and in vitro susceptibilities. Expression levels of antimony resistance-related genes were determined in CL isolates. Out of 1,949 suspected patients with CL and 148 rodents, 1,704 (87.4%) and 6 (4.05%) were positive with direct smear, respectively. Digestion patterns of BusRI (HaeIII) endonuclease enzyme were similar to what expected for Leishmania major. Phylogenetic analysis revealed that the highest interspecies similarity was found between current L. major sequences with L. major obtained from Russia and Uzbekistan. Out of 20 L. major samples tested, 13 (65%) were resistant to meglumine antimoniate (MA) treatment, with an activity index (AI) exceeding 4. The remaining 7 samples (35%) responded to MA treatment and were classified as sensitive isolates, with a confirmed sensitive phenotype based on their AI values. The comparison expression analysis of three major antimony resistance-associated genes in unresponsive clinical isolates demonstrated significant fold changes for TDR1 (4.78-fold), AQP1 (1.3-fold), and γ-GCS (1.17-fold) genes (P < 0.05). Herein, we demonstrate genetic diversity and antimony resistance of L. major isolated from human and reservoir hosts in north-eastern Iran, which could be the basis for planning future control strategies.

Is GRA6 Gene a Suitable Marker for Molecular Typing of Toxoplasma Gondii? A Scoping Systematic Review.

Toxoplasmosis is a zoonotic disease with a worldwide prevalence that is caused by Toxoplasma gondii. This study aimed to summarize available data on genotyping T. gondii strains based on the GRA6 gene marker in different hosts around the world. We conducted a comprehensive literature search using five international databases (PubMed, Scopus, Science Direct, Web of Science, and Google Scholar) from inception until December 2021. We identified 32 papers eligible for inclusion in this systematic review. The majority of studies (50%) were carried out in Iran (n = 16) to identify T. gondii genotypes based on the GRA6 gene. Other countries with reported studies include China, Japan, Sweden, and Italy (n = 2 each). Out of 3,434 samples collected from various hosts, most studies (n = 11) focused on human samples (34.4%), followed by ovine (n = 7), pig (n = 4), goat (n = 3) and soil and cattle (n = 2).Using various molecular methods such as conventional PCR, nested-PCR, real-time PCR, microsatellite analysis, and Restriction Fragment Length Polymorphism (RFLP), we found DNA positive results in 805 out of 3,434 samples. Of these, 285 (35.40%), 207 (25.71%), 182 (22.60%), 65 (8.07%), and 18 (2.23%) were infected with types I, II, III, mix I, II, III, and mix II, III, respectively. Our data demonstrate that the GRA6 gene marker has sufficient polymorphism to detect three types of T. gondii genotypes in various hosts. Identifying the specific genotype could be valuable in developing new strategies for treatment, vaccination, diagnosis, control, and prevention of T. gondii infection.

Relationship between Toxoplasma gondii infection and psychiatric disorders in Iran: A systematic review with meta-analysis.

BACKGROUND: Toxoplasma gondii, a ubiquitous parasitic protozoan, may be an important cause of neurological and psychiatric diseases. The present systematic review and meta-analysis, therefore, was conducted to investigate the scientific evidence regarding the potential association between T. gondii infection and psychiatric disorders in Iran. METHODS: We systematically reviewed articles from world-wide databases, including PubMed, Scopus, Science Direct, Web of Science, Google Scholar, and Iranian national databases up to July 30th, 2021. The Newcastle Ottawa Scale (NOS) was used to assess the quality of included studies. The common odds ratio (OR) was estimated using inverse variance and a random-effects model. Heterogeneity was assessed using the χ2-based Cochrane test (Q) and the I2 index. Also, sensitivity analyses and publication bias were calculated. Moreover, subgroup analysis was performed based on the type of disorder and quality score of different eligible studies. RESULTS: 16 studies were included in this meta-analysis. Our meta-analyses found that the OR of the risk of anti- T. gondii IgG and IgM in psychiatric patients compared to the control group was 1.56 (95% CI; 1.23-1.99) and 1.76 (95% CI: 1.19-2.61), respectively. Subgroup analysis based on the type of disorder showed that the OR of the risk of anti- T. gondii IgG in Iranian schizophrenia patients and other psychiatric disorders compared to the control group were 1.50 (95% CI; 1.09-2.07) and 2.03 (95% CI: 1.14-3.60), respectively, which are statistically significant. Also, the OR of the risk of anti- T. gondii IgM in Iranian schizophrenia and depression patients compared to the control group was 1.54 (95% CI; 0.9-2.64) and 1.03 (95% CI: 0.2-5.24), respectively, which are not statistically significant. Additionally, subgroup analysis based on quality scores showed no significant influence on the results according to the moderate quality studies. However, this association was significant according to the high quality studies. The obtained results of Egger's test were 1.5 (95% CI; -0.62-3.73, P = 0.15) and 0.47 (95% CI; -0.82-1.76, P = 0.45), respectively, indicating publication bias. The significant results of the heterogeneity analysis confirmed a high level of heterogeneity in the IgG test (P = 0.000, I2 = 66.6%). However, no significant results from the test of heterogeneity were detected in the IgM test (P = 0.15, I2 = 27.5%). The results of the sensitivity analysis showed that the impact of each study on the meta-analysis was not significant on overall estimates. CONCLUSIONS: Despite the limited number of studies, these outcomes supported a possible link between T. gondii infection and psychiatric disorders in Iran. However, more high-quality investigations are needed in the future.

Status of human cystic echinococcosis based on hospital records in Mazandaran Province: A first registry-based evidence.

Background: Human cystic echinococcosis, as an emerging neglected parasitic disease, is caused by tapeworms of the genus Echinococcus spp. Because of the medical and economic importance, this study aims to review the epidemiology and clinical features of hydatidosis in patients admitted to medical and surgical wards in three referral teaching hospitals over 15 years in Mazandaran Province, northern Iran. Methods: Data were collected from hospital records that were accessible via the hospital information system (HIS) between 2005 and 2019 (15 years).The demographic information (age, sex, living area, and occupation), dog contact, number of the cysts, types of organs involved, and history of disease recurrence were assessed. Results: One hundred twenty-one patients with human cystic echinococcosis (CE) were involved in the study, from whom 58 patients (47.93%) were male and 63 (52.07%) were female. The majority of patients were rural residents (64.46%) and also housewife (28.10%). Based on the results, only about 16.53% of the patients had history of close contacts with dogs. The liver was the organ involved in the most cases of CE. There were statistically significant differences between residence, occupation, history of close contacts with dogs, type of organs involved, number of cysts and history of disease recurrence (P < 0.05). Conclusions: Our data provides valuable registry-based information about CE in an endemic region. The data highlights that most patients lived in rural areas and were housewives. Additionally, they had a low rate of disease recurrence but a high rate of close contact with dogs. Moreover, further monitoring on registry-based program and strengthening the HIS in the provincial hospitals in the studied area are required.

Credible Serological Evidence of Latent Toxoplasma Infection Among Women with Primary Infertility: A Ten-Year Registry-Based Study.

BACKGROUND: Some evidence reveled that chronic infection with Toxoplasma gondii (T. gondii) has recently been associated with infertility in human and experimental model. This baseline study aimed to investigate serological evidence of Toxoplasma infection among infertile women who admitted to the in vitro fertilization (IVF) clinic at Imam Khomeini Hospital, Mazandaran province, Sari, northern Iran. SUBJECTS AND METHODS: In this retrospective (descriptive-analytical) study, all infertile women referred to the IVF clinic during 2010-2019 (10 years), constitute the study population. All data including demographic and some related characteristics were collected into a questionnaire and registered at the Iranian National Registry Center for Toxoplasmosis (INRCT) at the Mazandaran University of Medical Sciences, northern Iran. The existence of anti-Toxoplasma antibodies (IgG and IgM) was explored using a commercially available enzyme-linked immune sorbent assay (ELISA) kit (PishtazTeb, Iran), based on the manufacturer's protocol. RESULTS: Of 520 infertile women, anti-T. gondii IgG, IgM and both IgG and IgM antibodies were detected among 342/520 (65.77%), 1/520 (0.19) and 4/520 (0.77) infertile women, respectively. Primary and secondary infertility was detected in 74.56% and 25.44% of IgG seropositive infertile women, respectively. Also, most of the IgG seropositive subjects had no history of abortion, polycystic ovary syndrome (PCO), fibroma, contraceptive use and varicocele in spouse as primary cause of infertility. Furthermore, serum levels of prolactin and antimullerian (AMH) hormones were normal in 81.29 and 80.12% of infertile women with anti- T. gondii IgG, respectively. There was also a statistically significant difference between the seroprevalence of Toxoplasma infection and these variables associated to primary infertility (P < 0.05). CONCLUSION: According to the high prevalence (about two thirds) of chronic T. gondii infection among infertile women, particularly those with a history of abortion and primary infertility, it can be concluded that latent Toxoplasma infection pose a risk to infertile woman in the study area. Therefore, we advise that screening and treatment of Toxoplasma infection among infertile women must be favorably considered.

Green synthesis of nano-liposomes containing Bunium persicum and Trachyspermum ammi essential oils against Trichomonasvaginalis.

BACKGROUND: Trichomonas vaginalis, a parasitic flagellated protozoan, is one of the main non-viral sexually transmitted diseases worldwide. Treatment options for trichomoniasis are limited to nitroimidazole compounds. However, resistance to these drugs has been reported, which requires the development of new anti-Trichomonas agents that confer suitable efficacy and less toxicity. METHODS: In the present work, we assessed the effectiveness of the liposomal system containing essential oils of Bunium persicum and Trachyspermum ammi against T. vaginalis in vitro. The chemical composition of B. persicum and T. ammi were analyzed using gas chromatography-mass spectrometry (GC-MS). Liposomal vesicles were prepared with phosphatidylcholine) 70%) and cholesterol)30%) using the thin-film method. The essential oils of B. persicum and T. ammi were loaded into the liposomes using the inactive loading method. Liposomal vesicles were made for two plants separately. Their physicochemical features were tested using Zeta-Sizer, AFM and SEM. The anti-Trichomonas activity was determined after 12 and 24 h of parasite cultures in TYI-S-33 medium. RESULTS: After 12 and 24 h of administration, the IC50 of the B. persicum essential oil nano-liposomes induced 14.41 µg/mL and 45.19 µg/mL, respectively. The IC50 of T. ammi essential oil nano-liposomes induced 8.08 µg/mL and 25.81 µg/mL, respectively. CONCLUSIONS: These data suggested that nano-liposomes of the essential oils of B. persicum and T. ammi may be a promising alternative to current treatments for Trichomonas infection.

More Than Seventy Years of Research (1948-November 2021) on Toxoplasma gondii in Iran: A Narrative Review.

In this review, we intend to provide a summary of the activities of researchers in the field of Toxoplasma gondii in Iran, during the past 70 years. Most studies have been limited to epidemiological studies (mostly using ELISA and IFA methods). Designing a standard and reliable method using the specific antigens of this parasite is essential. So far, studies in the field of drug effects have not been able to introduce an effective drug with few side effects. Various types of vaccines have been developed, such as recombinant and DNA vaccines. However, none of them had a good efficacy. The use of multi-epitope vaccines as potential vaccines against toxoplasmosis is recommended. At present, limited studies have been conducted on the patterns of transmission and genetic diversity of isolated isolates in Iran. Future research to determine the genotype of T. gondii could play an important role in the study of population structure, and biological characteristics of this parasite. It is hoped that the results of this study will help control, prevent, and reduce the burden of disease caused by this parasite.

Exploring the Association Between Latent Toxoplasma gondii Infection and COVID-19 in Hospitalized Patients: First Registry-Based Study.

PURPOSE: This study aimed to determine the possible association between Toxoplasma gondii infection and COVID-19 outcomes among 133 patients with an RT-PCR-positive test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), hospitalized at Imam Khomeini Hospital, Sari, Mazandaran Province, northern Iran, during August to November 2020. METHODS: A questionnaire was used to collect baseline data from the patients who were registered to the Iranian National Registry Center for Toxoplasmosis (INRCT). Also, blood samples were taken from each patient for detecting anti-T. gondii antibodies and T. gondii DNA using enzyme-linked immunosorbent assay (ELISA) and conventional-PCR methods, respectively. Variables related to the COVID-19 severity and outcomes were indicated based on multiple multinomial logistic regression models. RESULTS: Of 133 patients enrolled in the INRCT with COVID-19 through RT-PCR, 50 (37.59%), 52 (39.1%), and 31 (23%) suffered from mild, moderate, and severe COVID-19, respectively. 57.1% of the patients who died had severe COVID-19, while among those with other outcomes, only 18.60% had severe COVID-19 (P < 0.05). Anti-T. gondii IgG was detected in 109/133 (81.95%) patients, which was not statistically significant (P > 0.05). Among those with negative and positive anti-T. gondii IgG, 2 (8.30%) and 29 (26.60%) had severe COVID-19, respectively (P > 0.05). T. gondii DNA and anti-T. gondii IgM were not found in any of the patients. Moreover, all deaths occurred in those with moderate or severe COVID-19 and a positive anti-T. gondii IgG. CONCLUSION: To our knowledge, this is the first registry-based study concerning T. gondii infection among patients with COVID-19. Our data show the high rate of latent T. gondii infection among COVID-19 with different severity. However, there is no significant relationship between latent T. gondii infection and COVID-19 severity and outcomes. Thus, conducting multicenter studies in different geographic regions of the world could offer a better understanding of this relationship.

Aurothiomalate-Based Drugs as Potentially Novel Agents Against Leishmania major: A Mini Review.

PURPOSE: Leishmaniasis is a major public health problem worldwide in many parts of the world. Current anti-leishmanial drugs have only limited clinical efficacy. Aurothiomalate derivatives are useful for treating rheumatoid arthritis, but have emerged as a promising therapeutic candidate for leishmaniasis. This paper gives a review of the literature about the usefulness of aurothiomalate derivatives against leishmaniasis. METHODS: In this study, we reviewed the proposed mechanisms of action of aurothiomalate and related compounds on the metabolism of L. major and collected data by searching relevant articles. RESULTS: Aurothiomalate-based drugs could be effective against leishmaniasis through two direct and indirect mechanisms: first, cytotoxic effects on parasites via thiomalate's false substrate role in the citric acid cycle against malate; and second, immunosuppressive and anti-inflammatory effects of aurothiomalate derivatives with prostaglandin production inhibitory effects. CONCLUSIONS: The current study documented that aurothiomalate-based drugs could be effective against leishmaniasis through two direct and indirect mechanisms of action. Gold thiomalate as a promising hit should be evaluated against L. major in vitro and in vivo conditions in the future.

The Potential Role of the Serotonin Transporter as a Drug Target against Parasitic Infections: A Scoping Review of the Literature.

BACKGROUND: Several in vitro and in vivo biological activities of serotonin, 5- hydroxytryptamine (5-HT), as a bioactive molecule, and its transporter (5-HT-Tr) were evaluated in parasitic infections. OBJECTIVE: Herein, the roles of 5-HT and 5-HTR in helminths and protozoan infections with medical and veterinary importance are reviewed. METHODS: We searched information in 4 main databases and reviewed published literature about the serotonin transporter's role as a promising therapeutic target against pathogenic parasitic infections between 2000 and 2021. RESULTS: Based on recent investigations, 5-HT and 5-HT-Tr play various roles in parasite infections, including biological function, metabolic activity, organism motility, parasite survival, and immune response modulation. Moreover, some of the 5-HT-TR in Schistosoma mansoni showed an excess of favorite substrates for biogenic amine 5-HT compared to their mammalian hosts. Furthermore, the main neuronal protein related to the G protein-coupled receptor (GPCR) was identified in S. mansoni and Echinococcus granulosus, playing main roles in these parasites. In addition, 5-HT increased in toxoplasmosis, giardiasis, and Chagas disease. On the other hand, in Plasmodium spp., different forms of targeted 5-HTR stimulate Ca2+ release, intracellular inositol triphosphate (ITP), cAMP, and protein kinase A (PKA) activity. CONCLUSION: This review summarized the several functional roles of the 5-HT and the importance of the 5-HT-TR as a drug target with minimal harm to the host to fight against helminths and protozoan infections. Hopefully, this review will shed light on research regarding serotonin transporter-based therapies as a potential drug target soon.

Evaluation of Bacterial Coinfection and Antibiotic Resistance in Patients with COVID-19 Under Mechanical Ventilation.

Patients with confirmed SARS-CoV-2 are principally at risk of emerging superinfections, particularly those caused by Gram-negative bacteria. Therefore, in this retrospective cohort study, we investigated the presence of bacteria in endotracheal aspirate samples in severe COVID-19 patients under mechanical ventilation between 20 February 2020 and 21 September 2020 in Mazandaran Heart Center Hospital, Iran. Outcomes were compared between ICU patients with confirmed SARS-CoV-2 (corona group) and those who suffer from other disease (non-corona group). Out of 38 subjects who met the diagnostic criteria for ventilator-associated pneumonia (VAP) in ICU, 22 and 16 patients in corona and non-corona groups, respectively, were enrolled in the study. Hospital length of stay in 27% of case in corona group was > 10 days. Also, SOFA score was > 10 in 64% and 25% of corona and non-corona groups, respectively (P < 0.05). Moreover, the number of death was significantly higher among corona patients (45%) than non-corona group (6%) in ICU (P < 0.05). Acinetobacter spp. were the most common bacteria in nine corona patients (41%) that were 100% resistant to amikacin, gentamycin, cefixime, and imipenem antibiotics. The prevalence of antibiotic resistance among pathogens isolated from patients with COVID-19 under mechanical ventilation in ICU highlighted the importance of preventing coinfections caused by this pathogen, suggesting an essential standardized approach to antibiotic stewardship in patients with COVID-19 for successful treatment.

Role of neglected parasitic diseases in the era of COVID-19 pandemics.

There are some doubts about the exact relationship between neglected infectious diseases (NIDs) and COVID-19 disease, which remains to be clearly defined. The present review summarized the effect of parasitic infections as the risk factors or protective agents in the COVID-19 pandemic. Parasites could proficiently modulate immune responses. Thus, parasitic infections could have a different impact on the incidence and clinical severity of COVID-19 in different regions of the world. Also, restoring programs to prevent, treat, and control NIDs, in particular helminths, could help in reducing the incidence and mortality of COVID-19 in endemic areas and help to increase vaccination effectiveness. Changes in the gut microbiome associated with helminth infection may have systemic immunomodulatory effects toward suppressing host immune responses, reducing vaccine efficacy and increasing the severity of other infectious diseases. The cytokine storm observed in severe cases of COVID-19 is characterized by a predominance of proinflammatory cytokines, such as IL-6. However, it is possible that helminth infection could change the outcome of infection by modifying the Th2 response to limit the inflammatory component; this would be particularly apparent in areas endemic for helminthic infections, which suggests a possible protective effect against COVID-19. Because parasitic infections affect more than 2 billion people throughout the world, their impact on COVID-19-associated effects on public health could be considerable. Further studies with larger sample sizes would be needed to explore the possible role of neglected parasitic infections in the COVID-19 pandemic.

Two decades of echinococcosis/hydatidosis research: Bibliometric analysis based on the web of science core collection databases (2000-2019).

Echinococcus granulosus sensu lato and Echinococcus multilocularis are responsible for serious health and economic implications for humans and animals. This study was designed to conduct a bibliometric analysis of global research on echinococcosis/hydatidosis included in the Web of Science Core Collection databases from 2000 to 2019. A total of 7066 relevant articles between 2000 and 2019 were identified. Most articles were published in 2015 (502 articles), 2017 (492 articles) and 2018 (493 articles), with the Veterinary Parasitology journal publishing the largest number of articles (237). Researchers from Xinjiang Medical University, China authored the most articles (388) in the field. Authors Craig, P.S. and Deplazes, P. were the most active in publishing143 and 126 hydatid cyst research papers, respectively. The most echinococcosis/hydatidosis publications originated from Turkey, China and Iran, with 1210, 708 and 531 articles, respectively. The highest levels of research collaboration were evident between China- England, China-France, England-France, China-Australia, and China-Japan. Also, the top researchers in this field had relatively extensive collaborations with each other. Our bibliometric analysis provides a picture of the scientific research into the echinococcosis/hydatidosis field. Further multi-national collaborative research efforts in this field should show promising progress in the future.

Nanoliposomes increases Anti-Trichomonas vaginalis and apoptotic activities of metronidazole.

Trichomoniasis, caused by Trichomonas vaginalis (T. vaginalis), is the most common non-viral sexually transmitted disease worldwide. As current trichomoniasis chemotherapies have many side effects, we examined the Anti-Trichomonas effects of nano-liposomal metronidazole (NLMTZ) compared to metronidazole (MTZ) in vitro. Liposomes were produced using the thin film hydration-sonication technique with a slight modification coated with MTZ. The average hydrodynamic diameter of monodispersed NLMTZ was evaluated by DLS and the morphological measurements were performed by scanning electron microscopy (SEM). The effects of NLMTZ and MTZ (5, 10, 20 and 40 µg/mL) on T. vaginalis trophozoites (105 cells/mL) in trypticase-yeast extract-maltose (TYM) medium were evaluated in different exposure times. Then, cell viability, IC50, SEM analysis and the expression of the metacaspase gene were assessed by qRT-PCR. Growth inhibition of MTZ in a concentration of 40 µg/mL was 39.34% after 3 h, whereas NLMTZ caused 51% growth inhibition after 3 h and lysed Trichomonas completely after 12 h. The IC50 values were estimated at 31.51 and 15.90 µg/mL after a 6 h exposure for MTZ and NLMTZ, respectively. Moreover, both T. vaginalis treated with MTZ and NLMTZ had high levels of metacaspase mRNA expression relative to the control groups (P< 0.05). A significant difference was observed between the apoptotic intensities of T. vaginalis treated with MTZ and NLMTZ (P< 0.05). This study showed that nano-liposomal MTZ is a potentially excellent approach for the treatment of trichomoniasis in vitro, although further studies are needed before consideration of clinical trials.

Toxoplasma gondii infection in patients with rheumatoid arthritis and systemic lupus erythematous diseases: serological and molecular evidence.

This study aimed to determine Toxoplasma gondii infection in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) patients in Mazandaran Province, north of Iran. During April 2019 to February 2020, 305 patients with RA (N=272) and SLE (N=33) diseases are included in this cross-sectional study. The baseline data of patients were collected into a questionnaire. Also, blood sample was taken from each patient in tubes containing k2-EDTA as anticoagulant for serological and molecular analyses. The presence of specific IgG antibody against T. gondii in plasma was explored using ELISA method. DNA was extracted and conventional-PCR method was done using RE primers on buffy coat samples. Anti-Toxoplasma IgG were detected among 105/272 RA (38.6%) and 11/33 (33%) SLE patients (P=0.55). IgG seropositivity was more common in females (95.70%) than in males (4.30%) and in 51-60 years old patients (37.10%) in rural populations (62.07%). Also, seropositivity was higher in patients who kept cats (93.95%). Keeping cats and patient's age were two studied risk factors which had significant relations with T. gondii seropositivity in patients (P<0.05). Overall, T. gondii DNA was found in 60 of 305 (19.7%) of enrolled patients, whether serology positive or negative (P<0.0001). Given the RA and SLE patients can be considered as a risk group for toxoplasmosis, in addition to the serological test, PCR based techniques is recommended for early and accurate detection of recent T. gondii infection.

Global Status of Toxoplasma gondii Seroprevalence in Rodents: A Systematic Review and Meta-Analysis.

Toxoplasmosis is one of the most prevalent infections in humans and animals caused by the intracellular protozoan parasite Toxoplasma gondii (T. gondii). Rodents, as intermediate and reservoir hosts, play a key role in the maintenance and transmission of T. gondii. They can be contaminated and maintain the parasite in the form of cysts in their bodies, demonstrating an infection source for their offsprings, predators (particularly felids), and other animals. Therefore, the present systematic review and meta-analysis study was carried out to evaluate the global seroprevalence of T. gondii in these mammals. For achieving the purpose of the current study, six English databases (PubMed, Science Direct, Web of Science, Scopus, ProQuest, and Google Scholar) were systematically searched for related studies from 1970 to 2018. Finally, a total of 52,372 records were screened, 105 records including 26,221 rodents were incorporated in the present study. By random effect models, the overall seroprevalence was calculated at 6% (95% CI = 6-7%), with the highest amount was observed in Africa (24%) and South America (18%), and the lowest amount in Europe (1%). The subgroup data analysis by gender manifested that the prevalence of Immunoglobulin G antibodies did not differ between genders (P > 0.05). Due to the significant heterogeneity, meta-regression models were applied based on serological techniques and continental regions; however, the obtained values were not statistically significant (P = 0.480 and P = 0.295, respectively). The present study revealed a relatively low level of T. gondii seroprevalence in rodents; however, if they were the main food source for their predators, they would cause high transmission of T. gondii.

The global serological prevalence of Toxoplasma gondii in felids during the last five decades (1967-2017): a systematic review and meta-analysis.

BACKGROUND: Felids (domestic and wild cats) are important in the epidemiology of the parasite Toxoplasma gondii because they are the only hosts that can excrete the environmentally resistant oocysts. We conducted a systematic review and meta-analysis to estimate the global prevalence of T. gondii in species of the family Felidae. METHODS: We searched seven databases (PubMed, Embase, Google Scholar, ScienceDirect, Scopus, Proquest and Web of Science) for studies reporting seroprevalence of T. gondii in felids from 1967 to 31 December 2017. A total of 217 published papers, containing 223 datasets were eligible for inclusion in the meta-analysis, comprised 59,517 domestic and 2733 wild cats from 1967 to 2017. RESULTS: The pooled global T. gondii seroprevalence was estimated to be 35% (95% CI: 32-38%) and 59% (95% CI: 56-63%) in domestic cats and wild felids, respectively, using random effects model. The seroprevalence was higher in Australia and Africa where the T. gondii seropositivity in domestic cats was 52% (95% CI: 15-89%) and 51% (95% CI: 20-81%), respectively. The lowest seroprevalence was estimated in Asia 27% (95% CI: 24-30%). The seroprevalence values for T. gondii in wild felids were 74% (95% CI: 62-83%) in Africa, 67% (95% CI: 23-111%) in Asia, 67% (95% CI: 58-75%) in Europe and 66% (95% CI: 41-91%) in South America. CONCLUSIONS: Our study provides the global prevalence of T. gondii in species of the family Felidae and is a source of information to aid public health workers in developing prevention plans.

Anti-Toxoplasma Activities of the Hydroalcoholic Extract of Some Brassicaceae Species.

BACKGROUND: Toxoplasma gondii (T. gondii) is a protozoan parasite that infects a wide range of warm-blooded animals and humans. The conventional anti-Toxoplasma treatments cause significant toxicity. Brassicaceae family contains several medicinal plants with anti-inflammatory, chemopreventive, insecticide, antibacterial, antiviral, and antiparasitic effects. In this study, the hydroalcoholic extract of some Brassicaceae species was investigated against T. gondii in vitro. MATERIALS AND METHODS: Seeds of Alyssum homolocarpum, Lepidium perfoliatum, Lepidium sativum, and aerial parts of Nasturtium officinale and Capsella bursa-pastoris were extracted by maceration method using 80% ethanol. Vero cells were treated with different concentrations (5-600 µg/mL) of the extracts and pyrimethamine (as positive control), and the cellular viability was verified. Next, Vero cells were infected by T. gondii tachyzoites (RH strain), and the viability of the infected cells was measured by a colorimetric 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. RESULTS: The 50% inhibitory concentration values were 5.1, 14.67, 32.49, 37.31, 71.35, and 2.63 µg/mL, and the selectivity indices were 8.06, 2.59, 0.74, 0.78, 0.65 (P < 0.05 compared with positive control), and 3.03 for L. sativum, L. perfoliatum, N. officinale, A. homolocarpum, C. bursa-pastoris, and pyrimethamine, respectively. CONCLUSION: The results of this study demonstrated that the hydroalcoholic extracts of L. sativum and L. perfoliatum have the promising anti-Toxoplasma activity by growth inhibition of T. gondii tachyzoites in infected cells.

The effect of edelfosine on GRA1 and MIC3 expressions in acute toxoplasmosis.

Phosphoinositide-dependent phospholipase-C (PI-PLC) triggers the calcium signaling pathway which plays an important role in dense granule and microneme secretion and pathogenesis of Toxoplasma gondii (T. gondii). There are limited data about the effects of phospholipid analogues against T. gondii. The current study assessed the effect of edelfosine, as a phospholipid analogue, on GRA1 and MIC3 expressions using in vitro and in vivo models of acute toxoplasmosis. Infected Vero cells were treated by edelfosine in two subgroups: 24 h following the cell infection and treatment at the same time of cell infection. Animal study was performed on forty mice in four groups including non-infected, infected untreated, infected edelfosine-treated, and infected pyrimethamine-treated. Gene and protein expression analyses were done using quantitative real-time PCR and western blot, respectively. Edelfosine significantly reduced the GRA1 (P < 0.01) and MIC3 (P < 0.01) mRNA and protein expressions in 24 h following the cell infection and at the same time of cell infection groups. In vivo study showed that the edelfosine significantly reduced the GRA1 expression in eye, and MIC3 expression in brain and liver. Moreover, the edelfosine-treated infected mice had significant higher survival rate compared with uninfected mice. The reducing effect of edelfosine on GRA1 and MIC3 mRNA and protein levels 24 h following the cell infection was more than treatment at the same time of cell infection group. Moreover, the effect of edelfosine on GRA1 and MIC3 expression in animal tissues was variable. These data showed that the edelfosine may decrease the T. gondii excretory/secretory antigens through inhibition of PI-PLC.