Increased levels of IL-17A in serum and amniotic fluid of pregnant women with acute toxoplasmosis.

This study detected and compared the levels of Il-17A, IFN-gamma and IL-10 in the amniotic fluid (AF) and serum of pregnant women with acute toxoplasmosis in southern Brazil. It also compared the serum levels of these mediators in pregnant women with acute or chronic toxoplasmosis and with uninfected women. The serological investigations of anti-T. gondii IgM and IgG from the 60 pregnant women were determined by chemiluminescence microparticle immunoassay (CMIA). Twenty patients were uninfected, twenty were in the chronic phase and twenty were in the acute phase of toxoplasmosis. The 20 pregnant women in acute phase all agreed with amniocentesis. Serum and AF cytokines were evaluated by sandwich enzyme-linked immunosorbent assay. The analyzed cytokines showed no significant difference in blood versus amniotic fluid levels of pregnant women in the acute toxoplasmosis. Furthermore, we observed that serum IL-17A was significantly higher in pregnant women in the acute phase of infection compared to pregnant women with chronic toxoplasmosis and seronegative pregnant women. T. gondii DNA was not amplified in any of the samples of amniotic fluid by the nested-PCR reaction. Serum IL-10 levels were also higher in negative pregnant women than in infected pregnant women. Our findings indicate the activation of an inflammatory response to infection by T. gondii and suggest that increased production of IL-17A may be a protective factor against infection of the fetus.

Análise do controle da toxoplasmose gestacional e ocular nos serviços de Atenção Primária da 15ª Regional de Saúde do Paraná / Control analysis of pregnancy and ocular toxoplasmosis in Primary Care centers of the 15th Health Division of the state of Parana

Introdução: A primo-infecção pelo Toxoplasma gondii na gestação causa um risco de transmissão fetal entre 10% e 100%. Em 2006, a 15ª Regional de Saúde do Paraná criou a Rede de Controle da Toxoplasmose Gestacional e Congênita com referência para o Hospital Universitário de Maringá. Objetivo: avaliar as medidas adotadas pelos profissionais da Atenção Primária, para o controle da toxoplasmose gestacional e ocular. Método: Foram sorteadas 20% das 39 Unidades Básicas de Saúde de quatro municípios pertencentes à 15ª Regional de Saúde. A abordagem aos profissionais que assistiam as gestantes foi mediada por um questionário estruturado. Os dados coletados foram sobre as medidas realizadas: com gestantes soro não reagentes, com suspeita aguda, e com toxoplasmose ocular. Resultados: A maioria dos profissionais desconhecia a rede de controle, maneiras de infecção e medidas profiláticas para toxoplasmose. Conclusão: Isto mostra a importância da atualização profissional e perseverança da educação continuada (AU)

INTRODUCTION The primary infection by Toxoplasma gondii in pregnancy leads to a 10%--100% risk of fetal transmission. In 2006, the15th Health Division of the state of Paraná created the Network for Gestational and Congenital Toxoplasmosis Control with reference to the University Hospital of the city of Maringá. OBJECTIVE to evaluate the measures taken by primary care professionals regarding the control of gestational and ocular toxoplasmosis. METHOD Twenty percent of the 39 Basic Health Units in four municipalities belonging to the 15th Health Division of Paraná. The professionals who attended the pregnant women were interviewed through structured questionnaires. Data were collected on the measures carried out with non-reactive pregnant women, with acute suspicion, and ocular toxoplasmosis. RESULTS Most professionals were unaware of this control network, of the mode of infection, and the toxoplasmosis prophylactic measures. CONCLUSION This shows the importance of professional updating, and perseverance in continuing education (AU)

Toxoplasma gondii genotypes isolated from pregnant women with follow-up of infected children in southern Brazil.

BACKGROUND: Toxoplasma gondii populations that perpetuate in South America's natural ecosystems display broad genetic diversity, but the impact of this diversity on humans is generally unknown. In this short communication, we depict the genotypic traits of four isolates related to congenital parasitism as it emerges in Southern Brazil. METHODS: Using the PCR-restriction fragment length polymorphism markers SAG1, 5'3'SAG2, alt. SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, Apico, and CS3. Three of the four strains (TgCTBral, TgCTBrv, and TgCTBrac) were identified as ToxoDB genotype #166. RESULTS: Three children displayed normal cognitive/psychomotor development, and one child displayed Sabin's tetrad (TgCTBral). CONCLUSION: Vertical transmission of the two genotypes was observed and contributes to knowledge of T. gondii strains isolated from humans in Brazil.

A prospective study of Toxoplasma-positive pregnant women in southern Brazil: a health alert.

We evaluated anti-Toxoplasma gondii IgM-reactive pregnant women seen at a high-risk pregnancy outpatient clinic. From March 2005 to January 2008 in Paraná, Brazil, pregnant women seen by the Brazilian Public Health System, in any gestational period, who were anti-T. gondii IgM-positive, were followed. Clinical symptoms were noted, and tests performed including IgA, IgG avidity, ultrasonogram, and amniocentesis (PCR/inoculation in mice). Of 75 patients, 8 showed low, 3 intermediate and 31 high IgG avidity. Of those who underwent the avidity test, 31 (70.5%) were in the second trimester of pregnancy. Thirty-two (42.7%) pregnant women received specific treatment. Six received triple combination treatment; in three, tachyzoites were isolated, although only one was PCR-positive, showing changes in the cerebral sonogram, borderline IgA, and the Sabin tetrad. One fetus died, and one non-reactive IgM pregnant woman showed ocular recurrence. The municipality of residence, contact with cats during adulthood, and ingestion of unpasteurized milk were shown to be important risk factors. Congenital toxoplasmosis was observed in a pregnancy referred late for treatment. Follow-up of children born to mothers with diagnosed or suspected acute toxoplasmosis is crucial in the management of the changes that toxoplasmosis may cause.