Congenital toxoplasmosis: evaluation of serological methods for the detection of anti-Toxoplasma gondii IgM and IgA antibodies

Rodrigues, Isolina Maria Xavier; Castro, Ana Maria de; Gomes, Marı́lia B.; Amaral, Waldemar Naves do; Avelino, Mariza Martins

doi:10.1590/s0074-02762009000300006

Cited by 29 publications

(21 citation statements)

References 10 publications

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“…This finding has not been previously reported in the literature. In the current study, IgA-specific antibodies anti-T gondii were associated with the worst prognosis of vertical transmission (neural-optical and systemic forms), described also by Rodrigues et al [69]. The specificity of tests was 100.0%, except for the IFAT-IgM (91.7%), but this was higher than that observed by Pinon et al [77].…”

Section: Discussionsupporting

confidence: 53%

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Congenital toxoplasmosis and prenatal care state programs

et al. 2014

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BackgroundControl programs have been executed in an attempt to reduce vertical transmission and the severity of congenital infection in regions with a high incidence of toxoplasmosis in pregnant women. We aimed to evaluate whether treatment of pregnant women with spiramycin associated with a lack of monitoring for toxoplasmosis seroconversion affects the prognosis of patients.MethodsWe performed a prospective cohort study with 246 newborns (NB) at risk for congenital toxoplasmosis in Goiânia (Brazil) between October 2003 and October 2011. We analyzed the efficacy of maternal treatment with spiramycin.ResultsA total of 40.7% (66/162) of the neonates were born seriously infected. Vertical transmission associated with reactivation during pregnancy occurred in 5.5% (9/162) of the NB, with one showing severe infection (systemic). The presence of specific immunoglobulins (fetal IgM and NB IgA) suggested the worst prognosis. Treatment of pregnant women by spiramycin resulted in reduced vertical transmission. When infected pregnant women did not undergo proper treatment, the risk of severe infection (neural-optical) in NB was significantly increased. Fetal IgM was associated with ocular impairment in 48.0% (12/25) of the fetuses and neonatal IgA-specific was related to the neuro-ophthalmologic and systemic forms of the disease. When acute toxoplasmosis was identified in the postpartum period, a lack of monitoring of seronegative pregnant women resulted in a higher risk of severe congenital infection.ConclusionTreatment of pregnant women with spiramycin reduces the possibility of transmission of infection to the fetus. However, a lack of proper treatment is associated with the onset of the neural-optical form of congenital infection. Primary preventive measures should be increased for all pregnant women during the prenatal period and secondary prophylaxis through surveillance of seroconversion in seronegative pregnant woman should be introduced to reduce the severity of congenital infection in the environment.

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Section: Discussionsupporting

confidence: 53%

“…The specificity for IgM of the tests was 100.0%, except for IFAT-IgM, which was 91.7%. The sensitivity of the tests was 60.9% for MEIA-IgM, 60.9% for ELFA-IgM, 59.6% for IFAT-IgM, and 57.1% for ELISA-IgA (as described in Rodrigues IMX et al), [69]. …”

Section: Methodsmentioning

confidence: 99%

Congenital toxoplasmosis and prenatal care state programs

et al. 2014

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“…Diagnosis of both acquired and congenital toxoplasmosis is still based on serology, by detection of IgG, IgM and, to a lesser extent, IgA abs against parasite crude extract or recombinant antigens. Different methods have been adapted for the detection of toxoplasmosis infection phase, for confirmation of congenital infection and even to monitor the effectiveness of treatment . As saliva samples are more accessible and their collection is less invasive than serum, several studies have focused on the detection of IgG, IgM or IgA abs in this oral fluid, those being the IgG abs with a better diagnostic performance …”

Section: Introductionmentioning

confidence: 99%

What do anti‐Toxoplasma gondii IgA and IgG subclasses in human saliva indicate?

Cañedo-Solares

Gómez‐Chávez

Luna-Pastén

et al. 2018

Parasite Immunology

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Diagnostic tests for toxoplasmosis are based on serological techniques due to their high sensitivity. Some IgG subclasses are related to clinical outcome in the congenital form. In this work, we determined the levels of IgG, IgA, IgG1, IgG2, IgG3 and IgG4 anti-Toxoplasma gondii antibodies in paired saliva and serum samples from 91 women by indirect ELISA using a crude extract of the RH strain. The levels of IgA, IgG2, IgG3 and IgG4 antibodies and, to a lesser extent, IgG1 did not correlate between saliva and serum, that is, most cases that were positive for one Ig class in a sample were negative or very low in the other, and vice versa. We also observed that most samples of saliva that were positive for one IgG subclass were also positive for at least 2 of the other 3; this contrasted with findings in serum, wherein each person was positive almost exclusively for one subclass, as demonstrated before by us and other researchers. Although these findings are disappointing for the use in diagnosis, the richer response in saliva might indicate local exposure to T. gondii antigens without systemic infection; thus, saliva might be reflecting a local (protective?) response against this protozoan.

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“…The use of anti‐ T. gondii IgM tests as a marker of CT has some limitations. The sensitivity of neonatal DBS has been reported to range from 41% to 86% (Robert‐Gangneux 2001; Montoya & Liesenfeld 2004; Rodrigues et al. 2009).…”

Section: Discussionmentioning

confidence: 99%

“…The use of anti-T. gondii IgM tests as a marker of CT has some limitations. The sensitivity of neonatal DBS has been reported to range from 41% to 86% (Robert-Gangneux 2001; Montoya & Liesenfeld 2004;Rodrigues et al 2009). IgM may not be detected at birth in infected children, and the sensitivity is even lower when gestational treatment for toxoplasmosis is used or when the infection occurs in the first half of pregnancy (Gilbert et al 2007;Petersen 2007).…”

Section: Discussionmentioning

confidence: 99%

Birth prevalence and characteristics of congenital toxoplasmosis in Sergipe, North‐east Brazil

Inagaki

Carvalheiro

Cipolotti

et al. 2012

Tropical Med Int Health

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Abstractobjectives To estimate, by neonatal screening, the birth prevalence of congenital toxoplasmosis among live-born infants in Sergipe state, Brazil, and to investigate the clinical features of affected infants.methods Dried blood spot specimens obtained from 15 204 neonates were assayed for the presence of anti-T. gondii IgM antibodies. Duplicate retesting was done in infants with positive and borderline results. Confirmatory testing in peripheral blood samples consisted of testing for anti-T. gondii IgG and IgM in infants and mothers. Those with possible congenital toxoplasmosis were evaluated and followed up to a median age of 20 months. Congenital infection was confirmed in the presence of persisting anti-T. gondii IgG antibodies beyond 12 months of age. All infants with confirmed infection were treated with pyrimethamine, sulfadiazine and folinic acid for 1 year.results Fifty-three infants had detectable IgM in dried blood spot specimens. Confirmatory testing was reactive in 39 ⁄ 50, of which, 38 completed follow-up. Six of 15 204 newborns were diagnosed with congenital toxoplasmosis, resulting in an estimated birth prevalence of four per 10 000 [CI 95% 1.4-8.0]. Four infants (67%) showed signs of congenital toxoplasmosis in their first year of life; three (75%) had retinochoroidal scars, and one had cerebral calcifications. Two infants remained asymptomatic until 20 months of age.conclusions The birth prevalence of congenital toxoplasmosis is high in the Brazilian state of Sergipe, with most of the infants showing ocular lesions. Preventive measures are strongly warranted.

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Congenital toxoplasmosis: evaluation of serological methods for the detection of anti-Toxoplasma gondii IgM and IgA antibodies

Cited by 29 publications

References 10 publications

Congenital toxoplasmosis and prenatal care state programs

Congenital toxoplasmosis and prenatal care state programs

What do anti‐Toxoplasma gondii IgA and IgG subclasses in human saliva indicate?

Birth prevalence and characteristics of congenital toxoplasmosis in Sergipe, North‐east Brazil

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