Is there any association between Toxoplasma gondii infection and bipolar disorder? A systematic review and meta-analysis

Barros, João Luís Vieira Monteiro de; Barbosa, Izabela Guimarães; Salem, Haitham; Rocha, Natália Pessoa; Kümmer, Arthur; Okusaga, Olaoluwa; Soares, Jair C.; Teixeira, Antônio Lúcio

doi:10.1016/j.jad.2016.11.016

Cited by 66 publications

(51 citation statements)

References 39 publications

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“…In a recent meta-analysis of 118 studies on T. gondii and bipolar disorder, only 8 met their criteria: original articles, published from January 1980 to June 2015, in English, Portuguese, or Spanish, and measured T. gondii serology. This study concluded that patients with bipolar disorder were more likely to be infected by T. gondii but with a low OR of 1.26, which was likely driven by the substantial overlap in T. gondii seropositivity prevalence in the included studies: 15.6% to 95.3% in bipolar patients and 16.3% to 87.3% in controls (82).…”

Section: T Gondii and Humansmentioning

confidence: 81%

Latent Toxoplasmosis Effects on Rodents and Humans: How Much is Real and How Much is Media Hype?

Johnson

Koshy

2020

mBio

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Toxoplasma gondii is a ubiquitous, intracellular protozoan parasite with a broad range of intermediate hosts, including humans and rodents. In many hosts, T. gondii establishes a latent long-term infection by converting from its rapidly dividing or lytic form to its slowly replicating and encysting form. In humans and rodents, the major organ for encystment is the central nervous system (CNS), which has led many to investigate how this persistent CNS infection might influence rodent and human behavior and, more recently, neurodegenerative diseases. Given the interest in this topic, here we seek to take a global approach to the data for and against the effects of latent T. gondii on behavior and neurodegeneration and the proposed mechanisms that might underlie behavior modifications.

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Section: T Gondii and Humansmentioning

confidence: 81%

Latent Toxoplasmosis Effects on Rodents and Humans: How Much is Real and How Much is Media Hype?

Johnson

Koshy

2020

mBio

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“…Toxoplasma gondii infection afflicts up to one‐third of the world's population . However, most infected patients are immunocompetent, and the infection is considered inert, with the exception of psychiatric changes that are associated with seropositivity and the presence of cysts in the brain . The infection occurs mainly after ingesting the parasite .…”

Section: Introductionmentioning

confidence: 99%

“…1 However, most infected patients are immunocompetent, and the infection is considered inert, with the exception of psychiatric changes that are associated with seropositivity and the presence of cysts in the brain. [2][3][4][5] The infection occurs mainly after ingesting the parasite. 6 The parasite then rapidly proliferates in the host's intestine by passing through the intestinal barrier and spreads, thus characterizing the acute phase of infection.…”

Section: Introductionmentioning

confidence: 99%

Acute Toxoplasma gondii infection alters the number of neurons and the proportion of enteric glial cells in the duodenum in Wistar rats

Trevizan

Schneider

Araújo

et al. 2018

Neurogastroenterology Motil

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Background Toxoplasma gondii infection can occur through the ingestion of raw meat that contains tissue cysts or food that contains oocysts. Through the ingestion of oocysts, the parasite crosses the intestinal barrier, where the enteric nervous system is located. The objective was to investigate the kinetics of neuronal and glial responses during acute T. gondii infection. Methods We used 45 Wistar rats that were divided into a control group and infected groups that were evaluated at 6, 12, 24, 48, 72 hours, 7 days, 10 days, and 15 days after infection. The rats received 5000 sporulated oocysts of the parasite orally. To detect neurons and enteric glia cells, the myenteric and submucosal plexuses of the duodenum underwent double‐labeling immunohistochemical techniques to evaluate HuC/HuD and S100, HuC/HuD and ChAT, and HuC/HuD and nNOS. Key Results We observed a reduction of the total neuron population in the submucosal plexus 72 hours after infection. Cholinergic neurons decreased in the submucosal plexus 15 days after infection, and nitrergic neurons decreased in the myenteric plexus 72 hours after infection. A decrease in the number of glial cells was observed 7 days after infection in the submucosal plexus, and an increase in the enteric glial cell (EGC)/neuron ratio was found in both plexuses 48 hours after infection. Conclusions and Inferences We found decrease of neurons and increase in the EGC/neuron ratio in both plexuses caused by acute T. gondii infection, with major alterations 72 hours after oral infection. The number of cholinergic neurons decreased in the submucosal plexus, and the number of nitrergic neurons decreased in the myenteric plexus. A decrease in the number of enteric glial cells was observed in the submucosal plexus, and an increase in the enteric glial cell/neuron ratio was observed in both ganglionate plexuses of the duodenum.

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“…Multiple reports suggest links between chronic T. gondii infection and mental illnesses, including schizophrenia [13–21] and bipolar disorder [14, 22–25]. Chronic T. gondii infection has also been associated with depression in psychiatric patients [26], women Veterans [27] and pregnant women [28].…”

Section: Introductionmentioning

confidence: 99%

Positive association between Toxoplasma gondii IgG serointensity and current dysphoria/hopelessness scores in the Old Order Amish: a preliminary study

et al. 2017

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AbstractToxoplasma gondii (T. gondii) IgG seropositivity and serointensity have been previously associated with suicidal self-directed violence (SSDV). Although associations with unipolar depression have also been investigated, the results have been inconsistent, possibly as a consequence of high heterogeneity. We have now studied this association in a more homogeneous population, [that is (i.e.) Old Order Amish (OOA)] with previously reported high T. gondii seroprevalence. In 306 OOA with a mean age of 46.1±16.7 years, including 191 (62.4%) women in the Amish Wellness Study, we obtained both T. gondii IgG titers (by enzyme-linked immunosorbent assay [ELISA]), and depression screening questionnaires (Patient Health Questionnaire [PHQ-9] [n=280] and PHQ-2 [n=26]). Associations between T. gondii IgG and dysphoria/hopelessness and anhedonia scores on depression screening questionnaires were analyzed using multivariable linear methods with adjustment for age and sex. Serointensity was associated with both current dysphoria/hopelessness (p=0.045) and current combined anhedonia and dysphoria/hopelessness (p=0.043), while associations with simple anhedonia and past/lifelong (rather than current) phenotypes were not significant. These results indicate the need for larger longitudinal studies to corroborate the association between dysphoria/hopelessness and T. gondii IgG-titers. Current hopelessness is a known risk factor for SSDV which responds particularly well to cognitive behavioral therapy, and may be a focused treatment target for T. gondii-positive individuals at high-risk for SSDV.

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Is there any association between Toxoplasma gondii infection and bipolar disorder? A systematic review and meta-analysis

Cited by 66 publications

References 39 publications

Latent Toxoplasmosis Effects on Rodents and Humans: How Much is Real and How Much is Media Hype?

Latent Toxoplasmosis Effects on Rodents and Humans: How Much is Real and How Much is Media Hype?

Acute Toxoplasma gondii infection alters the number of neurons and the proportion of enteric glial cells in the duodenum in Wistar rats

Positive association between Toxoplasma gondii IgG serointensity and current dysphoria/hopelessness scores in the Old Order Amish: a preliminary study

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