Toxoplasmosis

  • Mónica Lucia Giraldo Restrepo Universidad de Antioquia
Palabras clave: Toxoplasma gondii, epidemiología, clínica, diagnóstico, prevención.

Resumen

La toxoplasmosis es una zoonosis mundial causada por Toxoplasma gondii (T. gondii), un parásito intracelular que infecta varios tejidos, incluyendo el músculo esquelético, el intestino y el sistema nervioso. Su ciclo de vida incluye una fase intestinal (sexual) en gatos y otros felinos, y una fase extraintestinal (asexual) en felinos y no felinos. Esta fase extraintestinal se puede presentar en el hombre y en otras especies de sangre caliente, en quienes se manifiesta la enfermedad. Las personas se pueden infectar mediante la ingestión de carne mal cocida que contenga quistes de T. gondii y por la ingestión de ooquistes a partir de heces de gatos infectados. El riesgo de transmisión congénita en una madre gestante que se infecta por primera vez con el parásito puede ser hasta del 90% en el tercer trimestre, si no recibe tratamiento. En pacientes inmunocomprometidos, como los que padecen SIDA, una infección latente puede reactivarse causando enfermedad severa y hasta la muerte. Unas pruebas de laboratorio aplicadas e interpretadas en forma adecuada pueden ser de gran utilidad en los diferentes escenarios de esta enfermedad.

Descargas

La descarga de datos todavía no está disponible.

Biografía del autor/a

Mónica Lucia Giraldo Restrepo, Universidad de Antioquia

Enfermera. Magíster en Ciencias Básicas Biomédicas-Inmunología. Doctorado en Bioquímica e Inmunología. Profesora, Facultad de Medicina, Universidad de Antioquia.

Referencias bibliográficas

Boehringer EG, Fornari OE, Boehringer IK. The first case of Toxoplasma gondii in domestic ducks in Argentina Avian Dis 1962; 6: 391-396. https://doi.org/10.2307/1587913

Moulin AM. Historical introduction: the Institut Pasteur's contribution. Res Immunol 1993; 144: 8-13. https://doi.org/10.1016/S0923-2494(05)80089-6

Savva D. Toxoplasma. In Myint S and Cann A, eds. Molecular and cell biology of opportunistic infections in AIDS; London. 1992; 163-185. https://doi.org/10.1007/978-94-011-1530-8_7

Howe DK, Summers BC, Sibley LD. Acute virulence in mice is associated with markers on chromosome VIII in Toxoplasma gondii. Infect Immun 1996; 64: 5193-5198. https://doi.org/10.1128/iai.64.12.5193-5198.1996

Sibley LD, Howe DK. Genetic basis of pathogenicity in toxoplasmosis. Curr Top Microbiol Immunol 1996; 219: 3-15. https://doi.org/10.1007/978-3-642-51014-4_1

Toro-Montoya AI. Toxoplasmosis. Medicina & Laboratorio 1995; 5: 129-141.

Montoya JG, Liesenfeld O. Toxoplasmosis. Lancet 2004; 363: 1965-1976. https://doi.org/10.1016/S0140-6736(04)16412-X

Bahia-Oliveira LM, Jones JL, Azevedo-Silva J, Alves CC, Orefice F, Addiss DG. Highly endemic, waterborne toxoplasmosis in north Rio de Janeiro state, Brazil. Emerg Infect Dis 2003; 9: 55-62. https://doi.org/10.3201/eid0901.020160

Jones J, Lopez A, Wilson M. Congenital toxoplasmosis. Am Fam Physician 2003; 67: 2131-2138.

Gross U, Bohne W, Soete M, Dubremetz JF. Developmental differentiation between tachyzoites and bradyzoites of Toxoplasma gondii. Parasitol Today 1996; 12: 30-33. https://doi.org/10.1016/0169-4758(96)80642-9

Dubey JP, Lindsay DS, Speer CA. Structures of Toxoplasma gondii tachyzoites, bradyzoites, and sporozoites and biology and development of tissue cysts. Clin Microbiol Rev 1998; 11: 267-299. https://doi.org/10.1128/CMR.11.2.267

Jones JL, Kruszon-Moran D, Wilson M, McQuillan G, Navin T, McAuley JB. Toxoplasma gondii infection in the United States: seroprevalence and risk factors. Am J Epidemiol 2001; 154: 357-365. https://doi.org/10.1093/aje/154.4.357

Rosso F, Les JT, Agudelo A, Villalobos C, Chaves JA, Tunubala GA, et al. Prevalence of infection with Toxoplasma gondii among pregnant women in Cali, Colombia, South America. Am J Trop Med Hyg 2008; 78: 504-508. https://doi.org/10.4269/ajtmh.2008.78.504

Cook AJ, Gilbert RE, Buffolano W, Zufferey J, Petersen E, Jenum PA, et al. Sources of toxoplasma infection in pregnant women: European multicentre case-control study. European Research Network on Congenital Toxoplasmosis. Bmj 2000; 321: 142-147. https://doi.org/10.1136/bmj.321.7254.142

Vogel N, Kirisits M, Michael E, Bach H, Hostetter M, Boyer K, et al. Congenital toxoplasmosis transmitted from an immunologically competent mother infected before conception. Clin Infect Dis 1996; 23: 1055-1060. https://doi.org/10.1093/clinids/23.5.1055

Brenier-Pinchart MP, Garban F, Fricker-Hidalgo H, Richard MJ, Makowski C, Pelloux H. Avoidance of Toxoplasma gondii transmission from a recently infected donor to the recipient of hematopoietic stem cell transplantation. Bone Marrow Transplant 2005; 35: 735-736. https://doi.org/10.1038/sj.bmt.1704879

Mayes JT, O'Connor BJ, Avery R, Castellani W, Ca- rey W. Transmission of Toxoplasma gondii infection by liver transplantation. Clin Infect Dis 1995; 21: 511-515. https://doi.org/10.1093/clinids/21.3.511

Signorini L, Gulletta M, Coppini D, Donzelli C, Stellini R, Manca N, et al. Fatal disseminated toxoplasmosis during primary HIV infection. Curr HIV Res 2007; 5: 273-274. https://doi.org/10.2174/157016207780077011

Siegel SE, Lunde MN, Gelderman AH, Halterman RH, Brown JA, Levine AS, et al. Transmission of toxoplasmosis by leukocyte transfusion. Blood 1971; 37: 388-394. https://doi.org/10.1182/blood.V37.4.388.388

Bhopale GM. Pathogenesis of toxoplasmosis. Comp Immunol Microbiol Infect Dis 2003; 26: 213-222. https://doi.org/10.1016/S0147-9571(02)00058-9

Liesenfeld O. Immune responses to Toxoplasma gondii in the gut. Immunobiology 1999; 201: 229-239. https://doi.org/10.1016/S0171-2985(99)80063-1

Su C, Howe DK, Dubey JP, Ajioka JW, Sibley LD. Identification of quantitative trait loci controlling acute virulence in Toxoplasma gondii. Proc Natl Acad Sci U S A 2002; 99: 10753-10758.

https://doi.org/10.1073/pnas.172117099

Suzuki Y, Wong SY, Grumet FC, Fessel J, Montoya JG, Zolopa AR, et al. Evidence for genetic regulation of susceptibility to toxoplasmic encephalitis in AIDS patients. J Infect Dis 1996; 173: 265-268. https://doi.org/10.1093/infdis/173.1.265

McCabe RE, Remington JS. Toxoplasma gondii. In Mandell, Douglas and Bennet, eds. Principles and practice on infection disease. 1990; 2090-2103.

Gazzinelli RT, Denkers EY, Sher A. Host resistance to Toxoplasma gondii: model for studying the selective induction of cell-mediated immunity by intracellular parasites. Infect Agents Dis 1993; 2: 139-149.

Luft BJ, Hafner R, Korzun AH, Leport C, Antoniskis D, Bosler EM, et al. Toxoplasmic encephalitis in patients with the acquired immunodeficiency syndrome. Members of the ACTG 077p/ANRS 009 Study Team. N Engl J Med 1993; 329: 995-1000. https://doi.org/10.1056/NEJM199309303291403

Porter SB, Sande MA. Toxoplasmosis of the central nervous system in the acquired immunodeficiency syndrome. N Engl J Med 1992; 327: 1643-1648. https://doi.org/10.1056/NEJM199212033272306

Elsheikha HM. Congenital toxoplasmosis: priorities for further health promotion action. Public Health 2008; 122: 335-353. https://doi.org/10.1016/j.puhe.2007.08.009

Gay-Andrieu F, Marty P, Pialat J, Sournies G, Drier de Laforte T, Peyron F. Fetal toxoplasmosis and negative amniocentesis: necessity of an ultrasound follow- up. Prenat Diagn 2003; 23: 558-560. https://doi.org/10.1002/pd.632

Alford CA, Jr., Stagno S, Reynolds DW. Congenital toxoplasmosis: clinical, laboratory, and therapeutic considerations, with special reference to subclinical disease. Bull N Y Acad Med 1974; 50: 160-181.

Alexander J, Scharton-Kersten TM, Yap G, Roberts CW, Liew FY, Sher A. Mechanisms of innate resistance to Toxoplasma gondii infection. Philos Trans R Soc Lond B Biol Sci 1997; 352: 1355-1359. https://doi.org/10.1098/rstb.1997.0120

Dzierszinski FS, Hunter CA. Advances in the use of genetically engineered parasites to study immunity to Toxoplasma gondii. Parasite Immunol 2008; 30: 235- 244. https://doi.org/10.1111/j.1365-3024.2007.01016.x

Gazzinelli RT, Wysocka M, Hayashi S, Denkers EY, Hieny S, Caspar P, et al. Parasite-induced IL-12 stimulates early IFN-gamma synthesis and resistance during acute infection with Toxoplasma gondii. J Immunol 1994; 153: 2533-2543.

Lang C, Gross U, Luder CG. Subversion of innate and adaptive immune responses by Toxoplasma gondii. Parasitol Res 2007; 100: 191-203. https://doi.org/10.1007/s00436-006-0306-9

Gazzinelli RT, Amichay D, Sharton-Kersten T, Grunwald E, Farber JM, Sher A. Role of macrophage- derived cytokines in the induction and regulation of cell-mediated immunity to Toxoplasma gondii. Curr Top Microbiol Immunol 1996; 219: 127-139. https://doi.org/10.1007/978-3-642-51014-4_12

Hunter CA, Suzuki Y, Subauste CS, Remington JS. Cells and cytokines in resistance to Toxoplasma gondii. Curr Top Microbiol Immunol 1996; 219: 113-125. https://doi.org/10.1007/978-3-642-51014-4_11

Gazzinelli R, Xu Y, Hieny S, Cheever A, Sher A. Simultaneous depletion of CD4+ and CD8+ T lymphocytes is required to reactivate chronic infection with Toxoplasma gondii. J Immunol 1992; 149: 175-180.

Sharma SD. Immunology of toxoplasmosis. In Wyler DJ, ed. Modern parasite biology cellular, immunological and molecular aspects. Freeman and Company; USA. 1990; 184-199.

Mineo JR, Camargo ME, Ferreira AW. Enzyme-linked immunosorbent assay for antibodies to Toxoplasma gondii polysaccharides in human toxoplasmosis. Infect Immun 1980; 27: 283-287. https://doi.org/10.1128/iai.27.2.283-287.1980

Sharma SD, Mullenax J, Araujo FG, Erlich HA, Remington JS. Western Blot analysis of the antigens of Toxoplasma gondii recognized by human IgM and IgG antibodies. J Immunol 1983; 131: 977-983.

Montoya JG. Laboratory diagnosis of Toxoplasma gon- dii infection and toxoplasmosis. J Infect Dis 2002; 185 Suppl 1: S73-82. https://doi.org/10.1086/338827

Handman E, Goding JW, Remington JS. Detection and characterization of membrane antigens of Toxoplasma gondii. J Immunol 1980; 124: 2578-2583.

Huskinson J, Stepick-Biek PN, Araujo FG, Thulliez P, Suzuki Y, Remington JS. Toxoplasma antigens recognized by immunoglobulin G subclasses during acute and chronic infection. J Clin Microbiol 1989; 27: 2031-2038. https://doi.org/10.1128/jcm.27.9.2031-2038.1989

Chardes T, Bout D. Mucosal immune response in toxoplasmosis. Res Immunol 1993; 144: 57-60. https://doi.org/10.1016/S0923-2494(05)80100-2

Decoster A. Detection of IgA anti-P30 (SAG1) antibodies in acquired and congenital toxoplasmosis. Curr Top Microbiol Immunol 1996; 219: 199-207. https://doi.org/10.1007/978-3-642-51014-4_18

Sabin AB, Feldman HA. Dyes as Microchemical Indicators of a New Immunity Phenomenon Affecting a Protozoon Parasite (Toxoplasma). Science 1948; 108: 660-663. https://doi.org/10.1126/science.108.2815.660

Switaj K, Master A, Skrzypczak M, Zaborowski P. Recent trends in molecular diagnostics for Toxoplasma gondii infections. Clin Microbiol Infect 2005; 11: 170- 176. https://doi.org/10.1111/j.1469-0691.2004.01073.x

Gómez-Marín JE. Diagnóstico de la toxoplasmosis humana: nuevos conceptos y técnicas. Medicina & Laboratorio 2000; 9: 167-185.

Lappalainen M, Hedman K. Serodiagnosis of toxoplasmosis. The impact of measurement of IgG avidity. Ann Ist Super Sanita 2004; 40: 81-88.

Roberts A, Hedman K, Luyasu V, Zufferey J, Bessie- res MH, Blatz RM, et al. Multicenter evaluation of strategies for serodiagnosis of primary infection with Toxoplasma gondii. Eur J Clin Microbiol Infect Dis 2001; 20: 467-474. https://doi.org/10.1007/PL00011289

Tamma P. Toxoplasmosis. Pediatr Rev 2007; 28: 470- 471. https://doi.org/10.1542/pir.28-12-470

Remington JS, Thulliez P, Montoya JG. Recent developments for diagnosis of toxoplasmosis. J Clin Micro- biol 2004; 42: 941-945. https://doi.org/10.1128/JCM.42.3.941-945.2004

Ciardelli L, Meroni V, Avanzini MA, Bollani L, Tinelli C, Garofoli F, et al. Early and accurate diagnosis of congenital toxoplasmosis. Pediatr Infect Dis J 2008; 27: 125-129. https://doi.org/10.1097/INF.0b013e3181586052

Asociación Colombiana de Infectología. Guía de práctica clínica para toxoplasmosis durante el embarazo y toxoplasmosis congénita en Colombia. Infectio 2007; 3: 129-141.

Pradhan S, Yadav R, Mishra VN. Toxoplasma meningoencephalitis in HIV-seronegative patients: clinical patterns, imaging features and treatment outcome. Trans R Soc Trop Med Hyg 2007; 101: 25-33. https://doi.org/10.1016/j.trstmh.2006.02.021

Lefevre-Pettazzoni M, Bissery A, Wallon M, Cozon G, Peyron F, Rabilloud M. Impact of spiramycin treatment and gestational age on maturation of Toxoplasma gondii immunoglobulin G avidity in pregnant women. Clin Vaccine Immunol 2007; 14: 239-243. https://doi.org/10.1128/CVI.00311-06

Thiebaut R, Leproust S, Chene G, Gilbert R. Effectiveness of prenatal treatment for congenital toxoplasmosis: a meta-analysis of individual patients' data. Lancet 2007; 369: 115-122.

https://doi.org/10.1016/S0140-6736(07)60072-5

a Positive benefit of postnatal treatment in congenital toxoplasmosis. Arch Dis Child 2007; 92: 88-89.

Aggio FB, Muccioli C, Belfort R, Jr. Intravitreal triamcinolone acetonide as an adjunct in the treatment of severe ocular toxoplasmosis. Eye 2008; https://doi.org/10.1038/sj.eye.6703110

Caramello P, Brancale T, Forno B, Lucchini A, Pollono AM, Ullio A, et al. Relapse of Toxoplasma encephalitis and susceptibility to pyrimethamine: lack of evidence of treatment-induced resistance. Antimicrob Agents Chemother 1995; 39: 2371-2372. https://doi.org/10.1128/AAC.39.10.2371

Schurmann D, Grobusch MP, Ruf B. Rifabutin appears to be a promising agent for combination treatment of AIDS-related toxoplasma encephalitis. J Infect 1998; 36: 352-353.

https://doi.org/10.1016/S0163-4453(98)95035-6

Cómo citar
1.
Giraldo Restrepo ML. Toxoplasmosis. Med. Lab. [Internet]. 1 de julio de 2008 [citado 17 de octubre de 2021];14(7-8):359-75. Disponible en: https://medicinaylaboratorio.com/index.php/myl/article/view/481
Publicado
2008-07-01
Sección
Parasitología

Más sobre este tema