Effect of Toxoplasma gondii on the Expression of Cytotoxic T-Lymphocyte-Associated Protein 4 in Women with Toxoplasmosis

Abstract

Background: Toxoplasmosis is a disease caused by an obligatory intracellular protozoan parasite (Toxoplasma gondii). Cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) is a protein receptor that acts as an immunological checkpoint and reduces immune responses. Aims: The present study aimed to evaluate the expression of CTLA-4 protein in women with different toxoplasmosis stages and observed its role in the occurrence of abortion. Materials and Methods: Anti-Toxoplasma immunoglobulin M (IgM) and IgG antibodies were detected by enzyme-linked immunosorbent assay (ELISA) test in the sera of 116 patients with toxoplasmosis (46 aborted infected groups, 35 pregnant infected groups, and 35 married infected groups). Furthermore, this test was done for 70 control samples (35 aborted women without toxoplasmosis infection and 35 healthy women). As a final point, all samples were examined to measure the level of CTLA-4 using ELISA kits (MyBioSource. Com., Ltd., USA). Results: Results showed that a higher level of CTLA-4 was seen in the aborted women group 34 (73.9%) than in other infected groups, and the highest CTLA-4 levels were seen in IgG positive, 20 (43.47%) of 46 in the same group, than other types of antibodies. Furthermore, the highest concentration (948.2 ± 269.4 ng/ml) was indicated in the same group and type of antibodies, with a cutoff value of 597.0 ng/ml (71.7% sensitivity and 97.1% specificity). Conclusions: It can be concluded that the CTLA-4 level can be used as a predicted and supported factor for the occurrence of abortion in women infected with toxoplasmosis, especially in the chronic type of the disease (IgG-positive) with a cutoff value of 597.0 ng/ml with 71.7% sensitivity and 97.1% specificity.