Abstract
Toxoplasma gondii (T. gondii) is an intracellular parasite that infects humans, and seroprevalence of its infection varies from about 10 to 80 percent in different countries with a higher prevalence in warmer and humid regions. In this study, the rate of acute and chronic toxoplasmosis in patients with benign or malignant bone tumours was investigated. Fifty-three patients who suffered from various bone tumours, as well as sixty-five healthy controls with an unknown sero-logical profile for anti-Toxoplasma antibodies, were enrolled in this cross-sectional study. Anti-Toxoplasma antibodies were detected in serum samples using enzyme-linked immunosorbent assay (ELISA) and blood samples of them were used for real-time PCR. Thirty-two (60.32%) and twenty-one (39.63%) of patients had malignant tumours and benign tumours, respectively. The results showed a higher and significant seropositivity rate of IgM antibodies in primary bone tumour patients compared to the control group and Toxoplasma DNA became positive in 18.86% of patients with primary bone tumours and 6.15% of controls. Surprisingly, the high presence of parasite DNA was detected in patients with malignant tumours. The seroprevalence of T. gondii IgM antibodies and DNA positivity among the cancer patients were significantly higher than healthy individuals. Also, chronic toxoplasmosis (it was shown with IgG positive) appears to be more common in people with benign cancers than malignancies. The study showed a relatively high seroprevalence of anti-T. gondii antibodies in patients with primary bone cancer. However, the considerable rate of positive blood samples for the presence of parasite’s DNA should not be ignored. A key to the effective management of diseases in immunosuppressed individuals is prompt and accurate diagnosis of toxoplasmosis. Moreover, it seems that PCR tests may be more reliable than serological methods and it could be considered as a precise method for diagnosis of acute toxoplasmosis.
Highlights
Toxoplasma gondii (T. gondii) is an obligatory intracellular parasite that infects humans and many animal species and approximately one-third of the world’s population is at risk of infection with this protozoan [11, 25]
B lymphocytes produce various classes of antibodies in response to T. gondii infection which could be applied for serodiagnosis, like specific IgM which can be detected within 7–15 days in acute infection, class switching to IgG antibodies and production of a higher titer and avidity of this class of antibody is observed in chronic toxoplasmosis [12, 28]
A casecontrol study of 900 different cancer patients and 900 controls was conducted in China for evaluating the epidemiology of T. gondii infection and the results showed a high significant prevalence of anti T. gondii IgG in cancer patients but because of rare incidence of different bone tumours, this type of tumour hadn’t been mentioned [7], so in this study, we aimed to evaluate the serum levels of IgG and IgM using enzyme-linked immunosorbent assay (ELISA) and determine parasite-specific DNA by quantitative real-time polymerase chain reaction in aforementioned patients
Summary
Toxoplasma gondii (T. gondii) is an obligatory intracellular parasite that infects humans and many animal species and approximately one-third of the world’s population is at risk of infection with this protozoan [11, 25]. B lymphocytes produce various classes of antibodies in response to T. gondii infection which could be applied for serodiagnosis, like specific IgM which can be detected within 7–15 days in acute infection, class switching to IgG antibodies and production of a higher titer and avidity of this class of antibody is observed in chronic toxoplasmosis [12, 28]. One of the easiest diagnostic tests for the routine detection of toxoplasmosis is a screening of specific IgG and IgM antibodies in serum, ; the application of molecular techniques may be more sensitive and appropriative methods for diagnosis of acute toxoplasmosis in high-risk patients especially in cancerous people with low traceable antibodies in consequence of radio or chemotherapy [2, 22, 25]. Various histological types of primary bone tumours include benign (osteochondroma, giant cell tumour, exostosis) and malignant (osteosarcoma, Ewing’s sarcoma, chondrosarcoma) tumours with nonspecific symptoms which make it difficult to be managed by clinicians [10, 30]
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