Abstract
BackgroundThere is accumulating evidence for an increased susceptibility to infection in patients with arthritis. We sought to understand the epidemiology of Toxoplasma gondii infection in arthritis patients in eastern China, given the paucity of data on the magnitude of T. gondii infection in these patients.MethodsSeroprevalence of T. gondii infection was assessed by enzyme-linked immunosorbent assay using a crude antigen of the parasite in 820 arthritic patients, and an equal number of healthy controls, from Qingdao and Weihai cities, eastern China. Sociodemographic, clinical and lifestyle information on the study participants were also obtained.ResultsThe prevalence of anti-T. gondii IgG was significantly higher in arthritic patients (18.8%) compared with 12% in healthy controls (P < 0.001). Twelve patients with arthritis had anti-T. gondii IgM antibodies – comparable with 10 control patients (1.5% vs 1.2%). Demographic factors did not significantly influence these seroprevalence frequencies. The highest T. gondii infection seropositivity rate was detected in patients with rheumatoid arthritis (24.8%), followed by reactive arthritis (23.8%), osteoarthritis (19%), infectious arthritis (18.4%) and gouty arthritis (14.8%). Seroprevalence rates of rheumatoid arthritis and reactive arthritis were significantly higher when compared with controls (P < 0.001 and P = 0.002, respectively). A significant association was detected between T. gondii infection and cats being present in the home in arthritic patients (odds ratio [OR], 1.68; 95% confidence interval [CI]: 1.24 – 2.28; P = 0.001).ConclusionsThese findings are consistent with and extend previous results, providing further evidence to support a link between contact with cats and an increased risk of T. gondii infection. Our study is also the first to confirm an association between T. gondii infection and arthritis patients in China. Implications for better prevention and control of T. gondii infection in arthritis patients are discussed.Trial registrationThis is an epidemiological survey, therefore trial registration was not required.
Highlights
There is accumulating evidence for an increased susceptibility to infection in patients with arthritis
A significant difference (P < 0.001) was detected in the level of anti-T. gondii Immunoglobulin G (IgG) antibodies in 154 arthritis patients (18.8%) vs. 98 control subjects (12%)
Our analysis revealed no significant differences between female (21.2%) and male (18.8%) arthritis patients (P = 0.414)
Summary
There is accumulating evidence for an increased susceptibility to infection in patients with arthritis. Toxoplasmosis is a parasitic disease caused by infection with the obligate intracellular apicomplexan protozoan Toxoplasma gondii. This parasite is able to infect all warm-blooded animals and chronically infects approximately one-third of the world’s human population [1]. Patients undergoing immunosuppressive treatments or during pregnancy, infection with T. gondii can cause serious clinical consequences and even death [2,3,4,5]. A heightened risk of T. gondii infection in patients with rheumatic diseases can be attributed to alterations in innate and adaptive immune responses [18]. Patients with RA were found to be highly susceptible to T. gondii infection - during periods of immunosuppression that followed treatment with TNF-α inhibitors [19]. Contrasting data, suggest that T. gondii infection may ameriolate the severity of arthritis - delaying its onset in IL-1 receptor antagonistdeficient mice via T. gondii-derived Th1 immune response against Th17 cell-mediated arthritis [20]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
