The relation of Toxoplasma gondii with Tumor Necrotizing Factor-α in type II Diabetic patients

Abstract

Toxoplasma gondii is an obligate intracellular parasite that can cause variable clinical symptoms or can even be asymptomatic in immuno-competent individuals , whereas more severe symptoms are observed in immuno-compromised patients. Type 2 diabetes mellitus (T2DM) continues to be a major challenge for public health community, many factors play important role in the pathogenesis of diabetes such as obesity, physical inactivity, and dietary patterns.Moreover many infectious agents may play role in the pathogenesis of diabetes. Both toxoplasmosis and diabetes are very common in Iraq. Recently, some reports have spotlighted the probable relevance of diabetes mellitus (DM) and infectious agent as T. gondii, and it has been proposed that as a likely cause of diabetes. Objective: To determine the possible relation between T2DM and Toxoplasm by detection and evaluating IgM and IgG Toxoplasma gondii antibody and investigating the level of TNF-a, HbA1C in diabetic patients whether infected or not infected with Toxoplasma gondii. Methods: This case control study was conducted on 180 patients with T2DM along with 40 healthy age and gender matched individuals who were included as healthy control.All patients were investigated for the presence of Toxoplasma gondii by Rapid chromatographic test and by ECLA(ElectrochemiluminescenceImmunoassay). All samples whether positive or negative for toxoplasma, will be subjected for measuring HbA1C by automated Fluorescence Immunoassay (AFIAS) and TNF-a by ELISA technique. Results: This study showed that 42.2% of diabetic patients were infected with Toxoplasma gondii and 25% of apparently healthy control subjects were infected with Toxoplasma gondii ; moreover 46.4 % of diabetic patients on insulin therapy were infected with T.gondii whereas 37 % of diabetic patients on oral hypoglycemic agents (OHA) were infected with T. gondii. Furthermore IgG level , HbA1c levels and TNF were significantly high in diabetic patients on insulin who were infected with Toxoplasma gondii. Conclusion: Since the incidence of T.gondii in Diabetic patients was higher than in control group thus we may predict that immune disturbance in diabetes had paved the way to Toxoplasma infection or may be due to the parasite itself had direct effect on Beta cell of the pancreas that may lead to diabetes.