Abstract
Toxoplasmosis is an opportunistic infectious disease and may present a fatal outcome for human bone marrow transplant (BMT) recipients, due to the rapid disease course in immunosuppressed individuals. Several reports about occurrence of toxoplasmosis after BMT have been published in the literature, but this disease has been associated mainly due to reactivation of latent infection rather than primary infection. Even though there are reports of acute toxoplasmosis in recipients who were seronegative for T. gondii, suggesting transmission of infection after BMT, the source of infection in those cases has not been clearly demonstrated, whether it is due to the transplantation procedure by itself or from environmental source. Thus, the present study aimed to observe if it could be possible to demonstrate the parasite‘s ability to infect bone marrow (BM) cells and cause toxoplasmosis, when using an experimental model. Our results showed that 11% of hematopoietic and 7.1% of nonhematopoietic lineages may become infected when using in vitro experiments. Also, in vivo experiments demonstrated that, when C57BL/6 mice were infected with RH-RFP or ME-49-GFP T. gondii strains, the BM cells may be infected at different time points of infection. The parasites were detected by both fluorescent microscopy and qPCR. Also, when those BM samples were collected and used for BMT, the transplanted animals presented high rates of mortality and 87.5% of them became seropositive for T. gondii. Taken together, our results clearly demonstrated that it is possible to acquire primary T. gondii infection from the donor cells after BMT. Therefore, we are emphasizing that, before transplantation, serological screening for T. gondii infection from both donors and recipients, in addition to DNA search for this parasite from donor bone marrow cells, are necessary procedures to avoid the risk of T. gondii infection for immunocompromised patients.
Highlights
Toxoplasma gondii, a worldwide protozoan parasite, may cause opportunistic disease in immunodeficient individuals [1, 2]
Considering the importance to understand the possibility of T. gondii transmission through bone marrow transplant (BMT) due to donor-transmitted infection, the aim of the present work was to demonstrate if an experimental murine model could be appropriate to answer this question, by using animals under acute or chronic T. gondii infection as bone marrow donors
To evaluate the presence of T. gondii on BM during infection, cells from bone marrow were harvest from C57BL/6J mice in different times of infection to search for parasites
Summary
Toxoplasma gondii, a worldwide protozoan parasite, may cause opportunistic disease in immunodeficient individuals [1, 2]. T. gondii and Bone Marrow Transplantation from infected animals, as chicken, pig, sheep, and others, or by ingesting oocysts shed into the environment and contaminating soil or water, as well as by transplacentary transmission, or by solid organ transplantation [2, 3]. The infection in immunocompetent humans usually remains asymptomatic in 80% of the patients, or may present only flu-like symptoms [1, 5]. Severe cases can occur in transplacental transmission, when a woman becomes primary infected during pregnancy, or in immunocompromised patients, when primary or reactivated infections may occur. Severe cases may occur during posttransplant immunosuppressive treatment protocols in patients who received solid organs or bone marrow transplantation [1, 5]
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