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Severe South American ocular toxoplasmosis is associated with decreased Ifn-γ/Il-17a and increased Il-6/Il-13 intraocular levels

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de-la-Torre, Alejandra
Sauer, Arnaud
Pfaff, Alexander W.
Bourcier, Tristan
Brunet, Julie
Speeg-Schatz, Claude
Ballonzoli, Laurent
Villard, Odile
Ajzenberg, Daniel
Sundar, Natarajan

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2013

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Abstract
In a cross sectional study, 19 French and 23 Colombian cases of confirmed active ocular toxoplasmosis (OT) were evaluated. The objective was to compare clinical, parasitological and immunological responses and relate them to the infecting strains. A complete ocular examination was performed in each patient. The infecting strain was characterized by genotyping when intraocular Toxoplasma DNA was detectable, as well as by peptide-specific serotyping for each patient. To characterize the immune response, we assessed Toxoplasma protein recognition patterns by intraocular antibodies and the intraocular profile of cytokines, chemokines and growth factors. Significant differences were found for size of active lesions, unilateral macular involvement, unilateral visual impairment, vitreous inflammation, synechiae, and vasculitis, with higher values observed throughout for Colombian patients. Multilocus PCR-DNA sequence genotyping was only successful in three Colombian patients revealing one type I and two atypical strains. The Colombian OT patients possessed heterogeneous atypical serotypes whereas the French were uniformly reactive to type II strain peptides. The protein patterns recognized by intraocular antibodies and the cytokine patterns were strikingly different between the two populations. Intraocular IFN-γ and IL-17 expression was lower, while higher levels of IL-13 and IL-6 were detected in aqueous humor of Colombian patients. Our results are consistent with the hypothesis that South American strains may cause more severe OT due to an inhibition of the protective effect of IFN-γ.
Palabras clave
Interferón gamma , Factor estimulante de colonias de granulocitos , Protozoario , Factor estimulante de colonias de granulocitos y macrófagos , Agente bloqueador del receptor de interleucina 1 , Interleucina 1 , Interleucina 13 , Interleucina 15 , Interleucina 17 , Interleucina 1Beta , Interleucina 2 , Interleucina 4 , Interleucina 6 , Interleucina 8 , Proteína inflamatoria de macrófagos 1Beta , Proteína quimiotáctica de monocitos 1 , Anticuerpo del parásito , Factor de necrosis tumoral alfa , Humor acuoso , Artículo Clínico , Estudio controlado , Estudio transversal , Ensayo inmunoabsorbente ligado a enzimas , Examen de la vista , Técnica de genotipado , Inmunotransferencia , Reacción en cadena de la polimerasa multiplex , Carga Parásita , Reconocimiento de patrones , Expresión de proteínas , Reacción en cadena de la polimerasa en tiempo real , Serotipificación , Toxoplasma , Toxoplasmosis , ADN , Genotipo , Interferon-Gamma , Tipificación de secuencias multilocus , Reacción en cadena de la polimerasa
Keywords
Serotyping , Genotype , Dna , Multilocus Sequence Typing , Polymerase Chain Reaction , Middle Aged , Real Time Polymerase Chain Reaction , Protein Expression , Pattern Recognition , Parasite Load , Multiplex Polymerase Chain Reaction , Genotyping Technique , Immunoblotting , Eye Examination , Enzyme Linked Immunosorbent Assay , Cross-Sectional Study , Clinical Article , Controlled Study , Aqueous Humor , Tumor Necrosis Factor Alpha , Parasite Antibody , Monocyte Chemotactic Protein 1 , Interleukin 8 , Macrophage Inflammatory Protein 1Beta , Interleukin 6 , Interleukin 4 , Interleukin 2 , Interleukin 17 , Interleukin 1Beta , Interleukin 15 , Interleukin 13 , Interleukin 1 , Interleukin 1 Receptor Blocking Agent , Stimulating Factor , Granulocyte Macrophage Colony , Gamma Interferon , Protozoan , Granulocyte Colony Stimulating Factor
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