BMJ Open. 2017 Feb 13;7(2):e013019. doi: 10.1136/bmjopen-2016-013019.
Alvarado-Esquivel C1,
Méndez-Hernández EM2,
Salas-Pacheco JM2,
Ruano-Calderón LÁ3,
Hernández-Tinoco J2,
Arias-Carrión O4,
Sánchez-Anguiano LF2,
Castellanos-Juárez FX2,
Sandoval-Carrillo AA2,
Liesenfeld O5,6,
Ramos-Nevárez A7.
Abstract
OBJECTIVES:
To determine the association between Toxoplasma gondii infection and Parkinson's disease and to investigate whether T. gondii seropositivity is associated with the general characteristics of patients with Parkinson's disease.
DESIGN:
SETTING:
Cases and controls were enrolled in Durango City, Mexico.
PARTICIPANTS:
65 patients with Parkinson's disease and 195 age- and gender-matched control subjects without Parkinson's disease.
PRIMARY AND SECONDARY OUTCOME MEASURES:
Serum samples of participants were analysed for anti-T. gondii IgG and IgM antibodies by commercially available enzyme-linked immunoassays. Prevalence of T. gondii DNA was determined in seropositive subjects using PCR. The association between clinical data and infection was examined by bivariate analysis.
RESULTS:
Anti-T. gondii IgG antibodies were found in 6/65 cases (9.2%) and in 21/195 controls (10.8%) (OR 0.84; 95% CI 0.32 to 2.18; p=0.81). The frequency of high (>150 IU/mL) antibody levels was similar among cases and controls (p=0.34). None of the anti-T. gondii IgG positive cases and four of the anti-T. gondii IgG positive controls had anti-T. gondii IgM antibodies (p=0.54). The prevalence of T. gondii DNA was comparable in seropositive cases and controls (16.7% and 25%, respectively; p=1.0). Seroprevalence of T. gondii infection was associated with a young age onset of disease (p=0.03), high Unified Parkinson Disease Rating Scale scores (p=0.04) and depression (p=0.02). Seropositivity to T. gondii infection was lower in patients treated with pramipexole than in patients without this treatment (p=0.01). However, none of the associations remained significant after Bonferroni correction.
CONCLUSIONS:
The results do not support an association between T. gondii infection and Parkinson's disease. However, T. gondiiinfection might have an influence on certain symptoms of Parkinson's disease. Further research to elucidate the role of T. gondiiexposure on Parkinson's disease is warranted.
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KEYWORDS:
Parkinson’s disease; Toxoplasma gondii; case-control study; infection; seroprevalence
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