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Infectious diseases
Research
Toxoplasma gondii exposure and Parkinson's disease: a case–control study
  1. Cosme Alvarado-Esquivel1,
  2. Edna Madai Méndez-Hernández2,
  3. José Manuel Salas-Pacheco2,
  4. Luis Ángel Ruano-Calderón3,
  5. Jesús Hernández-Tinoco2,
  6. Oscar Arias-Carrión4,
  7. Luis Francisco Sánchez-Anguiano2,
  8. Francisco Xavier Castellanos-Juárez2,
  9. Ada Agustina Sandoval-Carrillo2,
  10. Oliver Liesenfeld5,6,
  11. Agar Ramos-Nevárez7
  1. 1Faculty of Medicine and Nutrition, Biomedical Research Laboratory, Juárez University of Durango State, Durango, Mexico
  2. 2Institute for Scientific Research “Dr. Roberto Rivera-Damm”, Juárez University of Durango State, Durango, Mexico
  3. 3General Hospital “450”, Secretary of Health, Durango, Mexico
  4. 4Unidad de Trastornos del Movimiento y Sueño, Hospital General Dr Manuel Gea González, Ciudad de México, México, Mexico
  5. 5Institute for Microbiology and Hygiene, Campus Benjamin Franklin, Charité Medical School, Hindenburgdamm 27, Berlin, Germany
  6. 6Roche Molecular Diagnostics, Pleasanton, California, USA
  7. 7Hospital Santiago Ramón y Cajal, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Durango, Mexico
  1. Correspondence to Dr Cosme Alvarado-Esquivel; alvaradocosme{at}yahoo.com

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 Case–control study.

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. gondii infection might have an influence on certain symptoms of Parkinson's disease. Further research to elucidate the role of T. gondii exposure on Parkinson's disease is warranted.

  • Toxoplasma gondii
  • infection
  • seroprevalence
  • Parkinson’s disease
  • case-control study

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-013019

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    Footnotes

    • Contributors CA-E designed the study protocol, performed the laboratory tests and data analysis and wrote the manuscript. EMM-H, JMS-P, LAR-C and AAS-C obtained the blood samples and clinical dat, and performed the data analysis. JH-T, OA-C, LFS-A, FXC-J and OL performed the data analysis and wrote the manuscript. All authors read and approved the final version of the manuscript.

    • Funding This study was financially supported by Juarez University of Durango State.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval This study was approved by the Ethics Committees of the General Hospital of the Secretary of Health and the Institute of Security and Social Services for the State Workers, Durango, Mexico.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.