The imbalance in the relationship between inflammatory and regulatory cytokines during gestational toxoplasmosis can be harmful to fetuses: A systematic review

Priscilla Vilela Dos Santos; Débora Nonato Miranda de Toledo; Débora Maria Soares de Souza; Tatiana Prata Menezes; Luiza Oliveira Perucci; Zolder Marinho Silva; Daniela Caldas Teixeira; Ed Wilson Rodrigues Vieira; Valter Ferreira de Andrade-Neto; Nathalia Sernizon Guimarães; André Talvani

doi:10.3389/fimmu.2023.1074760

The imbalance in the relationship between inflammatory and regulatory cytokines during gestational toxoplasmosis can be harmful to fetuses: A systematic review

Front Immunol. 2023 Jan 18:14:1074760. doi: 10.3389/fimmu.2023.1074760. eCollection 2023.

Authors

Priscilla Vilela Dos Santos^{1

2}, Débora Nonato Miranda de Toledo^{1

2}, Débora Maria Soares de Souza^{1

2}, Tatiana Prata Menezes^{1

2}, Luiza Oliveira Perucci¹, Zolder Marinho Silva^{1

2}, Daniela Caldas Teixeira³, Ed Wilson Rodrigues Vieira⁴, Valter Ferreira de Andrade-Neto⁵, Nathalia Sernizon Guimarães², André Talvani^{1

2

6}

Affiliations

¹ Laboratory of the Immunobiology of Inflammation, Department of Biological Sciences/Institute of Exact and Biological Sciences (ICEB), Federal University of Ouro Preto, Ouro Preto, MG, Brazil.
² Graduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, MG, Brazil.
³ Faculty of Medical Sciences of Minas Gerais, Belo Horizonte, MG, Brazil.
⁴ Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
⁵ Laboratory of Malaria and Toxoplasmosis Biology, Department of Microbiology and Parasitology, Federal University of the Rio Grande do Norte, Natal, RN, Brazil.
⁶ Graduate Program of Health Science, Infectiology and Tropical Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.

Abstract

Objective: To evaluate the available information on inflammatory and regulatory plasma mediators in pregnant women (PW) diagnosed with toxoplasmosis. Source: The PubMed, Embase, Scopus, and Lilacs databases were evaluated until October 2022. Study eligibility criteria: This review was carried out following the PRISMA and registered on the PROSPERO platform (CRD42020203951). Studies that reported inflammatory mediators in PW with toxoplasmosis were considered.

Evaluation methods: After excluding duplicate articles, two authors independently carried out the process of title and abstract exclusion, and a third resolved disagreements when necessary. The full text was evaluated to detect related articles. The extraction table was built from the following data: Author, year of publication, journal name and impact factors, country, study design, number of gestations and maternal age (years), gestational period, diagnosis of toxoplasmosis, levels of inflammatory markers, laboratory tests, and clinical significance. Methodological quality was assessed using Joanna Briggs Institute tools.

Results: Of the 1,024 studies reported, only eight were included. Of the 868 PW included in this review, 20.2% were IgM+/IgG- and 50.8% were IgM-/IgG+ to T. gondii, and 29.0% uninfected. Infected PW presented higher plasma levels ofIL-5, IL-6, IL-8, IL-17, CCL5, and IL-10. Regarding the methodological quality, four studies obtained high quality. Data from this review pointed out the maintenance of the inflammatory pattern during pregnancy with a closely related to the parasite.

Conclusion: Immune status in PW defined the course of the T. gondii infection, where the equilibrium between inflammatory and regulatory cytokines mitigated the harmful placenta and fetus effects.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420203951.

Keywords: Toxoplasma gondii; chemokines; cytokines; gestation; inflammation.

Publication types

Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Cytokines
Female
Fetus
Humans
Immunoglobulin G
Immunoglobulin M
Pregnancy
Toxoplasma*
Toxoplasmosis*

Substances

Cytokines
Immunoglobulin G
Immunoglobulin M