Russian MedicineRussian Medicine0869-21062412-9100Eco-Vector10103210.17816/0869-2106-2021-27-3-237-245Research ArticleLaboratory markers of toxoplasmosis in heart recipientsAbbazovaEvgeniya V.<p>MD, Cand. Sci. (Med.)</p>janifer@inbox.ruhttps://orcid.org/0000-0001-6328-8142GoncharovDmitriy B.<p>MD, Cand. Sci. (Biol.)</p>goncharov_toxo@mail.ruhttps://orcid.org/0000-0002-0250-4902DomonovaElvira A.<p>MD, Cand. Sci. (Biol.)</p>elvira.domonova@pcr.mshttps://orcid.org/0000-0001-8262-3938SilveystrovaOlga Yu.olga.silveystrova@pcr.mshttps://orcid.org/0000-0001-8412-9765KovalevaVasilisa A.vasilisa.Kovaliova@gmail.comhttps://orcid.org/0000-0003-0215-4938TitovaIrina V.<p>MD, Cand. Sci. (Med.)</p>i-titova-54@yandex.ruZakharevichVyacheslav M.<p>MD, Dr. Sci. (Med.), Professor</p>zaharslava@yandex.ruhttps://orcid.org/0000-0002-1090-6901KormilitsynaViktoriya G.v16k@rambler.ruhttps://orcid.org/0000-0002-6475-3904MuminovIlhomhodzha I.<p>MD, Cand. Sci. (Med.)</p>scorpion_if@mail.ruhttps://orcid.org/0000-0002-7509-1440KoloskovaNadezhda N.<p>MD, Dr. Sci. (Med.)</p>nkrasotka@mail.ruhttps://orcid.org/0000-0002-5819-9046KhalilulinTimur A.<p>MD, Cand. Sci. (Med.)</p>timur-medicina@list.ruhttps://orcid.org/0000-0002-6068-4462GabrielyanNina I.<p>MD, Dr. Sci. (Med.)</p>labgso@mail.ruhttps://orcid.org/0000-0003-1941-8311N.F. Gamaleya Federal Research Center of Epidemiology and MicrobiologyCentral Research Institute of EpidemiologyV.I. Shumakov Federal Research Center of Transplantology and Artificial Organs150520212732372451702202217022022Copyright © 2021, Eco-Vector2021<p><em>BACKGROUND.</em> The number of organ transplantation surgeries is growing every year, including heart transplantion. The full spectrum of infections in heart transplant recipients is not well understood. One of the infectious agents that is particularly difficult to recognize is <em>Toxoplasma gondii (T. gondii).</em></p>
<p><em>AIM: </em>This work determines the informative value of detecting laboratory markers of toxoplasmosis in patients after heart transplantation to identify active forms of invasion.</p>
<p><em>MATERIALS AND METHODS: </em>This investigation studied 121 heart recipients (95 men and 26 women) at different times after transplantation (several days to 12 years). Markers of <em>Toxoplasma </em>invasion were determined in blood sera, namely antibodies of the IgG, IgM, and IgA classes to <em>T. gondii</em>, avidity index of IgG antibodies to <em>T. gondii</em>, and DNA of the pathogen.</p>
<p><em>RESULTS: </em>In 60 patients (49.64.5%) after heart transplantation, markers of <em>Toxoplasma </em>invasion were identified. In 20 (16.53.6%) cases, markers of active invasion were revealed, namely IgM and IgA antibodies to <em>T. gondii </em>in six and 11 patients, respectively, low-grade IgG antibodies to <em>T. gondii </em>in three patients, and DNA of the pathogen in two cases. Based on the totality of studies, it was determined that the disease activity in 75% of cases was due to its reactivation, whereas in the other cases, it was a recent infection. Laboratory signs of toxoplasmosis reactivation occurred mainly during the first year after transplantation, which was probably associated with the intensity of immunosuppressive therapy.</p>
<p><em>CONCLUSIONS: </em>It was revealed that the most compelling studies indicating early signs of toxoplasmosis reactivation include detection of IgA antibodies to <em>T. gondii </em>and DNA of the pathogen. Further joint research is required by clinicians, epidemiologists, and laboratory diagnostics specialists to study the aspects of toxoplasmosis and disease diagnostics and preventionin patients after heart transplantation.</p>toxoplasmosisToxoplasma gondiiheart transplantationrecipientreactivationimmunosuppressionтоксоплазмозToxoplasma gondiiтрансплантация сердцареципиентреактивацияиммуносупрессия[Got'e SV, Shevchenko AO, Poptsov VN, et al. Opyt 800 transplantatsiy serdtsa v nmits transplantologii i iskusstvennykh organov im. akad. V.I. Shumakova. Russian journal of transplantology and artificial organs. 2017;19(S):52–53. (In Russ).][Derouin F, Pelloux H, Parasitology ESGoC. Prevention of toxoplasmosis in transplant patients. Clin Microbiol Infect. 2008;14(12):1089–1101.][Barbukhatti KO, Kosmacheva ED, Kolodina MV, et al. 5-year experience of orthotopic heart transplantation in the Krasnodar region. Russian Journal of Transplantology and Artificial Organs. 2015;17(2):80–84. (In Russ).][Poptsov VN, Saitgareev RSh, Shumakov DV, et al. Ortotopicheskaya transplantatsiya serdtsa U retsipientov 60 let i starshe. Russian Journal of Transplantology and Artificial Organs. 2016;18(S):28. (In Russ).][Simonenko MA, Nikolaev GV, Fedotov PA, et al. Infektsionnye oslozhneniya v rannem periode posle transplantatsii serdtsa. Russian Journal of Transplantology and Artificial Organs. 2019;21(S):37. (In Russ).][Spiridonov SV, Ostrovskiy YP, Valentyukevich AV, et al. Rezul'taty transplantatsii serdtsa v Respublike Belarus'. Russian Journal of Transplantology and Artificial Organs. 2019;21(S):46. (In Russ).][Chernyavskiy AM, Doronin DV, Fomichev AV, et al. 10-year heart transplantation experience in Novosibirsk. Russian Journal of Transplantology and Artificial Organs. 2018;20(1):23–31. (In Russ). doi: 10.15825/1995-1191-2018-1-23-31][Simonenko MA, Fedotov PA, Sazonova YV, et al. Oslozhneniya v otdalennom periode posle transplantatsii serdtsa. Russian Journal of Transplantology and Artificial Organs.2018;20(S1):38–39. (In Russ).][Gubareva EV, Goncharov DB, Kobets NV, et al. Approaches to diagnostics and prophylaxis of toxoplasmosis in HIV-infected patients. Epidemiology and Vaccinal Prevention. 2010;(4):60–65.][Robert-Gangneux F, Darde ML. Epidemiology of and diagnostic strategies for toxoplasmosis. Clin Microbiol Rev. 2012;25(2):264–296. doi: 10.1128/CMR.05013-11][Khurana S, Batra N. Toxoplasmosis in organ transplant recipients: Evaluation, implication, and prevention. Trop Parasitol. 2016;6(2):123–128. doi: 10.4103/2229-5070.190814][Robert-Gangneux F, Meroni V, Dupont D, et al. Toxoplasmosis in Transplant Recipients, Europe, 2010–2014. Emerg Infect Dis. 2018;24(8):1497–1504. doi: 10.3201/eid2408.180045][Wolyniec W, Sulima M, Renke M, Debska-Slizien A. Parasitic Infections Associated with Unfavourable Outcomes in Transplant Recipients. Medicina (Kaunas). 2018;54(2):27. doi: 10.3390/medicina54020027][Goncharov DB, Gabrielyan NI, Abbazova EV, et al. Toxoplasmosis as an opportunistic protozoan infestation and its significance in transplantation. Russian Journal of Transplantology and Artificial Organs. 2015;17(4):95–103. (In Russ).][Dard C, Marty P, Brenier-Pinchart MP, et al. Management of toxoplasmosis in transplant recipients: an update. Expert Rev Anti Infect Ther. 2018;16(6):447–460. doi: 10.1080/14787210.2018.1483721][Fernandez-Sabe N, Cervera C, Farinas MC, et al. Risk factors, clinical features, and outcomes of toxoplasmosis in solid-organ transplant recipients: a matched case-control study. Clin Infect Dis. 2012;54(3):355–361. doi: 10.1093/cid/cir806][Abbazova EV, Goncharov DB, Ievleva ES, et al. Monitoring toksoplazmennoy invazii v Moskve. In: Materialy XI Ezhegodnogo Vserossiyskogo Kongressa po infektsionnym boleznyam s mezhdunarodnym uchastiem (Moskva, 1–3 aprelya 2019g.). Moscow; 2019. P:5. (In Russ).][Patrat-Delon S, Gangneux JP, Lavoue S, et al. Correlation of parasite load determined by quantitative PCR to clinical outcome in a heart transplant patient with disseminated toxoplasmosis. J Clin Microbiol. 2010;48(7):2541–2545. doi: 10.1128/JCM.00252-10]