Folia Parasitologica 68:005 (2021) | DOI: 10.14411/fp.2021.005

Latent toxoplasmosis and vitamin D concentration in humans: three observational studies

©árka Kaňková1,2, Marie Bičíková3, Ludmila Máčová3, Jana Hlaváčová1, Kateřina Sýkorová1, Dobroslava Jandová4, Jaroslav Flegr1,2
1 Department of Philosophy and History of Science, Faculty of Science, Charles University, Prague, Czech Republic;
2 Applied Neurosciences and Brain Imaging, National Institute of Mental Health, Klecany, Czech Republic;
3 Institute of Endocrinology, Prague, Czech Republic;
4 Third Faculty of Medicine of Charles University, Prague, Czech Republic

Numerous recent studies show that vitamin D deficiency potentiates various chronic physical and psychiatric disorders and diseases. It has been shown that a similar range of disorders is also associated with latent infection with Toxoplasma gondii (Nicolle et Manceaux, 1908). For instance, among cancer, diabetes and schizophrenia patients, we find a higher prevalence of both toxoplasmosis and vitamin D deficiency. Theoretically, therefore, vitamin D deficiency could be the missing link between toxoplasmosis and these disorders. We tested this hypothesis by searching for decreased vitamin D levels in the serum of subjects infected with T. gondii (furthermore called Toxoplasma-infected subjects) in two cross-sectional and one case-control study. Results of the first cross-sectional study (N = 72) suggest that Toxoplasma-infected neurasthenic patients have non-significantly lower levels of calcidiol than Toxoplasma-free patients (study A: P = 0.26 in women, P = 0.68 in men). However, two other studies (study B: N = 400; study C: N = 191) showed a non-significantly higher concentration of vitamin D in Toxoplasma-infected subjects than in Toxoplasma-free subjects both in men (study B: P = 0.70, study C: P = 0.55) and in women (study B: P = 0.64, study C: P = 0.12). Taken together, our preliminary results thus do not support the hypothesis that toxoplasmosis could be associated with vitamin D decrease.

Keywords: Toxoplasma gondii, calcidiol, depression, mental disorders, schizophrenia.

Received: August 7, 2020; Revised: October 28, 2020; Accepted: November 11, 2020; Published online: February 12, 2021  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Kaňková, ©., Bičíková, M., Máčová, L., Hlaváčová, J., Sýkorová, K., Jandová, D., & Flegr, J. (2021). Latent toxoplasmosis and vitamin D concentration in humans: three observational studies. Folia Parasitologica68, Article 2021.005. https://doi.org/10.14411/fp.2021.005
Download citation

References

  1. Abbas S., Linseisen J., Slanger T., Kropp S., Mutschelknauss E., Flesch-Janys D., Chang-Claude J. 2008: Serum 25-hydroxyvitamin D and risk of post-menopausal breast cancer - results of a large case-control study. Carcinogenesis 29: 93-99. Go to original source... Go to PubMed...
  2. Ali A., Cui X., Eyles D. 2018: Developmental vitamin D deficiency and autism: putative pathogenic mechanisms. J. Steroid Biochem. Mol. Biol. 175: 108-118. Go to original source... Go to PubMed...
  3. Anderson P.H. 2017: Vitamin D activity and metabolism in bone. Curr. Osteoporos. Rep. 15: 443-449. Go to original source... Go to PubMed...
  4. Arling T., Yolken R., Lapidus M., Langenberg P., Dickerson F., Zimmerman S., Balis T., Cabassa J., Scrandis D., Tonelli L., Postolache T. 2009: Toxoplasma gondii antibody titers and history of suicide attempts in patients with recurrent mood disorders. J. Nerv. Ment. Dis. 197: 905-908. Go to original source... Go to PubMed...
  5. Babu P., Nagendra K., Navaz R., Ravindranath H. 2007: Congenital toxoplasmosis presenting as hypogonadotropic hypogonadism. Ind. J. Pediatr. 74: 577-579. Go to original source... Go to PubMed...
  6. Bin-Abbas B., Jabari M., Issa S., Al-Fares A., Al-Muhsen S. 2011: Vitamin D levels in Saudi children with type 1 diabetes. Saudi Med. J. 32: 589-592. Go to PubMed...
  7. Bizzaro G., Antico A., Fortunato A., Bizzaro N. 2017: Vitamin D and autoimmune diseases: is vitamin D receptor (VDR) polymorphism the culprit? Isr. Med. Assoc. J. 19: 438-443. Go to PubMed...
  8. Bresnahan M., Susser E., Schaefer C., Brown A., Sohler N., Begg M. 2007: Race and schizophrenia in a U.S. birth cohort. Schizophr. Bull. 33: 228-228.
  9. Cantor-Graae E., Selten J. 2005: Schizophrenia and migration: a meta-analysis and review. Am. J. Psychiatry 162: 12-24. Go to original source... Go to PubMed...
  10. da Silva R.C., Langoni H. 2009: Toxoplasma gondii: host-parasite interaction and behavior manipulation. Parasitol. Res. 105: 893-898. Go to original source... Go to PubMed...
  11. Datta P., Philipsen P.A., Olsen P., Bogh M.K., Johansen P., Schmedes A.V., Morling N., Wulf H.C. 2017: The half-life of 25(OH)D after UVB exposure depends on gender and vitamin D receptor polymorphism but mainly on the start level. Photochem. Photobiol. Sci. 16: 985-995. Go to original source... Go to PubMed...
  12. Davis J., Eyre H., Jacka F., Dodd S., Dean O., McEwen S., Debnath M., McGrath J., Maes M., Amminger P., McGorry P., Pantelis C., Berk M. 2016: A review of vulnerability and risks for schizophrenia: beyond the two hit hypothesis. Neurosci. Biobehav. Rev. 65: 185-194. Go to original source... Go to PubMed...
  13. Enko D., Fridrich L., Rezanka E., Stolba R., Ernst J., Wendler I., Fabian D., Hauptlorenz S., Halwachs-Baumann G. 2014: 25-Hydroxy-vitamin D status: limitations in comparison and clinical interpretation of serum-levels across different assay methods. Clin. Lab. 60: 1541-1550. Go to original source... Go to PubMed...
  14. Eyles D., Burne T., McGrath J. 2013: Vitamin D, effects on brain development, adult brain function and the links between low levels of vitamin D and neuropsychiatric disease. Front. Neuroendocrinol. 34: 47-64. Go to original source... Go to PubMed...
  15. Ferder M., Inserra F., Manucha W., Ferder L. 2013: The world pandemic of vitamin D deficiency could possibly be explained by cellular inflammatory response activity induced by the renin-angiotensin system. Am. J. Physiol. Cell Physiol. 304: C1027-C1039. Go to original source... Go to PubMed...
  16. Feskanich D., Ma J., Fuchs C., Kirkner G., Hankinson S., Hollis B., Giovannucci E. 2004: Plasma vitamin D metabolites and risk of colorectal cancer in women. Cancer Epidemiol. Biomarkers Prev. 13: 1502-1508. Go to original source... Go to PubMed...
  17. Flegr J. 2015a: Neurological and neuropsychiatric consequences of chronic Toxoplasma infection. Curr. Clin. Microbiol. Rep. 2: 163-172. Go to original source...
  18. Flegr J. 2015b: Schizophrenia and Toxoplasma gondii: an undervalued association? Expert Rev. Anti-Infect. Ther. 13: 817-820. Go to original source... Go to PubMed...
  19. Flegr J., Escudero D. 2016: Impaired health status and increased incidence of diseases in Toxoplasma-seropositive subjects - an explorative cross-sectional study. Parasitology 143: 1974-1989. Go to original source... Go to PubMed...
  20. Flegr J., Horáček J. 2018: Toxoplasmosis, but not borreliosis, is associated with psychiatric disorders and symptoms. Schizophr. Res. 197: 603-604. Go to original source... Go to PubMed...
  21. Flegr J., Klapilová K., Kaňková ©. 2014a: Toxoplasmosis can be a sexually transmitted infection with serious clinical consequences. Not all routes of infection are created equal. Med. Hypotheses 83: 286-289. Go to original source... Go to PubMed...
  22. Flegr J., Prandota J., Sovičková M., Israili Z. 2014b: Toxoplasmosis - a global threat. Correlation of latent toxoplasmosis with specific disease burden in a set of 88 countries. PLoS ONE 9: e90203. Go to original source... Go to PubMed...
  23. Flegr J., Příplatová L., Hampl R., Bičíková M., Řípová D., Mohr P. 2014c: Difference of neuro- and immunomodulatory steroids and selected hormone and lipid concentrations between Toxoplasma-free and Toxoplasma-infected but not CMV-free and CMV-infected schizophrenia patients. Neuroendocrinol. Lett. 35: 20-27. Go to PubMed...
  24. Flegr J., Sýkorová K., Fiala V., Hlaváčová J., Bičíková M., Máčová L., Kaňková ©. 2020: Increased 25(OH)D3 level in redheaded people: could redheadedness be an adaptation to temperate climate? Exp. Dermatol. 29: 598-609. Go to original source... Go to PubMed...
  25. Frenkel J., Hassanein K., Hassanein R., Brown E., Thulliez P., Quinteronunez R. 1995: Transmission of Toxoplasma gongii in Panama City, Panama: a 5-year prospective cohort study of children, cats, rodents, birds, and soil. Am. J. Trop. Med. Hyg. 53: 458-468. Go to original source... Go to PubMed...
  26. Garland C., Gorham E., Mohr S., Garland F. 2009: Vitamin D for cancer prevention: global perspective. Ann. Epidemiol. 19: 468-483. Go to original source... Go to PubMed...
  27. Ghaffarifar F., Pour M., Sharifi Z., Asl A., Al-Kawaz E. 2010: The effect of vitamin D3 Alone and mixed with IFN-gamma on tachyzoites of Toxoplasma gondii (RH strain) proliferation and nitric oxide (NO) production in infected macrophages of BALB/C mice. Iran. J. Parasitol. 5: 48-56.
  28. Haddad J.G., Hahn T.J. 1973: Natural and synthetic sources of circulating 25-hydroxyvitamin D in man. Nature 244: 515-517. Go to original source... Go to PubMed...
  29. Hlaváčová J., Flegr J., Řeľábek K., Calda P., Kaňková ©. 2021: Male-to-female presumed transmission of toxoplasmosis between sexual partners. Am. J. Epidemiol. In press. https://doi.org/10.1093/aje/kwaa198 Go to original source... Go to PubMed...
  30. Hsu P., Groer M., Beckie T. 2014: New findings: depression, suicide, and Toxoplasma gondii infection. J. Am. Assoc. Nurse Pract. 26: 629-637. Go to original source... Go to PubMed...
  31. Chakhtoura M., Azar S. 2013: The role of vitamin D deficiency in the incidence, progression, and complications of type 1 diabetes mellitus. Int. J. Endocrinol. 148673. Go to original source... Go to PubMed...
  32. Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. 1997: Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington, D.C.: National Academies Press.
  33. Kaňková ©., Flegr J., Calda P. 2015a: An elevated blood glucose level and increased incidence of gestational diabetes mellitus in pregnant women with latent toxoplasmosis. Folia Parasitol. 62: 056. Go to original source... Go to PubMed...
  34. Kaňková ©., Flegr J., Calda P. 2015b: The influence of latent toxoplasmosis on women's reproductive function: four cross-sectional studies. Folia Parasitol. 62: 041. Go to original source... Go to PubMed...
  35. Kaňková ©., Hlaváčová J., Flegr J. 2020: Oral sex: a new, and possibly the most dangerous, route of toxoplasmosis transmission. Med. Hypotheses 141: 5. Go to original source...
  36. Kashan Z., Shojaee S., Keshavarz H., Arbabi M., Delavari M., Salimi M. 2019: Vitamin D deficiency and Toxoplasma infection. Iran. J. Publ. Hlth 48: 1184-1186.
  37. Kodym P., Machala L., Roháčová H., ©irocká B., Malý M. 2007: Evaluation of a commercial IgE ELISA in comparison with IgA and IgM ELISAs, IgG avidity assay and complement fixation for the diagnosis of acute toxoplasmosis. Clin. Microbiol. Infect. 13: 40-47. Go to original source... Go to PubMed...
  38. Kolbeková P., Kourbatová E., Novotná M., Kodym P., Flegr J. 2007: New and old risk-factors for Toxoplasma gondii infection: prospective cross-sectional study among military personnel in the Czech Republic. Clin. Microbiol. Infect. 13: 1012-1017. Go to original source... Go to PubMed...
  39. Lavie C., DiNicolantonio J., Milani R., O'Keefe J. 2013: Vitamin D and cardiovascular health. Circulation 128: 2404-2406. Go to original source... Go to PubMed...
  40. Lerchbaum E., Obermayer-Pietsch B. 2012: Vitamin D and fertility: a systematic review. Eur. J. Endocrinol. 166: 765-778. Go to original source... Go to PubMed...
  41. Lund B., Sørensen O.H. 1979: Measurement of 25-hydroxyvitamin D in serum and its relation to sunshine, age and vitamin D intake in the Danish population. Scand. J. Clin. Lab. Invest. 39: 23-30. Go to original source... Go to PubMed...
  42. Markovitz A., Simanek A., Yolken R., Galea S., Koenen K., Chen S., Aiello A. 2015: Toxoplasma gondii and anxiety disorders in a community-based sample. Brain Behav. Immun. 43: 192-197. Go to original source... Go to PubMed...
  43. de Oliveira C., Hirani V., Biddulph J. 2018: Associations between vitamin D levels and depressive symptoms in later life: evidence from the English longitudinal study of ageing (ELSA). J. Gerontol. A. Biol. Sci. Med. Sci. 73: 1377-1382. Go to original source... Go to PubMed...
  44. Papadimitriou D.T. 2017: The big vitamin D mistake. J. Prev. Med. Publ. Hlth. 50: 278-281. Go to original source... Go to PubMed...
  45. Pedersen M., Mortensen P., Norgaard-Pedersen B., Postolache T. 2012: Toxoplasma gondii infection and self-directed violence in mothers. Arch. Gen. Psychiatry 69: 1123-1130. Go to original source... Go to PubMed...
  46. Ryan J.W., Anderson P.H., Turner A.G., Morris H.A. 2013: Vitamin D activities and metabolic bone disease. Clin. Chim. Acta 425: 148-152. Go to original source... Go to PubMed...
  47. Schneider B., Weber B., Frensch A., Stein J., Fritze J. 2000: Vitamin D in schizophrenia, major depression and alcoholism. J. Neural Transm. 107: 839-842. Go to original source... Go to PubMed...
  48. Sutterland A., Fond G., Kuin A., Koeter M., Lutter R., van Gool T., Yolken R., Szoke A., Leboyer M., de Haan L. 2015: Beyond the association. Toxoplasma gondii in schizophrenia, bipolar disorder, and addiction: systematic review and meta-analysis. Acta Psychiatr. Scand. 132: 161-179. Go to original source... Go to PubMed...
  49. Tayeb F., Salman Y., Ameen K. 2019: The impact of Toxoplasma gondii infection on the vitamin D3 levels among women in childbearing age in Kirkuk Province-Iraq. Open J. Med. Microbiol. 9: 151-167. Go to original source...
  50. Tenter A., Heckeroth A., Weiss L. 2000: Toxoplasma gondii: from animals to humans. Int. J. Parasitol. 30: 1217-1258. Go to original source... Go to PubMed...
  51. Torrey E., Bartko J., Yolken R. 2012: Toxoplasma gondii and other risk factors for schizophrenia: an update. Schizophr. Bull. 38: 642-647. Go to original source... Go to PubMed...
  52. Torrey E., Yolken R. 2003: Toxoplasma gondii and schizophrenia. Emerg. Infect. Dis. 9: 1375-1380. Go to original source... Go to PubMed...
  53. Tsiaras W., Weinstock M. 2011: Factors influencing vitamin D status. Acta Derm. Venereol. 91: 115-124. Go to original source... Go to PubMed...
  54. Tworoger S., Lee I., Buring J., Rosner B., Hollis B., Hankinson S. 2007: Plasma 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D and risk of incident ovarian cancer. Cancer Epidemiol. Biomarkers Prev. 16: 783-788. Go to original source... Go to PubMed...
  55. Viechtbauer W. 2010: Conducting meta-analyses in R with the metafor Package. J. Stat. Softw. 36: 1-48. Go to original source...
  56. Vierucci F., Del Pistoia M., Fanos M., Erba P., Saggese G. 2014: Prevalence of hypovitaminosis D and predictors of vitamin D status in Italian healthy adolescents. Ital. J. Pediatr. 40. Go to original source... Go to PubMed...
  57. Yuan Z., Gao S., Liu Q., Xia X., Liu X., Liu B., Hu R. 2007: Toxoplasma gondii antibodies in cancer patients. Cancer Lett. 254: 71-74. Go to original source... Go to PubMed...
  58. Zhou Y.H., Lu Y.J., Wang R.B., Song L.M., Shi F., Gao Q.F., Luo Y.F., Gu X.F., Wang P. 2002: [Survey of infection of Toxoplasma gondii in infertile couples in Suzhou countryside]. Zhonghua Nan Ke Xue 8: 350-352. (In Chinese.) Go to PubMed...