Seroepidemiology of Chronic Toxoplasmosis in Multiple Sclerosis Patients in Northeastern Iran

Fariba  Berenji; Mohammadali  Nahayati; Mehdi Afarideh  Sani; Mehdi  Zarean; Ghodratollah Salehi  Sangani; Bibi Razieh Hosseini  Farash

doi:10.18502/ijpa.v20i3.19610

Fariba Berenji Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
Mohammadali Nahayati Department of Neurology, Mashhad University of Medical Sciences Mashhad, Iran
Mehdi Afarideh Sani Department of Medicine, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
Mehdi Zarean Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
Ghodratollah Salehi Sangani Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
Bibi Razieh Hosseini Farash Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran

DOI: https://doi.org/10.18502/ijpa.v20i3.19610

Keywords: Toxoplasma gondii; Multiple sclerosis; Neuroinflammation; Seroprevalence

Abstract

Background: Toxoplasma gondii is a common intracellular parasite implicated in chronic infections that may contribute to the pathogenesis of multiple sclerosis (MS). The potential role of T. gondii in triggering or exacerbating neuroinflammatory processes has been suggested in several recent studies. We aimed to assess the seroprevalence of anti T. gondii IgG antibodies in MS patients compared to healthy individuals and to evaluate associated demographic, environmental, and lifestyle risk factors.

Methods: In this cross-sectional case-control study at the Comprehensive MS Center of Ghaem Hospital, Mashhad, Iran, 99 MS patients and 92 matched healthy controls were enrolled. Serum samples were tested for T. gondii IgG using ELISA, and data on demographics, pet ownership, diet, untreated water consumption, COVID-19 history, and MS symptoms (muscle weakness, bowel dysfunction, balance disorders, speech disturbances, and attack frequency) were collected. Multivariate logistic regression assessed associations between T. gondii seropositivity, clinical symptoms, and environmental factors.

Results: T. gondii seropositivity was significantly higher in the MS group (22%) compared to controls (8%) (P = 0.013). Pet ownership, particularly cat ownership, was identified as a significant risk factor (OR = 5.089, P = 0.037). No significant associations were found between seropositivity and raw or undercooked meat consumption, unwashed vegetable intake, or history of COVID-19. Additionally, among clinical symptoms in MS patients, muscle weakness and bowel dysfunction showed significant positive associations with T. gondii seropositivity.

Conclusion: The findings suggest a potential link between chronic T. gondii infection and MS, indicating that the parasite may play a role in modulating neuroinflammatory responses. Further longitudinal and multicenter studies are warranted to elucidate the underlying mechanisms and evaluate the impact of antiparasitic treatments in MS management.