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弓形虫病作为行为障碍的一个病因——证据与机制概述

Toxoplasmosis as a cause for behaviour disorders--overview of evidence and mechanisms.

作者信息

Fekadu Abebaw, Shibre Teshome, Cleare Anthony J

机构信息

Department of Psychiatry, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.

出版信息

Folia Parasitol (Praha). 2010 Jun;57(2):105-13. doi: 10.14411/fp.2010.013.

Abstract

BACKGROUND

There is growing interest in the role of microbial agents in the causation of psychiatric disorders. The neurotropic protozoan parasite Toxoplasma gondii is one of the main candidates and has been associated with various psychiatric conditions, including schizophrenia.

METHODS

A narrative review of the literature from the main medical databases (Medline, PubMed, PsycINFO), Google Scholar and Google using combinations of applicable terms.

RESULTS

T. gondii affects the brain in both the acute and the latent stages of infection causing apparent brain pathologies in infected rodents and both immuno-compromised and immuno-competent humans. In immuno-competent individuals, behavioural disorders are primarily related to the latent stages of the illness. Behavioural/mental disorders that include schizophrenia, mood disorders, personality changes and cognitive impairments may be related to infection with T. gondii. Evidence for a behavioural effect of T. gondii comes from observational reports in animal models and controlled behavioural analysis in humans. Indirect clues of infection also come from raised seroprevalence or serotitres of antitoxoplasma antibodies among those with mental disorders. The pathophysiologic mechanism through which T. gondii may exert its effect is not clear, but direct impact on the brain and changes in neuroimmunomodulation, neurotransmission and some gene-environment interactions are postulated.

CONCLUSION

There is evidence supporting a potential role of T. gondii infection in the onset of some behavioural disorders. Confirmation of such a role would prove a significant breakthrough in the search for the aetiology, treatment and prevention of behavioural disorders, such as schizophrenia. However, the associations remain preliminary.

摘要

背景

微生物制剂在精神疾病病因中的作用正受到越来越多的关注。嗜神经性原生动物寄生虫刚地弓形虫是主要候选因素之一,并且已与包括精神分裂症在内的各种精神疾病相关联。

方法

使用适用术语组合,对主要医学数据库(Medline、PubMed、PsycINFO)、谷歌学术和谷歌上的文献进行叙述性综述。

结果

刚地弓形虫在感染的急性期和潜伏期均会影响大脑,在受感染的啮齿动物以及免疫功能低下和免疫功能正常的人类中都会导致明显的脑部病变。在免疫功能正常的个体中,行为障碍主要与疾病的潜伏期有关。包括精神分裂症、情绪障碍、人格改变和认知障碍在内的行为/精神障碍可能与刚地弓形虫感染有关。刚地弓形虫行为效应的证据来自动物模型的观察报告和人类的对照行为分析。感染的间接线索还来自精神障碍患者中抗弓形虫抗体血清阳性率或血清滴度的升高。刚地弓形虫可能发挥其作用的病理生理机制尚不清楚,但推测其对大脑有直接影响,并在神经免疫调节、神经传递和一些基因-环境相互作用方面发生了变化。

结论

有证据支持刚地弓形虫感染在某些行为障碍发病中可能发挥的作用。证实这一作用将在寻找行为障碍(如精神分裂症)的病因、治疗和预防方面取得重大突破。然而,这些关联仍属初步。

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