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

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  1   2 , Débora Nonato Miranda de Toledo  1   2 , Débora Maria Soares de Souza  1   2 , Tatiana Prata Menezes  1   2 , Luiza Oliveira Perucci  1 , Zolder Marinho Silva  1   2 , Daniela Caldas Teixeira  3 , Ed Wilson Rodrigues Vieira  4 , Valter Ferreira de Andrade-Neto  5 , Nathalia Sernizon Guimarães  2 , André Talvani  1   2   6
Affiliations

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 et al. Front Immunol. .

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.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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