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      Is reactivation of toxoplasmic retinochoroiditis associated to increased annual rainfall? Translated title: La réactivation de la rétinochoroïdite toxoplasmique est-elle associée à l’augmentation des précipitations annuelles ?

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          Background: Reactivation of toxoplasmic retinochoroiditis is the most frequent form of uveitis in Misiones, Argentina. Fluctuations in the number of patients consulting with this type of uveitis were detected during the last decade. Since the province was consecutively exposed to rainy and dry periods over the last years, we decided to explore whether a relationship between reactivation of toxoplasmic retinochoroiditis and rain might be established according to the data registered during the 2004–2010 period. Results: The frequency of toxoplasmic reactivation episodes increases when precipitation increases (mostly in second and fourth trimesters of each year). Analysis of the independent variables demonstrates that precipitation is a significant predictor of the frequency of reactivation episodes. Although registered toxoplasmic reactivations were more frequent during the third trimester of the year, the association between the third trimester and the reactivation episodes did not reach statistical significance. Conclusion: Prolonged and intense rainfall periods were significantly associated with the reactivation of toxoplasmic retinochoroiditis. Changes promoted by this climatic condition on both the parasite survival in the soil as well as a putative effect on the host immune response due to other comorbidities are discussed.

          Translated abstract

          Introduction : La réactivation de la rétinochoroïdite toxoplasmique est la forme la plus fréquente d’uvéite à Misiones, Argentine. Des fluctuations du nombre de patients consultant avec ce type d’uvéite ont été constatées pendant la dernière décennie. Comme la province a été exposée à des périodes pluvieuses et sèches consécutives pendant les dernières années, nous avons décidé d’explorer si une relation entre la réactivation de rétinochoroïdite toxoplasmique et la pluie pouvait être établie en fonction des données enregistrées au cours de la période 2004–2010. Résultats : la fréquence des épisodes de réactivation toxoplasmique croît lorsque les précipitations augmentent (surtout dans les deuxième et quatrième trimestres de chaque année). L’analyse des variables indépendantes démontre que les précipitations sont un facteur prédictif significatif de la fréquence des épisodes de réactivation. Les réactivations toxoplasmiques enregistrées étaient plus fréquentes au cours du troisième trimestre de l’année mais l’association entre le troisième trimestre et les épisodes de réactivation n’a pas atteint une signification statistique. Conclusion : les périodes de pluie intense et prolongée étaient significativement associés à la réactivation de la rétinochoroïdite toxoplasmique. Les changements produits par ces conditions climatiques sur la survie du parasite dans le sol ainsi qu’un effet putatif sur la réponse immunitaire de l’hôte dû à d’autres comorbidités sont discutées.

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          Most cited references 30

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            Th3 CD4+ regulatory cells were identified during the course of investigating mechanisms associated with oral tolerance. Different mechanisms of tolerance are induced following oral antigen administration, including active suppression, clonal anergy and deletion. Low doses favor active suppression whereas high doses favor anergy/deletion. Th3 regulatory cells form a unique T-cell subset which primarily secretes transforming growth factor (TGF)-beta, provides help for IgA and has suppressive properties for both Th1 and Th2 cells. Th3 type cells are distinct from the Th2 cells, as CD4+ TGF-beta-secreting cells with suppressive properties have been generated from interleukin (IL)-4-deficient animals. In vitro differentiation of Th3 cells from Th precursors from T-cell antigen receptor (TCR) transgenic mice is enhanced by culture with TGF-beta, IL-4, IL-10, and anti-IL-12. Th3 CD4+ myelin basic protein regulatory clones are structurally identical to Th1 encephalitogenic clones in TCR usage, MHC restriction and epitope recognition, but produce TGF-beta with various amounts of IL-4 and IL-10. Because Th3 regulatory cells are triggered in an antigen-specific fashion but suppress in an antigen-non-specific fashion, they mediate "bystander suppression" when they encounter the fed autoantigen at the target organ. In vivo induction of Th3 cells and low dose oral tolerance is enhanced by oral administration of IL-4. Anti-CD86 but not anti-CD80 blocks the induction of Th3 cells associated with low dose oral tolerance. Th3 regulatory cells have been described in other systems (e.g. recovery from experimental allergic encephalomyelitis) but may be preferentially generated following oral antigen administration due to the gut immunologic milieu that is rich in TGF-beta and has a unique class of dendritic cells. CD4+CD25+ regulatory T-cell function also appears related to TGF-beta.
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              An unusually high prevalence of ocular toxoplasmosis in southern Brazil.

              Because of the frequency of ocular toxoplasmosis and its occurrence in multiple siblings in southern Brazil, a population-based household survey was performed to better understand the epidemiologic characteristics of the disease in this region. Of 1,042 individuals examined, 184 (17.7%) were deemed to have ocular toxoplasmosis on the basis of conservative assessment of ophthalmic findings. Of those with ocular toxoplasmosis, 183 (99.5%) had specific IgG antibodies, compared with only 140 of 181 age-matched control subjects (77.4%; P less than .001). The prevalence of ocular toxoplasmosis was 0.9% in 1- to 8-year-olds, 4.3% in 9- to 12-year-olds, 14.3% in 13- to 16-year-olds, and 21.3% (95% confidence interval, 18.6% to 24.2%) in all individuals 13 years or older. The prevalence of ocular toxoplasmosis in this population was more than 30 times higher than previous estimates for the same condition elsewhere. The low prevalence in the young children we studied supplements previous data suggesting that, in this population, ocular toxoplasmosis is a sequela of postnatal rather than congenital infection.

                Author and article information

                EDP Sciences
                14 November 2013
                : 20
                : ( publisher-idID: parasite/2013/01 )
                [1 ] Uveítis section, Rudzinski oftalmología Oberá Misiones Argentina
                [2 ] APTM clinic 25 de mayo Misiones Argentina
                [3 ] Instituto de Investigaciones Médicas Alfredo Lanari, University of Buenos Aires , Argentina
                [4 ] Uveitis section, Department of Ophthalmology, “Jose de San Martin” Clinical hospital, University of Buenos Aires Argentina
                Author notes
                [* ]Corresponding author: marcelor1@ 123456hotmail.com
                parasite130023 10.1051/parasite/2013044
                © M. Rudzinski et al., published by EDP Sciences, 2013

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 2, Tables: 1, Equations: 0, References: 45, Pages: 7
                Research Article


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