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Article Dans Une Revue Schizophrenia Research Année : 2018

Latent toxoplasma infection in real-world schizophrenia: Results from the national FACE-SZ cohort

G. Fond (1, 2) , L. Boyer (1, 2) , F. Schürhoff (2, 3) , F. Berna (2, 4, 5, 6) , O. Godin (2, 7, 8) , E. Bulzacka (3, 2) , M. Andrianarisoa (2, 3) , L. Brunel (2, 3) , Bruno Aouizerate (2, 9, 10) , D. Capdevielle (11, 2, 12, 13, 14) , I. Chereau (2, 15) , N. Coulon (2, 16, 3) , T. d'Amato (17, 2, 18, 19) , C. Dubertret (2, 20, 21) , J. Dubreucq (2) , C. Faget (13, 2, 1) , C. Lançon (2, 1) , S. Leignier (2) , J. Mallet (2, 20, 21) , D. Misdrahi (2, 10, 9, 22) , C. Passerieux (2, 23, 24, 25) , R. Rey (2, 18, 19, 17) , A. Schandrin (2, 12, 13, 14) , M. Urbach (2, 23, 24, 25) , P. Vidailhet (5, 6, 4, 26) , P.M. Llorca (2, 15) , M. Leboyer (2, 16, 3)
1 CEReSS - Centre d'études et de recherche sur les services de santé et la qualité de vie
2 Fondation FondaMental [Créteil]
3 IMRB - Institut Mondor de Recherche Biomédicale
4 HUS - Les Hôpitaux Universitaires de Strasbourg
5 NCPS - Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie
6 FMTS - Fédération de Médecine Translationnelle de Strasbourg
7 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
8 SU - Sorbonne Université
9 Centre hospitalier Charles Perrens [Bordeaux]
10 UB - Université de Bordeaux
11 UM1 - Université Montpellier 1
12 Hôpital de la Colombière
13 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
14 UM - Université de Montpellier
15 NPsy-Sydo - Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux
16 Pôle de Psychiatrie [Hôpital Henri Mondor]
17 Centre Hospitalier le Vinatier [Bron]
18 CRNL - Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center
19 UCBL - Université Claude Bernard Lyon 1
20 Hôpital Louis Mourier - AP-HP [Colombes]
21 USPC - Université Sorbonne Paris Cité
22 INCIA - Institut de Neurosciences cognitives et intégratives d'Aquitaine
23 CHV - Centre Hospitalier de Versailles André Mignot
24 HANDIReSP - Laboratoire de recherches cliniques et en santé publique sur les handicaps psychique, cognitif et moteur
25 UVSQ Santé - Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil
26 UNISTRA - Université de Strasbourg

Résumé

OBJECTIVE: Latent Toxoplasma infection has been associated with widespread brain immune activation, increased blood brain barrier permeability, neural disruption, increased dopamine release in dopaminergic neurons, with NMDA activation and with schizophrenia (SZ) onset risk. Toxoplasma has been suggested to be a source of chronic low-grade inflammation and this inflammation has been associated with cognitive impairment in SZ. The objective of the present study were (i) to determine if latent Toxoplasma infection was associated with specific clinical features in stabilized SZ subjects, with cognitive impairment and with increased low-grade peripheral inflammation and (ii) to determine if Treatments with Anti-Toxoplasmic Activity (TATA) were associated with improved outcomes in subjects with latent Toxoplasma infection. METHODS: A comprehensive 2 daylong clinical and neuropsychological battery was administered in 250 SZ subjects included between 2015 and 2017 in the national FondaMental Expert Center (FACE-SZ) Cohort. Solid phase-enzyme microplate immunoassay methods were used to measure IgG class of antibodies to T. gondii in blood sample. Latent Toxoplasma infection was defined by T. gondii IgG ratio ≥0.8, equivalent to ≥10 international units. Chronic peripheral inflammation was defined by highly sensitive C reactive protein blood level ≥ 3 mg/L. RESULTS: Latent Toxoplasma infection has been found in 184 (73.6%) of this national multicentric sample. In the multivariate analyses, latent Toxoplasma infection has been significantly associated with higher PANSS negative (aOR = 1.1 [1.1-1.1], p = 0.04) and excitement subscores (aOR = 1.3 [1.1-1.6], p = 0.01), with two specific symptoms (i.e., reference delusion (aOR = 3.6 [1.2-10.6] p = 0.01) and alogia (aOR = 16.7 [2.0-134.7], p = 0.008)) and with chronic low-grade peripheral inflammation (27.2% vs. 7.6%, aOR = 3.8 [1.4-10.3], p = 0.004). Extrapyramidal symptoms remained significantly associated with latent Toxoplasma infection. On the opposite, no significant association of latent Toxoplasma infection with age, gender, age at SZ onset, suicide behavior or cognitive deficits has been found in these models (all p > 0.05). TATA were associated with lower depressive symptoms (aOR = 0.8[0.7-0.9], p = 0.01), and with lower rates of chronic peripheral inflammation (20.9% vs. 48.6%, aOR = 3.5 [1.5-7.9], p = 0.003) but not with higher cognitive scores (p > 0.05). CONCLUSION: The present findings suggest that Toxoplasma is almost 3 times more frequent in SZ population compared to general population in France. The potential cerebral underpinnings of the association of latent Toxoplasma infection and the above-mentioned outcomes have been discussed. Future studies should confirm that TATA may be effective to reduce Toxoplasma-associated depressive symptoms and low-grade peripheral inflammation.
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Dates et versions

hal-02094446 , version 1 (09-04-2019)

Identifiants

Citer

G. Fond, L. Boyer, F. Schürhoff, F. Berna, O. Godin, et al.. Latent toxoplasma infection in real-world schizophrenia: Results from the national FACE-SZ cohort. Schizophrenia Research, 2018, 201, pp.373-380. ⟨10.1016/j.schres.2018.05.007⟩. ⟨hal-02094446⟩
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