A comparative study of Toxoplasma gondii seroprevalence in three healthy Chinese populations detected using native and recombinant antigens
© Sun et al.; licensee BioMed Central Ltd. 2013
Received: 22 July 2013
Accepted: 18 August 2013
Published: 20 August 2013
Toxoplasmosis is one of the most common parasitic zoonoses. The seroprevalence of Toxoplasma gondii infection in humans varies widely worldwide. Detection of Toxoplasma-specific antibodies has been a gold standard method for both epidemiological investigation and clinical diagnosis. Genetic investigation indicated that there is a wide distribution of different genome types or variants of the parasite prevalent in different areas. Thus the reliability of using antigens from parasites of a single genome type for diagnosis and epidemiology purposes needs to be extensively evaluated.
In this study, the prevalence of T. gondii infection among 880 clinically healthy individuals in China was systematically tested using crude soluble native antigens and purified recombinant antigens of type I and II T. gondii. The T. gondii-specific IgG and IgM in the sera was further confirmed using commercial Toxoplasmosis Diagnosis Kits and Western blot assays.
The sero-prevalence of T. gondii-specific IgG detected with crude native Type I and type II antigens was 12.2% and 11.3% respectively. Whereas the overall prevalence was more than 20% when combined with the results obtained with recombinant tachyzoite and bradyzoite antigens. There was an obvious variation in immune-recognition of parasite antigens among the individuals studied.
The general prevalence of anti-T. gondii IgG in the study population was likely much higher than previously reported. The data also suggested that there is more genetic diversity among the T. gondii isolates in China. Further, combination of recombinant antigens with clear immuno-recognition will be able to generate more sensitive diagnostic results than those obtained with crude antigens of T. gondii tachyzoites.
KeywordsToxoplasma gondii Prevalence Antigens China
Toxoplasma gondii is an intracellular parasite that can infect domestic, wild, and companion animals, and it also commonly infects humans . The importance of this parasite in food safety, human health and animal husbandry has been well recognized. Though T. gondii infection in humans with a normal immune competence is asymptomatic in most cases, the parasites do pose threats to individuals who are immunocompromised, such as HIV carriers . It has been estimated that up to one third of the world’s population has been infected by T. gondii with an endemicity from around 10% to 70% [1, 3–5] and the prevalence is higher in warm and humid areas [6–8]. In several studies, patients with schizophrenia were found to have a higher tendency of T. gondii infection [9–12], but there has been no conclusive correlation between T. gondii infection and psychiatric disease .
Toxoplasma gondii displays significant genetic diversity in different geographical regions [14–16]. Currently, toxoplasmosis is diagnosed primarily by demonstrating parasite-specific IgM or IgG antibodies in serum samples. Most of the commercially available tests use T. gondii native antigens derived from the fast growing tachyzoites which may result in variations in accuracy of detection. Recombinant antigens have been suggested as diagnostic reagents but their reliability may need extensive experimental validation [17, 18]. Further, T. gondii remains dormant as bradyzoites in immune competent individuals, which can convert to tachyzoites when the host immune defense system is compromised, and tachyzoites and bradyzoites do display different antigenic profiles . Thus it is critical to select accurate antigens for diagnostic and epidemiological purposes.
In this study, we investigated the level of anti-T. gondii IgG and IgM in the sera of more than 800 Chinese individuals living in the southern and northern regions of China, comparing crude antigens of RH (Type I) and ME49 (Type II) strains and 12 recombinant antigens of either Type I or Type II T. gondii. The purpose is to compare the sensitivity and consistency in detection of T. gondii specific antibodies in the same set of samples with different antigens.
Study populations and serum samples
880 serum samples from clinically healthy individuals were collected in Changchun, Daqing and Shanghai areas in China from July 2006 to June 2012 as described previously . The sera were collected with the consent of the volunteers. The study was carried out with permission from the Ethical Committee of Institute of Zoonosis, Jilin University, China.
Soluble native parasite antigens: T. gondii tachyzoites of RH and ME49 strains were cultivated in BHK (baby hamster kidney) cell lines as described earlier . Briefly parasites released from host cells were harvested, washed in PBS and lysed by sonication. The insoluble component such as cell debris was eliminated by centrifugation (12,000 rpm for 30 min) and the soluble proteins, respectively termed RH-Ag and ME49-Ag were collected and diluted to a final concentration of 1 mg/ml in PBS for the serological test.
Primer sequences used in the Polymerase Chain Reaction (PCR)
NCBI accession no.
Primer sequence (5’-3’)
Amplified product (bp)
Indirect ELISA assays were performed to measure the anti-T. gondii IgG level according to the standard protocol . All reaction steps except coating and washing were performed at 37°C. Briefly, Maxisor micro-ELISA plates (Nalge Nunc International, IL, USA) were coated with 50 μl per well of the T. gondii antigens (RH-Ag, ME49-Ag and 12 recombinant antigens, respectively) in a concentration of 5 μg/ml at 4°C overnight. The plates were washed five times with PBS containing 0.05% Tween 20 and blocked for 3–4 h at 37°C with 100 μl per well of 0.5% BSA in PBS. After washing, 50 μl of each serum sample, diluted at 1:50 was added to the well in triplicates for 1 h. Alkaline phosphatase-labelled goat antihuman IgG (Sigma, St. Louis, USA, 1:2000 dilution) was added to the well after washing. Finally, 50 μl of NPP [4-Nitrophenyl phosphate disodium salt hexahydrate] (Sigma, St. Louis, USA) and 9.7% diethanolamine (pH 9.8) were used to detect antigen-antibody reactions. The plates were finally read in a Biotek 93 micro-ELISA auto-reader 808 at 405 nm. A human serum sample, which was previously confirmed with negative reactivity to T. gondii by the direct agglutination test was included as a negative control in every plate. The GST protein was used as control for the GST-tag fusion antigens. The cut-off point of OD value for a positive sample was set to be at least two times higher than that of the negative sample at any dilution point as described previously .
To further confirm the ELISA data, all positive and 50 randomly selected negative sera were further tested by the commercial T. gondii IgG/IgM Kits (Haitai Biological Pharmaceuticals Co., Ltd, China) that can respectively detect human IgG and IgM, and Western blot assays using soluble extract of T. gondii. The procedure of the commercial IgG/IgM kit was performed according to the manufacturer’s instruction . For the purpose of Western blot assays, the parasite-derived soluble proteins were separated on a 12% SDS-PAGE gel and transferred onto nitrocellulose membranes (Bio-Rad, CA, USA). The membrane was cut into strips and incubated with the positive and negative sera (at 1:50 dilution) identified in the ELISA assays. Meanwhile, a serum of an individual previously confirmed with T. gondii infection was used as a positive control. The membrane strips were further incubated with an alkaline phosphatase-conjugated goat anti-human IgG antibody (1:20000 dilutions) after washing in TBST buffer (10 mM Tris, 150 mM NaCl, pH 8.0 and 0.05% Tween 20). Eventually, the strips were incubated with BCIP/NBT substrate solution to visualize the protein bands that were recognized by the specific antibodies.
The results were statistically analyzed using the SPSS 18.0 software package. Chi-square test was used to analyze the anti-T. gondii IgG seroprevalence by using twelve T. gondii antigens. The differences were considered to be statistically significant when the p value was less than 0.05 .
Results and discussion
Positive serum number and prevalence of anti- T. gondii IgG detected with different antigens
Strain of T. gondii
Stage and location
Number of samples (n = 880) with anti-T. gondii IgG and prevalence (%)
Independent positive rate
Combined positive rate
Tachyzoite crude antigens
Tachyzoite crude antigens
96 (10. 9%)
To test the differences in seroprevalence with tachyzoite- and bradyzoite-derived antigens, twelve recombinant antigens including three tachyzoite-specific, three bradyzoite-specific and six antigens likely expressed by both tachyzoites and bradyzoites (Table 2). These antigens have been previously proved to be immunogenic and frequently recognized by human antibodies [26–28]. The seroprevalence of specific IgG to the individual recombinant antigens were around 10%, with one exception, the positive rate (14.9%) of BAG1-GST was significantly higher than that observed with other recombinant antigens or even crude antigens (p < 0.05) (Table 2). Thus immuno-recognition of BAG1 is likely more prominent than other bradyzoite antigens during chronic infection. BAG1 was a 30 kDa cytosolic protein which is only expressed in the bradyzoites [29, 30]. Immunological studies suggested that BAG1 was very immunogenic and could induce early humoral and cell-mediated immune responses upon infection in humans . Thus it is not so surprising to observe a most prominent recognition of BAG1 by the sera compared to other tachyzoite- and bradyzoite-derived antigens.
On further analysis of the serum samples which were positive in the ELISA test, surprisingly it was found that the samples did not all overlapped or consistently react with the three kinds of antigen (Figure 1A). Among the 394 positive samples, 107 sera were positive with RH-Ag, 99 were positive with ME49-Ag and 248 were positive with the recombinant antigens. 20 samples which accounted for only 5.1% of all positive samples were detected by both RH-Ag and ME49-Ag. 20 samples, 5.1% of all positive sera, were detected by both RH-Ag and the Rec-Ags, and 26 sera, 6.6% of all positive samples, were detected by both ME49-Ag and the Rec-Ags (Figure 1A). Only 6 samples were positively detected in reactions with all three kinds of antigen and accounted for 1.5% of all positive samples. The reason that rAgs were more sensitive than native antigens may be due to the low concentration of the immunogenic components in the crude antigens. During T. gondii infection, a broad range of parasite antigens will be presented to the host immune system, thus the detection sensitivity using crude antigens will be affected by factors such as antibody affinity, antigen variation, inter-antigen interaction, and strain-specific responses. Similar results have been reported in previous studies [32, 33].
Analysis of the ELISA results in the assays with recombinant antigens of RH and ME49 strains showed, however, more overlapping between different strains (Figure 1B and Table 2). Among the 248 positive samples detected with the 12 recombinant antigens of either RH-, ME49- or common (RH/ME49) type, 71 samples were positive in reactions with all three types of antigen, which accounted for 28.6% of all positive samples, even though the detection rates with strain-specific rAgs were higher. The data further supported the finding that a combination of several immune-dominant antigens will generate a higher diagnostic efficiency . In contrast, 6.9% of the positive sera samples were detected by both RH-rAg and ME49-rAg, 11.3% were detected by both RH-rAg and common RH/ME49-rAg, and 9.7% were detected by both ME49-rAg and RH/ME49-rAg.
The positive rates of samples detected with the commercial T. gondii IgG/IgM Kits and Western blot
Number of positive sera by ELISA
Number of negative sera by ELISA
(n = 248)
(n = 50, randomly selected)
(Among serum samples)
P < 0.01
P < 0.05
In this study, we compared the immunorecognition of three kinds of T. gondii strain- and developmental status-specific antigens with the same set of sera. Results clearly showed that there were strikingly differences in the recognition of these antigens among the samples. The prevalence of anti-T. gondii IgG obtained with crude native RH-Ag and ME49-Ag was similar, whereas the prevalence obtained with recombinant antigens (rAgs) was significantly higher than that of the crude antigens. More importantly, the number of sera that cross-reacted with the three kinds of antigen was low, accounting for only 1.5% of the positive samples. Nevertheless the recombinant antigens had shown a significantly higher consistency in detection of T. gondii-specific IgG in the serum samples. Thus, the general prevalence of anti-T. gondii IgG was likely much higher than previously reported. The data further supported the conclusion that there is more genetic diversity among the T. gondii isolates in China [14–16], which argue for the necessity of the establishment of a method that can detect most, if not all, of the variant specific antibodies.
- Montoya JG, Liesenfeld O: Toxoplasmosis. Lancet. 2004, 363 (9425): 1965-1976. 10.1016/S0140-6736(04)16412-X.View ArticlePubMedGoogle Scholar
- Walle F, Kebede N, Tsegaye A, Kassa T: Seroprevalence and risk factors for Toxoplasmosis in HIV infected and non-infected individuals in Bahir Dar, Northwest Ethiopia. Parasit Vectors. 2013, 16; 6 (1): 15-View ArticleGoogle Scholar
- Alvarado-Esquivel C, Torres-Castorena A, Liesenfeld O, Garcia-Lopez CR, Estrada-Martinez S, Sifuentes-Alvarez A, Marsal-Hernandez JF, Esquivel-Cruz R, Sandoval-Herrera F, Castaneda JA: Seroepidemiology of Toxoplasma gondii infection in pregnant women in rural Durango, Mexico. J Parasitol. 2009, 95 (2): 271-274. 10.1645/GE-1829.1.View ArticlePubMedGoogle Scholar
- Liu Q, Wei F, Gao S, Jiang L, Lian H, Yuan B, Yuan Z, Xia Z, Liu B, Xu X: Toxoplasma gondii infection in pregnant women in China. Trans R Soc Trop Med Hyg. 2009, 103 (2): 162-166. 10.1016/j.trstmh.2008.07.008.View ArticlePubMedGoogle Scholar
- Flegr J, Preiss M, Klose J, Havlicek J, Vitakova M, Kodym P: Decreased level of psychobiological factor novelty seeking and lower intelligence in men latently infected with the protozoan parasite Toxoplasma gondii Dopamine, a missing link between schizophrenia and toxoplasmosis?. Biol Psychol. 2003, 63 (3): 253-268. 10.1016/S0301-0511(03)00075-9.View ArticlePubMedGoogle Scholar
- Garcia JL, Navarro IT, Ogawa L, de Oliveira RC, Kobilka E: Seroprevalence, epidemiology and ocular evaluation of human toxoplasmosis in the rural zone Jauguapita (Parana) Brazil. Rev Panam Salud Publica. 1999, 6 (3): 157-163.View ArticlePubMedGoogle Scholar
- Coelho RA, Kobayashi M, Carvalho LB: Prevalence of IgG antibodies specific to Toxoplasma gondii among blood donors in Recife, Northeast Brazil. Rev Inst Med Trop Sao Paulo. 2003, 45 (4): 229-231.View ArticlePubMedGoogle Scholar
- Tian YM, Dai FY, Huang SY, Deng ZH, Duan G, Zhou DH, Yang JF, Weng YB, Zhu XQ, Zou FC: First report of Toxoplasma gondii seroprevalence in peafowls in Yunnan Province, Southwestern China. Parasit Vectors. 2012, 19 (5): 205-View ArticleGoogle Scholar
- Hinze-Selch D, Daubener W, Eggert L, Erdag S, Stoltenberg R, Wilms S: A controlled prospective study of Toxoplasma gondii infection in individuals with schizophrenia: beyond seroprevalence. Schizophr Bull. 2007, 33 (3): 782-788. 10.1093/schbul/sbm010.PubMed CentralView ArticlePubMedGoogle Scholar
- Yolken RH, Bachmann S, Ruslanova I, Lillehoj E, Ford G, Torrey EF, Schroeder J: Antibodies to Toxoplasma gondii in individuals with first-episode schizophrenia. Clin Infect Dis. 2001, 32 (5): 842-844. 10.1086/319221.View ArticlePubMedGoogle Scholar
- Cetinkaya Z, Yazar S, Gecici O, Namli MN: Anti-Toxoplasma gondii antibodies in patients with schizophrenia–preliminary findings in a Turkish sample. Schizophr Bull. 2007, 33 (3): 789-791. 10.1093/schbul/sbm021.PubMed CentralView ArticlePubMedGoogle Scholar
- Hamidinejat H, Ghorbanpoor M, Hosseini H, Alavi SM, Nabavi L, Jalali MH, Borojeni MP, Jafari H, Mohammadaligol S: Toxoplasma gondii infection in first-episode and inpatient individuals with schizophrenia. Int J Infect Dis. 2010, 14 (11): e978-e981. 10.1016/j.ijid.2010.05.018.View ArticlePubMedGoogle Scholar
- Torrey EF, Bartko JJ, Lun ZR, Yolken RH: Antibodies to Toxoplasma gondii in patients with schizophrenia: a meta-analysis. Schizophr Bull. 2007, 33 (3): 729-736. 10.1093/schbul/sbl050.PubMed CentralView ArticlePubMedGoogle Scholar
- Zhou P, Zhang H, Lin RQ, Zhang DL, Song HQ, Su C, Zhu XQ: Genetic characterization of Toxoplasma gondii isolates from China. Parasitol Int. 2009, 58 (2): 193-195. 10.1016/j.parint.2009.01.006.View ArticlePubMedGoogle Scholar
- Zhou P, Nie H, Zhang LX, Wang HY, Yin CC, Su C, Zhu XQ, Zhao JL: Genetic characterization of Toxoplasma gondii isolates from pigs in China. J Parasitol. 2010, 96 (5): 1027-1029. 10.1645/GE-2465.1.View ArticlePubMedGoogle Scholar
- Dubey JP, Zhu XQ, Sundar N, Zhang H, Kwok OC, Su C: Genetic and biologic characterization of Toxoplasma gondii isolates of cats from China. Vet Parasitol. 2007, 145 (3–4): 352-356.View ArticlePubMedGoogle Scholar
- Kotresha D, Noordin R: Recombinant proteins in the diagnosis of toxoplasmosis. APMIS. 2010, 118 (8): 529-542.PubMedGoogle Scholar
- Macedo AG, Cunha JP, Cardoso TH, Silva MV, Santiago FM, Silva JS, Pirovani CP, Silva DA, Mineo JR, Mineo TW: SAG2A protein from Toxoplasma gondii interacts with both innate and adaptive immune compartments of infected hosts. Parasit Vectors. 2013, 5 (6): 163-View ArticleGoogle Scholar
- Gross U, Holpert M, Goebel S: Impact of stage differentiation on diagnosis of toxoplasmosis. Ann Ist Super Sanita. 2004, 40 (1): 65-70.PubMedGoogle Scholar
- Xiao Y, Yin J, Jiang N, Xiang M, Hao L, Lu H, Sang H, Liu X, Xu H, Ankarklev J: Seroepidemiology of human Toxoplasma gondii infection in China. BMC Infect Dis. 2010, 7 (10): 4-View ArticleGoogle Scholar
- Lindstrom I, Kaddu-Mulindwa DH, Kironde F, Lindh J: Prevalence of latent and reactivated Toxoplasma gondii parasites in HIV-patients from Uganda. Acta Trop. 2006, 100 (3): 218-222. 10.1016/j.actatropica.2006.11.002.View ArticlePubMedGoogle Scholar
- Jiang N, Cai P, Yin J, Hao L, Lu H, Wang X, Wang H, Chen Q: Characterization of antibody responses to the Sj23 antigen of Schistosoma japonicum after infection and immunization. Acta Trop. 2010, 116 (1): 9-14. 10.1016/j.actatropica.2010.04.015.View ArticlePubMedGoogle Scholar
- Balsari A, Poli G, Molina V, Dovis M, Petruzzelli E, Boniolo A, Rolleri E: ELISA for toxoplasma antibody detection: a comparison with other serodiagnostic tests. J Clin Pathol. 1980, 33 (7): 640-643. 10.1136/jcp.33.7.640.PubMed CentralView ArticlePubMedGoogle Scholar
- Glor SB, Edelhofer R, Grimm F, Deplazes P, Basso W: Evaluation of a commercial ELISA kit for detection of antibodies against Toxoplasma gondii in serum, plasma and meat juice from experimentally and naturally infected sheep. Parasit Vectors. 2013, 5 (6): 85-View ArticleGoogle Scholar
- Lyons RE, McLeod R, Roberts CW: Toxoplasma gondii tachyzoite-bradyzoite interconversion. Trends Parasitol. 2002, 18 (5): 198-201. 10.1016/S1471-4922(02)02248-1.View ArticlePubMedGoogle Scholar
- Sun XM, Ji YS, Elashram SA, Lu ZM, Liu XY, Suo X, Chen QJ, Wang H: Identification of antigenic proteins of Toxoplasma gondii RH strain recognized by human immunoglobulin G using immunoproteomics. J Proteomics. 2012, 21 (77): 423-432.View ArticleGoogle Scholar
- Amerizadeh A, Khoo BY, Teh AY, Golkar M, Abdul Karim IZ, Osman S, Yunus MH, Noordin R: Identification and real-time expression analysis of selected Toxoplasma gondii in-vivo induced antigens recognized by IgG and IgM in sera of acute toxoplasmosis patients. BMC Infect Dis. 2013, 13 (1): 287-10.1186/1471-2334-13-287.PubMed CentralView ArticlePubMedGoogle Scholar
- Amerizadeh A, Idris ZM, Khoo BY, Kotresha D, Yunus MH, Karim IZ, Saadatnia G, Teh AY, Noordin R: Identification of Toxoplasma gondii in-vivo induced antigens by cDNA library immunoscreening with chronic toxoplasmosis sera. Microb Pathog. 2013, 54: 60-66.View ArticlePubMedGoogle Scholar
- Bohne W, Gross U, Ferguson DJ, Heesemann J: Cloning and characterization of a bradyzoite-specifically expressed gene (hsp30/bag1) of Toxoplasma gondii, related to genes encoding small heat-shock proteins of plants. Mol Microbiol. 1995, 16 (6): 1221-1230. 10.1111/j.1365-2958.1995.tb02344.x.View ArticlePubMedGoogle Scholar
- Parmley SF, Weiss LM, Yang S: Cloning of a bradyzoite-specific gene of Toxoplasma gondii encoding a cytoplasmic antigen. Mol Biochem Parasitol. 1995, 73 (1–2): 253-257.View ArticlePubMedGoogle Scholar
- Di Cristina M, Del Porto P, Buffolano W, Beghetto E, Spadoni A, Guglietta S, Piccolella E, Felici F, Gargano N: The Toxoplasma gondii bradyzoite antigens BAG1 and MAG1 induce early humoral and cell-mediated immune responses upon human infection. Microbes Infect. 2004, 6 (2): 164-171. 10.1016/j.micinf.2003.11.009.View ArticlePubMedGoogle Scholar
- Araujo PR, Ferreira AW: High diagnostic efficiency of IgM-ELISA with the use of multiple antigen peptides (MAP1) from T. gondii ESA (SAG-1, GRA-1 and GRA-7), in acute toxoplasmosis. Rev Inst Med Trop Sao Paulo. 2010, 52 (2): 63-68. 10.1590/S0036-46652010000200001.View ArticlePubMedGoogle Scholar
- Pietkiewicz H, Hiszczynska-Sawicka E, Kur J, Petersen E, Nielsen HV, Stankiewicz M, Andrzejewska I, Myjak P: Usefulness of Toxoplasma gondii-specific recombinant antigens in serodiagnosis of human toxoplasmosis. J Clin Microbiol. 2004, 42 (4): 1779-1781. 10.1128/JCM.42.4.1779-1781.2004.PubMed CentralView ArticlePubMedGoogle Scholar
This article is published under license to BioMed Central Ltd. 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.