Department of Medical. Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Department of Neuroscience, University of Turin, Turin, Italy.
J Psychiatr Res. 2022 Sep;153:284-291. doi: 10.1016/j.jpsychires.2022.07.013. Epub 2022 Jul 6.
The relationship between toxoplasma gondii (T. gondii) infection and bipolar disorder (BD) is poorly understood. This review explores this relationship by estimating the strength of the association between the two conditions using data from published studies.
Following PRISMA guidelines, we performed a review and meta-analysis of published articles obtained from a systematic search of PubMed, PsycINFO, EMBASE and the Cochrane library up to January 10th, 2021. We included observational studies that compared seroprevalence of IgG class antibodies against T. gondii in patients with a diagnosis of BD with healthy controls. We excluded studies that included <10 participants in each study arm and patients with a serious concomitant medical illness. Discrepancies between the two independent researchers were resolved by consulting a third experienced researcher. Summary data were extracted from published reports. Analysis was conducted using both fixed-effects and random-effects models. The study is registered with PROSPERO number CRD42021237809.
The search yielded 23 independent studies with a total of 12690 participants (4021 with BD and 8669 controls). Persons with BD had a greater odd of seropositivity with toxoplasmosis than controls, both in the fixed-effects model (OR = 1.34 [95%CI: 1.19 to 1.51]) and the random-effects model (OR = 1.69 [95%CI: 1.21 to 2.36]). No publication bias was detected but reported results showed a high heterogeneity (I2 = 84% [95%CI:77%-89%]).
The findings support the relationship between toxoplasmosis infection and BD and suggests a need for studies designed to explore possible causal relationship. Such studies may also improve our understanding of the pathophysiology of BD and open other avenues for its treatment.
P.O.R. Sardegna F.S.E. 2014-2020.
弓形虫（Toxoplasma gondii，T. gondii）感染与双相障碍（Bipolar Disorder，BD）之间的关系尚未明确。本综述通过对已发表研究数据的分析，评估两者之间的关联强度，以探讨这一关系。
根据 PRISMA 指南，我们对 2021 年 1 月 10 日前从 PubMed、PsycINFO、EMBASE 和 Cochrane 图书馆系统检索到的已发表文章进行了综述和荟萃分析。我们纳入了比较 BD 患者与健康对照者血清 IgG 类抗 T. gondii 抗体阳性率的观察性研究。排除了每一组参与者少于 10 人的研究和伴有严重合并症的患者。如果两位独立的研究者之间存在分歧，则咨询第三位有经验的研究者解决。从已发表的报告中提取汇总数据。采用固定效应模型和随机效应模型进行分析。该研究已在 PROSPERO 注册，注册号为 CRD42021237809。
检索得到 23 项独立研究，共纳入 12690 名参与者（4021 名 BD 患者和 8669 名对照者）。BD 患者感染弓形虫的阳性率高于对照组，固定效应模型（OR=1.34 [95%CI：1.19 至 1.51]）和随机效应模型（OR=1.69 [95%CI：1.21 至 2.36]）均如此。未发现发表偏倚，但报告结果显示存在高度异质性（I2=84% [95%CI：77%-89%]）。
这些发现支持弓形虫感染与 BD 之间的关系，并提示需要进行旨在探索可能的因果关系的研究。这些研究还可能增进我们对 BD 病理生理学的理解，并为其治疗开辟新途径。
2014-2020 年撒丁岛 POR FSE 计划。
