Teimouri Aref, Mahmoudi Shima, Behkar Atefeh, Sahebi Keivan, Foroozand Hassan, Hassanpour Gholamreza, Keshavarz Hossein
Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Biotechnology Centre, Silesian University of Technology, Gliwice, Poland.
Iran J Parasitol. 2024 Oct-Dec;19(4):384-396. doi: 10.18502/ijpa.v19i4.17159.
is an intracellular parasite capable of crossing the placenta in pregnancy and infecting the developing fetus, leading to various congenital anomalies and even abortion. Acute infection is responsible for almost all cases of congenital toxoplasmosis in immunocompetent pregnant women. Prenatal screening for acute toxoplasmosis primarily involves maternal serology and fetal ultrasound imaging. When serological or ultrasound findings suggest acute infection, further diagnostic tests are necessary to confirm fetal infection. Currently, molecular methods to detect the parasite's DNA, including polymerase chain reaction-based methods, on amniotic fluid are the gold standard tests for the diagnosis of congenital toxoplasmosis. In this review, we aim to discuss various aspects of screening and diagnostic methods for toxoplasmosis in pregnancy, including (i) current serological assays, screening approaches, and future perspectives; (ii) the role of imaging techniques, with an emphasis on ultrasound; (iii) principles and recent advances in diagnostic molecular methods; (iv) emerging techniques, such as point-of-care-based tests and biosensors, and microRNAs as novel biomarkers of acute infection; and (v) an overview of screening programs in different countries, important epidemiological determinants, and recommendations for screening health policies.
是一种细胞内寄生虫，能够在孕期穿过胎盘并感染发育中的胎儿，导致各种先天性异常甚至流产。急性感染是免疫功能正常的孕妇中几乎所有先天性弓形虫病病例的病因。产前急性弓形虫病筛查主要包括母体血清学检查和胎儿超声成像。当血清学或超声检查结果提示急性感染时，需要进一步的诊断测试来确认胎儿感染。目前，检测羊水内寄生虫DNA的分子方法，包括基于聚合酶链反应的方法，是诊断先天性弓形虫病的金标准测试。在本综述中，我们旨在讨论孕期弓形虫病筛查和诊断方法的各个方面，包括：（i）当前的血清学检测、筛查方法及未来展望；（ii）成像技术的作用，重点是超声；（iii）诊断分子方法的原理和最新进展；（iv）新兴技术，如即时检测和生物传感器，以及作为急性感染新型生物标志物的微小RNA；（v）不同国家筛查项目概述、重要的流行病学决定因素以及筛查健康政策建议。
