Relationship Between Toxoplasmosis And Antiphospholipid Antibodies Igg , Igm In Aborted And Non Aborted Women

Objectives: The study was designed to an estimate the prevalence of antiphospholipid IgG and IgM antibodies with toxoplasmosis patients among aborted and non -aborted women. Methodology: A total number of 70 Iraqi patients aborted and non–aborted women were included in the present study. In addition, a total of 30 apparently healthy women and negative for antiphospholipid IgG and IgM antibodies were selected as a control group. The study was carried out during the period from October 2012 till January 2013. Blood samples and laboratory investigation was in Teaching Laboratory of the Medical city of Baghdad, using to detect antibodies type IgG and IgM for antiphospholipid and Toxoplasma gondii by utilize ELISA technique according to standard procedures describe by manufacturer. Results: The results showed that the age stratum (21–30) years was found to be highly frequent in both studied groups was significant (P<0.05). In addition, positive toxoplasmosis IgG antibodies testing in aborted women was higher than that observed in non aborted women group, significant ( P < 0.05). Present study illustrated that the total abortion cases was with positive in APL–IgM–Ab 12/58 (20.7%), whereas 46/58 (79.3%) was negative the statistical analysis were high significant. The results of our study demonstrate significant positive correlation between abortion toxoplasmosis IgG and IgM . Conclusion: The present study demonstrates a strong association between infectious agent Toxoplasma gondii and abortion in women with antiphospholipids antibodies. Positive toxoplasmosis IgM and IgG antibodies testing in abortion more than non – abortion. The frequency of antiphospholipids antibodies IgM and IgG positive in abortion more than nonabortion. Recommendation: cannot be according to the antiphospholipid antibodies IgG and IgM in abortion cases. So that further studies are needed to study the relationship between rubella virus and cytomegalovirus with antiphospholipid antibodies. Keyword: Toxoplasmosis, Antiphospholipid antibodies, patients aborted and non aborted.


Relationship Between Toxoplasmosis And Antiphospholipid Antibodies Igg , Igm
In Aborted And Non Aborted Women .

Abstract:
Objectives: The study was designed to an estimate the prevalence of antiphospholipid IgG and IgM antibodies with toxoplasmosis patients among aborted and non -aborted women.Methodology: A total number of 70 Iraqi patients aborted and non-aborted women were included in the present study.In addition, a total of 30 apparently healthy women and negative for antiphospholipid IgG and IgM antibodies were selected as a control group.The study was carried out during the period from October 2012 till January 2013.Blood samples and laboratory investigation was in Teaching Laboratory of the Medical city of Baghdad, using to detect antibodies type IgG and IgM for antiphospholipid and Toxoplasma gondii by utilize ELISA technique according to standard procedures describe by manufacturer.

Results:
The results showed that the age stratum (21-30) years was found to be highly frequent in both studied groups was significant (P<0.05).In addition, positive toxoplasmosis IgG antibodies testing in aborted women was higher than that observed in non -aborted women group, significant ( P < 0.05).Present study illustrated that the total abortion cases was with positive in APL-IgM-Ab 12/58 (20.7%), whereas 46/58 (79.3%) was negative the statistical analysis were high significant.The results of our study demonstrate significant positive correlation between abortion toxoplasmosis IgG and IgM .

Conclusion:
The present study demonstrates a strong association between infectious agent Toxoplasma gondii and abortion in women with antiphospholipids antibodies.Positive toxoplasmosis IgM and IgG antibodies testing in abortion more than nonabortion.The frequency of antiphospholipids antibodies IgM and IgG positive in abortion more than non-abortion.Recommendation: cannot be according to the antiphospholipid antibodies IgG and IgM in abortion cases.So that further studies are needed to study the relationship between rubella virus and cytomegalovirus with antiphospholipid antibodies.Keyword: Toxoplasmosis, Antiphospholipid antibodies, patients aborted and non aborted.

INTRODUCTION:
Maternal-fetal transmission of toxoplasmosis is dependent on the time of maternal infection.The earlier the fetus acquires the infection the more severe the consequences , however maternalfetal transmission is more likely to occur later in pregnancy.Disseminated toxoplasma may cause fetal death [1].Antiphospholipid syndrome (APS) is characterized by moderate-to-high levels of antiphospholipid antibodies (APA) and other clinical features , including recurrent pregnancy loss, fetal death , and thrombosis , preeclampsia , intrauterine growth retardation , premature labor and placental abruption.The effects of APA on pregnancy are significant: prospective fetal losses rise from 25 -34% in the absence of APA to 90% in cases of untreated APA [2].Antiphospholipid may affect any system and organ in the body including heart, kidney, skin , brain and placenta.This syndrome is predominant in (female to male ratio is 5 to 1) , especially during the childbearing years [3].Antiphospholipids antibodies (APA) are characterized by thrombosis and uteroplacental insufficicency ; therefore , investigations proposed that thrombosis within the uteroplacental circulation leads to placental infarction and eventual fetal death.This hypothesis has been supported by numerous case reports and case series of extensive thrombosis, infarction and necrosis in the placentas of women with APA and fetal death [4].This autoantibodies, increase the risk of blood clots that can block blood vessels in the placenta and lead to miscarriage and cause (5 to 10) percent of abortion [5].An abortion is the removal or expulsion of an embryo or fetus from the uterus, resulting in or caused by its death.[6].An abortion can occur spontaneously due to complications during pregnancy or can be induced.Abortion as a term most commonly refers to the induced abortion of human pregnancy, while spontaneous abortions are usually termed a miscarriage.The term abortion may also refer to the aborted embryo or fetus [7].Aims of the study to study prevalence of antiphospholipids IgG and IgM antibodies among abortion and toxoplasmosis.Prevalence antibodies for acute and chronic infection for more causes of abortion spreading that including toxoplasmosis and antiphospholipid antibodies with utilizing ELISA technique.

MATERIAL AND METHODS :
Study groups : The study was conducted on two groups, the first group were included 70 blood samples were taken from aborted and non aborted women whom referred to Medical city in Baghdad, a unit of immunological test to detect cause of abortion,the second group control group were included 30 blood sample taken from normal women ,age range was from 18 to 40 years.Sampling and laboratory investigation was in the Teaching Laboratories of the Medical City of Baghdad during the period from October 2012 till January 2013.Age groups as it is shown in table (1).

Sample collection
Blood was collected from each individual ,3 -5 ml of venous.The blood was allowed to clot naturally at room temperature , then the sera were separated after centrifugation at 1500 rpm for 3 -5 minutes.Haemolysis was avoided and each serum was divided into 2 -3 portions and placed into sterile plastic plain tubes using micropipette with sterile disposable tips.Each sample was then labeled by a serial number and the patient name .The sera were frozen at (-20 C˚) and later thawed.Sample at one time was subjected to the following serological tests: (Freezing-thawing was avoided) 1-Determination of anti-toxoplasmosis IgG and IgM antibodies by using ELISA technique .2-Determination of antiphospholipids IgG and IgM antibodies by using ELISA technique .Blood was collected and level of toxoplasmosis and antiphospholipids antibodies was estimated by Enzyme Linked Immunosorbent Assay (ELISA).Antiphospholipid antibodies IgG and IgM test (quantitative) .The tests were performed according to manufactures instruction by added 100 µ1 of diluted patient samples into the pipetting protocol.

Statistical analysis
In current ours study we used statistical program (SPSS) version (17.0) to study the significance between tests in each type of antibody IgG and IgM, present study used (Chisquare) to the data and appropriate (P< 0.05) consider significant in the direction of two [8].

Figure (1): Distribution of aborted and non-aborted women according to age groups.
Table (1) and figure (2) shows that distribution in different patient groups (31/58)(53.3%) of abortion women and (7/12)(58.3%) of non-abortion women have positive IgM -Ab to toxoplasmosis respectively, while (27/58) (46.6%) of abortion women and (5/12) (41.7%) of non-abortion women have negative IgM-Ab to toxoplasmosis respectively .The statistical analysis reflects no significant (P> 0.05).As it is shown in the table (3), (20.7%) of the total abortion cases was with positive in APL-IgM -Ab, whereas (79.3%) was with negative the statistical analysis were high significant.For the non-abortion group,the frequency( 16.7%) for positive and(83.3%)for the negative.Comparing of such results statistically revealed a high significant (P< 0.01) difference between the abortion and non-abortion.In the same table,the total positive cases were(14/70) representing (20%) whereas the total negative cases were (56/70) representing (80%) of the total.Statistically the difference was a high significant.(5) show the frequency of negative results in the test groups according to the studied groups.The highest frequency was noticed in the abortion (82.8%) compared to (17.2%) in the same group.The statistical analysis revealed high significant (P<0.01) between the negative and positive in the APL -IgG -Ab.For the nonabortion group, the frequency (100%) for negative and (0%) for the positive.Comparing of such results statistically revealed a high significant (P< 0.01) difference between the studied groups.As it is shown in table (3) that there are correlation positive direction for abortion group between Toxoplasmosis IgG and IgM, however there are significant effect for toxoplasmosis (P = 0.037 < 0.05).So, there are correlation negative between IgG, IgM antibodies and APL -IgM that no significant on abortion group in same the table.

DISCUSSION
Toxoplasma gondii .Is still more problems that cause abortion, still birth, premature delivery and congenital malformation in ours.In this study , the relationship between toxoplasmosis infection and increased antiphospholipid antibodies to aborted and nonaborted woman was evaluated.In this research a total of 70 women detected with toxoplasmosis, diagnosed by ELISA Technique for IgG and IgM antibodies.Out of the total 58/70 (82.9%) women were aborted , whereas 12/70 (17.1%) women were nonaborted.These results were in concordance with previous studies conducted [9,10].The clinical complications associated with the occurrence of anticardiolipin antibodies are collectively known as antiphospholipid syndrome: venous and arterial thrombosis , thrombocytopenia , spontaneous abortion , still births and premature births .According to the findings of this study, 14/70 (20%) of patients were positive for APL -IgM antibody.Previous studies in this field have 23 out of 117 young patients with stroke (7 males, 16 females 19.6%) were positive for both APL and ACL [11].

CONCLUSION
1-The present study demonstrates a strong association between Toxoplasma gondii infction and abortion in women.
2-Positive antitoxoplasmosis IgM and IgG antibodies testing in abortion more than nonabortion 3-The highest frequency of antiphospholipids antibodies IgM and IgG positive in abortion more than nonabortion.

RECOMMENDATION
1-Can not be according to the antiphospholipid IgG and IgM antibodies in abortion cases.2-Further studies are needed to study the relationship between rubella virus, cytomegalovirus and parvovirus with antiphospholipid antibodies.