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ERJ Open Res. 2019 May 28;5(2). pii: 00143-2018. doi: 10.1183/23120541.00143-2018. eCollection 2019 Apr.

High frequency of infection of lung cancer patients with the parasite Toxoplasma gondii.

Author information

1
Biomedical Research Centre and Ecosystems and Environment Research Centre, School of Science, Engineering and Environment, University of Salford, Salford, UK.
2
The University of Manchester, Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester and University Hospital of South Manchester NHS Foundation Trust, Manchester, UK.
3
Center for Parasitic Organisms, State Key Laboratory of Biocontrol, School of Life Sciences and Key laboratory of Tropical Diseases Control, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, P.R. China.

Abstract

Background:

Toxoplasma gondii is an intracellular protozoan parasite that can cause a wide range of clinical conditions, including miscarriage and pneumonia. The global prevalence is 30% in humans, but varies by locality (e.g. in the UK it is typically 10%). The association between lung cancer and T.gondii infection was investigated by direct detection in lung tissue samples.

Methods:

Lung tissue samples were taken from patients undergoing lung resection surgery (n=72) for suspected lung cancer (infection prevalence 100% (95% CI: 93.9-100%)). All 72 participants were confirmed as having lung cancer following subsequent diagnostic tests. In addition, bronchial biopsy samples were collected from non-lung cancer healthy control subjects (n=10). Samples were tested for T.gondii using PCR amplification of T.gondii specific gene markers and T.gondii specific immunohistochemistry.

Results:

All 72 lung cancer patients were infected with T.gondii (prevalence 100% (95% CI: 93.9-100%)). Of which, 95.8% (n=69) of patients showed evidence of active parasite stages. Infection prevalence in the controls (10%) was significantly lower (p<0.0001).

Conclusions:

Clinicians treating lung cancer patients should be aware of the potential presence of the parasite, the potential for induction of symptomatic complications and interference with treatment success.

Conflict of interest statement

Conflict of interest: J. Bajnok reports grants from British Society of Parasitology (provision of a travel grant to attend a conference), during the conduct of the study. Conflict of interest: M. Tarabulsi reports grants from Saudi Arabian Cultural Bureau (PhD studentship funding), during the conduct of the study. Conflict of interest: H. Carlin has nothing to disclose. Conflict of interest: K. Bown has nothing to disclose. Conflict of interest: T. Southworth has nothing to disclose. Conflict of interest: J. Dungwa has nothing to disclose. Conflict of interest: D. Singh reports personal fees from Apellis, Cipla, Genentech, Peptinnovate and Skyepharma, grants and personal fees from AstraZeneca, Boehringer Ingleheim, Chiesi, GlaxoSmithKline, Glenmark, Menarini, Merck, Mundipharma, Novartis, Pfizer, Pulmatrix, Teva, Therevance and Verona, all outside the submitted work. Conflict of interest: Z-R. Lun reports their laboratory is supported by a National Key R&D Program of China (2017YFD0500400), outside the submitted work. Conflict of interest: L. Smyth reports grants from Kidscan (charity grant funds for leukaemia research), outside the submitted work. Conflict of interest: G. Hide reports grants from Saudi Arabian Cultural Bureau (provision of funding to cover one of the authors’ PhD fees and research costs. Some of these research costs were used to purchase consumables to support this project. The funding was to support M. Tarabulsi and research consumables used by her and her PhD supervisor (G.Hide), grants from British Society of Parasitology (provision of a travel grant to J. Bajnok for attendance at a conference), during the conduct of the study.

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