Relationship between toxoplasmosis and autism: A systematic review and meta-analysis

Microb Pathog. 2020 Oct:147:104434. doi: 10.1016/j.micpath.2020.104434. Epub 2020 Aug 8.

Abstract

Toxoplasma gondii (T. gondii) is a foodborne parasite that is investigated in many psychiatric diseases, such as autism spectrum disorders (ASD). Therefore, a systematic literature review was conducted searching seven electronic databases on the prevalence of T. gondii antibodies among autism patients. The current study involved sensitivity analysis, meta-regression, subgroup analysis, publication bias test, and quality assessment of studies. On the basis of the findings, the odds ratio (OR) of latent Toxoplasma infection 1.93 (95% confidence intervals (CI): 1.01-3.66) was associated with ASD risk. However, there was no relationship between acute infection and ASD 0.39 (95% CI: 0.18-0.87). The obtained results of Begg's and Egger's tests showed no publication bias (P = 0.851 and P = 0.297, respectively). The sensitivity analysis confirmed robust and stable estimates with a significant level of heterogeneity (I2 = 78.1%, P < 0.000). Of the investigated patients' characteristics, only the gender variable was analyzed, indicating the combined ORs of 2.63 (95% CI: 0.29-23.63) in females and 2.62 (95% CI: 0.94-7.30) in male participants. This study showed that toxoplasmosis plays an important role as a risk factor for autism. However, further prospective investigations are highly recommended to illuminate the developmental pathways to this disorder and provide new strategies for the prevention and treatment of this disease.

Keywords: ASD; Autism; Autism spectrum disorder; Toxoplasma gondii; Toxoplasmosis.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Antibodies, Protozoan
  • Autistic Disorder* / epidemiology
  • Female
  • Humans
  • Male
  • Odds Ratio
  • Risk Factors
  • Seroepidemiologic Studies
  • Toxoplasma* / immunology
  • Toxoplasmosis* / complications
  • Toxoplasmosis* / epidemiology

Substances

  • Antibodies, Protozoan