title: Toxoplasma serotype is associated with development of ocular toxoplasmosis.
abstract: BACKGROUND
  Worldwide, ocular toxoplasmosis (OT) is the principal cause of posterior uveitis, a severe, life-altering disease. A Toxoplasma gondii enzyme-linked immunoassay that detects strain-specific antibodies present in serum was used to correlate serotype with disease.
  
  
  METHODS
  Toxoplasma serotypes in consecutive serum samples from German uveitis patients with OT were compared with non-OT seropositive patients with noninfectious autoimmune posterior uveitis. OT patients were tested for association of parasite serotype with age, gender, location, clinical onset, size, visual acuity, or number of lesions (mean follow-up, 3.8 years) to determine association with recurrences.
  
  
  RESULTS
  A novel, nonreactive (NR) serotype was detected more frequently in serum samples of OT patients (50/114, 44%) than in non-OT patients (4/56, 7%) (odds ratio, 10.0; 95% confidence interval 3.4-40.8; P < .0001). Non-OT patients were predominantly infected with Type II strains (39/56; 70%), consistent with expected frequencies in Central Europe. Among OT patients, those with NR serotypes experienced more frequent recurrences (P = .037). Polymerase chain reaction detected parasite DNA in 8/60 OT aqueous humor specimens but failed to identify Type II strain alleles.
  
  
  CONCLUSIONS
  Toxoplasma NR and Type II serotypes predominate in German OT patients. The NR serotype is associated with OT recurrences, underscoring the value of screening for management of disease.
authors.affiliation: Laboratory of Parasitic Diseases.
authors.forename: Leila
authors.initials: L
authors.lastname: Shobab
authors.forename: Uwe
authors.initials: U
authors.lastname: Pleyer
authors.forename: Joerdis
authors.initials: J
authors.lastname: Johnsen
authors.forename: Sylvia
authors.initials: S
authors.lastname: Metzner
authors.forename: Erick R
authors.initials: ER
authors.lastname: James
authors.forename: N
authors.initials: N
authors.lastname: Torun
authors.forename: Michael P
authors.initials: MP
authors.lastname: Fay
authors.forename: Oliver
authors.initials: O
authors.lastname: Liesenfeld
authors.forename: Michael E
authors.initials: ME
authors.lastname: Grigg
mesh_terms: D000293:Adolescent; D000328:Adult; D000913:Antibodies, Protozoan / Q000097:blood; D001483:Base Sequence; D016022:Case-Control Studies; D002648:Child; D016384:Consensus Sequence; D016054:DNA, Protozoan / Q000235:genetics; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058885:Multilocus Sequence Typing; D011446:Prospective Studies; D012008:Recurrence; D012703:Serotyping; D014122:Toxoplasma / Q000145:classification* / Q000235:genetics / Q000276:immunology; D014126:Toxoplasmosis, Ocular / Q000097:blood / Q000276:immunology / Q000469:parasitology*; D014605:Uveitis / Q000097:blood / Q000276:immunology / Q000469:parasitology; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan; D016054:DNA, Protozoan
keywords: Diagnosis; ocular inflammatory disease; serotype; toxoplasmosis; uveitis