Sero-prevalence of toxoplasmosis and Role of Cathepsin L-like and Cathepsin B-like Genes as Risk Factors for Abnormal Pregnancy Outcome

Background and objectives: Toxoplasma gondii ( T. gondii ) is a ubiquitous apicomplexan parasite. As an obligate intracellular parasite, T. gondii must invade host cells to survive and replicate. Five cathepsin proteases are encoded in the genome of T . gondii, cathepsin L like protein, cathepsin B like protein, and three cathepsin C like proteins. The present study was aimed to investigate the prevalence of toxoplasmosis among women in Erbil, and to study the role of cathepsin B and cathepsin L genes in the pathogenesis of toxoplasmosis as well as their role as risk factors for abnormal pregnancy outcome. Methods: This is a cross sectional study was carried out in Erbil from October 2018 to March 2019.  A total of 230 women at their reproductive age and who attended Maternity Teaching Hospital and Nazdar Bamarni primary Health Center were enrolled. Anti- toxoplasma IgG and IgM antibodies were detected by cobas 6000. Toxoplasma cathepsin B and cathepsin L – like genes were selected to be targets in PCR. Results: Anti-toxoplasma IgG and IgM were seropositive in 105 (45.7%) and 18 (7.8%) women, respectively. Of those women who were seropositive for toxoplasmosis, only 15(6.5%) of them were carrying both anti-toxoplasma IgG and IgM. No significant association of toxoplasmosis and educational level, socioeconomic level, age, history of abortion, abnormal baby birth weight were observed. PCR targeting cathepsin L was more sensitive to be used in the diagnosis of toxoplasmosis. Conclusion: Sero-prevalence of toxoplasmosis is relatively high in Erbil and cathepsin L gene is an efficient target for PCR and could be used as risk factor for abnormal pregnancy outcome.