Alteration of trophoblastic tissue apoptosis and their role in Toxoplasmosis induce miscarriage.

Fifty patients (aborted women), Their range age between (16 − 46) years, were included in this study.
All patients sera were subjected to Enzyme Linked Immunosorbent Assay (ELISA) to detect specific Toxoplasma gondii IgM and IgG , and assessment of lipid profile . In addition , trophoblastic tissues from the same patients were taken to confirm the infection of the T.gondii and to evaluate the expression of caspase 9 and caspase 3 using immunohistochemstry method. The patients were divided into two groups:
Group 1 :- patients with spontaneous miscarriage and Toxoplasma gondii positive : n= 16 women, with age distribution between (30-39) years. Group 2:- patients with spontaneous miscarriage and Toxoplasma gondii negative: n= 34 women, with age distribution between (20-29) years . Considered as a control group.
The frequency number of previous miscarriages was studied. It was found that Within Toxoplasma positive group , the highest percentage (50%) of patients was among those who had single previous miscarriages and to lesser percent (6.3%) that had four miscarriage. Within the patients control group , it was found that the highest percent (64.7%) was of those patients who had no previous miscarriages and to a lesser percent (2.9%) that had a previous three and four and more miscarriage .The frequency of gestational weeks when miscarriage had occurred was also studied. The highest frequency within the positive group for Toxoplasma gondii was 8 weeks gestational age (43.75%) , then 7 and 12 weeks gestational age (18.75%) ,and 4,5,14 weeks gestational age (6.25%). While The highest frequency within the negative group for Toxoplasma gondii was 12 weeks gestational age(29.41%) ,then 8 weeks gestational age (26.47%),then 7 weeks gestational age (11.76%) then 4,5,6 weeks gestational age (5.88%) then 10,14,15,23 and 24 weeks gestational age (2.94%).By using ELISA 16 (32%) of samples out of the 50 serum samples were positive for anti- Toxoplasma gondii IgM and the rest 34 (68%) were negative for IgM and 4 (8%) out of the (50) blood samples were positive for anti- Toxoplasma gondii IgG and the rest 46 (92%) were negative for IgG and these 4 positive for anti- Toxoplasma gondii IgG were positive for anti- Toxoplasma gondii IgM.
The immunohistochemstry (IHC) results showed that 18 (36%) of 50 women have Toxoplasma antigen within the trophoblastic tissue and 32 (64%) of 50 women were negative to Toxoplasma antigen by IHC method . two of the negative samples in ELISA were found to be positive for Toxoplasma antigen by using IHC this assures the specificity and sensitivity of IHC for diagnosis of Toxoplasma gondii.The lesser percent of caspase 9 and caspase 3 expression in Toxoplasma gondii positive group was (13.975%) and (7.088%) respectively compared to control group which was (45.831%) and (37.624%) respectively there was highly significant decrease (P<0.001) in mean percentage of caspase 9 and caspase 3 expression. indicating that Toxoplasma gondii downregulated apoptosis . The present study showed that there is no significant differences (p-value > 0.05)in lipid profile ( total cholesterol , high density lipoprotein HDL , low density
lipoprotein LDL )between Toxoplasma positive patients and the control( Toxoplasma negative ) when the mean value of total cholesterol of the patients with T.gondii positive was (129.675±8.374) mg/dL while patients with T.gondii negative the mean value was (121.609±6.210) mg/dL . As well as the mean value of HDL-cholesterol of patients with T.gondii positive was (114.875±18.334)mg/dL, while patients with T.gondii negative the mean value was (115.912±9.243) mg/dL. As well as the mean values of LDL-cholesterol of patients with T.gondii positive were (66.181±6.415)mg/dL, while patients with T.gondii negative the mean values was (54.600±4.599) mg/dL .indicating Toxoplasma can synthesis their own lipids without any changing in lipid profile parameters of the patients .