Pathophysiological Aspects of Ocular Toxoplasmosis: Host-parasite Interactions

ABSTRACT

Purpose

This review aims to present the state of the art to understand the pathophysiology of ocular toxoplasmosis (OT), providing further foundations that would help to improve the future treatment and prognosis of this potentially blinding disease.

Methods

A thorough literature search was performed in PubMed database. An additional search was made in Google Scholar to complete the collected items.

Results

Toxoplasma gondii ocular infection is one of the most frequent causes of posterior uveitis. Despite the ocular barriers, the parasite reaches the eye through different mechanisms. Once inside, it remains encysted livelong within the retina, and recurrences cannot be completely avoided. The complexity of host-parasite interactions, leading to the success of this parasite, encompasses host factors such as genetic predisposition, immune status, and age; and parasite factors such as strain diversity, virulence, phylogenetic origin, and geographical distribution. These factors influence the clinical presentation, course, and progression of the disease. Additional elements, such as pregnancy, eating behavior, and environmental, social, and cultural factors may also contribute to this complex balance.

Conclusions

The host-parasite interaction in OT is a complex and multifactorial relationship, with the parasite always on the driving edge of the game. There are still multiple incompletely understood fields to be investigated. Future research would permit further insight into the immune-biology of the parasite and recognition of the host-parasite interplay to improve the diagnostic and management performance.

KEYWORDS:

• Toxoplasma gondii
• ocular toxoplasmosis
• host-parasite
• immune response
• pathophysiology

Acknowledgments

We thank Universidad del Rosario for financing the proofreading of this manuscript, Enago for the manuscript language edition, and Natalia Martinez for illustrations.

Copyright statement

The Corresponding Author has the right to assign on behalf of all authors and does assign on behalf of all authors, a full assignment of all intellectual property rights for all content within the submitted study in any media known now or created in the future and permits this study (if accepted) to be published and to be fully exploited within the remit of the assignment as set out in the assignment which has been read.

Declaration of interest

All authors state that there is no conflict of interest relevant to this study to declare.