Beyond Latency: Chronic <i>Toxoplasma</i> Infection and Its Unveiled Behavioral and Clinical Manifestations—A 30-Year Research Perspective

Over the past three turbulent decades, research has profoundly reshaped our understanding of chronic <i>Toxoplasma gondii</i> infection—traditionally regarded as harmless in immunocompetent individuals—unveiling its surprising impact on human health, performance, and behavior. This revie...

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Main Authors: Ashkan Latifi, Jaroslav Flegr
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/13/7/1731
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author Ashkan Latifi
Jaroslav Flegr
author_facet Ashkan Latifi
Jaroslav Flegr
author_sort Ashkan Latifi
collection DOAJ
description Over the past three turbulent decades, research has profoundly reshaped our understanding of chronic <i>Toxoplasma gondii</i> infection—traditionally regarded as harmless in immunocompetent individuals—unveiling its surprising impact on human health, performance, and behavior. This review emphasizes the effects of chronic <i>Toxoplasma</i> infection on physical and mental health, cognitive performance, and behavioral changes, highlighting key findings from studies investigating these domains, with a particular focus on both ultimate and proximate mechanisms underlying the observed effects. To this end, the primary focus will be on human studies; however, animal model studies will also be thoroughly considered when necessary and appropriate, to provide context and additional important information. Research demonstrates that chronic <i>Toxoplasma</i> infection may contribute to a broad spectrum of physical health issues. Ecological studies have revealed correlations between toxoplasmosis prevalence and increased morbidity and mortality from various conditions, including cardiovascular diseases, neurological disorders, and certain cancers. Large-scale cross-sectional studies have further shown that infected individuals report a higher incidence of numerous health complaints and diagnosed diseases, suggesting a significant impact on overall physical well-being. In addition to physical health, lifelong <i>Toxoplasma</i> infection (subclinical toxoplasmosis) has been implicated in cognitive impairments and behavioral changes. Studies have reported associations between infection and poorer performance in areas such as reaction time, processing speed, working memory, and executive function. Many of these behavioral changes likely relate to worsened health and a shift towards a “fast life history strategy.” These cognitive deficits can have significant implications for daily functioning and performance. Furthermore, the role of <i>Toxoplasma</i> infection in the development or exacerbation of mental health disorders has been extensively investigated. Meta-analyses, ecological studies, and large-scale observational studies have demonstrated associations between <i>Toxoplasma</i> infection and an increased risk of disorders such as schizophrenia and obsessive–compulsive disorder. While the precise mechanisms underlying these associations remain under investigation, research suggests that neuroinflammation and alterations in neurotransmitter systems are likely to play a role. Far from being harmless, subclinical toxoplasmosis is increasingly recognized as a hidden factor influencing human health, behavior, and cognitive performance—with implications that extend well beyond the individual to public health at large. Further research is warranted to elucidate the complex interplay between <i>Toxoplasma</i> infection, host physiology, and the development of various physical, cognitive, behavioral, and mental health conditions.
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spelling doaj-art-be64267b5772488fa6b3c9c76d60415a2025-08-20T04:00:50ZengMDPI AGBiomedicines2227-90592025-07-01137173110.3390/biomedicines13071731Beyond Latency: Chronic <i>Toxoplasma</i> Infection and Its Unveiled Behavioral and Clinical Manifestations—A 30-Year Research PerspectiveAshkan Latifi0Jaroslav Flegr1Department of Philosophy and History of Sciences, Faculty of Science, Charles University, Viničná 7, 128 00 Prague, Czech RepublicDepartment of Philosophy and History of Sciences, Faculty of Science, Charles University, Viničná 7, 128 00 Prague, Czech RepublicOver the past three turbulent decades, research has profoundly reshaped our understanding of chronic <i>Toxoplasma gondii</i> infection—traditionally regarded as harmless in immunocompetent individuals—unveiling its surprising impact on human health, performance, and behavior. This review emphasizes the effects of chronic <i>Toxoplasma</i> infection on physical and mental health, cognitive performance, and behavioral changes, highlighting key findings from studies investigating these domains, with a particular focus on both ultimate and proximate mechanisms underlying the observed effects. To this end, the primary focus will be on human studies; however, animal model studies will also be thoroughly considered when necessary and appropriate, to provide context and additional important information. Research demonstrates that chronic <i>Toxoplasma</i> infection may contribute to a broad spectrum of physical health issues. Ecological studies have revealed correlations between toxoplasmosis prevalence and increased morbidity and mortality from various conditions, including cardiovascular diseases, neurological disorders, and certain cancers. Large-scale cross-sectional studies have further shown that infected individuals report a higher incidence of numerous health complaints and diagnosed diseases, suggesting a significant impact on overall physical well-being. In addition to physical health, lifelong <i>Toxoplasma</i> infection (subclinical toxoplasmosis) has been implicated in cognitive impairments and behavioral changes. Studies have reported associations between infection and poorer performance in areas such as reaction time, processing speed, working memory, and executive function. Many of these behavioral changes likely relate to worsened health and a shift towards a “fast life history strategy.” These cognitive deficits can have significant implications for daily functioning and performance. Furthermore, the role of <i>Toxoplasma</i> infection in the development or exacerbation of mental health disorders has been extensively investigated. Meta-analyses, ecological studies, and large-scale observational studies have demonstrated associations between <i>Toxoplasma</i> infection and an increased risk of disorders such as schizophrenia and obsessive–compulsive disorder. While the precise mechanisms underlying these associations remain under investigation, research suggests that neuroinflammation and alterations in neurotransmitter systems are likely to play a role. Far from being harmless, subclinical toxoplasmosis is increasingly recognized as a hidden factor influencing human health, behavior, and cognitive performance—with implications that extend well beyond the individual to public health at large. Further research is warranted to elucidate the complex interplay between <i>Toxoplasma</i> infection, host physiology, and the development of various physical, cognitive, behavioral, and mental health conditions.https://www.mdpi.com/2227-9059/13/7/1731parasitemanipulation hypothesisevolutionmental healthRhDRhesus D antigen
spellingShingle Ashkan Latifi
Jaroslav Flegr
Beyond Latency: Chronic <i>Toxoplasma</i> Infection and Its Unveiled Behavioral and Clinical Manifestations—A 30-Year Research Perspective
Biomedicines
parasite
manipulation hypothesis
evolution
mental health
RhD
Rhesus D antigen
title Beyond Latency: Chronic <i>Toxoplasma</i> Infection and Its Unveiled Behavioral and Clinical Manifestations—A 30-Year Research Perspective
title_full Beyond Latency: Chronic <i>Toxoplasma</i> Infection and Its Unveiled Behavioral and Clinical Manifestations—A 30-Year Research Perspective
title_fullStr Beyond Latency: Chronic <i>Toxoplasma</i> Infection and Its Unveiled Behavioral and Clinical Manifestations—A 30-Year Research Perspective
title_full_unstemmed Beyond Latency: Chronic <i>Toxoplasma</i> Infection and Its Unveiled Behavioral and Clinical Manifestations—A 30-Year Research Perspective
title_short Beyond Latency: Chronic <i>Toxoplasma</i> Infection and Its Unveiled Behavioral and Clinical Manifestations—A 30-Year Research Perspective
title_sort beyond latency chronic i toxoplasma i infection and its unveiled behavioral and clinical manifestations a 30 year research perspective
topic parasite
manipulation hypothesis
evolution
mental health
RhD
Rhesus D antigen
url https://www.mdpi.com/2227-9059/13/7/1731
work_keys_str_mv AT ashkanlatifi beyondlatencychronicitoxoplasmaiinfectionanditsunveiledbehavioralandclinicalmanifestationsa30yearresearchperspective
AT jaroslavflegr beyondlatencychronicitoxoplasmaiinfectionanditsunveiledbehavioralandclinicalmanifestationsa30yearresearchperspective