Diagnostic Performance of Serum Transforming Growth Factor-β in Toxoplasma gondii Infection, Urinary Tract Infection, and Coinfection: A Comparative Cross-Sectional Study

Abstract

Background: TGF-β regulates diverse biological processes, including immune modulation, infection susceptibility, and tumor progression. However, serum TGF-β levels in patients co-infected with Toxoplasma gondii and UTI are unknown. This study assessed serum TGF-β as a diagnostic biomarker across four groups defined by cancer status and demographics.
Methodology: A cross-sectional study with 150 subjects across four groups: control (46), T. gondii (45), UTI (46), and coinfection (13). Serum TGF-β was measured via ELISA. Comparisons used the Kruskal-Wallis test with a Bonferroni correction; ROC analysis evaluated diagnostic performance. Correlations and logistic regression identified predictors of cancer.
Results: Serum TGF-β concentrations differed significantly (H = 98.313, p < 0.001), highest in coinfection (173.00 pg/mL) and lowest in controls (19.00 pg/mL). ROC showed perfect separation from controls (AUC = 1.00; 100% sensitivity and specificity). AUC for cancer detection was 0.921 (sensitivity 71.2%, specificity 91.8%) at a ≥ 152.0 pg/mL cutoff. TGF-β correlated positively with cancer (rₛ=0.694, p < 0.01). Independent predictors: female gender (AOR=3.190), positive IgG (AOR=4.217), older age (AOR=1.044). TGF-β was notably higher in E. coli UTI cases versus the no-growth group (p < 0.001).
Conclusions: Circulating TGF-β levels effectively indicate infection and detect cancer, especially in co-infections. It is recommended as part of diagnostic panels for infection-related malignancy, particularly in resource-limited settings.