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Ke W, Ao C, Wei R, Zhu X, Shui J, Zhao J, Zhang X, Wang L, Huang L, Leng X, Zhu R, Wu J, Huang L, Huang N, Wang H, Weng W, Yang L, Tang S. Evaluating the clinical utility of semi-quantitative luciferase immunosorbent assay using Treponema pallidum antigens in syphilis diagnosis and treatment monitoring. Emerg Microbes Infect 2024; 13:2348525. [PMID: 38661428 PMCID: PMC11100446 DOI: 10.1080/22221751.2024.2348525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 04/23/2024] [Indexed: 04/26/2024]
Abstract
To assess the clinical applicability of a semi-quantitative luciferase immunosorbent assay (LISA) for detecting antibodies against Treponema pallidum antigens TP0171 (TP15), TP0435 (TP17), and TP0574 (TP47) in diagnosing and monitoring syphilis. LISA for detection of anti-TP15, TP17, and TP47 antibodies were developed and evaluated for syphilis diagnosis using 261 serum samples (161 syphilis, 100 non-syphilis). Ninety serial serum samples from 6 syphilis rabbit models (3 treated, 3 untreated) and 110 paired serum samples from 55 syphilis patients were used to assess treatment effects by utilizing TRUST as a reference. Compared to TPPA, LISA-TP15, LISA-TP17, and LISA-TP47 showed a sensitivity of 91.9%, 96.9%, and 98.8%, specificity of 99%, 99%, and 98%, and AUC of 0.971, 0.992, and 0.995, respectively, in diagnosing syphilis. Strong correlations (rs = 0.89-0.93) with TPPA were observed. In serial serum samples from rabbit models, significant differences in the relative light unit (RLU) were observed between the treatment and control group for LISA-TP17 (days 31-51) and LISA-TP47 (day 41). In paired serum samples from syphilis patients, TRUST titres and the RLU of LISA-TP15, LISA-TP17, and LISA-TP47 decreased post-treatment (P < .001). When TRUST titres decreased by 0, 2, 4, or ≥8-folds, the RLU decreased by 17.53%, 31.34%, 48.62%, and 72.79% for LISA-TP15; 8.84%, 17.00%, 28.37%, and 50.57% for LISA-TP17; 22.25%, 29.79%, 51.75%, and 70.28% for LISA-TP47, respectively. Semi-quantitative LISA performs well for syphilis diagnosis while LISA-TP17 is more effective for monitoring syphilis treatment in rabbit models and clinical patients.
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Affiliation(s)
- Wujian Ke
- Department of Sexually Transmitted Diseases, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Cailing Ao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
- Guangzhou Baiyun District Center for Disease Control and Prevention, Guangzhou, Guangdong Province, People’s Republic of China
| | - Ran Wei
- Department of Dermatology, Tianjin Children Hospital, Tianjin, People’s Republic of China
| | - Xiaozhen Zhu
- Center of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, Fujian Province, People’s Republic of China
- Institute of Infectious Disease, Medical College of Xiamen University, Xiamen, Fujian Province, People’s Republic of China
| | - Jingwei Shui
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Jianhui Zhao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Xiaohui Zhang
- Department of Sexually Transmitted Diseases, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Liuyuan Wang
- Department of Sexually Transmitted Diseases, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Liping Huang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Xinying Leng
- Department of Sexually Transmitted Diseases, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Rui Zhu
- Department of Sexually Transmitted Diseases, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Jiaxin Wu
- Department of Sexually Transmitted Diseases, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Lixia Huang
- Department of Sexually Transmitted Diseases, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Nanxuan Huang
- Department of Sexually Transmitted Diseases, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Haiying Wang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Wenjia Weng
- Department of Dermatology, Beijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Ligang Yang
- Department of Sexually Transmitted Diseases, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Shixing Tang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
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Silva ÂAO, Lima AA, Vasconcelos LCM, Almeida RA, Freitas NEM, Oliva TA, de Carvalho Ribeiro da Silva MF, Marchini FK, Zanchin NIT, de Siqueira IC, Santos FLN. Evaluating the diagnostic accuracy of TpN17 and TmpA recombinant proteins in syphilis detection: a phase II study. Front Microbiol 2024; 15:1348437. [PMID: 38476951 PMCID: PMC10929016 DOI: 10.3389/fmicb.2024.1348437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/06/2024] [Indexed: 03/14/2024] Open
Abstract
Syphilis is a sexually transmitted infection (STI) caused by the spiral bacterium Treponema pallidum. Diagnosis is based on epidemiology, clinical and serology, but serodiagnosis is challenging because distinct clinical forms of the infection may influence serological performance. Several recombinant Treponema pallidum-proteins have already been tested for syphilis diagnosis and they are critical to achieve high accuracy in serological testing. A total of 647 samples were included in the study: 180 T. pallidum-positive samples, 191 T. pallidum-negative samples and 276 sera from individuals infected with unrelated diseases. The diagnostic potential was validated by analysis of ROC curves. For the indirect ELISA, TpN17 (100%) and TmpA (99%) showed excellent AUC values. Sensitivity values were 97.2% for TpN17 and 90.6% for TmpA, while specificity was 100% for both molecules. According to the clinical phase, TmpA ranged from 84% to 97%, with the highest value for secondary syphilis. TpN17 was 100% sensitive for the primary and secondary stages and 93.2% for recent latent syphilis. All clinical phases achieved 100% specificity. Accuracy values showed that TmpA (> 95%) and TpN17 (> 98%) presented high diagnostic accuracy for all clinical stages of syphilis. Cross-reactivity was only observed in one sample positive for Chagas disease (1.5%), when TpN17 was evaluated. On the other hand, TmpA showed reactivity for two samples positive for Chagas disease (3.1%), one sample positive for HBV (1.25%), two samples positive for HIV (9.5%) and one sample positive for HTLV (1.6%). The TmpA antigen's performance was evaluated in multiple studies for syphilis diagnosis, corroborating our findings. However, TpN17 sensitivity values have ranged in other studies. According to clinical stages of the infection, our findings obtained close performance values.
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Affiliation(s)
- Ângelo Antônio Oliveira Silva
- Advanced Public Health Laboratory, Gonçalo Moniz Institute (IGM) Foundation Oswaldo Cruz (Fiocruz-BA), Salvador, Brazil
- Salvador University (UNIFACS), Salvador, Brazil
| | - Ayla Araújo Lima
- Advanced Public Health Laboratory, Gonçalo Moniz Institute (IGM) Foundation Oswaldo Cruz (Fiocruz-BA), Salvador, Brazil
| | | | - Rosângela Andrade Almeida
- Advanced Public Health Laboratory, Gonçalo Moniz Institute (IGM) Foundation Oswaldo Cruz (Fiocruz-BA), Salvador, Brazil
| | - Natália Erdens Maron Freitas
- Advanced Public Health Laboratory, Gonçalo Moniz Institute (IGM) Foundation Oswaldo Cruz (Fiocruz-BA), Salvador, Brazil
| | | | | | - Fabricio Klerynton Marchini
- Molecular Biology Institute of Paraná, Curitiba, Brazil
- Laboratory for Applied Science and Technology in Health, Carlos Chagas Institute (ICC) Oswaldo Cruz Foundation (Fiocruz-PR), Curitiba, Brazil
| | - Nilson Ivo Tonin Zanchin
- Structural Biology and Protein Engineering Laboratory, Carlos Chagas Institute (ICC) Oswaldo Cruz Foundation (Fiocruz-PR), Curitiba, Brazil
- Integrated Translational Program in Chagas Disease from Fiocruz (Fio-Chagas), Oswaldo Cruz Foundation (Fiocruz-RJ), Rio de Janeiro, Brazil
| | - Isadora Cristina de Siqueira
- Integrated Translational Program in Chagas Disease from Fiocruz (Fio-Chagas), Oswaldo Cruz Foundation (Fiocruz-RJ), Rio de Janeiro, Brazil
- Laboratory of Investigation in Global Health and Neglected Diseases, Gonçalo Moniz Institute (IGM) Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Brazil
| | - Fred Luciano Neves Santos
- Advanced Public Health Laboratory, Gonçalo Moniz Institute (IGM) Foundation Oswaldo Cruz (Fiocruz-BA), Salvador, Brazil
- Integrated Translational Program in Chagas Disease from Fiocruz (Fio-Chagas), Oswaldo Cruz Foundation (Fiocruz-RJ), Rio de Janeiro, Brazil
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Hu YT, Wu JB, Zhuang MH, Zhao YY, Lin Y, Jiang XY, Liu LL. A 4-fold or greater decrease in TPPA titers may indicate effective BPG treatment in primary syphilis. Int Immunopharmacol 2024; 127:111333. [PMID: 38091829 DOI: 10.1016/j.intimp.2023.111333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/17/2023] [Accepted: 11/29/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND In the majority of clinical environments, the treponema pallidum particle agglutination (TPPA) test is known for its higher specificity compared to the rapid plasma reagin (RPR) test and is commonly employed for the diagnosis of syphilis, but their use for serological monitoring after syphilis therapy is controversial. OBJECTIVES We aim to evaluate whether the TPPA titers is suitable for monitoring syphilis treatment efficacy. METHODS At first, 232 patients with primary syphilis were recruited. Serological testing was performed at baseline (initial visit) and at 6 months (±1 month) after benzathine penicillin G (BPG) treatment. Second, New Zealand white male rabbits were infected with Treponema pallidum (T. pallidum) to evaluate the changes in TPPA titers after BPG therapy. Finally, we compared the TPPA titers in the culture supernatant of rabbit splenocytes stimulated with T. pallidum with or without BPG. RESULTS After 6 months of treatment, 150 (64.7%) of 232 primary syphilis patients achieved serological cure, and 82 (35.3%) had adverse outcomes. Among 110 patients with TPPA titers decreased by more than fourfold, 109 of them were serological cure patients (≥4-fold decrease in RPR titers) (P < 0.0001). In the rabbit model of syphilis, the TPPA titers was significantly decreased in the treatment subgroup (P = 0.016) and remained constant (±2-fold) or increased (≥4-fold) in the nontreatment subgroup. In addition, T. pallidum resulted in a positive TPPA titers in the culture supernatant of splenocytes (median titers was 1: 80), while BPG could directly reduce the TPPA titers in the culture supernatant (median titers was 1: 40) (P = 0.032). CONCLUSIONS A 4-fold or greater decrease in TPPA titers may indicate effective treatment in primary syphilis. Combining TPPA titers with RPR titers results may potentially aid in the early diagnosis of syphilis.
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Affiliation(s)
- Yun-Ting Hu
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian Province, China
| | - Jia-Bin Wu
- Laboratory of Basic Medicine, Fuzong Clinical College (The 900th Hospital), Fujian Medical University, Fuzhou, Fujian Province, China
| | - Miao-Hui Zhuang
- Xiamen International Travel Health Care Center, Xiamen, Fujian Province, China
| | - Yuan-Yi Zhao
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian Province, China
| | - Yu Lin
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian Province, China
| | - Xiao-Yong Jiang
- Department of Dermatology, Zhongshan Hospital, School of Medicine, Xiamen University, Xiamen, Fujian Province, China.
| | - Li-Li Liu
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian Province, China; Xiamen Clinical Laboratory Quality Control Center, Xiamen, Fujian Province, China.
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4
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Wu S, Luo L, Ye F, Wang Y, Li D. Comprehensive Overview of Treponema pallidum Outer Membrane Proteins. Curr Protein Pept Sci 2024; 25:604-612. [PMID: 38661035 DOI: 10.2174/0113892037293502240328042224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 03/09/2024] [Accepted: 03/13/2024] [Indexed: 04/26/2024]
Abstract
Treponema pallidum, the causative agent of syphilis, is a sexually transmitted microorganism that exhibits remarkable motility capabilities, allowing it to affect various systems. Despite its structural resemblance to gram-negative bacteria due to its dual-membrane, T. pallidum possesses a lower abundance of outer membrane proteins (OMPs), which enables it to effectively conceal itself. This review presents a comprehensive analysis of the clinical diagnostic potential associated with the OMPs of T. pallidum. Furthermore, the known OMPs in T. pallidum that are responsible for mediating host interactions have been progressively elucidated. This review aims to shed light on the pathogenesis of syphilis, encompassing aspects such as vascular inflammation, chancre self-healing, neuroinvasion, and reinfection. Additionally, this review offers a detailed overview of the current state and prospects of development in the field of syphilis vaccines, with the ultimate goal of establishing a foundation for understanding the pathogenesis and implementing effective prevention strategies against syphilis.
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Affiliation(s)
- Sirui Wu
- Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR. China
| | - Lan Luo
- Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR. China
| | - Fei Ye
- Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR. China
| | - Yuanfang Wang
- Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR. China
| | - Dongdong Li
- Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR. China
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Xiong S, Liu Z, Zhang X, Huang S, Ding X, Zhou J, Yao J, Li W, Liu S, Zhao F. Resurgence of syphilis: focusing on emerging clinical strategies and preclinical models. J Transl Med 2023; 21:917. [PMID: 38105236 PMCID: PMC10726518 DOI: 10.1186/s12967-023-04685-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 10/30/2023] [Indexed: 12/19/2023] Open
Abstract
Syphilis, a sexually transmitted disease (STD) caused by Treponema pallidum (T. pallidum), has had a worldwide resurgence in recent years and remains a public health threat. As such, there has been a great deal of research into clinical strategies for the disease, including diagnostic biomarkers and possible strategies for treatment and prevention. Although serological testing remains the predominant laboratory diagnostic method for syphilis, it is worth noting that investigations pertaining to the DNA of T. pallidum, non-coding RNAs (ncRNAs), chemokines, and metabolites in peripheral blood, cerebrospinal fluid, and other bodily fluids have the potential to offer novel perspectives on the diagnosis of syphilis. In addition, the global spread of antibiotic resistance, such as macrolides and tetracyclines, has posed significant challenges for the treatment of syphilis. Fortunately, there is still no evidence of penicillin resistance. Hence, penicillin is the recommended course of treatment for syphilis, whereas doxycycline, tetracycline, ceftriaxone, and amoxicillin are viable alternative options. In recent years, efforts to discover a vaccine for syphilis have been reignited with better knowledge of the repertoire of T. pallidum outer membrane proteins (OMPs), which are the most probable syphilis vaccine candidates. However, research on therapeutic interventions and vaccine development for human subjects is limited due to practical and ethical considerations. Thus, the preclinical model is ideal for conducting research, and it plays an important role in clinical transformation. Different preclinical models have recently emerged, such as in vitro culture and mouse models, which will lay a solid foundation for clinical treatment and prevention of syphilis. This review aims to provide a comprehensive summary of the most recent syphilis tactics, including detection, drug resistance treatments, vaccine development, and preclinical models in clinical practice.
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Affiliation(s)
- Shun Xiong
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan Province, Hengyang Medical College, University of South China, Hengyang, 421001, China
| | - Zhaoping Liu
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan Province, Hengyang Medical College, University of South China, Hengyang, 421001, China
| | - Xiaohong Zhang
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan Province, Hengyang Medical College, University of South China, Hengyang, 421001, China
| | - Shaobin Huang
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan Province, Hengyang Medical College, University of South China, Hengyang, 421001, China
| | - Xuan Ding
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan Province, Hengyang Medical College, University of South China, Hengyang, 421001, China
| | - Jie Zhou
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan Province, Hengyang Medical College, University of South China, Hengyang, 421001, China
| | - Jiangchen Yao
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan Province, Hengyang Medical College, University of South China, Hengyang, 421001, China
| | - Weiwei Li
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan Province, Hengyang Medical College, University of South China, Hengyang, 421001, China
| | - Shuangquan Liu
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan Province, Hengyang Medical College, University of South China, Hengyang, 421001, China.
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital, Institution of Microbiology and Infectious Diseases, Hengyang Medical College, University of South China, Hengyang, 421001, China.
| | - Feijun Zhao
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan Province, Hengyang Medical College, University of South China, Hengyang, 421001, China.
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital, Institution of Microbiology and Infectious Diseases, Hengyang Medical College, University of South China, Hengyang, 421001, China.
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Zhang X, Duan J, Wang Y, Xie B, Zhou J, Zhao S, Yin W, Liu P, Zhao F. Insight into the invasion process and immune-protective evaluation of Tp0971, a membrane lipoprotein from Treponema pallidum. Microbiol Spectr 2023; 11:e0004723. [PMID: 37855609 PMCID: PMC10714829 DOI: 10.1128/spectrum.00047-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 09/01/2023] [Indexed: 10/20/2023] Open
Abstract
IMPORTANCE The past two decades have seen a worldwide resurgence in infections caused by Treponema pallidum (T. pallidum) subsp. pallidum, the syphilis spirochete. The well-recognized capacity of the syphilis spirochete for early dissemination and immune evasion has earned it the designation "the stealth pathogen." There are many hurdles to studying syphilis pathogenesis, most notably the difficulty of culturing and genetically manipulating T. pallidum, as well as the absence of an effective vaccine for T. pallidum prevention. T. pallidum infection in humans is a complex and lengthy process. In this study, we investigated the invasion process and the function of the infection-dependent antigen Tp0971 as an immunogen to inhibit the dissemination of T. pallidum in an animal infection model. This enables a better understanding of the specific pathogenic mechanism of this pathogen, syphilis pathogenesis, and vaccine research.
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Affiliation(s)
- Xiaohong Zhang
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan Province, Department of Clinical Laboratory Medicine of the First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang, China
| | - Junxia Duan
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan Province, Department of Clinical Laboratory Medicine of the First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang, China
| | - Yali Wang
- Department of Clinical Medicine Undergraduate, Hengyang Medical College, University of South China, Hengyang, China
| | - Bibo Xie
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan Province, Department of Clinical Laboratory Medicine of the First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang, China
| | - Jie Zhou
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan Province, Department of Clinical Laboratory Medicine of the First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang, China
| | - Sisi Zhao
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan Province, Department of Clinical Laboratory Medicine of the First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang, China
| | - Weiguo Yin
- Laboratory Department, Qingyuan People’s Hospital, Qingyuan, China
| | - Peng Liu
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan Province, Department of Clinical Laboratory Medicine of the First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang, China
| | - Feijun Zhao
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan Province, Department of Clinical Laboratory Medicine of the First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang, China
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Li S, Li W, Jin Y, Wu B, Wu Y. Advancements in the development of nucleic acid vaccines for syphilis prevention and control. Hum Vaccin Immunother 2023; 19:2234790. [PMID: 37538024 PMCID: PMC10405752 DOI: 10.1080/21645515.2023.2234790] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 06/12/2023] [Accepted: 07/05/2023] [Indexed: 08/05/2023] Open
Abstract
Syphilis, a chronic systemic sexually transmitted disease, is caused by the bacterium Treponema pallidum (T. pallidum). Currently, syphilis remains a widespread infectious disease with significant disease burden in many countries. Despite the absence of identified penicillin-resistant strains, challenges in syphilis treatment persist due to penicillin allergies, supply issues, and the emergence of macrolide-resistant strains. Vaccines represent the most cost-effective strategy to prevent and control the syphilis epidemic. In light of the ongoing global coronavirus disease 2019 (COVID-19) pandemic, nucleic acid vaccines have gained prominence in the field of vaccine research and development, owing to their superior efficiency compared to traditional vaccines. This review summarizes the current state of the syphilis epidemic and the preliminary findings in T. pallidum nucleic acid vaccine research, discusses the challenges associated with the development of T. pallidum nucleic acid vaccines, and proposes strategies and measures for future T. pallidum vaccine development.
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Affiliation(s)
- Sijia Li
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical College, Institution of Pathogenic Biology, University of South China, Hengyang, China
| | - Weiwei Li
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical College, Institution of Pathogenic Biology, University of South China, Hengyang, China
- Department of Clinical Laboratory, The Second People’s Hospital of Foshan, Foshan, China
| | - Yinqi Jin
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical College, Institution of Pathogenic Biology, University of South China, Hengyang, China
| | - Bin Wu
- First Affiliated Hospital, Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Yimou Wu
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical College, Institution of Pathogenic Biology, University of South China, Hengyang, China
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8
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Zhou X, Tang Y, Cao T, Ning L, Li Y, Xie X, Hu Y, He B, Peng B, Liu S. Treponema pallidum lipoprotein Tp0768 promotes the migration and adhesion of THP-1 cells to vascular endothelial cells through stress of the endoplasmic reticulum and the NF-κB/HIF-1α pathway. Mol Microbiol 2023; 119:86-100. [PMID: 36480422 DOI: 10.1111/mmi.15010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 10/23/2022] [Accepted: 11/23/2022] [Indexed: 12/13/2022]
Abstract
Endothelial cell injury is a key factor in the spread of infection and pathogenicity of Treponema pallidum. The migration and adhesion reaction mediated by T. pallidum lipoprotein plays an important role. This study aimed to systematically explore the migration and adhesion effect of T. pallidum lipoprotein Tp0768 and its molecular mechanism. Stimulating vascular endothelial cells with Tp0768 increased the expression of ICAM-1, MCP-1, and IL-8. Moreover, it promoted the migration and adhesion of THP-1 cells to vascular endothelial cells. Our results revealed that Tp0768 promoted the THP-1 cells migrating and adhering to vascular endothelial cells by the PERK and IRE-1α pathways of endoplasmic reticulum (ER) stress. We further demonstrated that the inhibition of the NF-κB pathway and the downregulation of hypoxia-inducible factor 1 alpha (HIF-1α) reduced the mRNA levels of ICAM-1, MCP-1, and IL-8 induced by Tp0768. Also, the adhesion rate of THP-1 cells to endothelial cells decreased. After inhibiting ER stress, NF-κB p65 nuclear translocation was weakened, and the mRNA level of HIF-1α was also significantly downregulated. Our results indicated that T. pallidum lipoprotein Tp0768 promoted the migration and adhesion of THP-1 cells to vascular endothelial cells through ER stress and NF-κB/HIF-1α pathway.
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Affiliation(s)
- Xiangping Zhou
- The First Affiliated Hospital, Department of Clinical Laboratory, Hengyang Medical School, University of South China, Hengyang, China
| | - Yun Tang
- The First Affiliated Hospital, Department of Clinical Laboratory, Hengyang Medical School, University of South China, Hengyang, China
| | - Ting Cao
- The First Affiliated Hospital, Department of Clinical Laboratory, Hengyang Medical School, University of South China, Hengyang, China
| | - Lichang Ning
- The First Affiliated Hospital, Department of Clinical Laboratory, Hengyang Medical School, University of South China, Hengyang, China
| | - Yumeng Li
- The First Affiliated Hospital, Department of Clinical Laboratory, Hengyang Medical School, University of South China, Hengyang, China
| | - Xiaoping Xie
- The First Affiliated Hospital, Department of Clinical Laboratory, Hengyang Medical School, University of South China, Hengyang, China
| | - Yibao Hu
- The First Affiliated Hospital, Department of Clinical Laboratory, Hengyang Medical School, University of South China, Hengyang, China
| | - Bisha He
- The First Affiliated Hospital, Department of Clinical Laboratory, Hengyang Medical School, University of South China, Hengyang, China
| | - Binfeng Peng
- The First Affiliated Hospital, Department of Clinical Laboratory, Hengyang Medical School, University of South China, Hengyang, China
| | - Shuangquan Liu
- The First Affiliated Hospital, Department of Clinical Laboratory, Hengyang Medical School, University of South China, Hengyang, China
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Luo Y, Xie Y, Xiao Y. Laboratory Diagnostic Tools for Syphilis: Current Status and Future Prospects. Front Cell Infect Microbiol 2021; 10:574806. [PMID: 33628742 PMCID: PMC7897658 DOI: 10.3389/fcimb.2020.574806] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 12/14/2020] [Indexed: 12/29/2022] Open
Abstract
With the increasing number of patients infected with syphilis in the past 20 years, early diagnosis and early treatment are essential to decline syphilis prevalence. Owing to its diverse manifestations, which may occur in other infections, the disease often makes clinicians confused. Therefore, a sensitive method for detecting T. pallidum is fundamental for the prompt diagnosis of syphilis. Morphological observation, immunohistochemical assay, rabbit infectivity test, serologic tests, and nucleic acid amplification assays have been applied to the diagnosis of syphilis. Morphological observation, including dark-field microscopy, silver-staining, and direct fluorescent antibody staining for T. pallidum, can be used as a direct detection method for chancre specimens in primary syphilis. Immunohistochemistry is a highly sensitive and specific assay, especially in the lesion biopsies from secondary syphilis. Rabbit infectivity test is considered as a sensitive and reliable method for detecting T. pallidum in clinical samples and used as a historical standard for the diagnosis of syphilis. Serologic tests for syphilis are widely adopted using non-treponemal or treponemal tests by either the traditional or reverse algorithm and remain the gold standard in the diagnosis of syphilis patients. In addition, nucleic acid amplification assay is capable of detecting T. pallidum DNA in the samples from patients with syphilis. Notably, PCR is probably a promising method but remains to be further improved. All of the methods mentioned above play important roles in various stages of syphilis. This review aims to provide a summary of the performance characteristics of detection methods for syphilis.
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Affiliation(s)
- Yuting Luo
- Department of Clinical Laboratory, The Second Affiliated Hospital of University of South China, Hengyang, China
| | - Yafeng Xie
- Department of Clinical Laboratory, The Second Affiliated Hospital of University of South China, Hengyang, China
| | - Yongjian Xiao
- Department of Clinical Laboratory, The Second Affiliated Hospital of University of South China, Hengyang, China
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Recombinant Treponema pallidum protein Tp0768 promotes proinflammatory cytokine secretion of macrophages through ER stress and ROS/NF-κB pathway. Appl Microbiol Biotechnol 2020; 105:353-366. [PMID: 33216161 PMCID: PMC7677105 DOI: 10.1007/s00253-020-11018-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/05/2020] [Accepted: 11/11/2020] [Indexed: 12/23/2022]
Abstract
In response to danger signals, macrophages rapidly produce many inflammatory cytokines that trigger the cascade release of inflammatory mediators, leading to tissue damage, which is an important cause of clinical manifestations of syphilis at all stages. However, we still know very little about the specific mechanism of this process. Tp0768 is an infection-stage-dependent antigen that plays an important role in the infection of Treponema pallidum. In this study, we demonstrated that Tp0768 stimulation of macrophages can cause IL-1β, IL-6, and IL-8 mRNA expression levels to increase in a dose- and time-dependent manner. Further research showed that Tp0768 activated ER stress and the ROS/NF-κB pathway in macrophages. Inhibition of ER stress and the ROS/NF-κB pathway inhibited the expression of IL-1β, IL-6, and IL-8 induced by Tp0768. In addition, pretreatment with a PERK pathway inhibitor significantly reduced the expression of the NF-κB and JNK pathways, while also downregulating the expression of IL-1β, IL-6, and IL-8. Tp0768 stimulation can activate IRE1α/XBP-1 signaling and participate in the induction of inflammatory cytokines through the JNK pathway. These findings indicate that Tp0768 promotes the secretion of proinflammatory cytokines IL-1β, IL-6, and IL-8 by macrophages through ER stress and the ROS/NF-κB pathway, which are also involved in the activation of the NF-κB and JNK pathways that are induced by the PERK pathway and activation of IRE1α/XBP-1 signaling. KEY POINTS: • This study found for the first time that the recombinant Treponema pallidum protein Tp0768 promotes the production of IL-1β, IL-6, and IL-8 by macrophages through ER stress. • Recombinant Treponema pallidum protein Tp0768 regulates the ROS/NF-κB pathway through ER stress. • ER stress-related pathway PERK induces the expression of IL-1β, IL-6, and IL-8 by activating the NF-κB pathway and the JNK pathway. • IRE1α can induce the splicing of XBP-1mRNA and activate the JNK pathway.
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Silva ÂAO, de Oliveira UD, Vasconcelos LDCM, Foti L, Leony LM, Daltro RT, Leitolis A, Lima FWDM, Krieger MA, Zanchin NIT, Santos FLN. Performance of Treponema pallidum recombinant proteins in the serological diagnosis of syphilis. PLoS One 2020; 15:e0234043. [PMID: 32555593 PMCID: PMC7302711 DOI: 10.1371/journal.pone.0234043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/18/2020] [Indexed: 11/18/2022] Open
Abstract
Syphilis serodiagnosis is challenging because distinct clinical forms of the infection may influence serological performance and discordant results between tests make clinical decisions difficult. Several recombinant Treponema pallidum-proteins have already been tested for syphilis diagnosis and they are critical to achieve high accuracy in serological testing. Our aim was to assess the varied from performance of T. pallidum-recombinant proteins TmpA, TpN17 and TpN47 for syphilis serodiagnosis. The proteins were evaluated using sera of 338 T. pallidum-negative, 173 T. pallidum-positive individuals and 209 sera from individuals infected with unrelated diseases. The diagnostic potential was validated by analysis of ROC curves. In the liquid microarray analyses, the ROC curve varied from 99.0% for TmpA and TpN17 to 100% for TpN47. The sensitivity score yielded values of up to 90% for TpN17, 100% for TpN47 and 80.0% for TmpA. The lowest and highest specificity values were presented by TpN47 (91.9%) and TmpA antigens (100%), respectively. TpN47 showed the highest accuracy score (95.5%) among all the recombinant proteins assayed. For the ELISA, the ROC curve was 97.2%, 91.8% and 81.6% for TpN17, TmpA and TpN47, respectively. TpN17 and TmpA yielded a sensitivity of 69.9%, while TpN47 obtained a value of 53.8%. Specificity was almost 100% for all three proteins. No cross-reaction was observed for TpN17 in the serum samples from non-bacterial infections. Regarding leptospirosis-positive samples, cross-reactivity score was varied from 8.6 to 34.6%. This is most probably due to conservation of the epitopes in these proteins across bacteria. The use of recombinant proteins in immunoassays for syphilis diagnosis was showed provide greater reliability to results of the treponemal assays. Despite the low sensitivity, the proteins showed high diagnostic capacity due to the AUC values found. However, an improvement in sensitivity could be achieved when antigenic mixtures are evaluated.
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Affiliation(s)
| | | | | | - Leonardo Foti
- Carlos Chagas Institute, Oswaldo Cruz Foundation (Fiocruz-PR), Curitiba, Paraná, Brazil
| | - Leonardo Maia Leony
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador, Bahia, Brazil
| | - Ramona Tavares Daltro
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador, Bahia, Brazil
| | | | | | - Marco Aurélio Krieger
- Carlos Chagas Institute, Oswaldo Cruz Foundation (Fiocruz-PR), Curitiba, Paraná, Brazil
- Molecular Biology Institute of Paraná, Curitiba, Paraná, Brazil
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Djokic V, Giacani L, Parveen N. Analysis of host cell binding specificity mediated by the Tp0136 adhesin of the syphilis agent Treponema pallidum subsp. pallidum. PLoS Negl Trop Dis 2019; 13:e0007401. [PMID: 31071095 PMCID: PMC6529012 DOI: 10.1371/journal.pntd.0007401] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 05/21/2019] [Accepted: 04/17/2019] [Indexed: 12/15/2022] Open
Abstract
Background Syphilis affects approximately 11 million people each year globally, and is the third most prevalent sexually transmitted bacterial infection in the United States. Inability to independently culture and genetically manipulate Treponema pallidum subsp. pallidum, the causative agent of this disease, has hindered our understanding of the molecular mechanisms of syphilis pathogenesis. Here, we used the non-infectious and poorly adherent B314 strain of the Lyme disease-causing spirochete, Borrelia burgdorferi, to express two variants of a known fibronectin-binding adhesin, Tp0136, from T. pallidum SS14 and Nichols strains. Using this surrogate system, we investigated the ability of Tp0136 in facilitating differential binding to mammalian cell lines offering insight into the possible role of this virulence factor in colonization of specific tissues by T. pallidum during infection. Principal findings Expression of Tp0136 could be detected on the surface of B. burgdorferi by indirect immunofluorescence assay using sera from a secondary syphilis patient that does not react with intact B314 spirochetes transformed with the empty vector. Increase in Tp0136-mediated adherence of B314 strain to human epithelial HEK293 cells was observed with comparable levels of binding exhibited by both Tp0136 alleles. Adherence of Tp0136-expressing B314 was highest to epithelial HEK293 and C6 glioma cells. Gain in binding of B314 strain expressing Tp0136 to purified fibronectin and poor binding of these spirochetes to the fibronectin-deficient cell line (HEp-2) indicated that Tp0136 interaction with this host receptor plays an important role in spirochetal attachment to mammalian cells. Furthermore, preincubation of these cell lines with fibronectin-binding peptide from Staphylococcus aureus FnbA-2 protein significantly inhibited binding of B314 expressing Tp0136. Conclusions Our results show that Tp0136 facilitates differential level of binding to cell lines representing various host tissues, which highlights the importance of this protein in colonization of human organs by T. pallidum and resulting syphilis pathogenesis. Syphilis is one of the most prevalent sexually transmitted infections that affect millions of people around the world. The causative bacterium, Treponema pallidum subsp. pallidum, can be transmitted from mother to fetus during maternal infection, resulting in adverse pregnancy outcomes. Although timely treatment of syphilis is highly effective, untreated infection causes late syphilis that affects virtually every organ and leads to serious clinical manifestations. Therefore, syphilis remains a serious healthcare problem. T. pallidum cannot be grown in laboratory using traditional methods, which has slowed the progress in understanding this pathogen biology and pathogenesis. We employed a novel approach of using a related bacterium, Borrelia burgdorferi, to express Tp0136 protein from two different T. pallidum isolates to study the function of this protein. This strategy enabled us to demonstrate the ability of this protein to bind to fibronectin and laminin receptors present on the surface of various host cells. We showed that Tp0136 facilitates binding to only those host cells that produce fibronectin. In addition, we found that Tp0136-mediated binding is not equivalent in all host cell types, suggesting that the protein could help in colonization of specific human organs and tissues during infection by T. pallidum.
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Affiliation(s)
- Vitomir Djokic
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers New Jersey Medical School, Newark, New Jersey, United States of America
| | - Lorenzo Giacani
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Nikhat Parveen
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers New Jersey Medical School, Newark, New Jersey, United States of America
- * E-mail:
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