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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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Papp JR, Park IU, Fakile Y, Pereira L, Pillay A, Bolan GA. CDC Laboratory Recommendations for Syphilis Testing, United States, 2024. MMWR Recomm Rep 2024; 73:1-32. [PMID: 38319847 PMCID: PMC10849099 DOI: 10.15585/mmwr.rr7301a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
This report provides new CDC recommendations for tests that can support a diagnosis of syphilis, including serologic testing and methods for the identification of the causative agent Treponema pallidum. These comprehensive recommendations are the first published by CDC on laboratory testing for syphilis, which has traditionally been based on serologic algorithms to detect a humoral immune response to T. pallidum. These tests can be divided into nontreponemal and treponemal tests depending on whether they detect antibodies that are broadly reactive to lipoidal antigens shared by both host and T. pallidum or antibodies specific to T. pallidum, respectively. Both types of tests must be used in conjunction to help distinguish between an untreated infection or a past infection that has been successfully treated. Newer serologic tests allow for laboratory automation but must be used in an algorithm, which also can involve older manual serologic tests. Direct detection of T. pallidum continues to evolve from microscopic examination of material from lesions for visualization of T. pallidum to molecular detection of the organism. Limited point-of-care tests for syphilis are available in the United States; increased availability of point-of-care tests that are sensitive and specific could facilitate expansion of screening programs and reduce the time from test result to treatment. These recommendations are intended for use by clinical laboratory directors, laboratory staff, clinicians, and disease control personnel who must choose among the multiple available testing methods, establish standard operating procedures for collecting and processing specimens, interpret test results for laboratory reporting, and counsel and treat patients. Future revisions to these recommendations will be based on new research or technologic advancements for syphilis clinical laboratory science.
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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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Ávila-Nieto C, Pedreño-López N, Mitjà O, Clotet B, Blanco J, Carrillo J. Syphilis vaccine: challenges, controversies and opportunities. Front Immunol 2023; 14:1126170. [PMID: 37090699 PMCID: PMC10118025 DOI: 10.3389/fimmu.2023.1126170] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 03/27/2023] [Indexed: 04/25/2023] Open
Abstract
Syphilis is a sexually or vertically (mother to fetus) transmitted disease caused by the infection of Treponema pallidum subspecie pallidum (TPA). The incidence of syphilis has increased over the past years despite the fact that this bacterium is an obligate human pathogen, the infection route is well known, and the disease can be successfully treated with penicillin. As complementary measures to preventive campaigns and early treatment of infected individuals, development of a syphilis vaccine may be crucial for controlling disease spread and/or severity, particularly in countries where the effectiveness of the aforementioned measures is limited. In the last century, several vaccine prototypes have been tested in preclinical studies, mainly in rabbits. While none of them provided protection against infection, some prototypes prevented bacteria from disseminating to distal organs, attenuated lesion development, and accelerated their healing. In spite of these promising results, there is still some controversy regarding the identification of vaccine candidates and the characteristics of a syphilis-protective immune response. In this review, we describe what is known about TPA immune response, and the main mechanisms used by this pathogen to evade it. Moreover, we emphasize the importance of integrating this knowledge, in conjunction with the characterization of outer membrane proteins (OMPs), to expedite the development of a syphilis vaccine that can protect against TPA infection.
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Affiliation(s)
- Carlos Ávila-Nieto
- IrsiCaixa AIDS Research Institute, Badalona, Spain
- Autonomous University of Barcelona, Cerdanyola del Vallès, Catalonia, Spain
| | | | - Oriol Mitjà
- Skin Neglected Tropical Diseases and Sexually Transmitted Infections Department, Germans Trias i Pujol Hospital, Badalona, Spain
- Fight Infections Foundation, Germans Trias i Pujol Hospital, Badalona, Catalonia, Spain
- Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic – Central University of Catalonia (UVic – UCC), Vic, Catalonia, Spain
| | - Bonaventura Clotet
- IrsiCaixa AIDS Research Institute, Badalona, Spain
- Fight Infections Foundation, Germans Trias i Pujol Hospital, Badalona, Catalonia, Spain
- Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic – Central University of Catalonia (UVic – UCC), Vic, Catalonia, Spain
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
- CIBERINFEC, Instituto de Salut Carlos III (ISCIII), Madrid, Spain
| | - Julià Blanco
- IrsiCaixa AIDS Research Institute, Badalona, Spain
- Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic – Central University of Catalonia (UVic – UCC), Vic, Catalonia, Spain
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
- CIBERINFEC, Instituto de Salut Carlos III (ISCIII), Madrid, Spain
| | - Jorge Carrillo
- IrsiCaixa AIDS Research Institute, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
- CIBERINFEC, Instituto de Salut Carlos III (ISCIII), Madrid, Spain
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5
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Khemthongcharoen N, Uawithya P, Yookong N, Chanasakulniyom M, Jeamsaksiri W, Sripumkhai W, Pattamang P, Juntasaro E, Kamnerdsook A, Houngkamhang N, Promptmas C. A simple and high -performance immobilization technique of membrane protein from crude cell lysate sample for a membrane-based immunoassay application. J Immunoassay Immunochem 2023; 44:76-89. [PMID: 36318041 DOI: 10.1080/15321819.2022.2137420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Membrane proteins are difficult to be extracted and to be coated on the substrate of the immunoassay reaction chamber because of their hydrophobicity. Traditional method to prepare membrane protein sample requires many steps of protein extraction and purification that may lead to protein structure deformation and protein dysfunction. This work proposes a simple technique to prepare and immobilize the membrane protein suspended in an unprocessed crude cell lysate sample. Membrane fractions in crude cell lysate were incorporated with the large unilamellar vesicle (LUV) that was mainly composed of POPC (1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine) before coating in the polystyrene plate by passive adsorption technique. Immunofluorescence staining and the Enzyme-Linked Immunosorbent Assay (ELISA) examination of a strictly conformation-dependent integral membrane protein, Myelin Oligodendrocyte Glycoprotein (MOG), demonstrate that LUV incorporated cell lysate sample obviously promotes MOG protein immobilization in the microplate well. With LUV incorporation, the dose-response curve of the MOG transfected cell lysate coating plate can be 2-9 times differentiated from that of the untransfected cell lysate coating plate. The LUV incorporated MOG transfected cell lysate can be efficiently coated in the microplate without carbonate/bicarbonate coating buffer assistance.
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Affiliation(s)
- Numfon Khemthongcharoen
- Department of Biomedical Engineering, Faculty of Engineering, Mahidol University, Nakhon Pathom, Thailand.,NECTEC, National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
| | - Panapat Uawithya
- Department of Physiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nutthapon Yookong
- Department of Physiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Mayuree Chanasakulniyom
- Department of Clinical Chemistry, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand.,Center for Standardization and Product Validation, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
| | - Wutthinan Jeamsaksiri
- Thai Microelectronics Center (TMEC), NECTEC, National Science and Technology Development Agency (NSTDA), Chachoengsao, Thailand
| | - Witsaroot Sripumkhai
- Thai Microelectronics Center (TMEC), NECTEC, National Science and Technology Development Agency (NSTDA), Chachoengsao, Thailand
| | - Pattaraluck Pattamang
- Thai Microelectronics Center (TMEC), NECTEC, National Science and Technology Development Agency (NSTDA), Chachoengsao, Thailand
| | - Ekachai Juntasaro
- Mechanical Engineering Simulation and Design Group, The Sirindhorn International Thai-German Graduate School of Engineering (TGGS), King Mongkut's University of Technology North Bangkok (KMUTNB), Bangkok, Thailand
| | - Ampol Kamnerdsook
- Thai Microelectronics Center (TMEC), NECTEC, National Science and Technology Development Agency (NSTDA), Chachoengsao, Thailand.,Mechanical Engineering Simulation and Design Group, The Sirindhorn International Thai-German Graduate School of Engineering (TGGS), King Mongkut's University of Technology North Bangkok (KMUTNB), Bangkok, Thailand
| | - Nongluck Houngkamhang
- College of Materials Innovation and Technology, King Mongkut's Institute of Technology Ladkrabang (KMITL), Bangkok, Thailand
| | - Chamras Promptmas
- Department of Biomedical Engineering, Faculty of Engineering, Mahidol University, Nakhon Pathom, Thailand
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6
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de Sá Queiroz JHF, dos Santos Barbosa M, Miranda LGO, de Oliveira NR, Dellagostin OA, Marchioro SB, Simionatto S. Tp0684, Tp0750, and Tp0792 Recombinant Proteins as Antigens for the Serodiagnosis of Syphilis. Indian J Microbiol 2022; 62:419-427. [PMID: 35974924 PMCID: PMC9375814 DOI: 10.1007/s12088-022-01017-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/20/2022] [Indexed: 11/28/2022] Open
Abstract
The incidence of syphilis has increased alarmingly over the years. Its diagnosis continues to be a challenge, leading to the search for new alternative and effective methods. The objective of this study was to select and evaluate three Treponema pallidum recombinant proteins for potential use in syphilis serodiagnosis. Bioinformatics analysis was performed with three T. pallidum antigens (Tp0684, Tp0750, and Tp0792) to assess their physical, antigenic, and structural characteristics. The antigens were chemically synthesized, recombinant plasmids were expressed in Escherichia coli BL21 Star™ (DE3), and the recombinant proteins were purified by nickel affinity chromatography. The antigenicity of the recombinant proteins was evaluated by western blotting and enzyme-linked immunosorbent assay (ELISA), using the sera from patients with primary and latent syphilis. In silico analysis indicated the antigenic potential once the exposed B cell epitopes were detected in the evaluated proteins. Sera from patients with primary and latent syphilis specifically recognized rTp0684, rTp0750, and rTp0792 recombinant antigens. Moreover, the rTp0684-ELISA receiver operating characteristic (ROC) analysis showed an area under the ROC curve of 0.99, indicating high diagnostic efficacy with 97.62% specificity and 95% sensitivity. In conclusion, rTp0684 showed better potential as an antigen for the development of syphilis serodiagnosis. Thus, bioinformatic analysis can be an important tool to guide the selection of antigens for serological diagnosis. Supplementary Information The online version contains supplementary material available at 10.1007/s12088-022-01017-w.
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Affiliation(s)
- Júlio Henrique Ferreira de Sá Queiroz
- Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados - UFGD, Rodovia Dourados - Itahum, km 12, Cidade Universitária, Dourados, MS 79804970 Brazil
| | - Marcelo dos Santos Barbosa
- Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados - UFGD, Rodovia Dourados - Itahum, km 12, Cidade Universitária, Dourados, MS 79804970 Brazil
| | - Lais Gonçalves Ortolani Miranda
- Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados - UFGD, Rodovia Dourados - Itahum, km 12, Cidade Universitária, Dourados, MS 79804970 Brazil
| | | | | | - Silvana Beutinger Marchioro
- Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados - UFGD, Rodovia Dourados - Itahum, km 12, Cidade Universitária, Dourados, MS 79804970 Brazil
- Laboratório de Imunologia e Biologia Molecular, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, BA Brazil
| | - Simone Simionatto
- Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados - UFGD, Rodovia Dourados - Itahum, km 12, Cidade Universitária, Dourados, MS 79804970 Brazil
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Chen D, Wang S, He Y, Fu Y, Zhao F, Zhou X, Yin H, Wan J, Huang Y, Wu Y, Cao L, Zeng T. Assessment of recombinant antigens Tp0100 and Tp1016 of Treponema pallidum for serological diagnosis of syphilis. J Clin Lab Anal 2022; 36:e24635. [PMID: 35908795 PMCID: PMC9459255 DOI: 10.1002/jcla.24635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 11/30/2022] Open
Abstract
Objective To discover novel serodiagnostic candidates for the serological diagnosis of syphilis. Methods Two recombinant Treponema pallidum proteins Tp0100 and Tp1016 were expressed, purified, and identified by Western Blotting. A total of 600 clinical serum samples were tested with the Tp0100‐based ELISA, the Tp1016‐based ELISA, and the commercial LICA Syphilis TP kit (ChIVD, Beijing, China). The sensitivities were determined by testing 340 samples from individuals with clinically diagnosed primary, secondary, latent, and tertiary syphilis. The specificities were determined by screening 260 samples from healthy controls and individuals with potentially cross‐reactive infections, including leptospirosis, Lyme disease, hepatitis B, tuberculosis, rheumatoid arthritis, systemic lupus erythematosus. Kappa (κ) values were applied to compare the agreement between clinical syphilis diagnosis and the Tp0100‐based ELISA, the Tp1016‐based ELISA, or the LICA Syphilis TP test. Results Using clinical syphilis diagnosis as the gold standard, Tp0100 exhibited an overall sensitivity of 95.6% and specificity of 98.1% for testing IgG antibody while Tp1016 demonstrated only an overall sensitivity of 75.0% and specificity of 79.6%. In contrast, the LICA Syphilis TP test revealed an overall sensitivity of 97.6% and specificity of 96.2%. In addition, the overall percent agreement and corresponding κ values were 96.7% (95% CI 95.6%–97.8%) and 0.93 for the Tp0100‐based ELISA, 77.0% (95% CI 74.3%–79.7%) and 0.54 for the Tp1016‐based ELISA, and 97.0% (95% CI 96.0%–98.0%) and 0.94 for the LICA Syphilis TP test, respectively. Conclusion The recombinant T. pallidum protein Tp0100 shows promise as a novel diagnostic antigen in the serological tests for syphilis.
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Affiliation(s)
- Dejun Chen
- Institution of Pathogenic Biology and Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Hengyang Medical School, University of South China, Hengyang, China.,Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, China
| | - Siqian Wang
- Clinical laboratory of the First Pepole's Hospital of Changde City, Changde, China
| | - Yuxing He
- Institution of Pathogenic Biology and Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Hengyang Medical School, University of South China, Hengyang, China.,Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, China
| | - Yue Fu
- Institution of Pathogenic Biology and Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Hengyang Medical School, University of South China, Hengyang, China.,Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, China
| | - Feijun Zhao
- Institution of Pathogenic Biology and Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Hengyang Medical School, University of South China, Hengyang, China.,Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, China
| | - Xiuping Zhou
- Department of Laboratory Medicine, Changsha Health Vocational College, Changsha, China
| | - Haoquan Yin
- Department of Clinical Medical Undergraduates, Hengyang Medical School, University of South China, Hengyang, China
| | - Jia Wan
- Department of Clinical Medical Undergraduates, Hengyang Medical School, University of South China, Hengyang, China
| | - Yunting Huang
- Department of Clinical Medical Undergraduates, Hengyang Medical School, University of South China, Hengyang, China
| | - Yimou Wu
- Institution of Pathogenic Biology and Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Hengyang Medical School, University of South China, Hengyang, China.,Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, China
| | - Longgu Cao
- College of Medical Imaging Laboratory and Rehabilitation, Xiangnan University, Chenzhou, China
| | - Tiebing Zeng
- Institution of Pathogenic Biology and Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Hengyang Medical School, University of South China, Hengyang, China.,Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, China
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8
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Chen J, Huang J, Liu Z, Xie Y. Treponema pallidum outer membrane proteins: current status and prospects. Pathog Dis 2022; 80:6649208. [PMID: 35869970 DOI: 10.1093/femspd/ftac023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 05/30/2022] [Accepted: 07/20/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
The outer membrane proteins (OMPs) of Treponema pallidum subsp. Pallidum (T. pallidum), the etiological agent of the sexually transmitted disease syphilis, has long been a hot research topic. Despite many hurdles to studying the pathogen, especially the inability to manipulate T. pallidum in vitro genetically1, considerable progress has been made in elucidating the structure, pathogenesis, and functions of T. pallidum OMPs. In this review, we integrate this information to garner fresh insights into the role of OMPs in the diagnosis, pathogenicity, and vaccine development of T. pallidum. Collectively, the essential scientific discussions herein should provide a framework for understanding the current status and prospects of T. pallidum OMPs.
Decades ago, researchers postulated that the poor surface antigenicity of T. pallidum is the basis for its ability to cause persistent infection. Still, they believed that the mysterious properties of T. pallidum should not be attributed to the presence of the outer membrane proteins (OMPs). Subsequent studies revealed that the OM, which lacks integral membrane proteins, prevents antibody binding2. Since the advent of recombinant DNA technology, the fragility of the OM, low protein content, and the lack of sequence relatedness between T. pallidum and Gram-negative OMPs have complicated efforts to characterize molecules residing at the host-pathogen interface. These hurdles have been overcome by using the genomic sequence with computational tools to identify proteins predicted to form beta barrels, the hallmark conformation of OMPs in many organisms. Diverse methodologies have also confirmed that some candidate OMPs from amphiphilic β-barrels are surface-exposed in T. pallidum. These studies have led to a structural homology model for BamA and established the bipartite topology of the T. pallidum repeat (Tpr) family of proteins. Recent bioinformatics has identified several structural orthologs for well-characterized Gram-negative OMPs, suggesting that the T. pallidum OMPs are more Gram-negative-like than previously supposed. Lipoprotein adhesins and proteases on the spirochete surface also may contribute to disease pathogenesis and protective immunity.
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Affiliation(s)
- Jinlin Chen
- Department of Clinical Laboratory, The Second Affiliated Hospital of University of South China , Hengyang 421001 , China
| | - Jielite Huang
- Department of Clinical Laboratory, The Second Affiliated Hospital of University of South China , Hengyang 421001 , China
| | - Zhuoran Liu
- Department of Clinical Laboratory, The Second Affiliated Hospital of University of South China , Hengyang 421001 , China
| | - Yafeng Xie
- Department of Clinical Laboratory, The Second Affiliated Hospital of University of South China , Hengyang 421001 , China
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Xu M, Xie Y, Zheng K, Luo H, Tan M, Zhao F, Zeng T, Wu Y. Two Potential Syphilis Vaccine Candidates Inhibit Dissemination of Treponema pallidum. Front Immunol 2021; 12:759474. [PMID: 34899710 PMCID: PMC8657604 DOI: 10.3389/fimmu.2021.759474] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/29/2021] [Indexed: 11/21/2022] Open
Abstract
Syphilis, caused by the spirochete Treponema pallidum subspecies pallidum, continues to be a major public health problem worldwide. Recent increases in the number of syphilis cases, in addition to the lack of an efficient vaccine against T. pallidum for humans, highlights an urgent need for the design and development of an efficacious syphilis vaccine. Here, we assess the vaccine potential of the adhesion protein Tp0136 and the outer membrane protein Tp0663. Rabbits were subcutaneously immunized with recombinant proteins Tp0136, Tp0663, or control PBS. Immunization with Tp0136 or Tp0663 generated a strong humoral immune response with high titers of IgG, as assessed by ELISA. Moreover, animals immunized with Tp0136 or Tp0663 exhibited attenuated lesion development, increased cellular infiltration at the lesion sites, and inhibition of treponemal dissemination to distant organs compared to the unimmunized animals. These findings indicate that Tp0136 and Tp0663 are promising syphilis vaccine candidates. Furthermore, these results provide novel and important information for not only understanding the pathogenic mechanisms of spirochetes, but also the development of spirochete-specific subunit vaccines.
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Affiliation(s)
- Man Xu
- Institution of Pathogenic Biology, Hengyang Medical School, University of South China, Hengyang, China.,Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, China
| | - Yafeng Xie
- Institution of Pathogenic Biology, Hengyang Medical School, University of South China, Hengyang, China.,Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, China.,Department of Clinical Laboratory, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Kang Zheng
- Department of Clinical Laboratory, Hengyang Central Hospital, Hengyang, China
| | - Haodang Luo
- Department of Clinical Laboratory, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, China
| | - Manyi Tan
- Department of Toxicology, Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Feijun Zhao
- Institution of Pathogenic Biology, Hengyang Medical School, University of South China, Hengyang, China.,Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, China
| | - Tiebing Zeng
- Institution of Pathogenic Biology, Hengyang Medical School, University of South China, Hengyang, China.,Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, China
| | - Yimou Wu
- Institution of Pathogenic Biology, Hengyang Medical School, University of South China, Hengyang, China.,Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, China
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10
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Park IU, Tran A, Pereira L, Fakile Y. Sensitivity and Specificity of Treponemal-specific Tests for the Diagnosis of Syphilis. Clin Infect Dis 2021; 71:S13-S20. [PMID: 32578866 PMCID: PMC7312216 DOI: 10.1093/cid/ciaa349] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We conducted a systematic review of relevant syphilis diagnostic literature to address the question, “What is the sensitivity and specificity of the treponemal tests currently approved by the Food and Drug Administration (FDA) for the diagnosis of syphilis (by stage)?” There were 16 treponemal assays evaluated: 13 immunoassays and 3 manual assays (fluorescent treponemal antibody absorbed test [FTA-ABS], microhemagglutination assay for Treponema pallidum antibodies [MHA-TP], Treponema pallidum particle agglutination assay [TP-PA]). MHA-TP and FTA-ABS were less sensitive in primary and secondary syphilis than TP-PA; TP-PA is the most specific manual treponemal assay. There is insufficient evidence to recommend one particular treponemal immunoassay (eg, enzyme immunoassays, chemiluminescence immunoassays, microbead immunoassays) over another based on published performance data. For diagnosis of neurosyphilis, cerebrospinal fluid (CSF) TP-PA has similar performance to CSF FTA-ABS in studies with patients with definitive or presumptive neurosyphilis. However, CSF treponemal testing has limitations in its sensitivity and specificity and should be interpreted within the context of the clinical scenario, additional CSF test results and syphilis prevalence.
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Affiliation(s)
- Ina U Park
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Department of Family and Community Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
- Correspondence: I. U. Park, Department of Family and Community Medicine, University of California San Francisco School of Medicine, Medical Consultant, Division of STD Prevention, Centers for Disease Control and Prevention, STD Control Branch, 850 Marina Bay Parkway, Building P, 2nd Floor, Richmond, CA 94804 ()
| | - Anthony Tran
- Public Health Laboratory, Department of Forensic Sciences, Washington, DC, USA
| | - Lara Pereira
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yetunde Fakile
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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11
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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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12
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Luo X, Zhang X, Gan L, Zhou C, Zhao T, Zeng T, Liu S, Xiao Y, Yu J, Zhao F. The outer membrane protein Tp92 of Treponema pallidum induces human mononuclear cell death and IL-8 secretion. J Cell Mol Med 2018; 22:6039-6054. [PMID: 30596396 PMCID: PMC6237608 DOI: 10.1111/jcmm.13879] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 07/30/2018] [Indexed: 12/19/2022] Open
Abstract
Treponema pallidum is the pathogen that causes syphilis, a sexually transmitted disease; however, the pathogenic mechanism of this organism remains unclear. Tp92 is the only T. pallidum outer membrane protein that has structural features similar to the outer membrane proteins of other Gram-negative bacteria, but the exact functions of this protein remain unknown. In the present study, we demonstrated that the recombinant Tp92 protein can induce human mononuclear cell death. Tp92 mediated the human monocytic cell line derived from an acute monicytic leukemia patient (THP-1) cell death by recognizing CD14 and/or TLR2 on cell surfaces. After the stimulation of THP-1 cells by the Tp92 protein, Tp92 may induce atypical pyroptosis of THP-1 cells via the pro-caspase-1 pathway. Meanwhile, this protein caused the apoptosis of THP-1 cells via the receptor-interacting protein kinase 1/caspase-8/aspase-3 pathway. Tp92 reduced the number of monocytes among peripheral blood mononuclear cells. Interestingly, further research showed that Tp92 failed to increase the tumour necrosis factor-α, interleukin (IL)-1β, IL-6, IL-10, IL-18 and monocyte chemotactic protein 1 (MCP)-1 levels but slightly elevated the IL-8 levels via the Nuclear Factor (NF)-κB pathway in THP-1 cells. The data suggest that Tp92 recognizes CD14 and TLR2, transfers the signal to a downstream pathway, and activates NF-κB to mediate the production of IL-8. This mechanism may help T. pallidum escape recognition and elimination by the host innate immune system.
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MESH Headings
- Antigens, Surface/genetics
- Bacterial Proteins/genetics
- Caspase 1/genetics
- Cell Death/genetics
- Cell Line, Tumor
- Cytokines/genetics
- Host-Pathogen Interactions/genetics
- Humans
- Interleukin-8/genetics
- Leukemia, Monocytic, Acute/genetics
- Leukemia, Monocytic, Acute/microbiology
- Leukemia, Monocytic, Acute/pathology
- Leukocytes, Mononuclear/microbiology
- Leukocytes, Mononuclear/pathology
- Lipopolysaccharide Receptors/genetics
- NF-kappa B/genetics
- Recombinant Proteins/genetics
- Signal Transduction/genetics
- Syphilis/genetics
- Syphilis/microbiology
- Syphilis/pathology
- Toll-Like Receptor 2/genetics
- Treponema pallidum/genetics
- Treponema pallidum/pathogenicity
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Affiliation(s)
- Xi Luo
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan ProvinceCollaborative Innovation Center for New Molecular Drug ResearchUniversity of South ChinaHengyangChina
| | - Xiaohong Zhang
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan ProvinceCollaborative Innovation Center for New Molecular Drug ResearchUniversity of South ChinaHengyangChina
- Department of Histology and EmbryologySchool of MedicineUniversity of South ChinaHengyangChina
| | - Lin Gan
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan ProvinceCollaborative Innovation Center for New Molecular Drug ResearchUniversity of South ChinaHengyangChina
| | - Chenglong Zhou
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan ProvinceCollaborative Innovation Center for New Molecular Drug ResearchUniversity of South ChinaHengyangChina
| | - Tie Zhao
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan ProvinceCollaborative Innovation Center for New Molecular Drug ResearchUniversity of South ChinaHengyangChina
| | - Tiebing Zeng
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan ProvinceCollaborative Innovation Center for New Molecular Drug ResearchUniversity of South ChinaHengyangChina
| | - Shuangquan Liu
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan ProvinceCollaborative Innovation Center for New Molecular Drug ResearchUniversity of South ChinaHengyangChina
- Department of Clinical LaboratoryThe First Affiliated Hospital of University of South ChinaHengyangChina
| | - Yongjian Xiao
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan ProvinceCollaborative Innovation Center for New Molecular Drug ResearchUniversity of South ChinaHengyangChina
- Department of Clinical LaboratoryThe Second Affiliated Hospital of University of South ChinaHengyangChina
| | - Jian Yu
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan ProvinceCollaborative Innovation Center for New Molecular Drug ResearchUniversity of South ChinaHengyangChina
| | - Feijun Zhao
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan ProvinceCollaborative Innovation Center for New Molecular Drug ResearchUniversity of South ChinaHengyangChina
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13
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Liu W, Deng M, Zhang X, Yin W, Zhao T, Zeng T, Liu S, Xiao Y, Zhang L, Luo X, Zhao F. Performance of novel infection phase-dependent antigens in syphilis serodiagnosis and treatment efficacy determination. Clin Chim Acta 2018; 488:13-19. [PMID: 30326217 DOI: 10.1016/j.cca.2018.10.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 09/12/2018] [Accepted: 10/09/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study was to screen new antigens for syphilis serodiagnosis. METHODS First, we determined whether the Treponema pallidum proteins Tp0971, Tp0768 and Tp0462 were infection phase-dependent antigens by observing serum reactivity differences in New Zealand rabbits infected with activated or inactivated T. pallidum. A non-infection phase-dependent antigen, the Tp92 membrane protein, was used as the negative control. Next, Tp0971-, Tp0768- and Tp0462-based ELISA was performed on 2138 human serum samples and compared with the T. pallidum passive particle agglutination assay (TPPA) and LiZhu™ Tp-ELISA. In addition, another 60 paired serum samples from patients at follow-up were analysed to evaluate the relationships between titre changes and differences in the A450 nm values of the Tp0971, Tp0768, Tp0462 and Tp92 antibodies measured by ELISA. RESULTS Compared with Tp92 (negative control), Tp0971, Tp0768 and Tp0462 were determined to be infection phase-dependent antigens. Compared with those of the TPPA, the sensitivities of Tp0971-, Tp0768- and Tp0462-based ELISA were 96.4%, 96.9% and 93.0%, respectively, and the specificities were 97.7%, 95.4% and 98.9%, respectively, resulting in consistencies of 97.1%, 96.2% and 95.9%, respectively. Compared with those of the LiZhu™ Tp-ELISA, the consistencies of Tp0971-, Tp0768- and Tp0462-based ELISA were 95.1%, 94.2% and 94.0%, respectively, with kappa values of 0.902, 0.884 and 0.880, respectively. Tp0971, Tp0768 and Tp0462 demonstrated high sensitivities and specificities, as well as high conformity to the TPPA and LiZhu™ Tp-ELISA. Moreover, a significantly positive Spearman rank correlation coefficient (0.82,*P < 0.05) was found between the difference in the A450 nm values of the Tp0971 antibody and the RPR titre change. CONCLUSION The infection phase-dependent antigens Tp0971, Tp0768 and Tp0462 are promising for syphilis diagnosis, and Tp0971 may be utilized to monitor curative effects during syphilis treatment.
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Affiliation(s)
- Wen Liu
- Pathogenic Biology Institute, Hengyang Medical College, University of South China, Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, University of South China, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang 421001, China
| | - Meixia Deng
- Pathogenic Biology Institute, Hengyang Medical College, University of South China, Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, University of South China, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang 421001, China
| | - Xiaohong Zhang
- Pathogenic Biology Institute, Hengyang Medical College, University of South China, Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, University of South China, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang 421001, China; Department of Histology and Embryology, Hengyang Medical College, University of South China, Hengyang 421001, China
| | - Weiguo Yin
- Laboratory Department, Yuebei People's Hospital, Shaoguan 5120264, China
| | - Tie Zhao
- Pathogenic Biology Institute, Hengyang Medical College, University of South China, Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, University of South China, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang 421001, China
| | - Tiebing Zeng
- Pathogenic Biology Institute, Hengyang Medical College, University of South China, Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, University of South China, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang 421001, China
| | - Shuangquan Liu
- Clinical Laboratory Department, The First Affiliated Hospital of the University of South China, Hengyang 421001, China
| | - Yongjian Xiao
- Clinical Laboratory Department, The Second Affiliated Hospital of the University of South China, Hengyang 421001, China
| | - Li Zhang
- Clinical Laboratory Department, Changde Hospital of the University of South China, Changde 415000, China
| | - Xi Luo
- Pathogenic Biology Institute, Hengyang Medical College, University of South China, Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, University of South China, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang 421001, China
| | - Feijun Zhao
- Pathogenic Biology Institute, Hengyang Medical College, University of South China, Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, University of South China, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang 421001, China.
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14
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Tan M, Xu M, Xiao Y, Xie Y, Jiang C, Zheng K, Chen Q, Zhao F, Zeng T, Wu Y. Screening and identification of immunoactive FlaB protein fragments of Treponema pallidum for the serodiagnosis of syphilis. Pathog Dis 2018; 76:4693838. [PMID: 29228176 DOI: 10.1093/femspd/ftx122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 12/02/2017] [Indexed: 11/14/2022] Open
Abstract
Flagellin is a classical pathogen-associated molecular pattern that can evoke a robust immune response. We have demonstrated previously that three full-length flagellins of Treponema pallidum, namely FlaB1, FlaB2 and FlaB3, did have diagnostic value in the serodiagnosis of syphilis. Here, we selected and constructed three recombinant fragments of each complete FlaB, both the conserved N-terminal and the C-terminal region, and the middle variable part, with the goal of exploring fragments unique to Treponema pallidum for use as antigen targets in a fragment-based serological test. The diagnostic performance of fragments was evaluated using different panels of serum specimens (= 332) by indirect IgG enzyme-linked immunosorbent assay. The data showed that all the conserved fragments exhibited excellent sensitivities (91.1-95.0%) but poor specificities (64.1-78.4%), while the three middle regions demonstrated higher sensitivities and specificities for detecting IgG antibody, with 92.7% and 96.1% for FlaB1M ('B1M'), 91.6% and 94.8% for B2M, and 95.0% and 100% for B3M, respectively. In comparison, the sensitivity and specificity of Architect Syphilis TP was found to be 95.5% and 94.8%, respectively. These findings revealed that the middle portion of each FlaB had epitopes specific for Treponema pallidum and identified B3M as a promising candidate antigen for the serodiagnosis of syphilis.
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Affiliation(s)
- Manyi Tan
- Pathogenic Biology Institute, Medical College, University of South China, 28 West Changsheng Road, Hengyang, Hunan 421001, China
| | - Man Xu
- Pathogenic Biology Institute, Medical College, University of South China, 28 West Changsheng Road, Hengyang, Hunan 421001, China
| | - Yongjian Xiao
- Department of Clinical Laboratory, The Second Affiliated Hospital of University of South China, Hengyang, Hunan 421001, China
| | - Yafeng Xie
- Department of Clinical Laboratory, The Second Affiliated Hospital of University of South China, Hengyang, Hunan 421001, China
| | - Chuanhao Jiang
- Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Kang Zheng
- Pathogenic Biology Institute, Medical College, University of South China, 28 West Changsheng Road, Hengyang, Hunan 421001, China
| | - Qian Chen
- Pathogenic Biology Institute, Medical College, University of South China, 28 West Changsheng Road, Hengyang, Hunan 421001, China
| | - Feijun Zhao
- Pathogenic Biology Institute, Medical College, University of South China, 28 West Changsheng Road, Hengyang, Hunan 421001, China
| | - Tiebing Zeng
- Pathogenic Biology Institute, Medical College, University of South China, 28 West Changsheng Road, Hengyang, Hunan 421001, China
| | - Yimou Wu
- Pathogenic Biology Institute, Medical College, University of South China, 28 West Changsheng Road, Hengyang, Hunan 421001, China
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15
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Sonmez C, Sezen F, Kilic S. Performance evaluation of nine different syphilis serological tests in comparison with the FTA-abs test. J Immunol Methods 2018; 464:9-14. [PMID: 30138611 DOI: 10.1016/j.jim.2018.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/04/2018] [Accepted: 08/10/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Serological methods have great importance for the detection of Treponema pallidum antibodies in syphilis diagnosis. The goal of the present study is to evaluate various commercially available screening assays in comparison with the FTA-abs test. METHODS A total of 363 serum samples were enrolled in the study. Following routine testing including RPR and TPHA tests, each sample was tested by treponemal immunoassays (Chorus Syphilis Screen Recombinant, Architect Syphilis TP, Syphilis Virclia Monotest, Siemens Advia Centaur Syphilis, Euroimmun Treponema pallidum Screen ELISA, Vircell Syphilis ELISA IgG + IgM, SD Bioline Syphilis). The result obtained from each test was compared with the confirmatory FTA-abs test. Kappa (κ) coefficients were used to compare the concordance of the tests. RESULTS When the various tests were evaluated in comparison with the FTA-abs test, the sensitivity, specificity and percent agreement of each test were as follows: Architect Syphilis TP, 92.3%, 94.5%, 92.8%; Chorus Syphilis Screen Recombinant, 87.9%, 91.2%, 88.7%; Syphilis Virclia Monotest, 80.5%, 97.8%, 84.9%; Siemens Advia Centaur Syphilis, 87.5%, 89%, 87.9%; Euroimmun Treponema pallidum Screen ELISA, 87.5%, 85.7%, 87.1%; Vircell Syphilis ELISA IgG + IgM, 73.2%, 62.6%, 70.5%; TPHA, 89%, 63.7%, 82.6%; SD Bioline Syphilis, 58.1%, 94.5%, 67.2%; RPR test, 57.7%, 57.1%, 57.6%. CONCLUSION The results of the present study show that Treponema pallidum specific immunoassays with a performance similar or better than TPHA test generally performed well with the confirmatory FTA-abs test and may be an alternative for screening total antibodies in syphilis infection.
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Affiliation(s)
- Cemile Sonmez
- Public Health General Directorate, Ministry of Health, Ankara, Turkey.
| | - Figen Sezen
- Public Health General Directorate, Ministry of Health, Ankara, Turkey
| | - Selcuk Kilic
- Public Health General Directorate, Ministry of Health, Ankara, Turkey; University of Health Sciences, Istanbul Medical Faculty, Department of Medical Microbiology, Istanbul, Turkey
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16
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Zhang L, Deng M, Zhang X, Yin W, Liu W, Luo X, Yang J, Chen F, Zhao F. Serological evaluation of antigen Tp0693 for diagnosis of syphilis. Exp Ther Med 2017; 14:4729-4736. [PMID: 29201173 PMCID: PMC5704258 DOI: 10.3892/etm.2017.5158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 06/15/2017] [Indexed: 12/05/2022] Open
Abstract
The aim of the present study was to evaluate the diagnostic value of the Treponema pallidum (Tp) antigen Tp0693 for syphilis. ELISA was used to examine the serum levels of Tp0693. The sample-to-cutoff ratio (S/CO) value was used to generate a receiver operating characteristic (ROC) curve. A correlation analysis was performed to compare the detection efficacy of Tp0693-specific ELISA, Treponema pallidum Particle Agglutination (TPPA), Tolulized Red Unheated Serum test (TRUST) and LiZhu™ Tp-ELISA. The area under the ROC curve was 0.99, indicating good diagnostic efficacy. When the diagnostic specificity reached 100%, the diagnostic sensitivity was up to 93.5%. Tp0693-specific ELISA results were not correlated with those of TPPA, TRUST and LiZhu™ Tp-ELISA (correlation coefficient, 0.122, 0.114 and 0.025, respectively). The latent syphilis rate was highest (12%, 9/75) for all syphilis specimens with a S/CO in the grey area. In conclusion, for syphilis specimens with a S/CO in the grey area, TPPA should be used for further confirmation of the diagnosis. Tp0693 may be used as a diagnostic antigen for syphilis; however, further study regarding its potential use is required.
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Affiliation(s)
- Li Zhang
- Department of Laboratory, The First People's Hospital of Changde Affiliated to The University of South China, Changde, Hunan 415000, P.R. China
- Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Institute of Pathogenic Biology, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Meixia Deng
- Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Institute of Pathogenic Biology, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Xiaohong Zhang
- Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Institute of Pathogenic Biology, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Weiguo Yin
- Department of Laboratory, Yuebei People's Hospital, Shaoguan, Guangdong 512026, P.R. China
- Department of Molecular Biology Research Center, Qingyuan People's Hospital, Qingyuan, Guangdong 511500, P.R. China
| | - Wen Liu
- Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Institute of Pathogenic Biology, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Xi Luo
- Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Institute of Pathogenic Biology, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Jie Yang
- Department of Clinical Medicine, Medical College, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Fei Chen
- Department of Clinical Medicine, Medical College, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Feijun Zhao
- Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Institute of Pathogenic Biology, University of South China, Hengyang, Hunan 421001, P.R. China
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Novel Treponema pallidum Recombinant Antigens for Syphilis Diagnostics: Current Status and Future Prospects. BIOMED RESEARCH INTERNATIONAL 2017; 2017:1436080. [PMID: 28523273 PMCID: PMC5421087 DOI: 10.1155/2017/1436080] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 03/21/2017] [Indexed: 11/18/2022]
Abstract
The recombinant protein technology considerably promoted the development of rapid and accurate treponema-specific laboratory diagnostics of syphilis infection. For the last ten years, the immunodominant recombinant inner membrane lipoproteins are proved to be sensitive and specific antigens for syphilis screening. However, the development of an enlarged T. pallidum antigen panel for diagnostics of early and late syphilis and differentiation of syphilis stages or cured syphilis remains as actual goal of multidisciplinary expertise. Current review revealed novel recombinant antigens: surface-exposed proteins, adhesins, and periplasmic and flagellar proteins, which are promising candidates for the improved syphilis serological diagnostics. The opportunities and limitations of diagnostic usage of these antigens are discussed and the criteria for selection of optimal antigens panel summarized.
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