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Liu Z, Zhang X, Xiong S, Huang S, Ding X, Xu M, Yao J, Liu S, Zhao F. Endothelial dysfunction of syphilis: Pathogenesis. J Eur Acad Dermatol Venereol 2024; 38:1478-1490. [PMID: 38376088 DOI: 10.1111/jdv.19899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/19/2024] [Indexed: 02/21/2024]
Abstract
Treponema pallidum is the causative factor of syphilis, a sexually transmitted disease (STD) characterized by perivascular infiltration of inflammatory cells, vascular leakage, swelling and proliferation of endothelial cells (ECs). The endothelium lining blood and lymphatic vessels is a key barrier separating body fluids from host tissues and is a major target of T. pallidum. In this review, we focus on how T. pallidum establish intimate interactions with ECs, triggering endothelial dysfunction such as endothelial inflammation, abnormal repairment and damage of ECs. In addition, we summarize that migration and invasion of T. pallidum across vascular ECs may occur through two pathways. These two mechanisms of transendothelial migration are paracellular and cholesterol-dependent, respectively. Herein, clarifying the relationship between T. pallidum and endothelial dysfunction is of great significance to provide novel strategies for diagnosis and prevention of syphilis, and has a great potential prospect of clinical application.
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Affiliation(s)
- 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, China
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang, 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, China
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang, China
| | - 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, China
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang, 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, China
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang, 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, China
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang, China
| | - Man Xu
- Institute of Pathogenic Biology and Key Laboratory of Special Pathogen Prevention and Control of Hunan Province, Hengyang Medical College, University of South China, Hengyang, China
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang, 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, China
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang, 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, China
- Department of Clinical Laboratory Medicine, 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, Hengyang Medical College, University of South China, Hengyang, China
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang, China
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Kaminiów K, Kotlarz A, Kiołbasa M, Pastuszczak M. Lack of Serological Response by Delivery to Syphilis Treatment Does Not Impact Pregnancy Outcomes. J Clin Med 2024; 13:4031. [PMID: 39064071 PMCID: PMC11277448 DOI: 10.3390/jcm13144031] [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: 05/21/2024] [Revised: 07/04/2024] [Accepted: 07/06/2024] [Indexed: 07/28/2024] Open
Abstract
Objectives: Maternal syphilis can lead to serious adverse pregnancy outcomes, including neonatal death. A 4-fold decline in blood non-treponemal titer at six months after the treatment of syphilis compared to the baseline is considered as an adequate serological response. However, the duration of normal human gestation does not allow the ascertainment of an adequate serological response. Aim: The aim of this study was to assess correlations between the lack of a 4-fold decrease in non-treponemal titer by delivery after syphilis treatment and fetal and newborns' condition and serological outcomes. Methods: Fourteen pregnant patients (gestational age 16-22 weeks) diagnosed with early syphilis (secondary or latent) were treated with intramuscular benzathine penicillin and subsequently monitored clinically, serologically, and ultrasonographically at monthly intervals. Based on the non-treponemal test results at delivery, patients were stratified into two groups: those with a 4-fold decline in titers and those without such a decline. All newborns were clinically and serologically assessed for congenital syphilis at birth and then monitored until serological tests became negative. Results: Fifty percent of the included women did not achieve a 4-fold decline in non-treponemal titer by delivery. Patients from the group showing a 4-fold decline in RPR titer at delivery and those without such a decline did not differ in basic demographic and clinical characteristics or in ultrasound parameters used for fetal assessment. Based on the clinical and laboratory assessments of newborns on the day of delivery and during a 6-month follow-up, none were diagnosed with congenital syphilis or required treatment for syphilis. Conclusions: The lack of an adequate serological response to syphilis therapy by delivery among patients treated between 16 and 22 weeks of pregnancy does not appear to be associated with adverse fetal and neonatal outcomes.
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Affiliation(s)
- Konrad Kaminiów
- Clinical Department of Dermatology, Medical University of Silesia, Marii Curie-Skłodowskiej 10, 41-800 Zabrze, Poland; (M.K.); (M.P.)
| | - Agnieszka Kotlarz
- Chair of Gynaecology and Obstetrics, Jagiellonian University Medical College, Mikołaja Kopernika 23, 31-501 Krakow, Poland;
| | - Martyna Kiołbasa
- Clinical Department of Dermatology, Medical University of Silesia, Marii Curie-Skłodowskiej 10, 41-800 Zabrze, Poland; (M.K.); (M.P.)
| | - Maciej Pastuszczak
- Clinical Department of Dermatology, Medical University of Silesia, Marii Curie-Skłodowskiej 10, 41-800 Zabrze, Poland; (M.K.); (M.P.)
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Cao Q, Li Y, Hu Y, He B, Tang Y, Cao T, Peng B, Zhou X, Liu S. Serofast status in syphilis: Pathogenesis to therapeutics. Clin Chim Acta 2024; 560:119754. [PMID: 38815665 DOI: 10.1016/j.cca.2024.119754] [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: 04/10/2024] [Revised: 05/25/2024] [Accepted: 05/27/2024] [Indexed: 06/01/2024]
Abstract
Syphilis, a sexually transmitted infection caused by Treponema pallidum, has been experiencing a rise in prevalence in recent years. "Syphilis serofast" describes a unique serological reaction in patients with syphilis whose clinical symptoms have resolved following consistent anti-syphilitic therapy, but the non-Treponema pallidum antigen serologic test is still positive. Syphilis serofast is a risk factor for syphilis recurrence, neurosyphilis, and multisystem involvement. Considering the current lack of comprehensive knowledge about the epidemiological characteristics, pathogenesis, and therapies of syphilis serofast, we conducted an online search of research relating to syphilis serofast over the last twenty years. Previous research has shown that the pathogenesis of syphilis serofast is mainly related to clinical factors, immune factors, syphilis subtypes, and T.pallidum membrane protein repeat gene antigen. There are two distinct viewpoints on the treatment of serofast: no excessive treatment and active treatment. In addition, serofast patients also showed two clinical outcomes: syphilis recurrence and persistent serofast status. This article systematically reviews the related factors, treatment, and clinical outcomes of syphilis serofast, provides a theoretical basis for its research, diagnosis, and treatment, and helps clinicians develop a follow-up treatment management plan for syphilis serofast.
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Affiliation(s)
- Qian Cao
- Department of Clinical Laboratory Medicine, Institution of microbiology and infectious diseases, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China.
| | - Yue Li
- Department of Clinical Laboratory Medicine, Institution of microbiology and infectious diseases, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China.
| | - Yibao Hu
- Department of Clinical Laboratory Medicine, Institution of microbiology and infectious diseases, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China.
| | - Bisha He
- Department of Clinical Laboratory Medicine, Institution of microbiology and infectious diseases, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China.
| | - Yun Tang
- Department of Clinical Laboratory Medicine, Institution of microbiology and infectious diseases, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China.
| | - Ting Cao
- Department of Clinical Laboratory Medicine, Institution of microbiology and infectious diseases, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China.
| | - Binfeng Peng
- Center of Laboratory Medicine and Pathology, The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha 410007, China.
| | - Xiangping Zhou
- Department of Clinical Laboratory Medicine, Institution of microbiology and infectious diseases, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China.
| | - Shuangquan Liu
- Department of Clinical Laboratory Medicine, Institution of microbiology and infectious diseases, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China.
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Zheng XQ, Li Z, Meng QQ, Li W, Li QL, Xie L, Xiao Y, Xu QY, Chen YY. Treponema pallidum recombinant protein Tp47 activates NOD-like receptor family protein 3 inflammasomes in macrophages via glycolysis. Int Immunopharmacol 2024; 126:111204. [PMID: 38016343 DOI: 10.1016/j.intimp.2023.111204] [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: 09/10/2023] [Revised: 10/31/2023] [Accepted: 11/07/2023] [Indexed: 11/30/2023]
Abstract
Glycolysis is a key pathway in cellular glucose metabolism for energy supply and regulates immune cell activation. Whether glycolysis is involved in the activation of NOD-like receptor family protein 3 (NLRP3) inflammasomes during Treponema pallidum (T. pallidum) infection is unclear. In this study, the effect of T. pallidum membrane protein Tp47 on NLRP3 inflammasome activation in rabbit peritoneal macrophages was analysed and the role of glycolysis in NLRP3 inflammasome activation was explored. The results showed that Tp47 promoted NLRP3, caspase-1, and IL-1β mRNA expression in macrophages, enhanced glycolysis and glycolytic capacity of macrophage, and promoted the production of macrophage glycolytic metabolites citrate, phosphoenolpyruvate, and lactate. The M2 pyruvate kinase (PKM2) inhibitor shikonin down-regulated the Tp47-promoted NLRP3, caspase-1, and IL-1β mRNA expression in macrophages, and suppressed the Tp47-enhanced glycolysis and glycolytic capacity. Similarly, si-PKM2 significantly inhibited Tp47-promoted NLRP3, caspase-1, and IL-1β mRNA expression and the Tp47-enhanced glycolysis and glycolytic capacity in macrophages. In conclusion, Tp47 activated NLRP3 inflammasomes via PKM2-dependent glycolysis and provided a new perspective on the effect of T. pallidum infection on host macrophages, which would contribute to the understanding of the infection mechanism and host immune mechanism of T. pallidum.
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Affiliation(s)
- Xin-Qi Zheng
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen 361004, China
| | - Ze Li
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen 361004, China
| | - Qing-Qi Meng
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen 361004, China
| | - Wei Li
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen 361004, China
| | - Qiu-Ling Li
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen 361004, China
| | - Lin Xie
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen 361004, China
| | - Yao Xiao
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen 361004, China; Department of Hospital Infection Management, School of Medicine, Zhongshan Hospital of Xiamen University, Xiamen University, Xiamen, China.
| | - Qiu-Yan Xu
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen 361004, China.
| | - Yu-Yan Chen
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen 361004, China.
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Zheng XQ, Kong XQ, He Y, Wang YJ, Xie L, Liu LL, Lin LR, Yang TC. Treponema pallidum recombinant protein Tp47 enhanced interleukin-6 secretion in human dermal fibroblasts through the toll-like receptor 2 via the p38, PI3K/Akt, and NF-κB signalling pathways. BIOCHIMICA ET BIOPHYSICA ACTA. MOLECULAR CELL RESEARCH 2023; 1870:119540. [PMID: 37468070 DOI: 10.1016/j.bbamcr.2023.119540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 07/03/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023]
Abstract
Interleukin-6 (IL-6) is a multi-effective cytokine involved in multiple immune responses. Whether fibroblasts also turn out to be a cytokine IL-6 factory during interaction with Treponema pallidum is not yet understood. To explore whether fibroblasts participate in inflammation due to syphilis, a series of experiments were performed to explore the role of T. pallidum lipoprotein Tp47 in IL-6 production in human dermal fibroblasts. The Toll-like receptor 2 (TLR2) and participating signalling pathways in this process were also evaluated. The results showed that the expressions of IL-6 and the protein levels of TLR2 in fibroblasts were upregulated after stimulation with Tp47, and this effect was impeded by the TLR2 inhibitor C29. In addition, Tp47 promoted the phosphorylation of p38, PI3K/Akt, and nuclear factor-kappaB (NF-κB), and the translocation of NF-κB in fibroblasts. Moreover, p38, PI3K, and NF-κB inhibitors significantly reduced IL-6 production in fibroblasts stimulated with Tp47. Furthermore, the TLR2 inhibitor C29 inhibited the phosphorylation of p38, Akt, and NF-κB, and the translocation of NF-κB in fibroblasts. In conclusion, our results showed that Tp47 enhanced IL-6 secretion in human dermal fibroblasts through TLR2 via p38, PI3K/Akt, and NF-κB signalling pathways. These findings contribute to our understanding of syphilis inflammation.
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Affiliation(s)
- Xin-Qi Zheng
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361004, China
| | - Xiang-Qi Kong
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361004, China; Department of Clinical Laboratory, Weifang People's Hospital, Weifang, Shandong 261000, China
| | - Yun He
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361004, China; Department of Medical Laboratory, The Second Affiliated Hospital of Xiamen Medical College, Xiamen 361004, China
| | - Yong-Jing Wang
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361004, China
| | - Lin Xie
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361004, China
| | - Li-Li Liu
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen 361004, China.
| | - Li-Rong Lin
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen 361004, China.
| | - Tian-Ci Yang
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen 361004, China.
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Liu J, Zhang R, Lian T, Chen Z, Zhang RL, Wang Q. Plasma Exosome-Derived microRNAs Profiles in Patients with Serofast Status: A Cross-Sectional Study. Int J Gen Med 2023; 16:1455-1469. [PMID: 37101664 PMCID: PMC10124566 DOI: 10.2147/ijgm.s404545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/07/2023] [Indexed: 04/28/2023] Open
Abstract
Purpose Syphilis is a sexually transmitted bacterial infection caused by Treponema pallidum (T. pallidum), which can lead to chronic morbidity and adverse complications. In clinical practice, serofast status (SF) patients present with clinical symptoms that are very similar to those of healthy individuals or syphilis-cured patients, and often require prolonged follow-up for diagnosis. Currently, there is increasing interest in the potential of plasma exosome-derived miRNA as a biomarker for the detection of infectious diseases. In this study, we aimed to explore the diagnostic potential of miRNA in SF and its possible biological implications. Patients and Methods Exosome-derived miRNAs were isolated from peripheral plasma samples obtained from 20 patients with secondary syphilis (SS), SF, serologically cured syphilis (SC), and healthy controls (HC), and differentially expressed miRNAs (DEmiRNAs) were identified by microarray analysis. Prediction of potential target genes, functional annotation, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were then performed. The expression of selected miRNAs was confirmed in 37 patients by quantitative reverse transcription polymerase chain reaction (RT-qPCR). A receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic performance of these miRNAs in differentiating syphilis from HC or SC. Results The expression profile of plasma exosome-derived miRNA was discovered in individuals with SF through microarray analysis. The targeted genes of DEmiRNAs were found to be involved in diverse biological processes according to GO and KEGG analysis, such as regulation of transcription, mitochondria, Golgi, immune system, apoptosis, Ras signaling pathway, etc. Using RT-qPCR validation, miR-1273g-3p, miR-4485-5p, miR-197-3p, and miR-1908-3p showed significant upregulation in patients with SF. These miRNAs exhibited a superior diagnostic ability, either individually or combined, to distinguish SF from SC or HC. Conclusion The DEmiRNAs in plasma exosomes may play a role in the pathogenesis of SF and have the potential to become a noble and effective diagnostic method.
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Affiliation(s)
- Jinquan Liu
- Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Center for STD Control, China Centers for Disease Control and Prevention, Nanjing, 210042, People’s Republic of China
| | - Ruihua Zhang
- Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Center for STD Control, China Centers for Disease Control and Prevention, Nanjing, 210042, People’s Republic of China
| | - Tingting Lian
- Department of Dermatology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People’s Republic of China
| | - Zuoxi Chen
- Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Center for STD Control, China Centers for Disease Control and Prevention, Nanjing, 210042, People’s Republic of China
| | - Rui-Li Zhang
- Department of Dermatology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210003, People’s Republic of China
- Correspondence: Rui-Li Zhang; Qianqiu Wang, Email ;
| | - Qianqiu Wang
- Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Center for STD Control, China Centers for Disease Control and Prevention, Nanjing, 210042, People’s Republic of China
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Platelet Indices Are the Promising Biomarkers in Monitoring Disease Activities in Patients with Syphilis. Int J Infect Dis 2022; 118:230-235. [PMID: 35301100 DOI: 10.1016/j.ijid.2022.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/25/2022] [Accepted: 03/09/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To uncover the role of the platelet indices in patients with syphilis. METHODS A total of 2061 syphilis patients and 528 healthy controls were enrolled in this retrospective cohort study. The data of platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and indicators of syphilis activities were collected. The correlations between the platelet indices and disease activities were analyzed. RESULTS 425 (20.6%) of all the 2061 patients were of primary and secondary syphilis, 433 (21.0%) latent, 463 (22.5%) serofast, 350 (17.0%) asymptomatic neurosyphilis and 390 (18.9%) symptomatic neurosyphilis. Compared with the healthy controls, PLT was significantly increased in the primary and secondary syphilis group. Whereas, MPV and PDW were significantly decreased in all stages of syphilis. These changes of platelets indices were reversed after anti-treponemal therapy. Further correlation analysis showed PLT was positively associated with the syphilis activity indicators [rapid plasma reagin (RPR) titer, cerebrospinal fluid white blood cell (CSF-WBC), CSF-protein, and CSF-VDRL (venereal disease research laboratory)] and inflammatory markers [WBC, C-reaction protein (CRP), and erythrocyte sedimentation rate (ESR)]. Conversely, PDW was negatively correlated with all of these parameters. MPV had an inverse relationship with RPR, ESR, and CRP. CONCLUSIONS Platelet indices are associated with syphilis activities.
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Chen H, Tong ML, Liu LL, Lin LR, Yang TC. The whole process of macrophage-Treponema pallidum interactions: Opsonic phagocytosis, nonopsonic phagocytosis and active invasion. Int Immunopharmacol 2022; 107:108657. [PMID: 35240382 DOI: 10.1016/j.intimp.2022.108657] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/16/2022] [Accepted: 02/23/2022] [Indexed: 11/05/2022]
Abstract
Despite the acknowledged central role of opsonophagocytosis in the process of syphilis, the interaction between Treponema pallidum and human macrophages during nonopsonophagocytosis and active invasion remains controversial. To investigate whether nonopsonic phagocytosis and active invasion, similar to opsonic phagocytosis, also participate in the process of macrophage-T. pallidum interactions, monocyte-derived macrophages were used to study the interactions of T. pallidum and macrophages in the presence of nonsyphytic or syphilitic serum and in the absence of serum in vitro using indirect immunofluorescence and flow cytometry to quantitate treponeme-macrophage interactions. The results showed that macrophages phagocytose T. pallidum under both nonopsonizing conditions (no serum or normal human serum (NHS)) and in the presence of opsonizing serum (secondary syphilitic serum (SSS)) in a time-dependent manner. The percentages of spirochete-positive macrophages in the SSS group were higher than those in the NHS and no-serum groups. Blocking FcγR or inactivating complement caused a significant decrease in the percentage of spirochete-positive macrophages in the SSS group but did not cause a decrease in the percentages of spirochete-positive macrophages in the NHS and no-serum groups. In addition, after inhibiting macrophage phagocytosis, approximately 30% of macrophages internalized spirochetes, verifying that T. pallidum actively penetrated macrophages rather than was ingested by them. This study provides evidence that opsonic phagocytosis, nonopsonic phagocytosis and active invasion are all active during T. pallidum-macrophage interactions and reveals a process of treponeme-macrophage interactions in T. pallidum pathogenesis.
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Affiliation(s)
- Hong Chen
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Man-Li Tong
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Li-Li Liu
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Li-Rong Lin
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China.
| | - Tian-Ci Yang
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China.
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Cognitive impairment in syphilis: Does treatment based on cerebrospinal fluid analysis improve outcome? PLoS One 2021; 16:e0254518. [PMID: 34255767 PMCID: PMC8277035 DOI: 10.1371/journal.pone.0254518] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/29/2021] [Indexed: 11/19/2022] Open
Abstract
Background Individuals with previous syphilis may experience cognitive impairment. The goal of this study was to determine if those at high risk for laboratory-defined neurosyphilis are cognitively impaired, and whether treatment based on cerebrospinal fluid (CSF) findings results in better outcomes. Methods Participants had a new syphilis diagnosis, serum RPR titer ≥ 1:32 or peripheral blood CD4+ T cells ≤ 350/ul (in persons living with HIV) and did not endorse neurological symptoms. They underwent computerized cognitive assessment with the CogState. Thirty-two were randomized to either undergo lumbar puncture (LP) or to not undergo LP and 14 underwent LP; 64 were not randomized and 48 opted to undergo LP. Results Demographics, cognitive complaints and cognitive impairment did not differ between randomized and nonrandomized participants. Two-thirds were cognitively impaired, and impairment was not more common in those with cognitive complaints. The adjusted odds of increased severity of impairment were 3.8 times greater in those with CSF pleocytosis compared to those without. Time to cognitive normalization, improvement or decline did not differ between those who did not undergo LP and those who underwent LP and whose treatment was based on CSF analysis. Taking into account pre-treatment cognitive impairment, the risk of cognitive decline was lower in those with CSF pleocytosis treated for neurosyphilis compared to those without CSF pleocytosis not treated for neurosyphilis, (HR 0.24 (95% CI 0.07–0.88], p = 0.03). Conclusion In individuals at high risk for laboratory-defined neurosyphilis, cognitive complaints are not a good indicator of cognitive impairment. Severity of cognitive impairment was greater in those with CSF pleocytosis. Identification and treatment of those with neurosyphilis may mitigate subsequent cognitive decline.
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Zhang RC, Zheng NN, Zhong LS. Association of TNF-α 308 G > A gene polymorphism with serofast in patients with syphilis. Australas J Dermatol 2020; 62:e294-e296. [PMID: 33200819 DOI: 10.1111/ajd.13481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/20/2020] [Accepted: 09/05/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Ruo-Chen Zhang
- Department of Dermatology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Na-Na Zheng
- Department of Dermatology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Lian-Sheng Zhong
- Department of Dermatology, Children's Hospital of Fudan university Xiamen Branch (Xiamen Children's Hospital), Xiamen, China
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11
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Xu S, Lin Y, Zhu X, Liu D, Tong M, Liu L, Yang T, Lin L. Autophagy promotes phagocytosis and clearance of
Treponema pallidum
via the NLRP3 inflammasome in macrophages. J Eur Acad Dermatol Venereol 2020; 34:2111-2119. [PMID: 32294266 DOI: 10.1111/jdv.16463] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/10/2020] [Indexed: 12/17/2022]
Affiliation(s)
- S.‐L. Xu
- Center of Clinical Laboratory Zhongshan Hospital School of Medicine Xiamen University Xiamen China
- Institute of Infectious Disease School of Medicine Xiamen University Xiamen China
| | - Y. Lin
- Center of Clinical Laboratory Zhongshan Hospital School of Medicine Xiamen University Xiamen China
- Institute of Infectious Disease School of Medicine Xiamen University Xiamen China
| | - X.‐Z. Zhu
- Center of Clinical Laboratory Zhongshan Hospital School of Medicine Xiamen University Xiamen China
- Institute of Infectious Disease School of Medicine Xiamen University Xiamen China
| | - D. Liu
- Center of Clinical Laboratory Zhongshan Hospital School of Medicine Xiamen University Xiamen China
- Institute of Infectious Disease School of Medicine Xiamen University Xiamen China
| | - M.‐L. Tong
- Center of Clinical Laboratory Zhongshan Hospital School of Medicine Xiamen University Xiamen China
- Institute of Infectious Disease School of Medicine Xiamen University Xiamen China
| | - L.‐L. Liu
- Center of Clinical Laboratory Zhongshan Hospital School of Medicine Xiamen University Xiamen China
- Institute of Infectious Disease School of Medicine Xiamen University Xiamen China
| | - T.‐C. Yang
- Center of Clinical Laboratory Zhongshan Hospital School of Medicine Xiamen University Xiamen China
- Institute of Infectious Disease School of Medicine Xiamen University Xiamen China
| | - L.‐R. Lin
- Center of Clinical Laboratory Zhongshan Hospital School of Medicine Xiamen University Xiamen China
- Institute of Infectious Disease School of Medicine Xiamen University Xiamen China
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12
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Qiang D, Wang J, Ci C, Tang B, Ke G, Chang X, Ji B, Shao X. Evaluation of serum cytokines to predict serofast in syphilis patients. J Infect Chemother 2020; 26:970-976. [PMID: 32414686 DOI: 10.1016/j.jiac.2020.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 04/11/2020] [Accepted: 04/21/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Syphilis serofast has been increasing in recent years and has resulted in a dramatic increase in medical expenses. However, there are not effective methods for serofast prediction in syphilis patients prior to treatment. AIMS AND OBJECTIVES The present study investigated novel serum biomarkers for the prediction of serofast in syphilis patients prior to treatment. MATERIALS AND METHODS Pre-treatment serum from patients with syphilis serofast and patients with syphilis serological cure were measured using antibody microarrays. The results generated from the antibody arrays were validated using ELISA. Healthy subjects were used as the controls. RESULTS Compared to serologically cured patients, six cytokines (IL-17F, TNF RI, TNF RII, IL-16, OPN, and MCSFR) were significantly lower, while five factors (MCP-3, LIF, G-CSF, MIP-3a, and GH) were higher in serofast patients. ELISA validation was in-line with the results generated from antibody arrays. Of significance, these cytokines were firstly observed to the differentially expressed in pre-treatment serofast patient serum samples. CONCLUSIONS The differentially expressed cytokines may be novel serum biomarkers for serofast prediction. These identified proteins play significant roles in the immune response, suggesting immune dysfunction may be the cause for syphilis serofast.
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Affiliation(s)
- Di Qiang
- Department of Dermatology and STD, Yi-Ji Shan Hospital, Wannan Medical College, Wuhu, China.
| | - Jingjing Wang
- Department of Dermatology and STD, Yi-Ji Shan Hospital, Wannan Medical College, Wuhu, China
| | - Chao Ci
- Department of Dermatology and STD, Yi-Ji Shan Hospital, Wannan Medical College, Wuhu, China
| | - Biao Tang
- Department of Dermatology and STD, Yi-Ji Shan Hospital, Wannan Medical College, Wuhu, China
| | - Guoling Ke
- Department of Dermatology and STD, Yi-Ji Shan Hospital, Wannan Medical College, Wuhu, China
| | - Xiaoli Chang
- Department of Dermatology and STD, Yi-Ji Shan Hospital, Wannan Medical College, Wuhu, China
| | - Bihua Ji
- Department of Dermatology and STD, Yi-Ji Shan Hospital, Wannan Medical College, Wuhu, China
| | - Xuefei Shao
- Department of Neurosurgery, Yi-Ji Shan Hospital of Wannan Medical College, Wuhu, Anhui, China.
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13
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Xu SL, Lin Y, Liu W, Zhu XZ, Liu D, Tong ML, Liu LL, Lin LR. The P2X7 receptor mediates NLRP3-dependent IL-1β secretion and promotes phagocytosis in the macrophage response to Treponema pallidum. Int Immunopharmacol 2020; 82:106344. [PMID: 32151957 DOI: 10.1016/j.intimp.2020.106344] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/22/2020] [Accepted: 02/22/2020] [Indexed: 10/24/2022]
Abstract
It is unclear whether P2X7 receptor (P2X7R) mediates NOD-like receptor family protein 3 (NLRP3)-dependent IL-1β secretion and spirochete phagocytosis in syphilis. This study was conducted to investigate the role of P2X7R in modifying NLRP3-dependent IL-1β secretion and regulating phagocytosis by Treponema pallidum (T. pallidum)-induced macrophages. Macrophages derived from a human acute monocytic leukemia cell line were cultured with T. pallidum. The activation of P2X7R in T. pallidum-treated macrophages occurred in a dose- and time-dependent manner. The P2X7R silencing group showed significantly decreased NLRP3 mRNA and protein levels (vs. the Tp group, P < 0.001). Similar results were observed for IL-1β secretion using ELISA (vs. the Tp group, P < 0.001). Furthermore, P2X7R siRNA transfection significantly decreased the percentage of spirochete-positive macrophages (29.73% vs. 70.83%, P < 0.001) and spirochete internalization (mean fluorescence intensity (MFI), 9.20 vs. 19.39, P < 0.001). This finding revealed that P2X7R played a role in the induction of NLRP3-dependent IL-1β secretion by T. pallidum-induced macrophages. Furthermore, we found that P2X7R plays an important role in IL-1β secretion and in the promotion of T. pallidum phagocytosis by macrophages. These results may not only contribute to our understanding of the immune mechanism that is active during T. pallidum infection but may also lay the groundwork for strategies to combat syphilis.
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Affiliation(s)
- Shi-Lan Xu
- Center of Clinical Laboratory, Zhongshan Hospital, School of Medicine, Xiamen University, Xiamen, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Yu Lin
- Center of Clinical Laboratory, Zhongshan Hospital, School of Medicine, Xiamen University, Xiamen, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Wei Liu
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xiao-Zhen Zhu
- Center of Clinical Laboratory, Zhongshan Hospital, School of Medicine, Xiamen University, Xiamen, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China.
| | - Dan Liu
- Center of Clinical Laboratory, Zhongshan Hospital, School of Medicine, Xiamen University, Xiamen, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Man-Li Tong
- Center of Clinical Laboratory, Zhongshan Hospital, School of Medicine, Xiamen University, Xiamen, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China.
| | - Li-Li Liu
- Center of Clinical Laboratory, Zhongshan Hospital, School of Medicine, Xiamen University, Xiamen, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China.
| | - Li-Rong Lin
- Center of Clinical Laboratory, Zhongshan Hospital, School of Medicine, Xiamen University, Xiamen, China; Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China.
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14
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Sambri V. The Laboratory Diagnosis of Bacterial Sexually Transmitted Diseases. Sex Transm Infect 2020. [DOI: 10.1007/978-3-030-02200-6_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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15
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Hachul M, Medeiros MVVD, Simões R, Bernardo WM. Sexually transmitted infections - laboratory diagnosis. ACTA ACUST UNITED AC 2019; 65:745-754. [PMID: 31340297 DOI: 10.1590/1806-9282.65.6.745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2019] [Indexed: 11/22/2022]
Abstract
The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.
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16
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Merlini E, Galli L, Tincati C, Cannizzo ES, Galli A, Gianotti N, Ancona G, Muccini C, Monforte AD, Marchetti G, Castagna A. Immune activation, inflammation and HIV DNA after 96 weeks of ATV/r monotherapy: a MODAt substudy. Antivir Ther 2019; 23:633-637. [PMID: 29589587 DOI: 10.3851/imp3234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2018] [Indexed: 10/17/2022]
Affiliation(s)
- Esther Merlini
- Department of Health Sciences, Clinic of Infectious Diseases and Tropical Medicine, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Laura Galli
- Infectious Diseases Department, IRCCS San Raffaele, Milan, Italy
| | - Camilla Tincati
- Department of Health Sciences, Clinic of Infectious Diseases and Tropical Medicine, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Elvira S Cannizzo
- Department of Health Sciences, Clinic of Infectious Diseases and Tropical Medicine, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Andrea Galli
- Infectious Diseases Department, IRCCS San Raffaele, Milan, Italy
| | - Nicola Gianotti
- Infectious Diseases Department, IRCCS San Raffaele, Milan, Italy
| | - Giuseppe Ancona
- Department of Health Sciences, Clinic of Infectious Diseases and Tropical Medicine, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Camilla Muccini
- Infectious Diseases Department, IRCCS San Raffaele, Milan, Italy
| | - Antonella d'Arminio Monforte
- Department of Health Sciences, Clinic of Infectious Diseases and Tropical Medicine, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Giulia Marchetti
- Department of Health Sciences, Clinic of Infectious Diseases and Tropical Medicine, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
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17
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Kojima N, Siebert JC, Maecker H, Rosenberg-Hasson Y, Leon SR, Vargas SK, Konda KA, Caceres CF, Klausner JD. Cytokine expression in Treponema pallidum infection. J Transl Med 2019; 17:196. [PMID: 31186010 PMCID: PMC6558693 DOI: 10.1186/s12967-019-1947-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/03/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Current syphilis tests cannot distinguish between active and past syphilis among patients with serofast rapid plasma reagin (RPR) titers. We investigated whether cytokine profiles might provide insight in the differentiation of active and treated syphilis. METHODS We collected quarterly serum samples from participants at risk for incident syphilis in a prospective cohort study of men and male-to-female transgender women. We defined incident syphilis as a new RPR titer ≥ 1:8 or a fourfold increase from a prior RPR titer and a positive Treponema pallidum particle agglutination assay. We measured cytokine expression using a 63-multiplex bead-based Luminex assay (eBiosciences/Affymetrix, San Diego, California, USA). We used tertile bins and Chi square tests to identify differences in proportions of cytokines between samples from patients with active and treated syphilis. We constructed a network of cytokine profiles from those findings. We used R software (R version 3.4.1, R, Vienna, Austria) to fit models. RESULTS We identified 20 pairs of cytokines (out of 1953 possible pairs) that differed between active and treated syphilis. From those, we identified three cytokine networks of interest: an Eotaxin-Rantes-Leptin network, a Mig-IL1ra-Trail-CD40L network, and an IL12p40-IL12p70 network. CONCLUSIONS Differences in cytokine profiles are present among men and male-to-female transgender women with active and treated syphilis. Cytokine assays may be a potentially useful tool for identifying active syphilis among patients with serologic syphilis reactivity.
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Affiliation(s)
- N Kojima
- David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA.
| | | | - H Maecker
- Human Immune Monitoring Center, Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Stanford, 94305, USA
| | - Y Rosenberg-Hasson
- Human Immune Monitoring Center, Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Stanford, 94305, USA
| | - S R Leon
- Laboratory of Sexual Health and Unit of Health, Sexuality and Human Development, Universidad Peruana Cayetano Heredia, Lima, USA
| | - S K Vargas
- Laboratory of Sexual Health and Unit of Health, Sexuality and Human Development, Universidad Peruana Cayetano Heredia, Lima, USA
| | - K A Konda
- David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
- Laboratory of Sexual Health and Unit of Health, Sexuality and Human Development, Universidad Peruana Cayetano Heredia, Lima, USA
| | - C F Caceres
- Laboratory of Sexual Health and Unit of Health, Sexuality and Human Development, Universidad Peruana Cayetano Heredia, Lima, USA
| | - J D Klausner
- David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
- Fielding School of Public Health, University of California Los Angeles, Los Angeles, 90024, USA
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18
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Pastuszczak M, Jakiela B, Wojas-Pelc A. Association of interleukin-10 promoter polymorphisms with serofast state after syphilis treatment. Sex Transm Infect 2018; 95:163-168. [PMID: 30341234 DOI: 10.1136/sextrans-2018-053753] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 09/11/2018] [Accepted: 09/15/2018] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES Recent studies suggested that upregulation of anti-inflammatory immune response during early syphilis may be associated with persistence of Treponema pallidum infection despite adequate treatment, resulting in a serofast state. The objective of this study was to determine whether enhanced interleukin (IL)-10-related response during early T. pallidum infection increased the risk of serofast syphilis. METHODS Two IL10 gene promoter polymorphisms affecting IL-10 production (-1082A>G [rs1800896], -592C>A [rs1800872]) and serum levels of IL-10 were measured in 80 patients with early syphilis before and 6 months after penicillin treatment and in 24 healthy volunteers (control group). RESULTS After 6 months, patients were stratified based on serological response into two groups: (1) serofast state (n = 28) and (2) serologically cured (n = 52). Pretreatment and post-treatment serum IL-10 levels were significantly higher in patients who remained serofast compared with those who had a serological cure (p<0.001). The GG genotype of the -1082A>G (rs1800896) polymorphism and the CC genotype of the -592C>A (rs1800872) polymorphism were significantly correlated with higher serum IL-10 levels. Moreover, the OR for remaining serofast for carriers of these genotypes was 16.2 (95% CI: 4.1 to 65.0, p<0.0001) and 2.9 (95% CI: 1.4 to 5.9, p=0.002), respectively. CONCLUSIONS We showed that a pronounced anti-inflammatory immune response may be an important predictor for the serofast state. Additionally, host-related factors such as polymorphisms of immune regulatory genes may influence the risk of remaining serofast after syphilis therapy.
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Affiliation(s)
- Maciej Pastuszczak
- Department of Dermatology, Jagiellonian University School of Medicine, Cracow, Poland
| | - Bogdan Jakiela
- Department of Medicine, Jagiellonian University School of Medicine, Cracow, Poland
| | - Anna Wojas-Pelc
- Department of Dermatology, Jagiellonian University School of Medicine, Cracow, Poland
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19
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Kenyon C, Osbak KK, Crucitti T, Kestens L. Syphilis reinfection is associated with an attenuated immune profile in the same individual: a prospective observational cohort study. BMC Infect Dis 2018; 18:479. [PMID: 30253745 PMCID: PMC6156855 DOI: 10.1186/s12879-018-3399-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 09/20/2018] [Indexed: 01/02/2023] Open
Abstract
Background Ascertaining if the clinical and immunological response to repeat syphilis differs from that in initial syphilis may assist in designing optimal syphilis screening strategies and vaccine design. Methods We prospectively recruited 120 patients with a new diagnosis of (baseline) syphilis. During a 24-month follow-up period, 11 of these patients had a further diagnosis of (repeat) syphilis. We conducted a paired comparison of their plasma cyto-chemokines at baseline and repeat syphilis. Results Comparing to their baseline infection, paired analyses of the 11 individuals with repeat infections during follow-up revealed that these reinfections had lower concentrations of Interferon (IFN)α (0.8 [Interquartile range (IQR) 0.8–0.8 vs. 12.2 [IQR 1.6–24.2], P = 0.004) and Chemokine (C-C motif) ligand (CCL) 4 (0.9 [IQR 0.9–12.2 vs. 17.5 [IQR 4.9–32.8], P = 0.022]. Conclusion In this small study of 11 individuals, repeat syphilis was found to present with an attenuated immune response. The relevance of these findings to the design of optimal syphilis screening programs is discussed.
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Affiliation(s)
- Chris Kenyon
- HIV/STI Unit, Institute of Tropical Medicine, Antwerp, Belgium. .,Division of Infectious Diseases and HIV Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town, 7700, South Africa.
| | | | - Tania Crucitti
- HIV/STI Reference Laboratory, Institute of Tropical Medicine, Antwerp, Belgium
| | - Luc Kestens
- Immunology Unit, Institute of Tropical Medicine, Antwerp, Belgium.,Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
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20
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Lin LR, Gao ZX, Lin Y, Zhu XZ, Liu W, Liu D, Gao K, Tong ML, Zhang HL, Liu LL, Xiao Y, Niu JJ, Liu F, Yang TC. Akt, mTOR and NF-κB pathway activation in Treponema pallidum stimulates M1 macrophages. Int Immunopharmacol 2018; 59:181-186. [PMID: 29656208 DOI: 10.1016/j.intimp.2018.03.040] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 03/20/2018] [Accepted: 03/30/2018] [Indexed: 12/14/2022]
Abstract
The polarization of macrophages and the molecular mechanism involved during the early process of syphilis infection remain unknown. This study was conducted to explore the influence of Treponema pallidum (T. pallidum) treatment on macrophage polarization and the Akt-mTOR-NFκB signaling pathway mechanism involved in this process. M0 macrophages derived from the phorbol-12-myristate-13-acetate-induced human acute monocytic leukemia cell line THP-1 were cultured with T. pallidum. T. pallidum induced inflammatory cytokine (IL-1β and TNF-α) expression in a dose- and time-dependent manner. However IL-10 cytokine expression decreased at the mRNA and protein levels. Additionally, the expression of the M1 surface marker iNOS was up-regulated with incubation time, and the expression of the M2 surface marker CD206 was low (vs. PBS treated macrophages, P < 0.001) and did not fluctuate over 12 h. Further studies revealed that Akt-mTOR-NFκB pathway proteins, including p-Akt, p-mTOR, p-S6, p-p65, and p-IκBα, were significantly higher in the T. pallidum-treated macrophages than in the PBS-treated macrophages (P < 0.05). In addition, inflammatory cytokine expression was suppressed in T. pallidum-induced M1 macrophages pretreated with LY294002 (an Akt-specific inhibitor) or PDTC (an NF-κB inhibitor), while inflammatory cytokine levels increased in T. pallidum-induced M1 macrophages pretreated with rapamycin (an mTOR inhibitor). These findings revealed that T. pallidum promotes the macrophage transition to pro-inflammatory M1 macrophages in vitro. The present study also provides evidence that Akt, mTOR and NF-κB pathway activation in T. pallidum stimulates M1 macrophages. This study provides novel insights into the innate immune response to T. pallidum infection.
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Affiliation(s)
- Li-Rong Lin
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, Medical College of Xiamen University, Xiamen 361004, China
| | - Zheng-Xiang Gao
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China
| | - Yong Lin
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, Medical College of Xiamen University, Xiamen 361004, China
| | - Xiao-Zhen Zhu
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, Medical College of Xiamen University, Xiamen 361004, China
| | - Wei Liu
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China
| | - Dan Liu
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China
| | - Kun Gao
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China
| | - Man-Li Tong
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, Medical College of Xiamen University, Xiamen 361004, China
| | - Hui-Lin Zhang
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, Medical College of Xiamen University, Xiamen 361004, China
| | - Li-Li Liu
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, Medical College of Xiamen University, Xiamen 361004, China
| | - Yao Xiao
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, Medical College of Xiamen University, Xiamen 361004, China
| | - Jian-Jun Niu
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, Medical College of Xiamen University, Xiamen 361004, China.
| | - Fan Liu
- Institute of Infectious Disease, Medical College of Xiamen University, Xiamen 361004, China; Medical College of Xiamen University, Xiamen 361004, China.
| | - Tian-Ci Yang
- Zhongshan Hospital, Medical College of Xiamen University, Xiamen 361004, China; Institute of Infectious Disease, Medical College of Xiamen University, Xiamen 361004, China.
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21
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Abstract
Treponema pallidum subspecies pallidum (T. pallidum) causes syphilis via sexual exposure or via vertical transmission during pregnancy. T. pallidum is renowned for its invasiveness and immune-evasiveness; its clinical manifestations result from local inflammatory responses to replicating spirochaetes and often imitate those of other diseases. The spirochaete has a long latent period during which individuals have no signs or symptoms but can remain infectious. Despite the availability of simple diagnostic tests and the effectiveness of treatment with a single dose of long-acting penicillin, syphilis is re-emerging as a global public health problem, particularly among men who have sex with men (MSM) in high-income and middle-income countries. Syphilis also causes several hundred thousand stillbirths and neonatal deaths every year in developing nations. Although several low-income countries have achieved WHO targets for the elimination of congenital syphilis, an alarming increase in the prevalence of syphilis in HIV-infected MSM serves as a strong reminder of the tenacity of T. pallidum as a pathogen. Strong advocacy and community involvement are needed to ensure that syphilis is given a high priority on the global health agenda. More investment is needed in research on the interaction between HIV and syphilis in MSM as well as into improved diagnostics, a better test of cure, intensified public health measures and, ultimately, a vaccine.
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Affiliation(s)
- Rosanna W Peeling
- London School of Hygiene &Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - David Mabey
- London School of Hygiene &Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Mary L Kamb
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Xiang-Sheng Chen
- National Center for STD Control, Chinese Academy of Medical Sciences and Peking Union Medical College Institute of Dermatology, Nanjing, China
| | - Justin D Radolf
- Department of Medicine, UConn Health, Farmington, Connecticut, USA
| | - Adele S Benzaken
- Department of Surveillance, Prevention and Control of STI, HIV/AIDS and Viral Hepatitis, Ministry of Health, Brasília, Brazil
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22
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Kenyon C, Osbak KK, Crucitti T, Kestens L. The immunological response to syphilis differs by HIV status; a prospective observational cohort study. BMC Infect Dis 2017; 17:111. [PMID: 28143443 PMCID: PMC5286814 DOI: 10.1186/s12879-017-2201-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 01/11/2017] [Indexed: 12/18/2022] Open
Abstract
Background It is not known if there is a difference in the immune response to syphilis between HIV-infected and uninfected individuals. Methods We prospectively recruited all patients with a new diagnosis of syphilis and tested their plasma for IFNα, IFNγ, IL-1β, IL-12p40, IL-12p70, IP-10, MCP-1, MIP-1α, MIP-1β, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10 and IL-17A at baseline pre-treatment and 6 months following therapy. Results A total of 79 HIV-infected [44 primary/secondary syphilis (PSS) and 35 latent syphilis (LS)] and 12 HIV-uninfected (10 PSS and 2 LS) cases of syphilis and 30 HIV-infected controls were included in the study. At the baseline visit, compared to the control group, concentrations of IL-10 were significantly elevated in the HIV-infected and uninfected groups. The level of IL-10 was significantly higher in the HIV-infected compared to the HIV-uninfected PSS group (25.3 pg/mL (IQR, 4.56–41.76) vs 2.73 pg/mL (IQR, 1.55–9.02), P = 0.0192). In the HIV-infected PSS group (but not the HIV-infected LS or HIV-uninfected PSS groups) the IP-10, MIP-1b, IL-6 and IL-8 were raised compared to the controls. IL-10 levels decreased but did not return to control baseline values by 6 months in HIV infected PSS and LS and HIV uninfected PSS. Conclusion PSS and LS in HIV-infected individuals is characterized by an increase in inflammatory and anti-inflammatory cytokines such as IL-10. The increase of IL-10 is greater in HIV-infected than uninfected individuals. Further work is required to ascertain if this is part of an immunological profile that correlates with adverse outcomes such as serofast syphilis and neurosyphilis, in HIV-infected individuals. Electronic supplementary material The online version of this article (doi:10.1186/s12879-017-2201-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chris Kenyon
- HIV/STI Unit, Institute of Tropical Medicine, Antwerp, Belgium. .,Division of Infectious Diseases and HIV Medicine, University of Cape Town, Anzio Road, Observatory 7700, Cape Town, South Africa.
| | | | - Tania Crucitti
- HIV/STI Reference Laboratory, Institute of Tropical Medicine, Antwerp, Belgium
| | - Luc Kestens
- Immunology Unit, Institute of Tropical Medicine,, Antwerp, Belgium.,Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
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