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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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Xie Q, Tang Y, Shen L, Yang D, Zhang J, Luo Q. Immunophenotypic variations in syphilis: insights from Mendelian randomization analysis. Front Immunol 2024; 15:1380720. [PMID: 38694502 PMCID: PMC11061532 DOI: 10.3389/fimmu.2024.1380720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 04/04/2024] [Indexed: 05/04/2024] Open
Abstract
Background Infection with Treponema pallidum instigates complex immune responses. Prior research has suggested that persistent Treponema pallidum infection can manipulate host immune responses and circumvent host defenses. However, the precise role of immune cells in Treponema pallidum infection across different stages remains a contentious issue. Methods Utilizing summary data from genome-wide association studies, we employed a two-sample Mendelian randomization method to investigate the association between 731 immunophenotypes and syphilis. Syphilis was categorized into early and late stages in this study to establish a more robust correlation and minimize bias in database sources. Results Our findings revealed that 33, 36, and 27 immunophenotypes of peripheral blood were associated with syphilis (regardless of disease stage), early syphilis and late syphilis, respectively. Subsequent analysis demonstrated significant variations between early and late syphilis in terms of immunophenotypes. Specifically, early syphilis showcased activated, secreting, and resting regulatory T cells, whereas late syphilis was characterized by resting Treg cells. More B cells subtypes emerged in late syphilis. Monocytes in early syphilis exhibited an intermediate and non-classical phenotype, transitioning to classical in late syphilis. Early syphilis featured naive T cells, effector memory T cells, and terminally differentiated T cells, while late syphilis predominantly presented terminally differentiated T cells. Immature myeloid-derived suppressor cells were evident in early syphilis, whereas the dendritic cell immunophenotype was exclusive to late syphilis. Conclusion Multiple immunophenotypes demonstrated associations with syphilis, showcasing substantial disparities between the early and late stages of the disease. These findings hold promise for informing immunologically oriented treatment strategies, paving the way for more effective and efficient syphilis interventions.
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Affiliation(s)
| | | | | | | | | | - Qingqiong Luo
- Department of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
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Tang Y, Shen L, Yang D, Zhang J, Xie Q, Sun F, Luo Q. Neutrophil CD64 index as a potential blood biomarker for the diagnosis of neurosyphilis in secondary and tertiary syphilis: A retrospective study. Heliyon 2024; 10:e29027. [PMID: 38596103 PMCID: PMC11002674 DOI: 10.1016/j.heliyon.2024.e29027] [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: 12/11/2023] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/11/2024] Open
Abstract
Objective To examine the correlation of neutrophil CD64 (nCD64) index with neurosyphilis (NS) across different stages of syphilis. Methods A total of 1243 syphilis patients at different stages (344 of primary, 385 of secondary, and 514 of tertiary) included in this study were divided into NS and non-NS (NNS). Correlations of nCD64 index with currently used syphilis biomarkers were explored using Spearman correlation test. Relationships between nCD64 index and NS at different stages were investigated by stratified analysis and restricted cubic spline model. The diagnostic performance of nCD64 index for NS was assessed by receiver operating characteristic (ROC) curve. Results Significant statistical correlations of nCD64 index with cerebrospinal fluid (CSF) NS indicators were found in secondary and tertiary syphilis. Increased nCD64 index was associated with increased risk of NS in secondary and tertiary syphilis. ROC analysis values further confirmed the diagnostic potential of nCD64 index for NS. Marked decrease of nCD64 index was observed in NS patients after effective antisyphilitic treatments. Conclusions The nCD64 index may help to the diagnosis of NS in secondary and tertiary syphilis.
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Affiliation(s)
- Yijie Tang
- Department of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Lingyun Shen
- Department of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Dandan Yang
- Department of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jiaqin Zhang
- Department of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qinghui Xie
- Department of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Fenyong Sun
- Department of Clinical Laboratory Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qingqiong Luo
- Department of Clinical Laboratory Medicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
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Chen Z, Du F, Zhang R, Wu Q, Lu Z, Zhang RL, Wang Q. ADAMTS5 Promotes Permeability of the Blood-Brain Barrier during Treponema pallidum Subspecies pallidum Invading the Central Nervous System. ACS Infect Dis 2024; 10:1222-1231. [PMID: 38536197 DOI: 10.1021/acsinfecdis.3c00664] [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] [Indexed: 04/13/2024]
Abstract
The pathogenesis of neurosyphilis remains unclear. A previous study found a noteworthy up-regulation of a disintegrin and metalloproteinase with thrombospondin type 1 motif 5 (ADAMTS5) gene in human brain microvascular endothelial cells cocultured with Treponema pallidum subspecies pallidum (Tp). To investigate the ADAMTS5 role in Tp invading the central nervous system (CNS), we conducted relevant experiments. Our study revealed that Tp caused an increase in human cortical microvascular endothelial cell/D3 (hCMEC/D3) barrier permeability and significantly enhanced ADAMTS5 expression. The heightened permeability of the hCMEC/D3 barrier was effectively mitigated by inhibiting ADAMTS5. During this process, Tp promoted interleukin-1β production, which, in turn, facilitated ADAMTS5 expression. Furthermore, Tp significantly reduced the glycocalyx on the surface of hCMEC/D3 cells, which was also ameliorated by inhibiting ADAMTS5. Additionally, ADAMTS5 and endothelial glycocalyx components notably increased in the cerebrospinal fluid of HIV-negative neurosyphilis patients. This research provided the first demonstration of the ADAMTS5 role in Tp invading the CNS and offered new insight into neurosyphilis pathogenesis.
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Affiliation(s)
- Zuoxi Chen
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China
| | - Fangzhi Du
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China
| | - Ruihua Zhang
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China
| | - Qingyun Wu
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China
| | - Zhiyu Lu
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China
| | - Rui-Li Zhang
- Department of Dermatology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210003, China
| | - Qianqiu Wang
- Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China
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Catalano AA, Yoon J, Fertuzinhos S, Reisert H, Walsh H, Kosana P, Wilson M, Gisslen M, Zetterberg H, Marra CM, Farhadian SF. Neurosyphilis is characterized by a compartmentalized and robust neuroimmune response but not by neuronal injury. MED 2024; 5:321-334.e3. [PMID: 38513660 PMCID: PMC11216317 DOI: 10.1016/j.medj.2024.02.005] [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: 07/21/2022] [Revised: 11/09/2023] [Accepted: 02/21/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Neurosyphilis is increasing in prevalence but its pathophysiology remains incompletely understood. This study assessed for CNS-specific immune responses during neurosyphilis compared to syphilis without neurosyphilis and compared these immune profiles to those observed in other neuroinflammatory diseases. METHODS Participants with syphilis were categorized as having neurosyphilis if their cerebrospinal fluid (CSF)-venereal disease research laboratory (VDRL) test was reactive and as having syphilis without neurosyphilis if they had a non-reactive CSF-VDRL test and a white blood cell count <5/μL. Neurosyphilis and syphilis without neurosyphilis participants were matched by rapid plasma reagin titer and HIV status. CSF and plasma were assayed for markers of neuronal injury and glial and immune cell activation. Bulk RNA sequencing was performed on CSF cells, with results stratified by the presence of neurological symptoms. FINDINGS CSF neopterin and five CSF chemokines had levels significantly higher in individuals with neurosyphilis compared to those with syphilis without neurosyphilis, but no markers of neuronal injury or astrocyte activation were significantly elevated. The CSF transcriptome in neurosyphilis was characterized by genes involved in microglial activation and lipid metabolism and did not differ in asymptomatic versus symptomatic neurosyphilis cases. CONCLUSIONS The CNS immune response observed in neurosyphilis was comparable to other neuroinflammatory diseases and was present in individuals with neurosyphilis regardless of neurological symptoms, yet there was minimal evidence for neuronal or astrocyte injury. These findings support the need for larger studies of the CSF inflammatory response in asymptomatic neurosyphilis. FUNDING This work was funded by the National Institutes of Health, grants K23MH118999 (S.F.F.) and R01NS082120 (C.M.M.).
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Affiliation(s)
- Allison A Catalano
- Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT, USA
| | - Jennifer Yoon
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
| | - Sofia Fertuzinhos
- Bioinformatics Support Hub, Cushing/Whitney Library, Yale School of Medicine, New Haven, CT, USA
| | - Hailey Reisert
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
| | - Hannah Walsh
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
| | - Priya Kosana
- Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT, USA
| | - Michael Wilson
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Magnus Gisslen
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christina M Marra
- Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - Shelli F Farhadian
- Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT, USA; Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA.
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Eallonardo SJ, Freitag NE. Crossing the Barrier: A Comparative Study of Listeria monocytogenes and Treponema pallidum in Placental Invasion. Cells 2023; 13:88. [PMID: 38201292 PMCID: PMC10778170 DOI: 10.3390/cells13010088] [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: 07/20/2023] [Revised: 12/03/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Vertically transmitted infections are a significant cause of fetal morbidity and mortality during pregnancy and pose substantial risks to fetal development. These infections are primarily transmitted to the fetus through two routes: (1) direct invasion and crossing the placenta which separates maternal and fetal circulation, or (2) ascending the maternal genitourinary tact and entering the uterus. Only two bacterial species are commonly found to cross the placenta and infect the fetus: Listeria monocytogenes and Treponema pallidum subsp. pallidum. L. monocytogenes is a Gram-positive, foodborne pathogen found in soil that acutely infects a wide variety of mammalian species. T. pallidum is a sexually transmitted spirochete that causes a chronic infection exclusively in humans. We briefly review the pathogenesis of these two very distinct bacteria that have managed to overcome the placental barrier and the role placental immunity plays in resisting infection. Both organisms share characteristics which contribute to their transplacental transmission. These include the ability to disseminate broadly within the host, evade immune phagocytosis, and the need for a strong T cell response for their elimination.
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Affiliation(s)
- Samuel J. Eallonardo
- Department of Microbiology and Immunology, University of Illinois Chicago, Chicago, IL 60612, USA;
| | - Nancy E. Freitag
- Department of Microbiology and Immunology, University of Illinois Chicago, Chicago, IL 60612, USA;
- Department of Pharmaceutical Sciences, University of Illinois Chicago, Chicago, IL 60612, USA
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Li W, Li S, Wang J, Yu M, Yang H, He Z, Tang Y, Liu J, Guo N, Xie D, Liu Z, Zheng K, Xu M, Wu Y. The outer membrane protein Tp92 of Treponema pallidum delays human neutrophil apoptosis via the ERK, PI3K/Akt, and NF-κB pathways. Mol Microbiol 2023; 120:684-701. [PMID: 37718557 DOI: 10.1111/mmi.15164] [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: 04/16/2023] [Revised: 09/01/2023] [Accepted: 09/03/2023] [Indexed: 09/19/2023]
Abstract
Syphilis is a persistent sexually transmitted disease caused by infiltration of the elusive pathogen Treponema pallidum. Despite the prevalence of human polymorphonuclear neutrophils (hPMNs) within cutaneous lesions, which are characteristic of incipient syphilis, their role in T. pallidum infection remains unclear. Tp92 is the only T. pallidum helical outer membrane protein that exhibits structural features similar to those of outer membrane proteins in other gram-negative bacteria. However, the functional mechanism of this protein in immune cells remains unclear. Neutrophils are short-lived cells that undergo innate apoptosis in response to external stimuli that typically influence this process. In this study, we determined that Tp92 impedes the activation of procaspase-3 via the ERK MAPK, PI3K/Akt, and NF-κB signaling pathways, consequently suppressing caspase-3 activity within hPMNs, and thereby preventing hPMNs apoptosis. Furthermore, Tp92 could also modulate hPMNs apoptosis by enhancing the expression of the anti-apoptotic protein Mcl-1, stimulating IL-8 secretion, and preserving the mitochondrial membrane potential. These findings provide valuable insights into the molecular mechanisms underlying T. pallidum infection and suggest potential therapeutic targets for syphilis treatment.
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Affiliation(s)
- Weiwei Li
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical College, Institution of Pathogenic Biology, University of South China, Hengyang, China
- Department of Clinical Laboratory, The Second People's Hospital of Foshan, Foshan, China
| | - Sijia Li
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical College, Institution of Pathogenic Biology, University of South China, Hengyang, China
| | - Jianye Wang
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical College, Institution of Pathogenic Biology, University of South China, Hengyang, China
- Key Laboratory of Immune Microenvironment and Disease of the Ministry of Education, Department of Immunology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Maoying Yu
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical College, Institution of Pathogenic Biology, University of South China, Hengyang, China
| | - Hongyu Yang
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical College, Institution of Pathogenic Biology, University of South China, Hengyang, China
| | - Zhangping He
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical College, Institution of Pathogenic Biology, University of South China, Hengyang, China
| | - Yuanyuan Tang
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical College, Institution of Pathogenic Biology, University of South China, Hengyang, China
| | - Jie Liu
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical College, Institution of Pathogenic Biology, University of South China, Hengyang, China
| | - Ningyuan Guo
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical College, Institution of Pathogenic Biology, University of South China, Hengyang, China
| | - Dongde Xie
- Department of Clinical Laboratory, The Second People's Hospital of Foshan, Foshan, China
| | - Zhaoping Liu
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical College, Institution of Pathogenic Biology, University of South China, Hengyang, China
| | - Kang Zheng
- Department of Clinical Laboratory, Hengyang Central Hospital, Hengyang, China
| | - Man Xu
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical College, Institution of Pathogenic Biology, University of South China, Hengyang, China
| | - Yimou Wu
- Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical College, Institution of Pathogenic Biology, University of South China, Hengyang, China
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Fang Y, Wu H, Liu G, Li Z, Wang D, Ning Y, Pan S, Hu Y. Secondary immunoreaction in patients with neurosyphilis and its relevance to clinical outcomes. Front Neurol 2023; 14:1201452. [PMID: 37346161 PMCID: PMC10281193 DOI: 10.3389/fneur.2023.1201452] [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: 04/06/2023] [Accepted: 05/16/2023] [Indexed: 06/23/2023] Open
Abstract
Background and purpose Several reported cases of autoimmune conditions such as anti-NMDAR encephalitis and neuromyelitis optica (AQP4) have been considered to be potentially secondary to Treponema pallidum infection. Since the role of immune impairment in neurosyphilis is unclear, in this retrospective study, we examined the correlation of the immune impairment in patients with neurosyphilis with their clinical characteristics and outcomes. Methods Clinical information was collected from patients with neurosyphilis in our center from January 2019 to December 2021. Cerebrospinal fluid (CSF) samples were subjected to indirect immunofluorescence tissue-based assay (IIF-TBA) on mouse brain sections and cell-based assay (CBA). The clinical characteristics and treatment outcomes of TBA-positive and-negative patients were compared. Results A total number of 81 patients diagnosed with neurosyphilis were included. The results of the CBA tests showed that three cases had anti-NMDAR, AQP4, or GAD65 antibodies, respectively. By TBA test, 38 patients (38/81, 46.9%) had positive immunostains, including staining of neuronal cells in 21 cases (21/38, 55.3%), glial cells in 11 cases (11/38, 28.9%), and neuronal and glial cells in six cases (6/38, 15.8%). We then compared the clinical characteristics and treatment outcomes between the TBA-positive and-negative patients and found that TBA-positive staining was significantly correlated with syphilis antibody titers (p = 0.027 for serum and p = 0.006 for CSF) and head MRI abnormalities (p < 0.001 for parenchymal abnormalities and p = 0.013 for white matter lesions). The cognitive prognosis of TBA-positive neurosyphilis patients was significantly worse than that of TBA-negative patients (p < 0.001). Conclusion The correlation between the TBA results and clinical data of our neurosyphilis patients imply the presence of secondary immune damage, which affected their prognosis. Therefore, TBA can be used as an additional biomarker for neurosyphilis patient prognosis.
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Affiliation(s)
- Yaxiu Fang
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Department of Neurology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hong Wu
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Guanghui Liu
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ziang Li
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Dongmei Wang
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yuping Ning
- Department of Neurology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Suyue Pan
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yafang Hu
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Du FZ, Zhang X, Zhang RL, Wang QQ. CARE-NS, a research strategy for neurosyphilis. Front Med (Lausanne) 2023; 9:1040133. [PMID: 36687428 PMCID: PMC9852909 DOI: 10.3389/fmed.2022.1040133] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/16/2022] [Indexed: 01/07/2023] Open
Abstract
Neurosyphilis is a major clinical manifestation of syphilis. In recent years, an increase in neurosyphilis cases has been reported in many countries. The overall incidence of neurosyphilis remains unknown, and there is a lack of understanding of the disease pathogenesis, which hampers clinical management, development of prevention strategies, and control. This article proposes the CARE-NS research strategy to enhance the clinical management of neurosyphilis, which consists of six key features: comprehensive management including multidisciplinary treatment (C), alleviating neurological impairment and sequelae (A), risk factors and clinical epidemiology (R), etiology and pathogenesis (E), new diagnostic indicators and strategies (N), and social impact and cost-effectiveness analysis (S).
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Affiliation(s)
- Fang-Zhi Du
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for STD Control, China Centers for Disease Control and Prevention, Nanjing, China
| | - Xu Zhang
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for STD Control, China Centers for Disease Control and Prevention, Nanjing, China
| | - Rui-Li Zhang
- Department of Dermatology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China,*Correspondence: Rui-Li Zhang,
| | - Qian-Qiu Wang
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for STD Control, China Centers for Disease Control and Prevention, Nanjing, China,Qian-Qiu Wang,
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Zhou X, Peng S, Song T, Tie D, Tao X, Jiang L, Zhang J. Neurosyphilis with ocular involvement and normal magnetic resonance imaging results affirmed by metagenomic next-generation sequencing. Front Cell Infect Microbiol 2022; 12:985373. [PMID: 36530424 PMCID: PMC9756949 DOI: 10.3389/fcimb.2022.985373] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 10/10/2022] [Indexed: 12/04/2022] Open
Abstract
The rapid and accurate identification of pathogenic agents is the key to guide clinicians on diagnosis and medication, especially for intractable diseases, such as neurosyphilis. It is extremely challenging for clinicians to diagnose neurosyphilis with no highly sensitive and specific test available. It is well known that the early transmission and immune evasion ability of Treponema pallidum have earned it the title of "stealth pathogen." Neurosyphilis has complex clinical manifestations, including ocular involvement, which is infrequent and often overlooked, but its neuroimaging results may be normal. Therefore, it is important to find a new test that can detect the presence or absence of Treponema pallidum immediately for the diagnosis of neurosyphilis. We reviewed all the patients admitted to the Sichuan Provincial People's Hospital between 2021 and 2022 who had ocular involvement and whose clinical samples were examined via metagenomic next-generation sequencing (mNGS), and we found 10 candidates for further analysis. The results of magnetic resonance imaging (MRI) were normal for four patients, and three of them met the diagnostic criteria for neurosyphilis confirmed by mNGS. In addition, the results of mNGS from the three patients were further validated using polymerase chain reaction (PCR). Five of the 10 patients had diplopia manifestations; two (20%) experienced abducens nerve palsies, two (20%) had eyelid drooping, and one (10%) had decreased vision. One of the 10 patients (10%) who was HIV positive and five patients had abnormal MRI results. To our knowledge, Treponema pallidum was detected by mNGS in patients with ocular involvement and normal MRI results for the first time. Given this situation, we recommend mNGS as a potential and supplementary tool for the diagnosis and differential diagnosis of neurosyphilis.
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Affiliation(s)
- Xiaoli Zhou
- Department of Laboratory Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China,Sichuan Translational Medicine Research Hospital, Chinese Academy of Sciences, Chengdu, China
| | - Shengkun Peng
- Sichuan Translational Medicine Research Hospital, Chinese Academy of Sciences, Chengdu, China,Department of Radiology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Tiange Song
- Department of Laboratory Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China,Sichuan Translational Medicine Research Hospital, Chinese Academy of Sciences, Chengdu, China
| | - Dandan Tie
- Department of Laboratory Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China,Sichuan Translational Medicine Research Hospital, Chinese Academy of Sciences, Chengdu, China
| | - Xiaoyan Tao
- Department of Laboratory Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China,Sichuan Translational Medicine Research Hospital, Chinese Academy of Sciences, Chengdu, China
| | - Li Jiang
- Department of Laboratory Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China,Sichuan Translational Medicine Research Hospital, Chinese Academy of Sciences, Chengdu, China,*Correspondence: Li Jiang, ; Jie Zhang,
| | - Jie Zhang
- Department of Laboratory Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China,Sichuan Translational Medicine Research Hospital, Chinese Academy of Sciences, Chengdu, China,*Correspondence: Li Jiang, ; Jie Zhang,
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11
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Wang G, Zou D, Lu X, Gu X, Cheng Y, Qi T, Cheng Y, Yu J, Ye M, Zhou P. Gut Microbiota Alternation in Disease Progression of Neurosyphilis. Infect Drug Resist 2022; 15:6603-6612. [PMID: 36406865 PMCID: PMC9673944 DOI: 10.2147/idr.s389155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/02/2022] [Indexed: 08/05/2023] Open
Abstract
Background The gut microbiota plays an important role in the development of neurological disorders such as Parkinson's disease and Alzheimer's disease. However, studies on the gut microbiota of patients with neurosyphilis (NS) were rarely reported. Methods In this study, we collected fecal samples from 62 syphilis patients, including 39 with NS and 23 with non-NS. Among the NS patients, 18 were general paresis (GP). The white blood cell counts, protein concentrations, and Venereal Disease Research Laboratory test positive rates of cerebrospinal fluid from patients in NS or GP group were significantly higher than those from patients in non-NS group. 16S ribosomal RNA sequencing results revealed that the alpha and beta diversities of the gut microbiota were similar between NS and non-NS patients or GP and non-NS patients. Results Linear discriminant analysis with effect size (LEfSe) analysis showed that some taxa, such as Coprobacter, were increased in both NS group and GP group, compared with non-NS group. Besides, the clade of Akkermansia was also overrepresented in GP Patients. Meanwhile, some taxa such as Clostridia_UCG-014 and SC-I-84 were underrepresented in NS patients. The abundances of class Bacilli and genus Alloprevotella were decreased in GP patients. Among them, the abundances of some taxa such as Coprobacter and Akkermansia have been reported to be associated with other neuropsychiatric disorders. Conclusion Our findings suggest that the alternation of the gut microbiota in NS patients may contribute to the course of NS, which will deepen our understanding of NS.
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Affiliation(s)
- Guixuan Wang
- Shanghai Skin Disease Clinical College of Anhui Medical University, Shanghai Skin Disease Hospital, Shanghai, People’s Republic of China
- STD Institute, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China
| | - Danyang Zou
- STD Institute, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China
| | - Xinying Lu
- STD Institute, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China
| | - Xin Gu
- STD Institute, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China
| | - Yuanyuan Cheng
- STD Institute, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China
| | - Tengfei Qi
- STD Institute, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China
| | - Yanchun Cheng
- STD Institute, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China
| | - Junjun Yu
- STD Institute, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China
| | - Meiping Ye
- STD Institute, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China
| | - Pingyu Zhou
- Shanghai Skin Disease Clinical College of Anhui Medical University, Shanghai Skin Disease Hospital, Shanghai, People’s Republic of China
- STD Institute, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China
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12
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Tang Y, Zhou Y, He B, Cao T, Zhou X, Ning L, Chen E, Li Y, Xie X, Peng B, Hu Y, Liu S. Investigation of the immune escape mechanism of Treponema pallidum. Infection 2022; 51:305-321. [PMID: 36260281 DOI: 10.1007/s15010-022-01939-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 10/07/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Syphilis is a chronic sexually transmitted disease caused by Treponema pallidum subspecies pallidum (T. pallidum), which is a public health problem that seriously affects human health worldwide. T. pallidum is characterized by early transmission and immune escape and is therefore termed an "invisible pathogen". METHODS This review systematically summarizes the host's innate and adaptive immune responses to T. pallidum infection as well as the escape mechanisms of T. pallidum. PURPOSE To lay the foundation for assessing the pathogenic mechanism and the systematic prevention and treatment of syphilis. CONCLUSION The immune escape mechanism of T. pallidum plays an important role in its survival. Exploring the occurrence and development of these mechanisms has laid the foundation for the development of syphilis vaccine.
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Affiliation(s)
- Yun Tang
- Department of Clinical Laboratory Medicine, Institution of Microbiology and Infectious Diseases, Hengyang Medical School, The First Affiliated Hospital, University of South China, No. 69, Chuanshan Road, Hengyang City, 421000, Hunan, China
| | - Yingjie Zhou
- Department of Clinical Laboratory Medicine, Institution of Microbiology and Infectious Diseases, Hengyang Medical School, The First Affiliated Hospital, University of South China, No. 69, Chuanshan Road, Hengyang City, 421000, Hunan, China
| | - Bisha He
- Department of Clinical Laboratory Medicine, Institution of Microbiology and Infectious Diseases, Hengyang Medical School, The First Affiliated Hospital, University of South China, No. 69, Chuanshan Road, Hengyang City, 421000, Hunan, China
| | - Ting Cao
- Department of Clinical Laboratory Medicine, Institution of Microbiology and Infectious Diseases, Hengyang Medical School, The First Affiliated Hospital, University of South China, No. 69, Chuanshan Road, Hengyang City, 421000, Hunan, China
| | - Xiangping Zhou
- Department of Clinical Laboratory Medicine, Institution of Microbiology and Infectious Diseases, Hengyang Medical School, The First Affiliated Hospital, University of South China, No. 69, Chuanshan Road, Hengyang City, 421000, Hunan, China
| | - Lichang Ning
- Department of Clinical Laboratory Medicine, Institution of Microbiology and Infectious Diseases, Hengyang Medical School, The First Affiliated Hospital, University of South China, No. 69, Chuanshan Road, Hengyang City, 421000, Hunan, China
| | - En Chen
- Department of Clinical Laboratory Medicine, Institution of Microbiology and Infectious Diseases, Hengyang Medical School, The First Affiliated Hospital, University of South China, No. 69, Chuanshan Road, Hengyang City, 421000, Hunan, China
| | - Yumeng Li
- Department of Clinical Laboratory Medicine, Institution of Microbiology and Infectious Diseases, Hengyang Medical School, The First Affiliated Hospital, University of South China, No. 69, Chuanshan Road, Hengyang City, 421000, Hunan, China
| | - Xiaoping Xie
- Department of Clinical Laboratory Medicine, Institution of Microbiology and Infectious Diseases, Hengyang Medical School, The First Affiliated Hospital, University of South China, No. 69, Chuanshan Road, Hengyang City, 421000, Hunan, China
| | - Binfeng Peng
- Department of Clinical Laboratory Medicine, Institution of Microbiology and Infectious Diseases, Hengyang Medical School, The First Affiliated Hospital, University of South China, No. 69, Chuanshan Road, Hengyang City, 421000, Hunan, China
| | - Yibao Hu
- Department of Clinical Laboratory Medicine, Institution of Microbiology and Infectious Diseases, Hengyang Medical School, The First Affiliated Hospital, University of South China, No. 69, Chuanshan Road, Hengyang City, 421000, Hunan, China
| | - Shuangquan Liu
- Department of Clinical Laboratory Medicine, Institution of Microbiology and Infectious Diseases, Hengyang Medical School, The First Affiliated Hospital, University of South China, No. 69, Chuanshan Road, Hengyang City, 421000, Hunan, China.
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13
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Du FZ, Zhang HN, Li JJ, Zheng ZJ, Zhang X, Zhang RL, Wang QQ. Neurosyphilis in China: A Systematic Review of Cases From 2009-2021. Front Med (Lausanne) 2022; 9:894841. [PMID: 35646949 PMCID: PMC9136070 DOI: 10.3389/fmed.2022.894841] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Considered the increased threaten of neurosyphilis in China, a review on cases reported in the literature to describe the clinical epidemiological characteristics of neurosyphilis cases, may be beneficial to the early detection and management strategies of neurosyphilis for clinicians. We searched the literature on Chinese neurosyphilis cases published from January 1, 2009 to December 31, 2021, described their clinical epidemiological characteristics and calculated the prevalence of neurosyphilis amongst other associated diseases, according to the individual study criteria. A total of 284 studies including 7,486 neurosyphilis cases were included. No meta-analysis was performed due to the heterogeneity of the data. Among 149 case reports and 93 retrospective case series studies, the main clinical manifestation of 3,507 neurosyphilis cases was cerebral parenchymal syphilis (57.3%), followed by asymptomatic neurosyphilis (16.7%), meningovascular syphilis (13.6%), meningitis syphilis (7.7%) and ocular syphilis (2.8%), etc. In addition, the initial diagnosis was incorrect in 53.2% patients, and the most frequent misdiagnoses were mental disorders (31.0%), stroke (15.9%), cognitive impairment (9.0%), etc. The positive or abnormal rates of cerebrospinal fluid non-treponemal and treponemal tests, white blood cell counts and protein concentrations were 74.2%, 96.2%, 61.5%, and 60.9%, respectively. Aqueous penicillin was the first choice for treatment in 88.3% cases, and 81.7% and 50.0% patients had response in the improvement of symptoms and serological effective in CSF, respectively. Among 26 studies on neurosyphilis patients amongst other associated diseases, the prevalence of neurosyphilis amongst central nervous system infectious diseases, syphilis-associated neurological symptoms, serofast status, coinfected with human immunodeficiency virus were 10.6%-30.1%, 23.2%-35.5%, 9.8%-56.1%, and 8.9%, respectively. In summary, the lack of early detection of neurosyphilis cases remains a clinical challenge. The high rate of misdiagnosis and high prevalence of neurosyphilis amongst associated diseases strongly remind clinicians to focus on the early detection among suspected cases. Besides, the standard treatment regimen and long-term follow-up, which complied with guideline should be provided. Further prospective studies are urgent to better delineate the clinical epidemiological characteristics of neurosyphilis in China.
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Affiliation(s)
- Fang-Zhi Du
- Department of Clinical Prevention and Control of STD, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, National Center for STD Control, China Centers for Disease Control and Prevention, Nanjing, China
| | - Hai-Ni Zhang
- Department of Clinical Prevention and Control of STD, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, National Center for STD Control, China Centers for Disease Control and Prevention, Nanjing, China
| | - Jing-Jing Li
- Department of Dermatology, The Fifth People's Hospital of Suzhou, Suzhou, China
| | - Zhi-Ju Zheng
- Department of Clinical Prevention and Control of STD, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, National Center for STD Control, China Centers for Disease Control and Prevention, Nanjing, China
| | - Xu Zhang
- Department of Clinical Prevention and Control of STD, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, National Center for STD Control, China Centers for Disease Control and Prevention, Nanjing, China
| | - Rui-Li Zhang
- Department of Dermatology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qian-Qiu Wang
- Department of Clinical Prevention and Control of STD, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, National Center for STD Control, China Centers for Disease Control and Prevention, Nanjing, China
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14
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Yan J, Luo L, Han J, Yan D, Zhang B, Zhang Z, Shi J, Zhu M, Yu J, Liu S, Qi J, Yang Z. Comparing Noninvasive Predictors of Neurosyphilis Among Syphilis Patients With and Without HIV Co-Infection Based on the Real-World Diagnostic Criteria: A Single-Center, Retrospective Cohort Study in China. AIDS Res Hum Retroviruses 2022; 38:406-414. [PMID: 34314231 DOI: 10.1089/aid.2021.0085] [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] [Indexed: 01/26/2023] Open
Abstract
Diagnosis of neurosyphilis is currently based on the cerebrospinal fluid (CSF) assessments and CSF-Venereal Disease Research Laboratory (CSF-VDRL) is the traditional "gold standard." In the real world, CSF assessments and CSF-VDRL are not always available. This study aimed to identify noninvasive predictors of neurosyphilis based on real-world clinical parameters and diagnostic criteria in populations with different HIV status. In this retrospective cohort study, syphilis patients with different HIV statuses hospitalized for neurosyphilis screening were retrospectively recruited at an infectious disease hospital. Neurosyphilis was defined by real-world diagnostic criteria. Logistic regression and receiver operating characteristic curve analysis were used to investigate and evaluate predictors of neurosyphilis. In total, 528 patients were enrolled, including 143 syphilis patients without HIV infection and 385 HIV/syphilis-co-infected patients. One hundred twelve and 304 neurosyphilis patients were identified in the HIV-negative and HIV-positive groups, respectively. A high serum toluidine red unheated serum test (TRUST) titer was a robust predictor of neurosyphilis in all participants. An age ≥50 years old [adjusted odds ratio (aOR) = 5.062, 95% confidence interval (CI), 1.449-17.680] in the HIV-negative group and CD4+ T cell count <330/μL (<300 as reference, aOR = 0.552, 95% CI, 0.315-0.966) in the HIV-positive group were predictors of asymptomatic neurosyphilis. In real-world situations, for asymptomatic syphilis patients, relatively old age and a high serum TRUST titer in HIV-negative populations, and CD4+ T cells <330/μL and/or serum TRUST titer >1:64 in HIV-positive populations might predict neurosyphilis.
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Affiliation(s)
- Jun Yan
- Xixi Hospital of Hangzhou, Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
| | - Lian Luo
- Xixi Hospital of Hangzhou, Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
| | - Jie Han
- Xixi Hospital of Hangzhou, Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
| | - Dingyan Yan
- Xixi Hospital of Hangzhou, Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
| | - Binhai Zhang
- Xixi Hospital of Hangzhou, Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
| | - Zhongdong Zhang
- Xixi Hospital of Hangzhou, Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
| | - Jinchuan Shi
- Xixi Hospital of Hangzhou, Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
| | - Mingli Zhu
- Xixi Hospital of Hangzhou, Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
| | - Jianhua Yu
- Xixi Hospital of Hangzhou, Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
| | - Shourong Liu
- Xixi Hospital of Hangzhou, Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
| | - Jianjiang Qi
- Hangzhou Seventh People's Hospital, Affiliated Mental Center, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
| | - Zongxing Yang
- Xixi Hospital of Hangzhou, Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China
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15
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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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16
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Wu KX, Wang XT, Hu XL, Jiang XY, Zhuang JC, Xu YZ, Lin LR, Tong ML, Yang TC, Liu LL. LncRNA-ENST00000421645 Upregulates Kank1 to Inhibit IFN-γ Expression and Promote T Cell Apoptosis in Neurosyphilis. Front Microbiol 2021; 12:749171. [PMID: 34917045 PMCID: PMC8669649 DOI: 10.3389/fmicb.2021.749171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 11/10/2021] [Indexed: 12/24/2022] Open
Abstract
Long non-coding RNAs are involved in many infectious diseases. Our previous studies showed that lncRNA-ENST00000421645 expression is increased in T lymphocytes of neurosyphilis patients compared to healthy controls. However, whether lncRNA-ENST00000421645 has biological functions remains unclear. The current study was undertaken to understand the mechanism of lncRNA-ENST00000421645 in T lymphocyte function in neurosyphilis patients. The lncRNA-ENST00000421645 pull-down assay showed that lncRNA-ENST00000421645 acted on the acetylase NAT10. The chromatin immunoprecipitation (ChIP)-PCR results showed that lncRNA-ENST00000421645 promoted the acetylation of histone H3K27 adjacent to the Kank1 promoter, thereby promoting Kank1 protein expression. Kank1 promotes 14-3-3 protein expression, inhibits NF-kB activation, inhibits IFN-γ secretion by T lymphocytes, and promotes T lymphocyte apoptosis. Taken together, our findings suggest a novel mechanism that LncRNA-ENST00000421645 upregulates Kank1 to inhibit IFN-γ expression and promote T cell apoptosis in neurosyphilis.
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Affiliation(s)
- Kai-Xuan Wu
- Center of Clinical Laboratory, School of Medical, Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Xiao-Tong Wang
- Center of Clinical Laboratory, School of Medical, Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Xin-Lin Hu
- Department of Dermatology, School of Medical, Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Xiao-Yong Jiang
- Department of Dermatology, School of Medical, Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Jing-Cong Zhuang
- Department of Neurology, School of Medical, Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Yan-Zhu Xu
- Department of Dermatology, School of Medical, Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Li-Rong Lin
- Center of Clinical Laboratory, School of Medical, Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Man-Li Tong
- Center of Clinical Laboratory, School of Medical, Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Tian-Ci Yang
- Center of Clinical Laboratory, School of Medical, Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Li-Li Liu
- Center of Clinical Laboratory, School of Medical, Zhongshan Hospital, Xiamen University, Xiamen, China
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17
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Liu WN, Wu KX, Wang XT, Lin LR, Tong ML, Liu LL. LncRNA- ENST00000421645 promotes T cells to secrete IFN-γ by sponging PCM1 in neurosyphilis. Epigenomics 2021; 13:1187-1203. [PMID: 34382410 DOI: 10.2217/epi-2021-0163] [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] [Indexed: 12/23/2022] Open
Abstract
Aim: Neurosyphilis patients exhibited significant expression of long noncoding RNA (lncRNA) in peripheral blood T lymphocytes. In this study, we further clarified the role of lncRNA-ENST00000421645 in the pathogenic mechanism of neurosyphilis. Methods: lncRNA-ENST00000421645 was transfected into Jurkat-E6-1 cells, namely lentivirus (Lv)-1645 cells. RNA pull-down assay, flow cytometry, RT-qPCR, ELISA (Neobioscience Technology Co Ltd, Shenzhen, China) and RNA immunoprecipitation chip assay were used to analyze the function of lncRNA-ENST00000421645. Results: The expression of IFN-γ in Lv-1645 cells was significantly increased compared to that in Jurkat-E6-1 cells stimulated by phorbol-12-myristate-13-acetate (PMA). Then, it was suggested that lncRNA-ENST00000421645 interacts with PCM1 protein. Silencing PCM1 significantly increased the level of IFN-γ in Lv-1645 cells stimulated by PMA. Conclusion: This study revealed that lncRNA-ENST00000421645 mediates the production of IFN-γ by sponging PCM1 protein after PMA stimulation.
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Affiliation(s)
- Wen-Na Liu
- Center of Clinical Laboratory, Zhongshan Hospital, School of Medical, Xiamen University, Xiamen, Fujian Province, China.,Department of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science & Technology of China, Chengdu, China
| | - Kai-Xuan Wu
- Center of Clinical Laboratory, Zhongshan Hospital, School of Medical, Xiamen University, Xiamen, Fujian Province, China
| | - Xiao-Tong Wang
- Center of Clinical Laboratory, Zhongshan Hospital, School of Medical, Xiamen University, Xiamen, Fujian Province, China
| | - Li-Rong Lin
- Center of Clinical Laboratory, Zhongshan Hospital, School of Medical, Xiamen University, Xiamen, Fujian Province, China
| | - Man-Li Tong
- Center of Clinical Laboratory, Zhongshan Hospital, School of Medical, Xiamen University, Xiamen, Fujian Province, China
| | - Li-Li Liu
- Center of Clinical Laboratory, Zhongshan Hospital, School of Medical, Xiamen University, Xiamen, Fujian Province, China
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18
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Xia W, Zhao J, Su B, Jiao Y, Weng W, Zhang M, Wang X, Guo C, Wu H, Zhang T, Gao Y, Li Z. Syphilitic infection impairs immunity by inducing both apoptosis and pyroptosis of CD4 + and CD8 + T lymphocytes. Innate Immun 2020; 27:99-106. [PMID: 32873094 PMCID: PMC7780356 DOI: 10.1177/1753425920952840] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Syphilis is an important health problem worldwide; however, few studies have probed the impact of syphilitic infection on T cell turnover. The mechanisms behind the frequency of T cell subset changes and the associations between these subsets during syphilitic infection remain unclear. Herein, we used a cell-staining method and flow cytometry to explore changes in T cell subpopulations and potential contribution of apoptosis and pyroptosis that triggered therein. We investigated caspase-1-mediated pyroptosis and caspase-3-mediated apoptosis of CD4+ and CD8+ T cells, the major effector lymphocytes with pivotal roles in the pathogenesis of infectious diseases. We found that the levels of caspase-1 and caspase-3 increased in both the circulation and intracellularly in CD4+ and CD8+ T cells. Caspase-1 showed a continual increase from early latent stage infection through to phase 2 disease, whereas caspase-3 increased through to phase 1 disease but declined during phase 2. In addition, serum levels and intracellular expression of caspase-1 and caspase-3 were positively correlated. Overall, this study increases our understanding of how syphilitic infection influences CD4+ and CD8+ T-cell turnover, which may help with designing novel and effective strategies to control syphilis infection and prevent its transmission.
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Affiliation(s)
- Wei Xia
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Beijing Key Laboratory for HIV/AIDS Research, China
| | - Jinxue Zhao
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Department of Dermatology, Beijing Youan Hospital, Capital Medical University, China.,Department of Dermatology, The First Hospital of Fangshan District, China
| | - Bin Su
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Beijing Key Laboratory for HIV/AIDS Research, China
| | - Yanmei Jiao
- Treatment and Research Center for Infectious Diseases, the Fifth Medical Center of the General Hospital of PLA, China *Wei Xia and Jinxue Zhao contributed equally to the article
| | - Wenjia Weng
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Department of Dermatology, Beijing Youan Hospital, Capital Medical University, China
| | - Ming Zhang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Department of Dermatology, Beijing Youan Hospital, Capital Medical University, China
| | - Xiaodan Wang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Department of Dermatology, Beijing Youan Hospital, Capital Medical University, China
| | - Caiping Guo
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China
| | - Hao Wu
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Beijing Key Laboratory for HIV/AIDS Research, China
| | - Tong Zhang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Beijing Key Laboratory for HIV/AIDS Research, China
| | - Yanqing Gao
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China.,Department of Dermatology, Beijing Youan Hospital, Capital Medical University, China
| | - Zaicun Li
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, China
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19
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Gu X, Gao Y, Yan Y, Marks M, Zhu L, Lu H, Guan Z, Shi M, Ni L, Peng R, Zhao W, Wu J, Qi T, Lu S, Qian Y, Gong W, Zhou P. The importance of proper and prompt treatment of ocular syphilis: a lesson from permanent vision loss in 52 eyes. J Eur Acad Dermatol Venereol 2020; 34:1569-1578. [PMID: 32163642 PMCID: PMC7496700 DOI: 10.1111/jdv.16347] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 02/25/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Ocular involvement can occur at any stage of syphilis. Prompt diagnosis and proper treatment of ocular syphilis are vital to avoid long-term consequences. OBJECTIVES To describe the risk factors for ocular syphilis and clinical features of blindness caused by syphilis. METHODS We report risk factors for ocular syphilis amongst patients seen at the Shanghai Skin Disease Hospital between October 2009 and October 2017. We identify patients with ocular syphilis resulting in blindness and report the clinical characteristics, laboratory findings and treatment outcomes of these patients. RESULTS A total of 8310 new cases of syphilis were seen, of which 213 patients had ocular disease and 50 patients had blindness due to syphilis. Increasing age and higher RPR titres were associated with ocular involvement but there was no association with HIV status. Blindness in syphilis was restricted predominantly to patients with optic nerve involvement and not patients with isolated uveitis. Fifty patients (and a total of 67 eyes) met the WHO definition of blindness prior to treatment for syphilis. At the end of follow-up, vision had improved in 24 of 67 eyes (35.8%) after treatment. Successful treatment of uveitis was associated with the best improvement in visual acuity, whilst patient with underlying optic atrophy prior to treatment had the worst visual outcome. CONCLUSIONS Ocular involvement is an important manifestation of syphilis which may result in blindness. Our data demonstrate outcomes for ocular syphilis are poor if detected late; early recognition and diagnosis is therefore vital to avoid permanent visual loss.
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Affiliation(s)
- X. Gu
- Sexually Transmitted Disease InstituteShanghai Skin Disease HospitalSchool of MedicineTongji UniversityShanghaiChina
| | - Y. Gao
- Sexually Transmitted Disease InstituteShanghai Skin Disease HospitalSchool of MedicineTongji UniversityShanghaiChina
| | - Y. Yan
- Department of OphthalmologyRenji HospitalSchool of MedicineJiaotong UniversityShanghaiChina
| | - M. Marks
- Department of Clinical ResearchLondon School of Hygiene & Tropical MedicineLondonUK
| | - L. Zhu
- Sexually Transmitted Disease InstituteShanghai Skin Disease HospitalSchool of MedicineTongji UniversityShanghaiChina
| | - H. Lu
- Sexually Transmitted Disease InstituteShanghai Skin Disease HospitalSchool of MedicineTongji UniversityShanghaiChina
| | - Z. Guan
- Sexually Transmitted Disease InstituteShanghai Skin Disease HospitalSchool of MedicineTongji UniversityShanghaiChina
| | - M. Shi
- Sexually Transmitted Disease InstituteShanghai Skin Disease HospitalSchool of MedicineTongji UniversityShanghaiChina
| | - L. Ni
- Sexually Transmitted Disease InstituteShanghai Skin Disease HospitalSchool of MedicineTongji UniversityShanghaiChina
| | - R. Peng
- Sexually Transmitted Disease InstituteShanghai Skin Disease HospitalSchool of MedicineTongji UniversityShanghaiChina
| | - W. Zhao
- Sexually Transmitted Disease InstituteShanghai Skin Disease HospitalSchool of MedicineTongji UniversityShanghaiChina
| | - J. Wu
- Sexually Transmitted Disease InstituteShanghai Skin Disease HospitalSchool of MedicineTongji UniversityShanghaiChina
| | - T. Qi
- Sexually Transmitted Disease InstituteShanghai Skin Disease HospitalSchool of MedicineTongji UniversityShanghaiChina
| | - S. Lu
- Sexually Transmitted Disease InstituteShanghai Skin Disease HospitalSchool of MedicineTongji UniversityShanghaiChina
| | - Y. Qian
- Sexually Transmitted Disease InstituteShanghai Skin Disease HospitalSchool of MedicineTongji UniversityShanghaiChina
| | - W. Gong
- Sexually Transmitted Disease InstituteShanghai Skin Disease HospitalSchool of MedicineTongji UniversityShanghaiChina
| | - P. Zhou
- Sexually Transmitted Disease InstituteShanghai Skin Disease HospitalSchool of MedicineTongji UniversityShanghaiChina
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20
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Mwatelah R, McKinnon LR, Baxter C, Abdool Karim Q, Abdool Karim SS. Mechanisms of sexually transmitted infection-induced inflammation in women: implications for HIV risk. J Int AIDS Soc 2019; 22 Suppl 6:e25346. [PMID: 31468677 PMCID: PMC6715949 DOI: 10.1002/jia2.25346] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 06/20/2019] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Globally, sexually transmitted infections (STI) affect >300 million people annually, and are a major cause of sexual and reproductive health complications in women. In this commentary, we describe how STIs interact with the immune and non-immune cells, both within and below the cervicovaginal mucosal barrier, to cause inflammation, which in turn has been associated with increased HIV acquisition risk. DISCUSSION STIs have a major impact on the female genital mucosa, which is an important biological and physical barrier that forms the first line of defence against invading microorganisms such as HIV. Pattern recognition of STI pathogens, by receptors expressed either on the cell surface or inside the cell, typically triggers inflammation at the mucosal barrier. The types of mucosal responses vary by STI, and can be asymptomatic or culminate in the formation of discharge, ulcers and/or warts. While the aim of this response is to clear the invading microbes, in many cases these responses are either evaded or cause pathology that impairs barrier integrity and increases HIV access to target cells in the sub-mucosa. In addition, innate responses to STIs can result in an increased number of immune cells, including those that are the primary targets of HIV, and may contribute to the association between STIs and increased susceptibility to HIV acquisition. Many of these cells are mediators of adaptive immunity, including tissue-resident cells that may also display innate-like functions. Bacterial vaginosis (BV) is another common cause of inflammation, and evidence for multiple interactions between BV, STIs and HIV suggest that susceptibility to these conditions should be considered in concert. CONCLUSIONS STIs and other microbes can induce inflammation in the genital tract, perturbing the normal robust function of the mucosal barrier against HIV. While the impact of STIs on the mucosal immune system and HIV acquisition is often under-appreciated, understanding their interactions of the infections with the immune responses play an important role in improving treatment and reducing the risk of HIV acquisition. The frequent sub-clinical inflammation associated with STIs underscores the need for better STI diagnostics to reverse the immunological consequences of infection.
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Affiliation(s)
- Ruth Mwatelah
- Department of Medical Microbiology and Infectious DiseasesUniversity of ManitobaWinnipegCanada
| | - Lyle R McKinnon
- Department of Medical Microbiology and Infectious DiseasesUniversity of ManitobaWinnipegCanada
- Centre for the AIDS Programme of Research in South Africa (CAPRISA)University of KwaZulu‐NatalDurbanSouth Africa
| | - Cheryl Baxter
- Centre for the AIDS Programme of Research in South Africa (CAPRISA)University of KwaZulu‐NatalDurbanSouth Africa
| | - Quarraisha Abdool Karim
- Centre for the AIDS Programme of Research in South Africa (CAPRISA)University of KwaZulu‐NatalDurbanSouth Africa
- Department of EpidemiologyColumbia UniversityNew YorkNYUSA
| | - Salim S Abdool Karim
- Centre for the AIDS Programme of Research in South Africa (CAPRISA)University of KwaZulu‐NatalDurbanSouth Africa
- Department of EpidemiologyColumbia UniversityNew YorkNYUSA
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21
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Liu LL, Liu WN, Jiang XY, Jun-Ren, Chen MH, Liu ZJ, Lin Y, Zhu SG, Lin LR, Zheng WH, Yan JH, Yang TC. Changes of T lymphocyte subsets in patients with HIV-negative symptomatic neurosyphilis. Microb Pathog 2019; 130:213-218. [DOI: 10.1016/j.micpath.2019.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 01/31/2019] [Accepted: 03/06/2019] [Indexed: 10/27/2022]
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22
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Guo N, Liu L, Yang X, Song T, Li G, Li L, Jiang T, Gao Y, Zhang T, Su B, Wu H. Immunological Changes in Monocyte Subsets and Their Association With Foxp3 + Regulatory T Cells in HIV-1-Infected Individuals With Syphilis: A Brief Research Report. Front Immunol 2019; 10:714. [PMID: 31024549 PMCID: PMC6465566 DOI: 10.3389/fimmu.2019.00714] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 03/18/2019] [Indexed: 12/11/2022] Open
Abstract
The incidence of syphilis has increased dramatically in men who have sex with men (MSM), especially those with HIV-1 infection. Treponema pallidum and HIV-1 are bidirectionally synergistic, accelerating disease progression reciprocally in co-infected individuals. We have shown that monocytes have different effects on T helper cells at different stages of HIV-1 infection. However, the immunological changes in the three monocyte subsets and in regulatory T cells (Tregs), and the associations between these cell types during syphilis infection among HIV-1-infected MSM remain unclear. Herein, we used cell staining methods to explore changes in monocyte subsets and Tregs and any associations between these cells. We found that the frequency of classical monocytes was higher in the rapid plasma reagin (RPR+) group than in the healthy controls (HCs) and the chronic HIV-1 infection (CHI) plus RPR+ (CHI&RPR+) group. The frequencies of Foxp3+CD25+CD45RA+ and Foxp3+Helios+CD45RA+ Tregs were significantly higher in the RPR+, CHI, and CHI&RPR+ groups than in HCs, whereas the frequency of CD45RA+ Tregs was lower in the CHI&RPR+ group than in CHI group. The frequencies of Foxp3+CD25+CD45RO+ and Foxp3+Helios+CD45RO+ Tregs were lower in the RPR+, CHI, and CHI&RPR+ groups than in HCs. The frequency of intermediate monocytes was inversely correlated with the frequency of CD45RA+ Tregs and positively correlated with the frequency of CD45RO+ Tregs. These results demonstrate for the first time that intermediate monocytes control the differentiation of Treg subsets in Treponema pallidum/HIV-1 co-infections. These findings provide new insights into an immunological mechanism involving monocytes/Tregs in HIV-infected individuals with syphilis.
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Affiliation(s)
- Na Guo
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Lifeng Liu
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Xiaodong Yang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Ting Song
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Guanxin Li
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Li Li
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Taiyi Jiang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Yanqing Gao
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Tong Zhang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Bin Su
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Hao Wu
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
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23
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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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24
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Sun J, Meng Z, Wu K, Liu B, Zhang S, Liu Y, Wang Y, Zheng H, Huang J, Zhou P. Tracing the origin of Treponema pallidum in China using next-generation sequencing. Oncotarget 2018; 7:42904-42918. [PMID: 27344187 PMCID: PMC5189996 DOI: 10.18632/oncotarget.10154] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 06/01/2016] [Indexed: 12/29/2022] Open
Abstract
Syphilis is a systemic sexually transmitted disease caused by Treponema pallidum ssp. pallidum (TPA). The origin and genetic background of Chinese TPA strains remain unclear. We identified a total of 329 single-nucleotide variants (SNVs) in eight Chinese TPA strains using next-generation sequencing. All of the TPA strains were clustered into three lineages, and Chinese TPA strains were grouped in Lineage 2 based on phylogenetic analysis. The phylogeographical data showed that TPA strains originated earlier than did T. pallidum ssp. pertenue (TPE) and T. pallidum ssp. endemicum (TPN) strains and that Chinese TPA strains might be derived from recombination between Lineage 1 and Lineage 3. Moreover, we found through a homology modeling analysis that a nonsynonymous substitution (I415F) in the PBP3 protein might affect the structural flexibility of PBP3 and the binding constant for substrates based on its possible association with penicillin resistance in T. pallidum. Our findings provide new insight into the molecular foundation of the evolutionary origin of TPA and support the development of novel diagnostic/therapeutic technology for syphilis.
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Affiliation(s)
- Jun Sun
- STD Institute, Shanghai Skin Disease Hospital, Shanghai, China
| | - Zhefeng Meng
- Oncology Bioinformatics Center, Minhang Hospital, Fudan University, Shanghai, China
| | - Kaiqi Wu
- School of Laboratory Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Biao Liu
- School of Laboratory Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Sufang Zhang
- Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University, Shanghai, China
| | - Yudan Liu
- Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University, Shanghai, China
| | - Yuezhu Wang
- Shanghai-MOST Key Laboratory for Disease and Health Genomics, Chinese National Human Genome Center and National Engineering Center for Biochip at Shanghai, Shanghai, China
| | - Huajun Zheng
- Shanghai-MOST Key Laboratory for Disease and Health Genomics, Chinese National Human Genome Center and National Engineering Center for Biochip at Shanghai, Shanghai, China
| | - Jian Huang
- Shanghai-MOST Key Laboratory for Disease and Health Genomics, Chinese National Human Genome Center and National Engineering Center for Biochip at Shanghai, Shanghai, China.,Key Laboratory of Systems Biomedicine (Ministry of Education) and Collaborative Innovation Center of Systems Biomedicine, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Pingyu Zhou
- STD Institute, Shanghai Skin Disease Hospital, Shanghai, China.,Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University, Shanghai, China
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25
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Drago F, Javor S, Parodi A. Relevance in biology and mechanisms of immune and treatment evasion of Treponema pallidum. GIORN ITAL DERMAT V 2017; 154:573-580. [PMID: 29199801 DOI: 10.23736/s0392-0488.17.05830-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
INTRODUCTION During syphilis a compelling fight is engaged between the host's humoral and cellular immune responses that work to eliminate the infection and Treponema pallidum (T. pallidum) that manages to evade eradication and cause chronic infection. Different mechanisms are utilized by treponemes to overcome immunological response. Although penicillin (BPG) proved to be effective in quelling the early manifestations of the disease and consequently its contagiousness, questions remain about its ability to prevent the late complications and to provide a microbiological eradication in vivo. In fact, both serological and microbiological failures have been reported following conventional treatment. EVIDENCE ACQUISITION We reviewed some biologic properties of T. pallidum in order to establish a relationship with the persistence of the infection and the alleged treatment resistance. EVIDENCE SYNTHESIS The host humoral response, sometimes, may not protect completely against T. pallidum and accounts for the persistent infection and tertiary damages. In fact, the cell mediated response during infection may be downregulate in response to pathogen-derived molecules, or indirectly by generating Treg cells. It is also possible that there are strain types of T. pallidum with higher ability of evasion determining neurosyphilis. In addition, apart the impressive results that BPG has made on the syphilis cutaneous lesions, concerns still remain on its efficacy in preventing late complications. CONCLUSIONS Understanding the biology of the T. pallidum may help researchers in this field to develop future target therapies in order to prevent persistent infection and progression of the disease.
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Affiliation(s)
- Francesco Drago
- Section of Dermatology, Department of Health Sciences, San Martino University Hospital IRCCS, University of Genoa, Genoa, Italy
| | - Sanja Javor
- Section of Dermatology, Department of Health Sciences, San Martino University Hospital IRCCS, University of Genoa, Genoa, Italy -
| | - Aurora Parodi
- Section of Dermatology, Department of Health Sciences, San Martino University Hospital IRCCS, University of Genoa, Genoa, Italy
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26
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Yu Q, Cheng Y, Wang Y, Wang C, Lu H, Guan Z, Huang J, Gong W, Shi M, Ni L, Wu J, Peng R, Zhou P. Aberrant Humoral Immune Responses in Neurosyphilis: CXCL13/CXCR5 Play a Pivotal Role for B-Cell Recruitment to the Cerebrospinal Fluid. J Infect Dis 2017; 216:534-544. [PMID: 28931218 DOI: 10.1093/infdis/jix233] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 05/22/2017] [Indexed: 12/29/2022] Open
Abstract
Background Previous studies documented that humoral immune responses participated in neurological damage in neurosyphilis patients. However, the mechanisms that trigger and maintain humoral immunity involved in neurosyphilis remain unknown. Methods Using flow cytometry, expression of B cells was measured in neurosyphilis and non-neurosyphilis. Expression of immunoglobulin indices and chemokine ligand CXCL13 was detected by enzyme-linked immunosorbent assay. The migration and inhibition assays were evaluated by modified chamber assays. The presence of CXCL13+ cells, cluster of differentiation (CD)20+ B cells, CD3+ T cells, CD138+ plasma cells and CD35+ follicular dendritic cells was studied by immunohistochemistry. Results Enrichment of B cells was observed and activated in the cerebrospinal fluid (CSF) of neurosyphilis patients. Immunoglobulin indices were increased and associated with the progress to neurosyphilis. High expression of CSF CXCL13 mediated B cell migration both in vitro and in vivo. There was a positive correlation among the CSF B cells, immunoglobulin indices, and CSF CXCL13 levels. Ectopic germinal centers (EGCs), important structures for humoral immunity, were observed in the intracranial syphilitic gumma. Conclusions CXCL13/CXCR5 mediated the aggregation of B cells, that directed the aberrant humoral immune responses via the formation of EGCs, which suggests a molecular mechanism of neurological damage in neurosyphilis.
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Affiliation(s)
- Qian Yu
- Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University
| | - Yuanyuan Cheng
- Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University
| | - Yuanyuan Wang
- Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University
| | - Cuini Wang
- STD Institute, Shanghai Skin Disease Hospital
| | - Haikong Lu
- STD Institute, Shanghai Skin Disease Hospital
| | | | - Jian Huang
- Key Laboratory of Systems Biomedicine (Ministry of Education) and Collaborative Innovation Center of Systems Biomedicine, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, People's Republic of China
| | | | - Mei Shi
- STD Institute, Shanghai Skin Disease Hospital
| | - Liyan Ni
- STD Institute, Shanghai Skin Disease Hospital
| | - Juan Wu
- STD Institute, Shanghai Skin Disease Hospital
| | - Ruirui Peng
- STD Institute, Shanghai Skin Disease Hospital
| | - Pingyu Zhou
- Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University.,STD Institute, Shanghai Skin Disease Hospital
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27
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Duffy SS, Keating BA, Perera CJ, Moalem-Taylor G. The role of regulatory T cells in nervous system pathologies. J Neurosci Res 2017; 96:951-968. [DOI: 10.1002/jnr.24073] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 03/28/2017] [Accepted: 04/06/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Samuel S. Duffy
- School of Medical Sciences; University of New South Wales UNSW; Sydney Australia
| | - Brooke A. Keating
- School of Medical Sciences; University of New South Wales UNSW; Sydney Australia
| | - Chamini J. Perera
- School of Medical Sciences; University of New South Wales UNSW; Sydney Australia
| | - Gila Moalem-Taylor
- School of Medical Sciences; University of New South Wales UNSW; Sydney Australia
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28
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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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29
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Wang C, Wu K, Yu Q, Zhang S, Gao Z, Liu Y, Ni L, Cheng Y, Guan Z, Shi M, Lu H, Lou Y, Zhou P. CXCL13, CXCL10 and CXCL8 as Potential Biomarkers for the Diagnosis of Neurosyphilis Patients. Sci Rep 2016; 6:33569. [PMID: 27650493 PMCID: PMC5030708 DOI: 10.1038/srep33569] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 08/23/2016] [Indexed: 01/03/2023] Open
Abstract
At present, diagnosis for neurosyphilis remains a major clinical challenge. Venereal Disease Research Laboratory (VDRL) titer of the cerebrospinal fluid (CSF) is suboptimally sensitive to diagnose neurosyphilis, which can be negative in neurosyphilis patients, especially in asymptomatic neurosyphilis patients. In the search for biomarkers of neurosyphilis, we investigated the chemokine profile in CSF of neurosyphilis patients and found that the concentrations of CXCL13, CXCL10 and CXCL8 were selectively elevated in neurosyphilis patients and correlated with CSF protein concentration and CSF-VDRL titer. After antibiotic treatment, the concentration of these chemokines was dramatically reduced. The area under the ROC curve (AUC) of CSF CXCL13, CXCL8,CXCL10 and the CSF/serum ratio of CXCL13, CXCL8,CXCL10 in the diagnosis of neurosyphilis were 0.940, 0.899, 0.915, 0.963, 0.846 and 0.926, respectively. The corresponding sensitivities/specificities of CSF CXCL13, CXCL8,CXCL10 and the CSF/serum ratio of CXCL13, CXCL8,CXCL10 in diagnosis of neurosyphilis were 85.4%/89.1%, 79%/90.1% and 79.6%/91.1%, 86.6%/99%, 79%/73.3% and 86%/92.1%, respectively. Our results suggest that the elevated concentrations of CXCL13, CXCL8, and CXCL10 or their increasing CSF/serum ratios may be potential biomarkers of neurosyphilis, particularly for asymptomatic neurosyphilis. Reduced concentration of these chemokines may indicate the prognosis of antibiotic therapy.
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Affiliation(s)
- Cuini Wang
- STD Institute, Shanghai Skin Disease Hospital, Shanghai, P. R. China
| | - Kaiqi Wu
- School of Laboratory Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qian Yu
- Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University, Shanghai, P. R. China
| | - Sufang Zhang
- Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University, Shanghai, P. R. China
| | - Zixiao Gao
- Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University, Shanghai, P. R. China
| | - Yudan Liu
- Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University, Shanghai, P. R. China
| | - Liyan Ni
- STD Institute, Shanghai Skin Disease Hospital, Shanghai, P. R. China
| | - Yuanyuan Cheng
- Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University, Shanghai, P. R. China
| | - Zhifang Guan
- STD Institute, Shanghai Skin Disease Hospital, Shanghai, P. R. China
| | - Mei Shi
- STD Institute, Shanghai Skin Disease Hospital, Shanghai, P. R. China
| | - Haikong Lu
- STD Institute, Shanghai Skin Disease Hospital, Shanghai, P. R. China
| | - Yongliang Lou
- School of Laboratory Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Pingyu Zhou
- STD Institute, Shanghai Skin Disease Hospital, Shanghai, P. R. China.,Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University, Shanghai, P. R. China
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Yu N, Zhang QQ, Zhang K, Xie Y, Zhu HQ, Lin XJ, Di Q. Comparative study of CD4 and CD45RO T cells and CD20 B cells in cerebrospinal fluid of syphilitic meningitis and tuberculous meningitis patients. APMIS 2016; 124:764-9. [PMID: 27467195 DOI: 10.1111/apm.12572] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 05/30/2016] [Indexed: 12/11/2022]
Abstract
This study was to investigate the differences of lymphocyte in the cerebrospinal fluid (CSF) of patients with syphilis meningitis (SM) and tuberculous meningitis (TBM) for new diagnostic insights. Totally, 79 cases of SM and 45 cases of TBM were enrolled. In the CSF, the CD4, CD45RO or CD20 positive lymphocytes were detected by immunohistochemistry. The proportion of CD4 T cells in the CSF lymphocytes in patients with SM was significantly higher than that in patients with TBM (p < 0.05). After medical therapy, there was a significantly decline trend of the CD4 T-cell proportion in both groups (p < 0.05). The proportion of CD45RO T cells in CSF lymphocytes of patients with SM was less than that of patients with TBM (p < 0.05). After medical therapy, the positive ratio of CD45RO T cells was increased in the CSF of both group patients (p < 0.05). The proportion of CD20B cells in the CSF lymphocytes was not obviously different between the two groups during every stage. In conclusion, there are strong differences of CD4 and CD45RO T-cell ratio, but not the CD20 B cells in the meningitis. CD4 and CD45RO T cells in CSF are a useful complement in differentially diagnosing SM and TBM; it contributes to further understand the pathogenesis and prognosis of SM and TBM.
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Affiliation(s)
- Nian Yu
- Department of Neurology, Nanjing Medical University, Affiliated Nanjing Brain Hospital, Nanjing, China
| | - Qiao-Quan Zhang
- Department of Pathology, Nanjing Medical University, Affiliated Nanjing Brain Hospital, Nanjing, China
| | - Kang Zhang
- Department of Neurology, Nanjing Medical University, Affiliated Nanjing Brain Hospital, Nanjing, China
| | - Yuan Xie
- Department of Pathology, Nanjing Medical University, Affiliated Nanjing Brain Hospital, Nanjing, China
| | - Hai-Qing Zhu
- Department of Pathology, Nanjing Medical University, Affiliated Nanjing Brain Hospital, Nanjing, China
| | - Xing-Jian Lin
- Department of Neurology, Nanjing Medical University, Affiliated Nanjing Brain Hospital, Nanjing, China
| | - Qing Di
- Department of Neurology, Nanjing Medical University, Affiliated Nanjing Brain Hospital, Nanjing, China
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Drago F, Merlo G, Ciccarese G, Agnoletti AF, Cozzani E, Rebora A, Parodi A. Changes in neurosyphilis presentation: a survey on 286 patients. J Eur Acad Dermatol Venereol 2016; 30:1886-1900. [PMID: 27306850 DOI: 10.1111/jdv.13753] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 01/06/2016] [Indexed: 11/28/2022]
Abstract
Although neurosyphilis (NS) keeps plaguing worldwide, often with oligosymptomatic and atypical manifestations, the most recent reports fail to provide useful information, like details of the clinical history and even of the previous early therapy. We conducted a survey of the literature of the last 5 years on the clinical presentation of NS, recording the aforementioned inaccuracies. One hundred and thirty-seven articles were collected, reporting on 286 patients. General paresis was the commonest form (49%), often manifesting with cognitive impairment and psychiatric symptoms. Syphilitic meningitis was found in 63 patients (22%), mainly with ocular or auditory involvement. Meningovascular and tabetic form were both found in 12% of cases. Gummatous and epileptic manifestations were rare. Perusal of the literature confirms that NS prevalence is increasing, often with manifestations that are atypical for timing and type of lesions. Unfortunately, many articles are lacking of critical information, like an accurate clinical history and timing of the therapy making difficult to assess the effectiveness of penicillin in preventing NS.
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Affiliation(s)
- F Drago
- Di.S.Sal. Section of Dermatology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy
| | - G Merlo
- Di.S.Sal. Section of Dermatology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy.
| | - G Ciccarese
- Di.S.Sal. Section of Dermatology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy
| | - A F Agnoletti
- Di.S.Sal. Section of Dermatology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy
| | - E Cozzani
- Di.S.Sal. Section of Dermatology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy
| | - A Rebora
- Di.S.Sal. Section of Dermatology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy
| | - A Parodi
- Di.S.Sal. Section of Dermatology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy
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Zhao J, Ma J, Zhang X, Li Q, Yang X. Equilibrium of Treg/Th17 cells of peripheral blood in syphilitic patients with sero-resistance. Exp Ther Med 2016; 11:2300-2304. [PMID: 27284313 PMCID: PMC4887784 DOI: 10.3892/etm.2016.3178] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 03/22/2016] [Indexed: 12/31/2022] Open
Abstract
The aim of the present study was to examine changes of cellular homeostasis in regulatory T (Treg) and T helper 17 (Th17) cells by detecting the proportion of Treg and Th17 cells of peripheral blood, as well as the expression of specific transcription factors in these two types of cells, in syphilitic patients with sero-resistance. A total of 49 subjects were enrolled in the study and divided into two groups, comprising 26 cases of sero-resistant syphilitic patients in the experimental group, and 23 cases of healthy donors in the normal control group. Flow cytometry was applied to examine the proportion of Treg and Th17 cells, as well as the quantitative expression of relevant specific transcription factors [forkhead box P3 (Foxp3) and retinoic acid-related orphan receptor γt (ROR-γt)] in the two groups. A correlation analysis was subsequently performed. The results showed that in syphilitic patients with sero-resistance, the proportion of peripheral blood Treg cells was obviously higher than that of the normal control group (p<0.01) and the proportion of Th17 cells was significantly lower than that of the normal control group (p<0.01). In addition, the expression of transcription factor Foxp3 in CD4+ T cells was higher than that of the normal control group, while the expression of ROR-γt was lower than that of the normal control (p<0.05). The expression of Foxp3 and ROR-γt in peripheral blood CD4+ T cells had a negative correlation (r=-0.481, p<0.01). In conclusion, the peripheral blood of syphilitic patients with sero-resistance may have abnormalities in Treg/Th17 cellular balance.
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Affiliation(s)
- Jianbin Zhao
- Department of Dermatology, The First People's Hospital of Xuzhou, Xuzhou, Jiangsu 221002, P.R. China
| | - Jie Ma
- Department of Dermatology, The First People's Hospital of Xuzhou, Xuzhou, Jiangsu 221002, P.R. China
| | - Xiaoyan Zhang
- Department of Dermatology, The First People's Hospital of Xuzhou, Xuzhou, Jiangsu 221002, P.R. China
| | - Qing Li
- Department of Dermatology, The First People's Hospital of Xuzhou, Xuzhou, Jiangsu 221002, P.R. China
| | - Xueping Yang
- Department of Dermatology, The First People's Hospital of Xuzhou, Xuzhou, Jiangsu 221002, P.R. China
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Affiliation(s)
- Francesco Drago
- DISSAL, Department of Dermatology, IRCCS A.O.U. San Martino-IST, Largo Rosanna Benzi, Genoa, Italy
| | - Sanja Javor
- DISSAL, Department of Dermatology, IRCCS A.O.U. San Martino-IST, Largo Rosanna Benzi, Genoa, Italy
| | - Aurora Parodi
- DISSAL, Department of Dermatology, IRCCS A.O.U. San Martino-IST, Largo Rosanna Benzi, Genoa, Italy
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34
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Lu P, Zheng DC, Fang C, Huang JM, Ke WJ, Wang LY, Zeng WY, Zheng HP, Yang B. Cytokines in cerebrospinal fluid of neurosyphilis patients: Identification of Urokinase plasminogen activator using antibody microarrays. J Neuroimmunol 2015; 293:39-44. [PMID: 27049560 DOI: 10.1016/j.jneuroim.2015.12.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 12/11/2015] [Accepted: 12/22/2015] [Indexed: 12/11/2022]
Abstract
Little is known regarding protein responses to syphilis infection in cerebrospinal fluid (CSF) of patients presenting with neurosyphilis. Protein and antibody arrays offer a new opportunity to gain insights into global protein expression profiles in these patients. Here we obtained CSF samples from 46 syphilis patients, 25 of which diagnosed as having central nervous system involvement based on clinical and laboratory findings. The CSF samples were then analyzed using a RayBioH L-Series 507 Antibody Array system designed to simultaneously analyze 507 specific cytokines. The results indicated that 41 molecules showed higher levels in patients with neurosyphilis in comparison with patients without neural involvement. For validation by single target ELISA, we selected five of them (MIP-1a, I-TAC/CXCL11, Urokinase plasminogen activator [uPA], and Oncostatin M) because they have previously been found to be involved in central nervous system (CNS) disorders. The ELISA tests confirmed that uPA levels were significantly higher in the CSF of neurosyphilis patients (109.1±7.88pg/ml) versus patients without CNS involvement (63.86±4.53pg/ml, p<0.0001). There was also a clear correlation between CSF uPA levels and CSF protein levels (p=0.0128) as well as CSF-VDRL titers (p=0.0074) used to diagnose neurosyphilis. No significant difference between the two groups of patients, however, was found in uPA levels in the serum, suggesting specific activation of the inflammatory system in the CNS but not the periphery in neurosyphilis patients. We conclude that measurements of uPA levels in CSF may be an additional parameter for diagnosing neurosyphilis.
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Affiliation(s)
- Ping Lu
- Guangdong Provincial Center for STI & Skin Diseases Control and Prevention, Guangzhou 510091, China
| | - Dao-Cheng Zheng
- Guangdong Provincial Center for STI & Skin Diseases Control and Prevention, Guangzhou 510091, China
| | - Chang Fang
- Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jin-Mei Huang
- Guangdong Provincial Center for STI & Skin Diseases Control and Prevention, Guangzhou 510091, China
| | - Wu-Jian Ke
- Guangdong Provincial Center for STI & Skin Diseases Control and Prevention, Guangzhou 510091, China
| | - Liu-Yuan Wang
- Guangdong Provincial Center for STI & Skin Diseases Control and Prevention, Guangzhou 510091, China
| | - Wei-Ying Zeng
- Guangdong Provincial Center for STI & Skin Diseases Control and Prevention, Guangzhou 510091, China
| | - He-Ping Zheng
- Guangdong Provincial Center for STI & Skin Diseases Control and Prevention, Guangzhou 510091, China
| | - Bin Yang
- Guangdong Provincial Center for STI & Skin Diseases Control and Prevention, Guangzhou 510091, China.
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Shi M, Peng RR, Gao Z, Zhang S, Lu H, Guan Z, Gao Y, Wang C, Zhou P. Risk profiles of neurosyphilis in HIV-negative patients with primary, secondary and latent syphilis: implications for clinical intervention. J Eur Acad Dermatol Venereol 2015; 30:659-66. [PMID: 26660338 DOI: 10.1111/jdv.13514] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 10/01/2015] [Indexed: 11/26/2022]
Affiliation(s)
- M. Shi
- Department of Sexually Transmitted Disease Institute; Shanghai Skin Disease Hospital; Shanghai China
| | - R.-R. Peng
- Department of Sexually Transmitted Disease Institute; Shanghai Skin Disease Hospital; Shanghai China
| | - Z. Gao
- Department of Sexually Transmitted Disease Institute; Shanghai Skin Disease Hospital; Shanghai China
- Clinical School of Anhui Medical University; Anhui Medical University; Hefei Anhui China
| | - S. Zhang
- Department of Sexually Transmitted Disease Institute; Shanghai Skin Disease Hospital; Shanghai China
- Clinical School of Anhui Medical University; Anhui Medical University; Hefei Anhui China
| | - H. Lu
- Department of Sexually Transmitted Disease Institute; Shanghai Skin Disease Hospital; Shanghai China
| | - Z. Guan
- Department of Sexually Transmitted Disease Institute; Shanghai Skin Disease Hospital; Shanghai China
| | - Y. Gao
- Department of Sexually Transmitted Disease Institute; Shanghai Skin Disease Hospital; Shanghai China
| | - C. Wang
- Department of Sexually Transmitted Disease Institute; Shanghai Skin Disease Hospital; Shanghai China
| | - P. Zhou
- Department of Sexually Transmitted Disease Institute; Shanghai Skin Disease Hospital; Shanghai China
- Clinical School of Anhui Medical University; Anhui Medical University; Hefei Anhui China
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Wang Q, Gao X, Yuan Z, Wang Z, Meng Y, Cao Y, Plotnikoff NP, Griffin N, Shan F. Methionine enkephalin (MENK) improves lymphocyte subpopulations in human peripheral blood of 50 cancer patients by inhibiting regulatory T cells (Tregs). Hum Vaccin Immunother 2015; 10:1836-40. [PMID: 25424790 DOI: 10.4161/hv.28804] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
MENK, a penta-peptide is considered as being involved in the regulatory feedback loop between the immune and neuroendocrine systems, with marked modulation of various functions of human immune cells. The aim of the present work was to investigate change of lymphocyte subpopulations in peripheral blood of 50 cancer patients before and after treatment with MENK. Peripheral blood mononuclear cells (PBMCs) of peripheral blood from 50 cancer patients were isolated by density gradient centrifugation using Ficoll-Paque solution and cultured with MENK. We measured proliferation of total nucleated cells, subpopulations of individual CD4+T cells, CD8+T cells, CD4+CD25+ regulatory T cells (Treg), natural killer cells (NK) before and after treatment with 10(-12)M MENK in cell culture by flow cytometry (FCM). Our results indicated that MENK showed a strong inhibiting effect on Treg cells while it stimulated marked proliferation of other lymphocyte subpopulations. All data obtained were of significance statistically. It was therefore concluded that MENK could work as a strong immune booster with great potential in restoring damaged human immune system and we could consider MENK as a drug to treat cancer patients, whose immune systems are damaged by chemotherapy or radiotherapy. Furthermore we could consider MENK as a chemotherapy additive, which would sustain immune system of cancer patients during the process of chemotherapy to get maximized efficacy with minimized side effect.
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Affiliation(s)
- Qiushi Wang
- a Department of Cord Blood Bank, Shengjing Hospital; China Medical University; Heping District, Shenyang, PR China
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37
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Pastuszczak M, Jakiela B, Jaworek AK, Wypasek E, Zeman J, Wojas-Pelc A. Association of Interleukin-10 promoter polymorphisms with neurosyphilis. Hum Immunol 2015; 76:469-72. [PMID: 26100683 DOI: 10.1016/j.humimm.2015.06.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 06/16/2015] [Indexed: 11/19/2022]
Abstract
Interleukin 10 (IL-10) is a potent anti-inflammatory cytokine. Increased production of IL-10 has been found in late syphilis, presumably creating favorable conditions for bacteria persistence. Single-nucleotide polymorphisms (SNPs) within the promoter of IL-10 gene have been found to influence IL-10 production. We investigated whether SNPs in the IL-10 gene promoter are associated with cerebrospinal fluid (CSF) levels of IL-10 and neurosyphilis. Polymorphisms in the gene for IL-10 (G→A mutation at the position -1084 and C→A mutation at the position -592) were sought in 35 patients with syphilis and 24 healthy volunteers. CSF examination (i.e. routine laboratory tests and IL-10 levels) was performed in all syphilis patients. Neurosyphilis was defined as reactive CSF VDRL test or CSF white blood cells⩾5/μL and CSF protein concentration⩾45mg/dL. Overall, 31% of patients with syphilis had neurosyphilis. CSF IL-10 levels were significantly higher in patients with neurosyphilis when compared to those with syphilis but not neurosyphilis. -1082 GG and -592 CC genotypes were significantly associated with higher CSF IL-10 levels. Moreover, these genotypes were found to be more frequent in individuals with neurosyphilis in comparison to those without neurosyphilis. Anti-inflammatory immune response seems to be important in pathogenesis of neurosyphilis. Our data suggest that host-related factors, such as SNPs of immune regulatory genes may influence the susceptibility to neurosyphilis.
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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
| | | | - Ewa Wypasek
- Institute of Cardiology, Jagiellonian University School of Medicine, Cracow, Poland
| | - Jacek Zeman
- Department of Dermatology, Jagiellonian University School of Medicine, Cracow, Poland
| | - Anna Wojas-Pelc
- Department of Dermatology, Jagiellonian University School of Medicine, Cracow, Poland
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38
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Wang C, Zhu L, Gao Z, Guan Z, Lu H, Shi M, Gao Y, Xu H, Yang XF, Zhou P. Increased interleukin-17 in peripheral blood and cerebrospinal fluid of neurosyphilis patients. PLoS Negl Trop Dis 2014; 8:e3004. [PMID: 25080350 PMCID: PMC4117445 DOI: 10.1371/journal.pntd.0003004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 06/02/2014] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Treponema pallidum infection evokes vigorous immune responses, resulting in tissue damage. Several studies have demonstrated that IL-17 may be involved in the pathogenesis of syphilis. However, the role of Th17 response in neurosyphilis remains unclear. METHODOLOGY/PRINCIPAL FINDINGS In this study, Th17 in peripheral blood from 103 neurosyphilis patients, 69 syphilis patients without neurological involvement, and 70 healthy donors were analyzed by flow cytometry. The level of IL-17 in cerebrospinal fluid (CSF) was quantified by ELISA. One-year follow up for 44 neurosyphilis patients was further monitored to investigate the role of Th17/IL-17 in neurosyphilis. We found that the frequency of Th17 cells was significantly increased in peripheral blood of patients with neurosyphilis, in comparison to healthy donors. IL-17 in CSF were detected from 55.3% neurosyphilis patients (in average of 2.29 (0-59.83) pg/ml), especially in those with symptomatic neurosyphilis (61.9%). CSF IL-17 was predominantly derived from Th17 cells in neurosyphilis patients. Levels of IL-17 in CSF of neurosyphilis patients were positively associated with total CSF protein levels and CSF VDRL (Venereal Disease Research Laboratory) titers. Notably, neurosyphilis patients with undetectable CSF IL-17 were more likely to confer to CSF VDRL negative after treatment. CONCLUSIONS These findings indicate that Th17 response may be involved in central nervous system damage and associated with clinical symptoms in neurosyphilis patients. Th17/IL-17 may be used as an alternative surrogate marker for assessing the efficacy of clinical treatment of neurosyphilis patients.
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Affiliation(s)
- Cuini Wang
- STD Institute, Shanghai Skin Disease Hospital, Shanghai, People′s Republic of China
| | - Lin Zhu
- Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University, Shanghai, People′s Republic of China
| | - Zixiao Gao
- Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University, Shanghai, People′s Republic of China
| | - Zhifang Guan
- STD Institute, Shanghai Skin Disease Hospital, Shanghai, People′s Republic of China
| | - Haikong Lu
- STD Institute, Shanghai Skin Disease Hospital, Shanghai, People′s Republic of China
| | - Mei Shi
- STD Institute, Shanghai Skin Disease Hospital, Shanghai, People′s Republic of China
| | - Ying Gao
- STD Institute, Shanghai Skin Disease Hospital, Shanghai, People′s Republic of China
| | - Huanbin Xu
- STD Institute, Shanghai Skin Disease Hospital, Shanghai, People′s Republic of China
| | - X. Frank Yang
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Pingyu Zhou
- STD Institute, Shanghai Skin Disease Hospital, Shanghai, People′s Republic of China
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Marra CM, Sahi SK, Tantalo LC, Ho EL, Dunaway SB, Jones T, Hawn TR. Toll-like receptor polymorphisms are associated with increased neurosyphilis risk. Sex Transm Dis 2014; 41:440-6. [PMID: 24922103 PMCID: PMC4414322 DOI: 10.1097/olq.0000000000000149] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Single-nucleotide polymorphisms (SNPs) in toll-like receptors (TLR) 1, 2, and 6 impair cell signaling in response to spirochetal lipoproteins. We investigated whether common SNPs in TLR1, TLR2, or TLR6 were associated with laboratory- or clinically-defined neurosyphilis. METHODS Polymorphisms in the genes for TLR1 (a T→G mutation at position 1805), TLR2 (a G→A mutation at position 2258), and TLR6 (a C→T mutation at position 745) were sought in 456 white patients with syphilis. Laboratory-defined neurosyphilis included a reactive cerebrospinal fluid (CSF)-Venereal Disease Research Laboratory (VDRL) test. Clinically-defined neurosyphilis included new vision or hearing loss. Controls had CSF white blood cells of 5/μL or less, nonreactive CSF-Venereal Disease Research Laboratory, and no vision or hearing loss. RESULTS Overall, 26.2% of patients had laboratory-defined and 36.2% had clinically-defined neurosyphilis. Compared with controls, patients with any of the 3 SNPs were more likely to have laboratory-defined neurosyphilis. Those with TLR2 or TLR6 SNPs were more likely to have clinically-defined neurosyphilis. These associations were independent of serum rapid plasma reagin titer. CONCLUSIONS A common TLR1 polymorphism is associated with an increased risk of laboratory-defined neurosyphilis, and common TLR2 and TLR6 polymorphisms are associated with an increased risk of both laboratory- and clinically-defined neurosyphilis. These data suggest that host factors impact the natural history of syphilis.
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Affiliation(s)
| | - Sharon K. Sahi
- Department of Neurology, University of Washington, Seattle, WA, USA
| | | | - Emily L. Ho
- Department of Neurology, University of Washington, Seattle, WA, USA
| | | | - Trudy Jones
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Thomas R. Hawn
- Department of Medicine, University of Washington, Seattle, WA, USA
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