Advances in laboratory diagnostic methods for cerebrospinal fluid testing for neurosyphilis

Gao, Zhengxiang; Gou, Yunjiu; Liu, Xiaoqin; Peng, Leiwen

doi:10.3389/fpubh.2022.1030480

Cited by 21 publications

(12 citation statements)

References 64 publications

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“…The non-treponemal tests of CSF mainly include the venereal disease research laboratory (VDRL) test, the rapid plasma reagin (RPR) test and the TRUST test. 16 A meta-analysis showed that the sensitivity of the CSF-VDRL ranged from 49–87.5% and the specificity ranged from 74–100% for diagnosing NS. CSF RPR is 51–82% sensitive and 82–100% specific for diagnosing NS.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Treponema pallidum DNA and CXCL13 in Cerebrospinal Fluid in HIV-Negative Syphilis Patients

Yang

et al. 2022

IDR

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Neurosyphilis (NS) is a chronic infectious disease associated with Treponema pallidum subsp. pallidum (TP) infection of the central nervous system. The purpose of this study was to offer evidence for the diagnosis and treatment of NS by revealing the detection of TP DNA and CXCL13 concentration in the cerebrospinal fluid (CSF) of HIV-negative syphilis patients. Patients and Methods: This study included 75 syphilis patients. The frequency of TP invasion into the CSF was detected by nested PCR. ELISA was performed to detect CSF CXCL13 concentrations, and ROC analysis was performed to assess diagnostic accuracy. Sociodemographic data, clinical symptoms, and laboratory indices of patients were collected. CSF CXCL13 levels and clinical characteristics of syphilis patients were investigated retrospectively. Results: The detection rate of CSF DNA of TP by nested PCR was 5.3% and 16.7% in HIV-negative syphilis patients and NS patients, respectively. There was a significant difference between the NS and non-NS groups in terms of neurological symptoms, CSF TPPA, CSF TRUST, CSF nucleated cells, CSF protein, and CSF CXCL13 levels (P<0.05). ROC curve analysis showed that the AUC for CSF CXCL13 levels was 0.906 (95% CI 0.832-0.981, P <0.0001), with an optimal critical value of 57.85 pg/mL and sensitivity and specificity of 88.89% and 78.95%, respectively. Conclusion: Nested PCR can be used as an auxiliary diagnosis of NS, and CSF CXCL13 >60 pg/mL has high sensitivity and specificity for NS patients and non-NS patients. CXCL13 may be a useful marker to distinguish NS from non-NS syphilis in HIVnegative patients.

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Section: Discussionmentioning

confidence: 99%

Analysis of Treponema pallidum DNA and CXCL13 in Cerebrospinal Fluid in HIV-Negative Syphilis Patients

Yang

et al. 2022

IDR

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“…To present, no VDRL kits in China have received SFDA (State Food and Drug Administration) approval, and the “China National Guidelines for the Diagnosis and Treatment of Syphilis, Gonorrhea and Chlamydia Trachomatis Infection (2020)” suggested the RPR and TRUST for substitute tests ( 34 ). The results of the CSF-FTA-ABS test can be utilized as a diagnostic indicator of neurosyphilis, in accordance with the guidelines for the diagnosis and treatment of syphilis in China, and in the absence of these conditions, the CSF-FTA-ABS test could be substituted with the CSF-TPPA test ( 37 ).…”

Section: Discussionmentioning

confidence: 99%

Performance of the nontreponemal tests and treponemal tests on cerebrospinal fluid for the diagnosis of neurosyphilis: A meta-analysis

Xie

Wang

Zheng

et al. 2023

Front. Public Health

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BackgroundNontreponemal and treponemal tests for analyzing cerebrospinal fluid to confirm the existence of neurosyphilis have been widely used, so we aim to evaluate and compare their performance on the cerebrospinal fluid in the diagnosis of neurosyphilis.MethodsWe conducted a systematic literature search on five databases and utilized a bivariate random-effects model to perform the quantitative synthesis.ResultsNontreponemal tests demonstrated a pooled sensitivity of 0.77 (95% CI: 0.68–0.83), a pooled specificity of 0.99 (95% CI: 0.97–1.00), and a summary AUC of 0.97 (95% CI: 0.95–0.98). The pooled sensitivity, pooled specificity, and summary AUC of treponemal tests were 0.95 (95% CI: 0.90–0.98), 0.85 (95% CI: 0.67–0.94), and 0.97 (95% CI: 0.95–0.98), respectively. The pooled specificity of all nontreponemal tests varied minimally (ranging from 0.97 to 0.99), with TRUST (0.83) having a higher pooled sensitivity than VDRL (0.77) and RPR (0.73). Among all treponemal tests, EIA has outstanding diagnostic performance with a pooled sensitivity of 0.99 and a pooled specificity of 0.98.ConclusionNontreponemal tests exhibited a higher pooled specificity, and treponemal tests exhibited a higher pooled sensitivity in diagnosing neurosyphilis on cerebrospinal fluid. TRUST may be a satisfactory substitute for VDRL. EIA is a prospective diagnostic tool that deserves further study in the future. Our study may be useful to clinical laboratories in selecting appropriate serological tests on the cerebrospinal fluid for the diagnosis of neurosyphilis.

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“…Linear regression analysis was performed using time (x) as the horizontal coordinate and gene copy number concentration (y) as the vertical coordinate. It was evaluated based on eqn (1), according to ISO guide 35.…”

Section: Establishment Of Digital Pcr Rmpmentioning

confidence: 99%

“…33,34 Compared with the current routine method, dPCR has high sensitivity for detecting low levels of Treponema pallidum and the detection rate of TP DNA is not signicantly different in different biological uid samples. 35 dPCR is potentially valuable and powerful for clinical diagnosis, decision-making and treatment options for patients with latent TP infection. The latest assay PCR-LwCas13a, like dPCR, is highly specic and can accurately measure the number of target molecules to provide quantitative information.…”

Section: Evaluation Of Dpcr In a Simulated Stem Cell Matrixmentioning

confidence: 99%

Establishment of reference measurement procedure and reference material for Treponema pallidum

Lin,

Yang,

Wang

et al. 2024

Anal. Methods

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Advances in laboratory diagnostic methods for cerebrospinal fluid testing for neurosyphilis

Cited by 21 publications

References 64 publications

Analysis of Treponema pallidum DNA and CXCL13 in Cerebrospinal Fluid in HIV-Negative Syphilis Patients

Analysis of Treponema pallidum DNA and CXCL13 in Cerebrospinal Fluid in HIV-Negative Syphilis Patients

Performance of the nontreponemal tests and treponemal tests on cerebrospinal fluid for the diagnosis of neurosyphilis: A meta-analysis

Establishment of reference measurement procedure and reference material for Treponema pallidum

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