CARE-NS, a research strategy for neurosyphilis

Du, Fangzhi; Zhang, Xu; Zhang, Ruili; Wang, Qianqiu

doi:10.3389/fmed.2022.1040133

Cited by 2 publications

(3 citation statements)

References 52 publications

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“…Since 2019, the Chinese Center for Disease Control and Center for Sexually Transmitted Disease Control conducted a clinical sentinel surveillance and build a research alliance for nationwide neurosyphilis to comprehend the incidence of neurosyphilis and address key issues concerning clinical management and scientific research of this condition. 7 Hence, it is speculated that the focus of the Chinese government on the prevention and control of neurosyphilis may be accountable for the increased number of research studies in China. Due to the limited number of included studies in certain subgroups, such as those with prospective design, sample sizes less than 200, asymptomatic and symptomatic neurosyphilis, and HIV-infected individuals, it is not possible to calculate the combined diagnostic value.…”

Section: Discussionmentioning

confidence: 99%

“… 6 In recent years, there has been an increased focus on the investigation of diagnostic biomarkers for neurosyphilis, such as CXC chemokine family members (CXCL13, CXCL10, CXCL8), macrophage migration inhibition factor, neurofilament light chain, glial fibrillar acidic protein, ubiquitin C-terminal hydrolase-L1, metabolites, exosomal miRNA in CSF, CD8+ IFN-g+ cells and antibody index for the intrathecal synthesis of specific anti-treponemal IgG in peripheral blood. These biomarkers have been demonstrated to be predictive of neurosyphilis, 7 8 with CXCL13 being the most extensively researched among them.…”

Section: Introductionmentioning

confidence: 99%

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Cerebrospinal fluid CXCL13 concentration for diagnosis of neurosyphilis: a systematic review and meta-analysis

Du,

Zhang,

Zheng

et al. 2024

BMJ Open

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ObjectiveTo systematically assess the diagnostic accuracy of CXCL13 testing of cerebrospinal fluid (CSF) for neurosyphilis diagnosing.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, Cochrane Library and Web of Science databases from their inception until 1 May 2023.Eligibility criteriaBoth cross-sectional and case–control diagnostic test studies evaluating the diagnostic value of CSF CXCL13 in diagnosing neurosyphilis were included, with no language restrictions.Data extraction and synthesisTwo researchers extracted data independently from all finally included articles. The updated Quality Assessment of Diagnostic Accuracy Studies tool was used to assess the quality of the included studies. Quantitative synthesis was done using a bivariate random-effects model.ResultsThis meta-analysis included seven eligible studies involving a total of 1152 patients with syphilis and 430 patients with neurosyphilis. The pooled sensitivity, specificity and summary area under the curve (AUC) of CSF CXCL13 testing for the diagnosis of neurosyphilis were 0.76 (95% CI 0.64 to 0.85; I2=82%), 0.83 (95% CI 0.80 to 0.85; I2=32.29%) and 0.84 (95% CI 0.81 to 0.87), respectively. Sensitivity analysis confirmed the stability of the combined results. Meta-regression analysis revealed that the heterogeneity of pooled sensitivity was related to different study regions; subgroup analysis indicated that the diagnostic value of CSF CXCL13 testing reported in studies from China was superior to that reported in non-Chinese studies (pooled sensitivity, specificity and summary AUC values were 0.84(I2=0) vs 0.64 (I2=79.53%), 0.83 (I2=42.03%) vs 0.83 (I2=32.87%) and 0.87 vs 0.83, respectively). The diagnostic value reported in studies with a sample size ≥200, unclassified neurosyphilis and HIV-negative subgroups was superior to the total combined value.ConclusionsThis meta-analysis has demonstrated a reasonable level of accuracy for diagnosis of neurosyphilis with CSF CXCL13 testing. Further multicentre, prospective diagnostic studies, especially in asymptomatic neurosyphilis and HIV-infected patients, are needed to provide more evidence for evaluation before clinical application.PROSPERO registration numberCRD42023414212.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cerebrospinal fluid CXCL13 concentration for diagnosis of neurosyphilis: a systematic review and meta-analysis

Du,

Zhang,

Zheng

et al. 2024

BMJ Open

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“…It is speculated that similar patterns also exist in patients with neurosyphilis ( 10 ). Neurosyphilis not only imposes a great economic burden on patients but also causes a decline in quality of life due to the stigma associated with the disease ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Neurosyphilis: insights into its pathogenesis, susceptibility, diagnosis, treatment, and prevention

Wu,

Ye,

Wang

et al. 2024

Front. Neurol.

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Background and aimInvasion of the central nervous system by Treponema pallidum can occur at any stage of syphilis. In the event that T. pallidum is not cleared promptly, certain individuals may experience progression to neurosyphilis, which manifests as cognitive and behavioral abnormalities, limb paralysis, and potentially fatal outcomes. Early identification or prevention of neurosyphilis is therefore crucial. The aim of this paper is to conduct a critical and narrative review of the latest information focusing exclusively to the pathogenesis and clinical management of neurosyphilis.MethodologyTo compile this review, we have conducted electronic literature searches from the PubMed database relating to neurosyphilis. Priority was given to studies published from the past 10 years (from 2013 to 2023) and other studies if they were of significant importance (from 1985 to 2012), including whole genome sequencing results, cell structure of T. pallidum, history of genotyping, and other related topics. These studies are classic or reflect a developmental process.ResultsNeurosyphilis has garnered global attention, yet susceptibility to and the pathogenesis of this condition remain under investigation. Cerebrospinal fluid examination plays an important role in the diagnosis of neurosyphilis, but lacks the gold standard. Intravenous aqueous crystalline penicillin G continues to be the recommended therapeutic approach for neurosyphilis. Considering its sustained prominence, it is imperative to develop novel public health tactics in order to manage the resurgence of neurosyphilis.ConclusionThis review gives an updated narrative description of neurosyphilis with special emphasis on its pathogenesis, susceptibility, diagnosis, treatment, and prevention.

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CARE-NS, a research strategy for neurosyphilis

Cited by 2 publications

References 52 publications

Cerebrospinal fluid CXCL13 concentration for diagnosis of neurosyphilis: a systematic review and meta-analysis

Cerebrospinal fluid CXCL13 concentration for diagnosis of neurosyphilis: a systematic review and meta-analysis

Neurosyphilis: insights into its pathogenesis, susceptibility, diagnosis, treatment, and prevention

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