Treponema pallidum-specific immune responses and autoimmunity in patients who remain serofast after treatment of syphilis

Abstract

IntroductionApproximately 15% of appropriately treated patients with early syphilis remain serofast. The pathogenesis and clinical significance of this phenomenon are unclear.AimTo determine the significance of Treponema pallidum-specific immune responses and autoimmunity in the treatment outcome of syphilis (serofast or proper serological response).Material and methodsForty-eight patients with secondary and early latent syphilis (ELS) were enrolled in this study. Reactivity of IgM/IgG antibodies to the treponemal antigens TpN47, TpN17, TpN15 and TmpA was evaluated before and 12 months after intramuscular penicillin therapy for syphilis. Additionally, the presence of antinuclear antibodies (ANA) was determined 12 months after treatment.ResultsAfter 1 year, patients were stratified into two groups based on their serological response: (1) serofast (n = 10) and (2) serologically-cured (n = 38) patients. The serological cure rate was 79.2% at 12 months after treatment. Weak pre- and post-treatment antibody reactivity to TpN47 antigen was found to be significantly associated with a higher risk of the serofast state (OR = 64; 95% CI: 5.01–817; p < 0.005). Patients who remained serofast had a significantly higher ANA prevalence and mean titer when compared to those with proper serological responses (100% vs. 5.3%, respectively, p < 0.005; 1 : 640 vs. 1 : 160, respectively, p < 0.005).ConclusionsWe demonstrate that baseline antigen-specific immune response to Treponema pallidum may be an important predictor of the treatment outcome. Further studies are warranted to identify the role of autoimmunity in the pathomechanism of the serofast state.

Evaluación de un prototipo de ensayo de aglutinación látex-estreptavidina-tp17 para detección de anticuerpos anti-Treponema pallidum

“…Este trabajo se propuso el objetivo general de evaluar un prototipo de ensayo de aglutinación de látex-estreptavidina-Tp17 para detección de anticuerpos anti-Treponema pallidum, el cual se logró mediante la realización de diferentes pruebas y ensayos. La utilización del antígeno Tp17 como agente sensibilizante para detección de anticuerpos específicos generados en respuesta a infecciones por T. pallidum, brinda un resultado congruente con lo demostrado por otros autores, los cuales aseguran que es una proteína que en contacto con suero de pacientes infectados demuestra elevada y persistente reactividad incluso post tratamiento (15) .…”

“…Diversas pruebas treponémicas se valen de la utilización de proteínas recombinantes, debido a que las lipoproteínas de membrana de T. pallidum inducen una respuesta inmune fuerte, como es el caso de la Tp17, la misma tiene la capacidad de aumentar la expresión de moléculas de adhesión, inducir la actividad quimiotáctica de células THP-1 y aumentar la producción de TNF-α por parte de los macrófagos (10)(11)(12)(13)(14)(15)(16) .…”

Autoimmune Hepatitis Induced after Treatment of Syphilitic Hepatitis

“…Researchers hypothesized that the destruction of host tissues in genetically susceptible individuals led to the breakdown of immune tolerance and production of autoantibodies. 18 A molecular database query investigating structural similarities between moieties on T. pallidum proteins and liver antigens has not yet been reported in the literature. Such a study would elucidate whether a molecular mimicry event could explain the association between SH and AIH as it presented in this case, and help determine if SH and its treatment are risk factors for AIH.…”

“…Researchers hypothesized that the destruction of host tissues in genetically susceptible individuals led to the breakdown of immune tolerance and production of autoantibodies. 18 …”

Effects of HBeAg Status on cellular immune function of patients with Hepatitis B virus/Treponema Pallidum Co-infection

“…1 Syphilis is a chronic systemic sexually transmitted disease cause by Treponema pallidum (TP) infection. 2 Since HBV and TP share the same bodily-fluid transmission routes, co-infection involving both viruses are very common. In an HBV/TP co-infection, the patient's autoimmune system makes a series of immune responses to participate in the pathological process within Note: Wei Luo and Hanxiao Xin are both considered as first author.…”