Postepy Dermatol Alergol. 2019 Oct;36(5):620-625. doi: 10.5114/ada.2018.77497. Epub 2018 Aug 6.
Pastuszczak M1, Kotnis-Gąska A2, Jakubowicz B3, Wojas-Pelc A1.
Author information
1
Department of Dermatology, Jagiellonian University Medical College, Krakow, Poland.
2
Department of Laboratory Diagnostics, John Paul 2 Hospital, Krakow, Poland.
3
Department of Microbiology, University Hospital, Krakow, Poland.
Abstract
INTRODUCTION:
Approximately 15% of appropriately treated patients with early syphilis remain serofast. The pathogenesis and clinical significance of this phenomenon are unclear.
AIM:
To determine the significance of Treponema pallidum-specific immune responses and autoimmunity in the treatment outcome of syphilis (serofast or proper serological response).
MATERIAL AND METHODS:
Forty-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.
RESULTS:
After 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).
CONCLUSIONS:
We 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.
Copyright: © 2018 Termedia Sp. z o. o.
KEYWORDS:
autoimmunity; immune response; serofast; syphilis
PMID: 31839781 PMCID: PMC6906955 DOI: 10.5114/ada.2018.77497
Pastuszczak M1, Kotnis-Gąska A2, Jakubowicz B3, Wojas-Pelc A1.
Author information
1
Department of Dermatology, Jagiellonian University Medical College, Krakow, Poland.
2
Department of Laboratory Diagnostics, John Paul 2 Hospital, Krakow, Poland.
3
Department of Microbiology, University Hospital, Krakow, Poland.
Abstract
INTRODUCTION:
Approximately 15% of appropriately treated patients with early syphilis remain serofast. The pathogenesis and clinical significance of this phenomenon are unclear.
AIM:
To determine the significance of Treponema pallidum-specific immune responses and autoimmunity in the treatment outcome of syphilis (serofast or proper serological response).
MATERIAL AND METHODS:
Forty-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.
RESULTS:
After 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).
CONCLUSIONS:
We 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.
Copyright: © 2018 Termedia Sp. z o. o.
KEYWORDS:
autoimmunity; immune response; serofast; syphilis
PMID: 31839781 PMCID: PMC6906955 DOI: 10.5114/ada.2018.77497
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