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PubMed1988

Invasion of the central nervous system by Treponema pallidum: implications for diagnosis and treatment.

STUDY OBJECTIVES: To determine the prevalence of Treponema pallidum in cerebrospinal fluid (CSF) of patients with syphilis, to determine the effect of concurrent HIV infection on central nervous system involvement by T. pallidum, and to examine the efficacy of conventional therapy for asymptomatic neurologic involvement. PATIENTS: Fifty-eight patients with untreated syphilis who consented to lumbar puncture, representing approximately 10% of new cases of syphilis during the study period. INTERVENTIONS: Lumbar puncture was done on all patients. Rabbit inoculation was used to test cerebrospinal fluid for viable T. pallidum. Patients with normal fluid received recommended benzathine penicillin therapy according to the stage of syphilis; patients with CSF abnormalities were offered 10-day therapy for neurosyphilis. RESULTS: Treponema pallidum was isolated from the CSF of 12 (30%) of 40 patients (95% CI, 17 to 46) with untreated primary and secondary syphilis; isolation of T. pallidum was significantly associated (P = 0.008) with the presence of two or more abnormal laboratory variables (among leukocyte count, protein concentration, and CSF-Venereal Disease Research Laboratory [VDRL] test). Two (67%) of 3 early latent (CI, 13 to 100) and 3 (20%) of 15 late latent syphilis patients (CI, 5 to 47) also had reactive CSF-VDRL tests and elevated cell and protein levels, although T. pallidum was not isolated. Concurrent infection with the human immunodeficiency virus (HIV) was not associated with isolation of T. pallidum, increased number of CSF abnormalities, or reactive CSF serologic tests for syphilis, although CSF pleocytosis was commoner in subjects infected with HIV. Treatment with conventional benzathine penicillin G (2.4 mIU) failed to cure 3 of 4 patients with secondary syphilis from whom T. pallidum was isolated before therapy; all 3 patients in whom treatment failed were HIV seropositive when treated or seroconverted during follow-up. CONCLUSIONS: Central nervous system invasion by T. pallidum is common in early syphilis, and is apparently independent of HIV infection. Examination of the CSF may be beneficial in patients with early syphilis, and therapy should be guided by knowledge of central nervous system involvement. Conventional benzathine penicillin G therapy may have reduced efficacy in patients with early syphilis who are also infected with HIV.

Adult↗

PubMed1999

[Laboratory-based evaluation of DainaScreen TPAb to detect specific antibodies against Treponema pallidum].

A newly developed immunochromatography assay, DainaScreen TPAb (Dainabot, Tokyo), to detect antibodies specific to Treponema pallidum was evaluated. When we tested serum and plasma samples of Syphilis Mixed Titer Performance Panel PSS201 (Boston Biomedica, Inc. , Bridgewater, MA, U.S.A.), all the test results obtained by DainaScreen TPAb were comparable to those determined by fluorescent treponemal antibody absorption test (FTA-ABS). Both within-run and day-to-day variation tests were highly precise, and no discrepant interpretation was obtained by the different medical technicians performed. Also, the testings of whole blood and plasma for individual samples gave same interpretations. The minimum detectable antibody titer was equal to that of Mediace TPLA (Sekisui Chemicals, Osaka) determined by Behring Nephelometer Analyzer (Dade Behring, Marburg, Germany). All the test results by DainaScreen TPAb for clinical serum samples were comparable to those by Mediace TPLA. With these results, we can conclude that DainaScreen TPAb is a rapid, practical and easy-to-perform alternative to detect antibodies specific to Treponema pallidum, in particular as being a point-of-care testing.

Antibodies, Bacterial↗

PubMed2000

Isolation of oral spirochetes from dogs and cats and provisional identification using polymerase chain reaction (PCR) analysis specific for human plaque Treponema spp.

Identification of plaque spirochetes from dogs is rare and no studies to date report cultivation of canine or feline plaque spirochetes. Plaque samples obtained from canine and feline patients were cultured in broth media. Spirochetes cultured were subjected to microscopic evaluation and were cloned on a solid medium. The clones were provisionally identified using species-specific PCR for treponema isolated from human plaque. Canine spirochete clones included Treponema denticola, T. socranskii ssp., T. vincentii, T. maltophilum, T. medium, and T. pectinovorum. Feline clones included T. maltophilum and T. socranskii. Non-amplified clones may represent novel treponemes. Future studies will be aimed at comparison of the spirochetes present in dogs and cats with or without periodontal disease.

Animals↗

PubMed2003

Detection of Treponema pallidum DNA in cutaneous lesions of secondary syphilis and characterization of the inflammatory infiltrate.

OBJECTIVE: To investigate the possible mechanism of the cutaneous lesion formation in secondary syphilis and role of cellular immunity in the pathogenesis of syphilis. METHODS: Treponema pallidum DNA was detected in 24 formalin-fixed, paraffin-embedded skin specimens from lesions of secondary syphilis by nested PCR. The inflammatory infiltrate in the cutaneous lesions of secondary syphilis was investigated using immunohistochemical technique. RESULTS: The TP-specific DNA was found in 10 of 24 (45.8%) lesions of secondary syphilis. However, no Treponema pallidum were found in all 24 tissue section samples when silver staining was performed. CD45RO (+) Tcells were found in all syphilis lesions with strong staining. CD68 (+) cells were found in 68.2% of the skin specimens. Meanwhile, a few CD20 (+) cells and CD57 (+) cells were seen in the infiltrates. CONCLUSION: The cutaneous lesions might be formed by invasion of TP to skin rather than an allergic reaction. The predominant T cells and macrophages infiltrating in secondary syphilitic lesions indicate that cellular immunity might play a critical role in host reaction against TP infection.

DNA, Bacterial↗

PubMed1991

Pathogen-specific humoral response in Treponema pallidum-infected humans, rabbits, and guinea pigs.

Molecular analysis of the humoral response to pathogen-specific polypeptides was done using sera from patients at different stages of syphilis and sera from Treponema pallidum-infected rabbits and guinea pigs collected at various times after infection. The sera were examined by ELISA, fluorescent treponemal antibody absorption test (FTA-ABS), and immunoblot before and after sequential adsorption with cyanogen bromide-activated Sepharose 4B coupled individually to five sonicated nonpathogenic treponemes. Guinea pig antisera were also adsorbed with rabbit proteins. After adsorption, sera from all three species reacted neither by ELISA nor by immunoblot with nonpathogenic treponemes, nor did guinea pig sera react with rabbit proteins. Regardless of the species of treponema used for initial adsorption, none by itself could effectively remove all cross-reactivities. Nine pathogen-specific polypeptides (15, 17, 33, 37, 39, 43, 45, 47, 97 kDa), eight (15-47 kDa) known as integral membrane or endoflagellar components, were commonly recognized by the tree species when chancre immunity developed. The substantial reduction in immune reactivity after adsorption suggests that most of these peptides consist of specific and common treponemal epitopes. Throughout the various stages of the human disease, pathogen-specific antibodies were exclusively of the IgG isotype.

Animals↗

PubMed1991

Characterization of monoclonal antibodies to two Treponema denticola serotypes by the indirect fluorescent-antibody assay.

Members of the genus Treponema have been implicated as possible aetiologic agents of periodontal disease. Previously developed murine monoclonal antibodies (MAbs) to two Treponema denticola strains were characterized by an indirect fluorescent-antibody (IFA) technique. Fifteen T. denticola strains and 32 other bacteria commonly isolated from periodontal pockets were used in the screening process. Two monoclonal antibodies to T. denticola ATCC 33521, serotype B, reacted with five T. denticola isolates, and one monoclonal antibody to T. denticola ATCC 33520, serotype c, reacted with two T. denticola isolates. There was no cross-reactivity between MAbs to the two serotypes. Preliminary tests of the MAbs on human periodontal samples show that they are useful in detecting these bacteria in clinical samples.

Antibodies, Bacterial↗

PubMed1990

[The dynamics of Treponema-specific blood immunoglobulins in early forms of syphilis].

The study has involved 73 patients with syphilis, 31 female and 42 male ones, aged 18-42. Four of these suffered from primary seronegative, 14 from primary seropositive, 21 from secondary fresh, 22 from secondary recurrent, and 12 from early latent seropositive syphilis. Peripheral blood sera were under study. Treponema-specific antibodies of the IgM and IgG classes were titered by enzyme immunoassay. The detected changes in Treponema-specific immunoglobulinemia are in good correlation with clinical staged pattern of syphilis and antiinfectious immunity status.

Adolescent↗

PubMed1985

Multiplication in liquid medium of Treponema sp. isolated from intestinal contents of swine.

Treponema hyodysenteriae and Treponema innocens were multiplied by a simple culture method in liquid medium. TSB medium was prepared by the PRAS method in plasma bottles containing glass beads. Spirochaetes were injected through the rubber stopper and the bottles were incubated while revolving round their axes. The most abundant growth of spirochaetes in rotary culture was observed after 72 h incubation at 40 degrees C. whereas the highest number of viable cells in stationary culture was observed after 120 h. However, in the latter case the number of cells was lower than introduced at inoculation. Growth of the bacteria was stimulated by equine serum and 5% addition of rumen fluid. Optimal growth temperature was 40 degrees C.

Animals↗

PubMed1989

[Nutritional requirements for oral Treponema].

Oral Treponema is still difficult to cultivate in vitro because of lacking of our knowledge about what they require for growth. The aim of this study was to find what were the nutritional requirements for them. Treponema denticola, T. vincentii, and T. socranskii were cultivated in various broths to seek which fractions of tryptone and rabbit serum, or serum proteins were stimulatory. Treponemal growth was assessed by turbidity readings. It was obvious that a weakly negative-charged peptide isolated from tryptone with molecular weight of about 800 daltons was stimulatory. However, further characterization of this peptide was failed, since the yield of the final fractions was too low to be identified with the conventional methods. The results on rabbit serum fractionated by a liquid chromatograph showed that serum proteins with molecular weight of 150,000 daltons were also stimulatory for T. denticola. Among the commercially available serum proteins, human and bovine ceruloplasmin gave good results. They could substitute for rabbit serum in the growth of T. denticola and T. vincentii.

Animals↗

PubMed1989

[Electron microscope study of the plasmid DNA from various strains of Treponema pallidum].

Electron microscopic investigation and electrophoretic analysis of DNA from two cultural strains of pale treponemes (Treponema pallidum VIII and Treponema pallidum Reiter) allowed us to identify the circular molecules of plasmid DNA their size evaluated as 7 to 8 MD. Side by side with the molecules of this size the electron microscopic pictures of the plasmid DNA of both strains of pale treponemes show small superspiralized molecules of plasmid DNA. According to electrophoretic data the size of this DNA is evaluated as two thousand base pairs.

DNA, Bacterial↗

PubMed1988

Serological investigations for antibodies against Treponema pallidum on the Cape Verde Islands (Santiago and Santo Antao)--2. report.

On the Cape Verde Islands, Santiago and Santo Antao 581 human blood samples were collected. The VDRL and TPHA tests were employed in the serological examinations of samples for antibodies against Treponema pallidum. Positive reactions were shown in 2 of the 191 sera from the Santiago Island and in 12 of the 390 sera from the Santo Antao Island in both the VDRL and the TPHA tests. Including the alone TPHA-positives of 5 and 8 sera respectively, results in a 3.7% of positive sera for Santiago and a 5.1% for Santo Antao. By not taking into account children under 13 years of age, the positivity rises to 4.2% and 7.6% respectively. Giving a total contamination rate of 6.3% for Treponema pallidum.

Adolescent↗

PubMed1982

Rapid detection of Treponema pallidum and cytomegalovirus specific IgM antibodies with the passive haemagglutination.

For the detection of Treponema pallidum-specific IgM antibodies in patients' serum samples four simple and rapid methods are compared and evaluated. They show decreasing sensitivity and specificity in the row listed: (1) Treponema pallidum haemagglutination (TPHA) after IgM separation by affinity chromatography on controlled-pore glass heads (anti-IgM-CPG), or (2) by ion exchange chromatography on DEAE-cellulose; (3) solid-phase haemagglutination (SPHA) in glass microvials or (4) on polysterene microplates. The latter tests have found to be inferior, although they can be considerably improved by the use of affinity chromatography--purified catch antibodies. The commercially available DEAE-cellulose microcolumn delivers a simple method for IgM separation, and in spite of a relatively high IgA contamination it proved to be useful also for CMV-specific IgM haemagglutination tests, as compared to ELISA results.

Antibodies, Bacterial↗

PubMed1983

Detecting anti-Treponema hyodysenteriae antibodies in swine serum using immunofluorometry.

An indirect fluorescent antibody test was adapted for measuring serum anti-Treponema hyodysenteriae antibodies with a fluorometer. The immunofluorescence was recorded as fluorescent signal units. Cultures of T. hyodysenteriae and Treponema innocens were used as antigen. There was a significant (P less than 0.01) correlation between the immunofluorescence recorded with the fluorometer and that evaluated visually with a microscope. The swine exposed orally to swine dysentery infective inoculum and subsequently hyperimmunized by the intravenous inoculation of live cultures of T. hyodysenteriae had the highest average fluorescent signal unit, which was 104.5. There was a significant (P less than 0.01) correlation between the level of anti-T. hyodysenteriae antibody and the interval length between the last day of diarrhea and the day of bleeding. However, in measuring fluorescent signal units in serum from swine infected with nonpathogenic large spirochetes, (T. innocens), there was also a significant (P less than 0.01) correlation between T. hyodysenteriae and T. innocens as antigen. The coefficient of variation of the average fluorescent signal unit for a highly positive serum and a highly negative serum between 16 runs of assays were 5.7% and 19% respectively; the coefficient of variation of the average fluorescent signal unit for duplicate samples on 358 serum samples tested was 5.8%.

Animals↗

PubMed1983

[Treponema pallidum or Spirochaeta pallida?].

First Schaudinn and Hoffmann named the causative organism of syphilis Spirochaeta pallida. Short time later Schaudinn proposed the name Treponema. He mentioned it in a letter of October 14, 1905 to Hoffmann. He supposed that this germ may be a flagellate. This was not correct. The electron-microscopic investigations revealed that this idea did not concur. Therefore it is better to call them Spirochaeta pallida and not Treponema pallidum any more.

Germany↗

PubMed1981

Shedding of Treponema hyodysenteriae, transmission of disease, and agglutinin response to pigs convalescent from swine dysentery.

Fecal shedding of Treponema hyodysenteriae, transmission of disease, and humoral antibody production against the large spirochete were evaluated in pigs convalescent from experimentally induced swine dysentery. Untreated pigs (n = 21) and 5 pigs that had been treated with virginiamycin were included in the study. Treponema organisms were culturally detected in the feces of 2 untreated pigs as long as 70 and 71 days, and in the feces of 1 treated pig as long as 83 days after the last clinical evidence of disease. Of 8 convalescent pigs that intermittently discharged T hyodysenteriae in their feces, 4 transmitted clinical disease to exposed susceptible pigs. One of the convalescent animals has been free of clinical signs of disease for 57 days before introduction of the susceptible pigs. Treated and untreated convalescent pigs developed similarly elevated agglutinin titers that were maintained as long as 150 days after infection. There was no apparent correlation between the frequency or duration of fecal shedding of the spirochetes and the magnitude of the agglutinin titers of the convalescent pigs.

Agglutination Tests↗

PubMed1976

[Survival and humoral response of mice infected with Treponema pallidum (author's transl)].

To judge the pathogenicity of Treponema palllidum in mice, we inoculated two groups of animals. 1) One with a normal immune system : adult Swiss mice. 2) The other with an immune system presenting a defect in T cells : athymic Nude mice. No lesions appeared at the points of inoculation and the survival of these animals was not modified compared with control animals. We have also carried out a study of antitreponema antibodies in adult and new-born Swiss mice, using, for the adults, various concentrations of treponema pallidum and various routes of inoculation. In adult mice, the search for antibodies by fluorescence, showed, firstly, that the intradermal route permits a more rapid humoral response than the intraperitoneal route, with higher antibody titers. Furthermore, an inoculum of 8,6 X 10(6) per mice, gives earlier results and higher titers than those obtained with an inoculum twice lower. The earliness of the positive Nelson test is independent of the route of inoculation but related to the injected dose. On the other hand, the Kline reaction remained negative for all groups of mice throughout the whole period of our study. In new-born mice, 76% only became positive on fluorescence and Nelson test.

Animals↗

PubMed1977

Swine dysentery: inoculation of gnotobiotic pigs with Treponema hyodysenteriae and Vibrio coli and a Peptostreptococcus.

Pure cultures of Treponema hyodysenteriae given orally to conventional pigs resulted in the development of swine dysentery, whereas identical cultures given to gnotobiotic pigs did not produce the disease. Oral inoculation of gnotobiotic pigs with Vibrio coli and/or a peptostreptococcus in addition to T. hyodysenteriae did not result in dysentery. Neutralization of gastric secretions with NaHCO3 immediately prior to inoculation with T. hyodysenteriae increased the period during which treponemes were evident in the feces, as did the inoculation of this organism via the intracecal route. None of the gnotobiotic pigs with a persistent fecal Treponema population developed signs of dysentery. Factors other than those investigated in this work must play a part in the etiology of swine dysentery.

Animals↗

PubMed2004

[Syphilis. Clinical aspects of Treponema pallidum infection].

Syphilis is a sexually transmitted infection by Treponema pallidum. Without antibiotic treatment syphilis lasts for several decades and may develop up to 4 different clinical stages. Usually, the disease begins with a distinct painless and indurated ulcer at the contact site: the primary chancre. An indolent regional lymph node swelling is usually associated with the syphilitic chancre. After spontaneous healing of the primary lesion and several weeks of latency, the clinical symptoms of secondary syphilis occur. Treponema pallidum bacteremia leads to common symptoms like fever and malaise, but also to a generalized lymphadenopathy, and a broad variety of lesions of the skin and mucosal membranes. Non-pruritic transient exanthems often involving palms and soles, condylomata lata, and a specific angina with mucous patches of the oral cavity are prominent signs. After several relapses, which are characterized by a decreasing intensity of clinical symptoms, secondary syphilis then resolves spontaneously. A second period of latency follows, lasting 3-12 years. Then the outcome of untreated syphilis becomes apparent: spontaneous healing by elimination/inactivation of the spirochetes (75%) or transition to tertiary syphilis (25%). Two kinds of granulomatous skin reactions are typical for tertiary syphilis: superficial nodular syphilids and gummas. The bones, as well as the cardiovascular and central nervous system, may also be involved. Finally, metasyphilis with severe and sometimes lethal neurological symptoms (tabes dorsalis, progressive paralysis) occurs 10 to 30 years after primary infection. Except for irreversible tissue destruction which occurs prior to therapy, all stages of syphilis can be cured completely.

AIDS-Related Opportunistic Infections↗