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Protracted Treponema pallidum-induced cutaneous chancres in rabbits infected with human T-cell leukemia virus type I.

In a preliminary study, two of four rabbits infected with human T-cell leukemia virus type I (HTLV-I) demonstrated prolonged primary chancres following superinfection with Treponema pallidum, the causative agent of syphilis. Two rabbits inoculated with 1 x 10(7) HTLV-I-infected human MT-2 cells and two with infected rabbit cells from a line established in this laboratory (RLT-P), developed latent HTLV-I infection as detected by seroconversion 10 weeks after infection and by detection of HTLV-I sequences in the DNA of peripheral blood lymphocytes after amplification by polymerase chair reaction (PCR) 15 weeks after infection. The rabbits remained clinically normal and had normal blood counts. Six months after infection, the four HTLV-infected rabbits and two noninfected controls were challenged by the intradermal inoculation of 1 x 10(6) Treponema pallidum into eight sites on the shaved back. The lesions of two of the HTLV-I-infected rabbits had a time course similar to non-HTLV-I-infected controls and were completely healed by 4 weeks. The lesions of one of the other two rabbits with progressive disease began to heal about 7 weeks after T. pallidum challenge. The cutaneous lesions in the other rabbit remained dark-field positive and became a confluent eschar at 8 weeks; healing only after treatment with penicillin. Four months after the primary challenge none of the six rabbits previously challenged with T. pallidum had developed lesions after rechallenge and thus expressed chancre immunity. These results demonstrate that rabbits with latent HTLV-I infections may have defective cell-mediated immunity.

Animals↗

Host response to Treponema pallidum infection. I. Quantitative changes of lipids in rabbit organs.

Levels of phospholipids, glycolipids and cardiolipin were determined in various organs of Treponema pallidum-infected rabbits. The phospholipid levels on the second week of infection decreased significantly in the spleen but remained unchanged in other organs. During the same time, glycolipids decreased significantly in both kidney and heart. 3 days after infection, a brief but significant increase of cardiolipin in the spleen was observed. Heat-killed T. pallidum but not Treponema reiteri caused a similar effect. The possible implication of these changes in the immunopathology of syphilis is discussed.

Animals↗

Specific agglutination of Treponema pallidum by sera from rabbits and human beings with treponemal infections.

A method has been described for the preparation of Treponema pallidum suspensions that are suitable for specific agglutination studies and can be stored at 4 degrees C. for months without loss of agglutinability. Such suspensions have been shown to react with two distinct antibodies in the serum of syphilitic animals and man: Wassermann antibody and a specific treponeme agglutinin. It has been demonstrated that the agglutination of treponemes by specific treponeme agglutinin is enhanced by heat treatment or aging of the suspension, and inhibited by a divalent cation, probably Ca(++), normally present in serum. This inhibition has been overcome by the use of a chelating agent, ethylene-diamine tetracetate. These findings have been utilized to devise a simple agglutination test for the diagnosis of treponeme infections that is very sensitive and highly specific. This test has been carried out with 430 human sera, and a comparison has been made of the results of the agglutination, treponemal immobilization, and standard serological tests on these sera. The agglutination test appears to have a specificity comparable to the treponemal immobilization test and considerably greater than the standard serological tests.

Agglutination↗

Binding of glycosaminoglycans to the surface of Treponema pallidum and subsequent effects on complement interactions between antigen and antibody.

Acidified bovine serum albumin (acid BSA) reacts with glycosaminoglycans to form a precipitate. This reaction was adapted to Treponema pallidum to show glycosaminoglycans associated with the surface of the micro-organism. As testicular infection progressed from days 4 to 18, treponemes showed increasing amounts of these surface components. High speed centrifuging effectively removed the glycosaminoglycans, thus indicating that they were loosely bound. The subsequent addition of commercial preparations of hyaluronic acid or chondroitin sulphate resulted in their immediate adherence to the surface of the pathogens T pallidum and T pertenue, but not to the non-pathogens T vincenti, T denticola, or T phagedenis. The amount adhering to the treponemal surface varied depending on the concentration added. Intradermal inoculation showed that the virulence of T pallidum was not altered by the glycosaminoglycans associated with its surface. The coating of treponemes with hyaluronic acid or chondroitin sulphate did not interfere with neutralising antibodies or antibodies found by radioimmunoassay using whole organisms. In contrast, hyaluronic acid or chondroitin sulphate on the treponemal surface did interfere with immobilising antibodies. Results are discussed in terms of the potential role of the treponemal glycosaminoglycans in the infectious process.

Animals↗

A ONE-DAY TREPONEMA PALLIDUM IMMOBILIZATION TEST.

The author has previously shown that the addition of egg-white lysozyme to the reaction mixture used in the Treponema pallidum immobilization test (TPI test) can reduce the time required for immobilization from 18 hours to as little as 6 hours. This opened up the possibility of developing a one-day TPI test and of further simplifying the procedure, as the conditions do not need to be so strictly controlled to ensure survival of the treponemes for the shorter time. In this paper it is shown that the standard procedure of incubation under an atmosphere of nitrogen and carbon dioxide can be replaced by incubation under a layer of liquid paraffin. The survival of treponemes is satisfactory under these conditions and the oil technique does not alter the sensitivity of the 6-hour test with added lysozyme. Comparative tests using the standard procedure, the lysozyme-gas technique and the lysozyme-oil technique showed that both modifications give the same degree of sensitivity and specificity after incubation for 6 hours as does the standard method. The feasibility of introducing these modifications into routine laboratory practice is discussed.

Laboratories↗

TESTS FOR SYPHILIS. THE INCREASING INCIDENCE OF BIOLOGIC FALSE POSITIVE REACTIONS AS MEASURED BY TREPONEMA PALLIDUM IMMOBILIZATION.

Analysis of data obtained in 25,787 Treponema pallidum immobilization tests in a ten-year period showed an increase in the incidence of biologic false positive (BFP) reactions for syphilis, and a decrease in the incidence of reactive TPI tests. The percentage of BFP tests increased from 54.2 per cent in 1953 to 70.7 per cent in 1962. Reaction to a standard serologic test for syphilis (STS) indicates only that the patient may have syphilis. A subsequent non-reactive TPI test remains the best procedure for ruling out a diagnosis of syphilis. Thus the clinician should be made more aware of the fact that a biologic false positive reaction strongly implies the existence of another disease, the cause of which should be investigated.

Biological Products↗

Cultivation of pathogenic treponema in tissue cultures of SflEp cells.

Recently, the successful in vitro cultivation of the Nichols strain of Treponema pallidum was achieved. Afterward, attempts were made to cultivate three other strains of T. pallidum and two strains of T. pertenue. The cultivation of the KKJ, Mexico A, and Bosnia A strains of T. pallidum was somewhat successful; the average increases were 10.8, 9.1, and 7.5-fold, respectively. The range of growth for each of these strains varied dramatically from experiment to experiment. The KKJ strain varied from 14.4 to 8.0-fold; the Mexico A strain from 12.8 to 5.4-fold; and the Bosnia A strain from 11.3 to 3.6-fold. However, the attempts to cultivate the Gauthier and the FB strains of T. pertenue were unsuccessful. The average increases were 1.7 and 1.9-fold, respectively. Although the maximum growth observed was about threefold with either of these strains of T. pertenue, over 50% of the treponemes remained motile for 10 d. These results suggest that although each of these strains of T. pallidum and T. pertenue has been shown to be genetically identical, they are very diverse biologically even among strains of the same species.

Animals↗

Molecular characterization of receptor binding proteins and immunogens of virulent Treponema pallidum.

Receptor binding proteins of Treponema pallidum were identified by incubation of [35S]methionine-labeled, soluble T. pallidum preparations with formaldehyde-fixed HEp-2 cells. Three major treponemal proteins (bands 1--3) that avidly bound to the eucaryotic cell surface were detected by sodium dodecylsulfate-polyacrylamide gel electrophoresis and fluorography. Brief trypsin treatment of HEp-2 cells before formaldehyde fixation reduced the extent of the interaction of these treponemal macromolecules, which implicated receptor-mediated attachment mechanisms. The presence of unlabeled T. pallidum preparations directly competed with radiolabeled T. pallidum samples for the available HEp-2 cells, which suggested a limiting number of membrane binding sites. Samples of unlabeled avirulent Reiter treponeme did not compete. T. Pallidum immunogens were examined by radioimmunoprecipitation with human and rabbit syphilitic sera. Of interest were the similarities and extent of the humoral response represented by the detection of antigen-antibody complexes against numberous treponemal proteins, including bands 1--3. T. pallidum portein band 1 appeared to be the major antigenic stimulus. Formation of antigen-antibody complexes between 35S-labeled T. pallidum proteins and human syphilitic sera was prevented by unlabeled T. pallidum but not by T. phagedenis preparations, which demonstrated specificity of the reaction. Gel profiles of radioimmunoprecipitation assays using radiolabeled T. pallidum antigens and human syphilitic and yaws sera delineated both the similarities and differences in the humoral response to these two spirochetes. The latter suggested both overlapping and distinguishing antigenic properties between T. pallidum and T. pertenue. Detection in yaws sera of specific antibody against T. pallidum protein bands 1--3 further incriminates the role of these three treponemal proteins as virulence determinants.

Animals↗

Failure of the Treponema pallidum immobilization test to provide additional diagnostic information about contemporary problem sera.

Two hundred forty-five sera submitted to the Center for Disease Control, Atlanta, Ga., (CDC) were analyzed serologically in an attempt to demonstrate the diagnostic value of the Treponema pallidum immobilization (TPI) test when performed in addition to the fluorescent treponemal antibody-absorption (FTA-Abs) test. Diagnoses for the patients whose sera were tested were based on information supplied by the referring physicians. Fifty-four per cent of the diagnostic problems were resolved merely by the finding of a negative result with the FTA-Abs test. There was agreement between the serologic results of the referring laboratory and those of the CDC for 76% of sera tested by the Venereal Disease Research Laboratory test and for 71% of sera tested by the FTA-Abs test. For patients with treponemal disease, the sensitivity of the TPI test was 56% and that of the FTA-Abs test was 78%. When the FTA-Abs test was reactive, a negative TPI test was not significantly associated with systemic lupus erythematosus (P > 0.6) or other collagen vascular disease (P > 0.6), nor was a positive TPI test associated with treponemal disease (P > 0.09). It is concluded that once the result of the FTA-Abs test is known, the TPI test does not provide additional diagnostic information.

Fluorescent Antibody Technique↗

Production of murine monoclonal antibodies to the major axial filament polypeptide of Treponema pallidum.

A suitable immunization protocol for the stimulation of a murine antibody response to the axial filament polypeptides of Treponema pallidum was established. A range of monoclonal antibodies (Mabs) specific for different epitopes of the major axial filament polypeptide (37 kDa) was generated which demonstrated diversity in their ability to react with other treponemal species. Immunogold electron microscopy located the 37 kDa antigen on the surface of the axial filament structure. The early appearance of specific antibody to this polypeptide in infected man and rabbit indicates that such Mabs are potentially useful for the diagnosis of early syphilis.

Animals↗

Influence of cardiolipin antibodies on the binding of treponemal specific antibodies in the fluorescence treponemal antibody absorption test and the Treponema pallidum immobilisation test.

The aim of the present study was to investigate the biological role of cardiolipin antibodies during Treponema pallidum infection. Inhibition of the binding of treponemal specific antibodies at the early and late stages of infection by cardiolipin antibodies was shown in the fluorescence treponemal antibody absorption (FTA-ABS) test and T. pallidum immobilisation (TPI) test. Incubation of treponemes with cardiolipin antibodies followed by a second incubation with treponemal specific antibodies resulted in a reduction of the titres of the FTA-ABS test and the TPI test. The findings suggest that cardiolipin antibody production should be considered as a virulence mechanism of pathogenic treponemes with the purpose of evading the host defence mechanisms.

Animals↗

Studies on the lysozyme independence of immune immobilisation of Treponema pallidum and the frequency of lysozyme autoantibodies in syphilitic sera.

The role of lysozyme in the immune immobilisation of Treponema pallidum is not yet fully understood. The T. pallidum immobilisation assay was used to demonstrate that the immobilisation and lysis of T. pallidum in vitro by antibodies (serum, IgG fraction or IgM fraction) and complement proceed in a lysozyme-independent mode. In the presence of lysozyme the rate of immobilisation increased. In contrast with its effect on Escherichia coli, the effect of lysozyme on T. pallidum was governed exclusively by its enzymic activity rather than by the cationic protein nature of the molecule. Lysozyme, released from stimulated phagocytes, induced formation of lysozyme antibodies in 59.6% of syphilis patients as determined by lysozyme antibody ELISA. The highest frequency was found in patients with untreated secondary syphilis, whereas untreated primary syphilis was only rarely accompanied by the presence of lysozyme antibodies. Cross-reactivities between lysozyme and treponemal antigens were excluded by immunoblotting. The autoantibodies did not influence the lysozyme activity. It was concluded that the formation of lysozyme antibodies is only an epiphenomenon in the host defence against treponemal infection.

Animals↗

Antigenic analysis of Treponema pallidum: cross-reactions between individual antigens of T. pallidum and T. Reiter.

Seven antigens were demonstrated in the Nichols pathogenic strain of Treponema pallidum when tested by cross immunoelectrophoresis against rabbit antibodies raised by immunization with T. pallidum sonicate. Indirect evidence was obtained for the presence of two more T. pallidum antigens. Of the nine antigens six reacted with antibodies in a human syphilitic serum pool. Cross-reactions between individual T. Reiter antigens and the seven directly demonstrated T. pallidum antigens were studied by different immunoelectrophoretic techniques, using rabbit anti-T. Reiter Ig, rabbit anti-T. pallidum Ig, and human syphilitic serum pool. Of the seven T. pallidum antigens three were found in T. Reiter, three had epitopes identical to corresponding antigens in T. Reiter, and one had both cross-reacting and T. pallidum-specific epitopes. Human syphilitic serum had antibodies against two of the T. pallidum-specific antigens and against four T. pallidum antigens cross-reacting with antigens of T. Reiter.

Animals↗

Loss of Treponema pallidum during incubation in Nelson's survival medium with or without serum added.

Treponema pallidum organisms suspended in equal parts of Nelson's survival medium alone and with addition of various sera were counted in 5 microliters samples before and after 18 hours' anaerobic incubation at 35 degrees C. Samples in which the treponemes were not Poisson-distributed were excluded from the study. A loss of greater than 30% occurred in 230 out of 391 samples. The disappearance of treponemes did not seem to be caused by treponemal agglutination during incubation. There was no adherence of treponemes to the formed elements remaining in the suspension. The loss was not dependent on the concentration of syphilitic serum, nor was it influenced by the presence of immobilizing antibody in the serum. Lack of rigorous anaerobiosis during the manipulations did not influence the treponemal loss. The loss was independent of the density of the treponemal suspensions which did not contain unheated guinea-pig serum (GPS). The relative frequency of the loss exceeding 30% was highest in suspensions containing unheated GPS. However, the extent of loss in individual samples was haphazardly distributed among suspensions of all the compositions examined. The loss of treponemes seems to depend on at least two factors: a) a factor which is eluted together with the treponemes from the syphilitic orchitis and b) the presence of active guinea-pig complement. It is conjectured that the complement is non-immunologically activated and acts through the alternative pathway.

Agglutination↗

In vitro and in vivo activities of sedecamycin against Treponema hyodysenteriae.

Sedecamycin (lankacidin A), one of the lankacidin-group antibiotics, showed potent activity against Treponema hyodysenteriae. The MICs of sedecamycin against 79 field isolates of T. hyodysenteriae ranged from 0.78 to 12.5 micrograms/ml, the MIC for 90% of the strains tested (MIC90) being 3.13 micrograms/ml. The protective and therapeutic effects of sedecamycin were compared with those of carbadox, tiamulin, and lincomycin against experimental infection with T. hyodysenteriae in mice. The protective effect of sedecamycin was similar to that of carbadox, two times more potent than that of tiamulin, and three times greater than that of lincomycin. In the therapeutic test, sedecamycin showed activity similar to that of carbadox and was two times more active than both tiamulin and lincomycin. At doses of 10 mg or more of sedecamycin per kg, the recurrence of shedding of T. hyodysenteriae into the feces of mice was not detected for at least 8 weeks postmedication.

Animals↗

Automated, quantitative microhemagglutination assay for Treponema pallidum antibodies.

An automated, quantitative microhemagglutination assay for antibodies to Treponema pallidum was developed by using T. pallidum-sensitized erythrocytes and an automatic serial-dilution instrument. Reactivity was found in sera from 54 rabbits and 6 chimpanzees infected with T. pallidum. Reactivity was also found in sera from animals infected with T. pertenue, T. carateum, and T. cuniculi. No reactivity was found in sera from 75 normal rabbits or from 129 rabbits immunized with cultivatable treponemes or a variety of other bacteria. In approximately 3 min, 13 twofold serial dilutions of each of 8 preabsorbed sera and the addition of sensitized erythrocytes to each dilution were accomplished automatically. The automated assay can serve as a research tool in quantitating antibodies to pathogenic treponemes, and evaluation of its clinical usefulness seems warranted.

Absorption↗

Treponema pallidum surface immunofluorescence assay for serologic diagnosis of syphilis.

A surface immunofluorescence assay (SIFA) using live spirochetes was analyzed and compared with Western blot (WB), fluorescent treponemal antibody absorption (FTA-ABS), microhemagglutination (MHA-TP), and Treponema pallidum immobilization (TPI) assays for detecting serum antibodies to T. pallidum in patients with syphilis, in disease controls, and in healthy subjects. SIFA and WB were 99% sensitive (99 of 100 positive specimens) and specific (140 of 140 negative specimens); FTA-ABS showed a sensitivity and a specificity of 90 and 89% (90 of 100 positive and 125 of 140 negative specimens), respectively. MHA-TP showed a sensitivity of 84% (84 of 100 positive specimens) and a specificity of 98.5% (138 of 140 negative specimens). Finally, TPI had a sensitivity of 52% (52 of 100 positive specimens) and a specificity of 100% (140 of 140 negative specimens). The T. pallidum SIFA was therefore highly specific, showing no equivocal reactivities with control sera, and sensitive. The results suggest the possible use of SIFA as a confirmatory test in the serologic diagnosis of syphilis.

Adult↗

Purification of a Reiter treponemal protein antigen that is immunologically related to an antigen in Treponema pallidum.

A protein antigen called TR-o was isolated from supernatant of a sonically treated Reiter treponeme. The isolation procedure included anion-exchange chromatography on Whatman DE-52, hydrophobic interaction chromatography on decyl agarose, and finally gel filtration on Ac-A-22 Ultrogel. The fractionations were monitored by immunoprecipitation techniques. The recovery was found to be 35%, and the isolated protein was enriched 220 times. The molecular weight of the native protein was estimated to be 550,000 by polyacrylamide gel electrophoresis and 450,000 by gel filtration. Only one 66,000-molecular-weight polypeptide was found by sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the purified protein. The protein was immunologically pure when tested in crossed immunoelectrophoresis against polyspecific rabbit anti-Reiter immunoglobulin, detecting more than 40 treponemal antigens. A monospecific antiserum was raised in rabbits immunized with the purified protein. Monospecific rabbit anti-TR-o gave strong fluorescence with both the Reiter treponeme and Treponema pallidum. The corresponding antigen in T. pallidum could not be demonstrated directly in a crude T. pallidum sonic extract, but rabbit anti-T. pallidum immunoglobulin contained precipitating antibodies against the purified protein. No antibodies against TR-o were found in selected sera from patients with secondary syphilis reactive in traditional syphilis tests.

Animals↗