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PubMed1992

Treponemicidal activity of anti-treponemal lymphotoxins and their relation to circulating immune complexes and autolymphocytotoxins.

It was previously reported that spleen cells of rabbits infected with Treponema pallidum produced anti-treponemal lymphotoxins (ATL). This ability was distinctly disturbed when circulating immune complexes (CIC) and autolymphocytotoxins (AL) were present in the sera of cell donors. ATL liberated from cells of donors without CIC and AL displayed a marked ability to immobilize treponemes. The percentage of immobilized treponemes varied according to the type of cells used for ATL liberation and their density. The most active was ATL from T cells (density 4 x 10(8) ml-1) and the weakest was the one from B lymphocytes. In the presence of CIC in sera of cell donors the weakest ATL was from macrophages and in the presence of AL from T lymphocytes. When both factors (CIC and AL) were present ATL from T lymphocytes did not immobilize treponemes. This seems to suggest that the impairment of the cells' ability to produce ATL may facilitate the survival of treponemes in the host despite the presence of immunologically competent cells.

Animals↗
PubMed1982

Comparison of the activities of ceftriaxone and penicillin G against experimentally induced syphilis in rabbits.

The activity of ceftriaxone, a newly developed cephalosporin, against early cutaneous infections with Treponema pallidum in rabbits was compared with that of equimolar doses of penicillin G. Activity was related to the time required for cutaneous lesions to become dark-field negative, serological response, and the disappearance of T. pallidum from the popliteal lymph nodes. Both antibiotics were very effective in the treatment of syphilis in this animal model. The 50% curative dose for penicillin G was 0.8 mumol/kg (0.29 mg or 480 U/kg) and for ceftriaxone, it was 1.45 mumol/kg (0.96 mg/kg). Overall, ceftriaxone was slightly less effective than penicillin G was. Transmission and scanning electron microscopy studies of testicular aspirates obtained from rabbits treated with ceftriaxone revealed alterations in the treponeme surface which apparently resulted in changes in cell permeability and morphology.

Animals↗
PubMed1993

Experimental model of congenital syphilis.

Female LSH hamsters infected with Treponema pallidum subsp, endemicum before pregnancy or during early pregnancy transmit a form of syphilis to the fetus that is similar to human congenital syphilis. The offspring develops rhinitis, skin rash, failure to thrive, and hepatosplenomegaly. T. pallidum is detectable in their livers, spleens, and nasal secretions. Immunoglobulin M antibodies are detected in the serum.

Animals↗
PubMed1979

Ultrastructural study of satellite lymph nodes in syphilitic rabbits.

In an electron microscopy study of lymph nodes from syphilitic rabbits plasmablasts and plasma cells were unequivocally identified in germinal centres. Up to 20% of the plasma cells possessed unusual cytological features. Paracortical hypoplasia was shown to be associated with actively phagocytic histiocytes. These findings may reflect morphological correlates of the aberrant immune regulation which has been observed in infection with Treponema pallidum.

Animals↗
PubMed1980

Recent observations on the serology of syphilis.

Routine screening of 404 742 sera by the automated micro-haemagglutination assay (AMHA-TP) and the Venereal Disease Research Laboratory (VDRL) test showed that 9848 specimens gave a reactive result to one of the three assays. Reactive results were confirmed by the fluorescent treponemal antibody absorption (FTA-ABS) test. The possibility of false-positive results varied from 0.04-0.38% of all specimens or from 1.7-15.7% of reactive sera. The VDRL test failed to detect reactivity in 56.54% of sera from patients who had previously been infected with Treponema pallidum. The importance of routine testing by the AMHA-TP is illustrated by the detection of four patients with mesaortitis and two with active neurosyphilis among a selected group of 54 patients who had non-reactive results to the VDRL test. Testing of cerebrospinal fluid specimens by the AMHA-TP test produced more specific results than by the other two tests.

Antibodies, Bacterial↗
PubMed1980

Immunoglobulin-bearing lymphoid cells in primary syphilis. Quantitative and elution studies.

The delay in antibody production in response to infection with Treponema pallidum may be caused by a block in the differentiation of antigen-stimulated B (Bursa-dependent) lymphoid cells towards plasma cells. This hypothesis was tested by a study to detect clonal expansion of immunoglobulin-bearing B lymphoid cells by in-vitro immunofluorescence tests in patients with primary syphilis. In addition, antibodies eluted from circulating lymphoid cells were investigated for treponemal binding by the enzyme-linked immunosorbent assay, the T pallidum immobilisation test, and the immunoglobulin class-specific FTA-ABS test. Results indicated that the number of IgG-bearing lymphoid cells were increased in patients with primary syphilis. However, in only a few cases could antitreponemal antibodies be eluted from isolated lymphoid cells. For this reason, the original hypothesis was rejected.

Antibodies, Bacterial↗
PubMed1980

T lymphoid cells in primary syphilis. Quantitative studies.

In previous studies to assess the role of cell-mediated immunity in Treponema pallidum infection investigations of delayed type skin hypersensitivity tests, lymphocyte transformation test, leucocyte migration inhibition tests, and histological studies of the reticuloendothelial system have been performed. In this study, the numbers of T (thymus-dependent ) lymphoid cells in 10 patients with primary syphilis (eight untreated) were estimated by the rosette technique. Results indicate a significant decrease in the number of T lymphoid cells in patients with primary syphilis.

Humans↗
PubMed1988

Gummatous penile ulceration and generalised lymphadenopathy in homosexual man: case report.

A case of granulomatous penile ulceration associated with generalised lymphadenopathy in a homosexual man aged 43 is presented. His serum gave positive results to tests for syphilis, but was negative for antibody to human immunodeficiency virus (HIV). His condition responded briskly to treatment with procaine penicillin, and we conclude that the clinical features were attributable to infection with Treponema pallidum.

Adult↗
PubMed1998

Pathogenesis and treatment of HTLV-I associated myelopathy.

That HTLV-I is not a latent infection is indicated by the detection of mRNA in the peripheral blood and CNS of patients with HTLV-I infection and by the persisting humoral and cellular immune responses. Indeed the frequency of anti-HTLV CTL is extremely high. The reduction in anti-TAX CTL frequency following reduction in proviral load suggests that removal of viral antigen may result in a reduced inflammatory response at least in peripheral blood and although the clinical data should be interpreted with caution, perhaps in the CNS. Patients with more advanced disease, and possibly fixed deficits may not benefit from either anti-inflammatory or antiretroviral treatment. The patients with most to gain are those with least deficit in whom early diagnosis and treatment will depend on raising awareness of HTLV-I beyond the neurological community. Many patients with HAM first present to a urologist or gynaecologist with bladder dysfunction or may have been seen in the genitourinary clinical with impotence or positive treponemal serology, which in the older patient is often the result of childhood infection with Treponema pallidum pertenue. Investigation of these patients should include HTLV-I serology and further investigation of HTLV-I positive patients should include proviral load measurements as well as markers of inflammation. Treatments whether antiviral or anti-inflammatory should be assessed for their effect on both as well as a clinical response.

Adolescent↗
PubMed2005

Biological false-positive tests comprise a high proportion of Venereal Disease Research Laboratory reactions in an analysis of 300,000 sera.

This retrospective study on syphilis screening at the sexually transmitted infection (STI) unit of a University Department emphasizes the necessity of a treponemal-specific test as the appropriate screening test. The Venereal Disease Research Laboratory (VDRL) test for syphilis screening may, under certain circumstances, yield positive results in patients not infected with Treponema pallidum, a phenomenon referred to as biological false-positive (BFP) VDRL test. The aim of this study was to determine the frequency of BFP tests in a large sample of sera. In this retrospective study, we analysed the results of parallel VDRL and T. pallidum haemagglutination (TPHA) testing of a total of 514,940 blood samples obtained from patients at the Vienna General Hospital between January 1988 and November 1999. Patients' sera with incomplete data on stage and sex and duplicate sera were excluded, leaving 300,000 sera for analysis. The seroprevalence for syphilis was 1.77% (n = 5320), as determined by a positive TPHA test. It was significantly higher in male than in female patients (2.03% versus 1.58%, P<0.001). Of the patients reactive in the TPHA test, 3257 (61.2%) were negative in the VDRL. With regard to reactivity in VDRL testing, 2799 patients (0.92%) of the study population were positive, of whom 736 (26%) were biological false positive. BFP reactivity was found in 0.24% of all patients and was significantly higher in women than in men (0.27% versus 0.20%, P<0.001) and in patients over 60 years of age (0.34%) as compared with those under 60 (0.25%, P<0.001). This proportion might be even higher, as reactivity in the VDRL at 1:0 and 1:2 dilutions without a positive treponemal test was not reported. The subgroup of HIV-positive patients (n = 1415) revealed a 10-fold higher rate of BFP tests (2.1% versus 0.24), an effect being statistically significant. In a low syphilis prevalence population, BFP reactions comprise a high proportion of all VDRL reactors. Therefore, the use of the VDRL as a screening procedure is challenged.

Adolescent↗
PubMed2006

A patient with early syphilis complicated by fatty liver who showed an alleviation of hepatopathy accompanied by jaundice after receiving anti-syphilitic therapy.

A 42-year-old male with visceral obesity and a fatty liver presented with hepatopathy accompanied by jaundice and was diagnosed to have early syphilis based on the results of standard serologic tests and clinical findings. Both the subjective and objective findings including hepatopathy were rapidly alleviated by anti-syphilitic therapy. Severe hepatopathy accompanied by jaundice used to be considered a rare complication. However, due to contemporary unhealthy lifestyle patterns characterized by hypernutrition and a lack of exercise the occurrence of fatty liver is now dramatically increasing. Our findings suggest that the occurrence of fatty liver can exacerbate the damage to the hepatic parenchyma due to a Treponema pallidum infection.

Adult↗
PubMed1954

A decade of reorientation in the treatment of venereal syphilis.

As experience with penicillin in the treatment of venereal syphilis has grown over the last decade, this drug, used without adjuvants, has become increasingly widely accepted as being effective, convenient, non-toxic, and relatively inexpensive. Metal chemotherapy required the use of repeated subcurative doses over a long period of time and was essentially suppressive in character; penicillin can be given in the form of repository preparations which ensure a treponemacidal blood-level of long duration. These can be given in large single doses or in repeated smaller doses; the therapeutic results will not vary whichever of these procedures is used.In the first part of this paper, the authors discuss the effect of penicillin and the time factor, the choice of penicillin preparation, the mode of administration, and the reaction to infection with Treponema pallidum. In the second part, they consider the present status of penicillin therapy in venereal syphilis, dealing with the principles of follow-up and control; with the treatment of early, latent, late, and congenital syphilis; and with the treatment of incubating syphilis and contacts.

Humans↗
PubMed1964

LIPOIDAL ANTIGEN AND TPI REACTIONS IN SERA FROM ETHIOPIA. EFFECT OF LONG-DISTANCE SERUM TRANSPORTATION ON ANTIBODIES.

In order to evaluate results obtained in Addis Ababa with lipoidal antigen tests for syphilis on 269 human sera, and, if possible, to determine how many positive seroreactors were in fact infected with Treponema pallidum, these sera were sent by air to Copenhagen for re-examination by the VDRL, Kahn, CWRM and TPI tests.Approximately 60% of sera reactive in VDRL tests in Ethiopia were also VDRL-reactive in Copenhagen, and some 75% were TPI-reactive. As the same VDRL techniques were used in the two laboratories, the difference in reactivity is attributed to antibody loss during transport. Sera non-reactive in TPI testing but VDRL-reactive in Addis Ababa are considered to be non-treponemal, showing false positive reactions.The low rate of agreement between the Addis Ababa VDRL tests and the Copenhagen TPI tests on sera from persons under 21 years suggests that congenital syphilis is rare in Ethiopia, in confirmation of clinical findings. However, the author considers that no conclusions on the prevalence of syphilis in Ethiopia can be drawn from the over-all results of this study.

Antibodies↗