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PubMedDate not supplied

Recombinant Treponema pallidum antigens in syphilis serology.

Treponema pallidum, the etiological agent of syphilis, is characterized by a paucity of surface exposed outer membrane proteins and a high content of cytoplasma membrane associated lipoproteins. At all stages of infection intense antibody responses against lipoproteins are detectable. In order to provide antigens for syphilis diagnosis the highly immunogenic lipoproteins TpN17, TpN29-35 (TpD), TpN44.5 (TmpA), TpN47, and TpN35 (TmpC) and the membrane protein TpN39 (BMP) were cloned. Insertion of PCR amplified DNA into an E. coli expression vector resulted in high level expression of antigens. N-terminal hexahistidine sequence allowed efficient purification of fusion proteins by metal chelate affinity chromatography. The recombinant antigens were tested in enzyme-linked immunosorbent assays. TpN17, TpN47, and TpN44.5 antigens showed high antibody titers. Assays with the three antigens combined resulted in a further improvement of diagnostic sensitivity in comparison with single antigens. Antibodies were found in 17 of 18 patients in all stages of syphilis, whereas 42 normal human sera were nonreactive. No cross-reactivity was detected in 24 sera of patients with Lyme borreliosis.

Antigens, Bacterial↗
PubMedDate not supplied

A serological study of the age distribution of endemic treponematoses in children from Mali, Africa.

Using the Treponema Pallidum Haemagglutination Assay (TPHA) for the demonstration of treponema-specific antibodies, 444 children in age groups between 5 months and 10 years from different parts of Mali (Africa) were investigated for endemic treponematoses. The rate of seroreactivity (1,85%) in the age groups under four years (n = 270) indicates a low incidence of treponemal infections. From these observations it can be concluded that treponemal infections in infants are not caused by suckling of the babies on infectious nipples of their mothers. The high rate of TPHA-reactive children (17,8%) in the age groups between 5 and 10 years (n = 174) can be explained by the assumption of nonvenereal transmission of the disease. Furthermore, 101 mothers from Bamako and their newborn babies, were investigated serologically. In 17 mothers (17%) the TPHA was reactive. Treponema-specific antibodies were transmitted to the children in all cases and with nearly identical antibody titres.

Age Factors↗
PubMed1999

Chronic Meningitis.

Chronic meningitis may be caused by a large number of infectious agents, including spirochetes (Treponema pallidum, Borrelia burgdorferi), Mycobacterium tuberculosis, and fungi (primarily Cryptococcus neoformans). The incidence of these specific causes of chronic meningitis has been impacted since the advent of HIV infection, and new information is also available on how this epidemic has affected populations in developing countries of the world. In the area of diagnostics, the development of polymerase chain reaction has been a major advance that has increased our capabilities for identifying etiologic agents (such as M. tuberculosis) that are difficult to culture. Finally, the management of patients with chronic meningitis has evolved, and the availability of new antifungal agents and adjunctive strategies has changed the approach to the patient with cryptococcal meningitis.

Journal Article↗
PubMedDate not supplied

Peptide-protein microarrays for the simultaneous detection of pathogen infections.

We describe novel peptide-protein microarrays, which were fabricated using semicarbazide glass slides that permitted the immobilization of glyoxylyl peptides by site-specific ligation and the immobilization of proteins by physisorption. The arrays permitted the simultaneous serodetection of antibodies directed against hepatitis C virus (HCV core p21 15-45 peptide, NS4 1925-1947 peptide, core, NS3, NS4, and mixture of core, NS3, NS4, and NS5 antigens), hepatitis B virus (HBc, HBe, and HBs), human immunodeficiency virus (Gp41 and Gp120 for HIV-I and Gp36 for HIV-II), Epstein-Barr virus (VCAp18 153-176 peptide), and syphilis (rTpN47 and rTpN17) antigens using an immunofluorescence assay. Peptide-protein microarrays displayed high signal-to-noise ratios, sensitivities, and specificities for the detection of antibodies as revealed by the analysis of a collection of human sera referenced against these five pathogens.

Communicable Diseases↗
PubMed1982

Syphilis in pregnant women in Zambia.

Because of the high incidence of congenital syphilis at the University Teaching Hospital, Lusaka, Zambia, the potential risks of congenital infection and fetal loss due to syphilis were assessed by screening 202 antenatal patients, 340 pregnant women admitted to the hospital whose pregnancies ended in either spontaneous abortion or stillbirth, and 469 consecutive babies delivered at the hospital. Primary serological screening was performed with the rapid plasma reagin test, and reactive sera were confirmed by the Treponema pallidum haemagglutination test. In all cases detailed histories were obtained and patients were examined for clinical signs of syphilis. The TPHA test result was reactive in 12.5% of antenatal patients and in 42% of women who aborted in the later half of pregnancy. Among 469 consecutive babies delivered at the hospital, 30 had reactive results to the TPHA test; of these two were stillborn and four had signs of congenital syphilis at birth. Thus, syphilis appears to affect adversely an appreciably high number of pregnant women in Zambia. For this reason a special campaign to screen adequately and treat pregnant women and neonates is needed.

Female↗
PubMed1975

[Seroepidemiological studies related to the association of genital herpes to cervical cancer (author's transl)].

Blood sera of 290 patients were examined for the presence of antibodies against herpes simplex virus type 1 and type 2 (HSV-1 and HSV-2): 1. lues - seronegative individuals, 2. patients with specific lues antibodies, and 3. patients with so-called carcinoma in situ and invasive carcinoma of the uterine cervix. The group of syphilis-seropositive individuals served as control for the group with cervical lesions, because in both groups certain socioepidemiologic factors (promiscuity, early sexual intercourse) appear to be prevalent. The average value for HSV-2-antibodies was significantly higher in patients with cervical lesions than that in lues-seropositive individuals. Also, the average value was higher in the lues-seropositive group than that in the lues-seronegative group. The frequency of HSV-2-antibodies was highest in the group of patients with so-called carcinoma in situ and invasive carcinoma, less in the lues-seropositive group, and even more less in the lues-seronegative group. These results make it unlikely that the connection between cervical carcinoma and HSV-2-infection is a common or "nonsense"-correlation. They suggest a more narrow correlation between both diseases, but leave open whether it consists of either a causal relationship between herpes infection and the development of cervical carcinoma, or a predilection for herpes infection in the cervical region by the carcinomatous tissue.

Adult↗
PubMed1986

Spirochetal diseases of the CNS.

The neurotropism of the spirochete is evident from the above discussions of syphilis, Lyme disease, leptospirosis, and relapsing fever. In all of these diseases, the organism very likely enters the CNS very early in the course of the disease. The fate of the organism then depends on the virulence of the spirochete, the host defenses, and any antibiotic treatment administered. Why Treponema pallidum lays dormant in the CNS and then somehow reactivates is a mystery; the same mystery occurs in Lyme disease. Leptospirosis and relapsing fever seem to be infections much more limited in time, and are not reported to cause these long-term sequelae. The treatment of these last two infections seems to be fairly straightforward. However, the appropriate treatment for the various stages of the disease in both syphilis and Lyme disease in order to prevent long-term sequelae is not universally accepted. At this time, it seems that high-dose intravenous penicillin is the treatment of choice for each of these infections shown to be active in the nervous system.

Central Nervous System Diseases↗
PubMed1990

Soluble factors from rabbit spleen cells kill and lyse Treponema pallidum in vitro.

Antibody and complement immobilize (kill) Treponema pallidum in vitro. Recent evidence also documents immobilization by soluble factors released by activated macrophages and lymphocytes. Immune-mediated lysis of treponemes, however, has not been reported. The findings in this paper focus on apparent treponemal lysis by rabbit splenic cell preparations. Using cells from animals infected testicularly for 9 to 12 days, unfractionated splenic preparations, as well as adherent and nonadherent preparations, killed and lysed T. pallidum. Phagocytosis alone could not explain the detrimental effects of adherent cells. When cytochalasin B was used to block phagocytosis, decreases in treponemal numbers were still detected. In related studies, immune rabbit sera did not enhance treponemicidal activity of the adherent cells. To assess the specificity of these reactions, T. pallidum was incubated with two monocyte-like cell lines (human U937 and mouse P388D1). Neither cell line was detrimental, and treponemal numbers were not lowered. The soluble nature of the treponemicidal factors from adherent and nonadherent preparations was shown by physically separating these cells from the organisms and demonstrating treponemal killing and lysis. In summary, clearance of T. pallidum from infected tissues is probably at least partially attributed to macrophage phagocytosis. Our findings suggest another mechanism involving lytic factors secreted by activated adherent and nonadherent cells.

Animals↗
PubMed1998

Etiology of genital ulcers and prevalence of human immunodeficiency virus coinfection in 10 US cities. The Genital Ulcer Disease Surveillance Group.

To determine the etiology of genital ulcers and to assess the prevalence of human immunodeficiency virus (HIV) infection in ulcer patients in 10 US cities, ulcer and serum specimens were collected from approximately 50 ulcer patients at a sexually transmitted disease clinic in each city. Ulcer specimens were tested using a multiplex polymerase chain reaction assay to detect Haemophilus ducreyi, Treponema pallidum, and herpes simplex virus (HSV); sera were tested for antibody to HIV. H. ducreyi was detected in ulcer specimens from patients in Memphis (20% of specimens) and Chicago (12%). T. pallidum was detected in ulcer specimens from every city except Los Angeles (median, 9% of specimens; range, 0%-46%). HSV was detected in >/=50% of specimens from all cities except Memphis (42%). HIV seroprevalence in ulcer patients was 6% (range by city, 0%-18%). These data suggest that chancroid is prevalent in some US cities and that persons with genital ulcers should be a focus of HIV prevention activities.

Female↗
PubMed1987

Monoclonal antibodies directed against surface-associated polypeptides of Treponema pallidum define a biologically active antigen.

Murine monoclonal antibodies (Mabs) were raised against two outer-membrane-associated polypeptides of Treponema pallidum (47 and 44 kDa). Three Mabs against each polypeptide were investigated further and only those directed against the 44 kDa polypeptide were demonstrated to have immobilizing activity. The specificity of the Mabs for T. pallidum was determined by Western blotting procedures and the surface association of the antigens was inferred by immunogold electron microscopy. The clear distinction between these two polypeptides in their biological activity could help to explain the pathobiology of syphilis infections as the 47 kDa antigen has been shown to be associated with the outer membrane of this organism. Inactivity of such a surface-located protein in antibody-mediated anti-treponemal mechanisms could account for the observed ability of this organism to survive in the face of strong antibody responses in infection.

Animals↗
PubMed2003

Periodontal pathogens in subgingival plaque of HIV-positive subjects with chronic periodontitis.

Many putative periodontal pathogens associated with periodontal disease in human immunodeficiency virus (HIV)-infected patients also occur in non-HIV-infected individuals. This study examined the prevalence of eight periodontal pathogens in HIV-positive and HIV-negative patients with chronic periodontitis using the 16s RNA polymerase chain reaction technique. The results showed a significant prevalence of Porphyromonas gingivalis and Treponema denticola among HIV-negative patients compared to HIV-positive patients. Sixty percent of the patients in both groups were colonized by five to six species. Odds ratio analysis revealed a statistically significant positive association between three of the 28 possible combinations in the HIV-positive group. They included Prevotella nigrescens/Campylobacter rectus, P. nigrescens/P. gingivalis and P. nigrescens/T. denticola. Although the prevalence of periodontal pathogens is similar in both the groups, the combination of certain periodontal pathogens may be responsible for chronic periodontitis seen in HIV-infected adults.

Adult↗
PubMed2004

Barriers to infectious disease care among lesbians.

Despite the considerable number of women in the United States who identify as lesbian, few data exist that address lesbians' health needs. The Institute of Medicine emphasized that data on sexually transmitted infections, Pap smear screening, and cervical dysplasia among lesbians were needed to guide clinical practice, policy development, and patient education. Use of surveillance data for this purpose is limited because risk classifications exclude same-gender sex among women or subsume it under behavior considered as higher risk. However, sexual transmission of human papillomavirus, HIV, Treponema pallidum, and Trichomonas vaginalis between women has been reported. Data indicate that lesbians receive routine Pap smear screening less frequently than is optimal. Moreover, lesbians commonly report previous pregnancy, induced abortion, and hormonal contraceptive use. Education of lesbians and their care providers should counter assumptions that sex between women confers no risk for transmission of sexually transmitted infections, and lesbians should receive Pap smears according to current guidelines.

Female↗
PubMed1974

In vitro lymphocyte response to Treponema refringens im human syphilis.

The response of lymphocytes from patients with syphilis and normal subjects was studied in vitro by using phytohemagglutinin (PHA), pokeweed mitogen (PWM), streptolysin O (SLO), and a preparation of Treponema refringens. Normal lymphocytes exhibited a dose-response curve to treponemes. Although lymphocytes from patients with primary and secondary syphilis responded normally to PHA and PWM, their response to SLO was suppressed and they failed to show significant stimulation by treponemes. Serum from syphilitic patients did not affect normal lymphocytes, and culturing lymphocytes from patients with syphilis in normal serum did not restore their responsiveness. Six to 10 weeks after syphilitic patients had been treated, the degree of stimulation by treponemes was the same as for normal subjects. These data give indirect support to the hypothesis that immunological suppression occurs during active infection with T. pallidum.

Antigens, Bacterial↗