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PubMed1982

Further studies on replication of virulent Treponema pallidum in tissue cultures of Sf1Ep cells.

A number of parameters aimed at optimizing culture conditions for both Sf1Ep cells and Treponema pallidum have been investigated. Optimum temperature for replication of T. pallidum ranged between 33 and 35 degrees C. At 33 degrees C, replication occurred in the presence of atmospheric oxygen concentrations of less than 0.3 to 10%, the optimum range being 1.5 to 5%. No replication occurred in the presence of 12.5% oxygen. When both temperature and oxygen concentrations were varied between 33 and 35 degrees C and 1.5 to 5%, respectively, little differences in replication were noted. Although variation in the oxygen concentration within each temperature group had little or no effect on replication, it did have an effect on motility, which remained greater in the 5% oxygen concentration after 9 to 12 days of cultivation. Optimum concentration of fetal bovine serum in the culture medium was 20%, although replication occurred in concentrations ranging from 5 to 30%. If carefully screened, calf serum could be substituted for fetal bovine serum. Testis extract was an essential component of the culture medium. Although extract obtained from an adult rabbit--either normal or T. pallidum infected--was slightly superior, replication of T. pallidum occurred when rat or hamster testis extract was substituted.

Animals↗
PubMed1995

Syphilis screening in out-of-hospital care.

To estimate the rates of syphilis infection in inner-city patients managed by prehospital providers, a convenience sampling of prehospital patients who had intravenous lines initiated was screened for syphilis over a nine-month study period from February 1992 through October 1992. In a university-affiliated inner-city emergency department served by a city ambulance company, patients 18 years of age or older transported via ambulance who had had intravenous lines initiated at the scene or en route had a Venereal Disease Research Laboratory (VDRL) and microhemagglutination-Treponema pallidum (MHA-TP) drawn and performed by the state laboratory as a routine serological test. If the results were reactive with no previous history of syphilis recorded in the state registry, the state health department and/or one of the authors of this study contacted the patient for follow-up treatment. Age, race, sex, and diagnostic category (medical, surgical/obstetric, or neuropsychiatric) were recorded. Results were checked with the state syphilis registry. Latent syphilis was defined as a reactive VDRL and MHA-TP with no prior history of infection or record of infection in the state syphilis registry. Chi-squared test was used in statistical analysis for comparisons among ages, races, and sexes, with P > .05 considered significant. Three hundred two subjects 18 years of age and older consenting to a screening VDRL and MHA-TP had serum drawn. Two hundred seventy-nine patients were enrolled in the study after 23 patients were excluded because of improper data collection or insufficient serum collection. There were 174 men (63%) and 105 women (37%), with 73 white (26%) and 199 African-Americans (71%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Rapid in vitro immobilisation of purified Treponema pallidum (Nichols strain), and protection by extraction fluids from rabbit testes.

The use of Percoll-purified treponemes in an assay similar to the Treponema pallidum Immobilisation test demonstrated that immobilisation of purified treponemes by seronegative normal human serum proceeded at a much higher rate than that of unpurified treponemes. This suggests that the removal of the testicular extract makes the treponemes more vulnerable to this action. A preincubation of the purified treponemes with the testicular extract from infected or uninfected testes delayed their rate of immobilisation to that demonstrated by the unpurified treponemes. This showed that substances produced during the infection are probably not responsible for the delay in immobilisation. Discrimination between the classical and the alternative pathway of complement activation, studied by the ethylene glycol-bis (beta-aminoethyl ether) N,N,N',N'-tetraacetic acid (EGTA) method, showed that the classical pathway was responsible for the rapid immobilisation of the purified treponemes. However, the slow immobilisation in the EGTA-serum samples suggested a minor role of the alternative pathway in the immobilisation of the purified treponemes. Since the testicular extracts exerted an anti-complement activity, it needs to be investigated whether the protection offered to the purified treponemes by the testicular extracts is based on their deteriorating effect on the classical complement pathway or is due to a re-establishment of the protective cover around the treponemes.

Animals↗
PubMed1983

Molecular basis of immunological cross-reactivity between Treponema pallidum and Treponema pertenue.

Protein antigens of Treponema pallidum, Nichols strain, and Treponema pertenue, Gauthier strain, were identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blotting techniques. Treponemal proteins were solubilized in 1% sodium dodecyl sulfate, electrophoresed on 12.5% polyacrylamide gels, and either stained with Coomassie brilliant blue or electrophoretically transferred to nitrocellulose paper. These antigen blots were incubated with sera from rabbits infected with either T. pallidum or T. pertenue and 125I-labeled staphylococcal protein A and exposed to X-ray film for visualization of antigenic molecules. Protein profiles of each organism separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and stained with Coomassie brilliant blue showed no distinguishable differences. Antigenic profiles as determined by Western blots were similar with two exceptions. A 39,500-dalton band was present on T. pertenue but absent from T. pallidum, and a 19,000-dalton band was present on T. pallidum but absent from T. pertenue (although two additional antigenic bands at 21,000 and 18,000 daltons were seen on T. pertenue). Because these differences were detected by using antisera raised against either T. pallidum or T. pertenue, these molecules must contain some antigenic determinants in common despite their differences in molecular weight.

Antigens, Bacterial↗
PubMed1985

The axial filament antigen of Treponema pallidum.

Axial filaments (flagella) of Treponema pallidum have been purified in large enough quantities to be analysed electrophoretically. They produced a characteristic linear precipitate in two-dimensional immunoelectrophoresis. Polyacrylamide gel electrophoresis showed three major polypeptides, the most prominent having an apparent molecular weight of 37,000, about 1500 less than the corresponding component of axial filaments of the Reiter treponeme. A doublet of less abundant polypeptides of 33,500-34,000 MW also differed slightly from those of the Reiter treponeme. Western blot analysis showed that the principal polypeptide of the T. pallidum axial filament was strongly antigenic, and antibody to it was prominent in sera from hyperimmunized, as well as acutely infected (orchitic), rabbits, and in soluble fractions from acutely infected rabbit testes from which large numbers of viable treponemes had been extracted. This indicated that antibody to this component was ineffective in eliminating treponemes from the tissue.

Animals↗
PubMed1979

[Attempts at developing a syphilis vaccine (author's transl)].

Numerous investigators tried over the years to induce artifically immunity against syphilis by use of a variety of treponema preparations. None of these immunization experiments performed by different means and routes provided clear evidence of acquired immunity in animals and humans given various vaccine preparations against challenge with even minimal doses of virulent T. pallidum. In recent years, however, promising results have been obtained in the immunization study. Two types of syphilis vaccine have been developed which were found very effective in conferring a protection against syphilitic infection on rabbits: (1) the first vaccine contains T. pallidum attenuated by gamma irradiation, and the other one (2) contains T. pallidum killed by penicillin. In addition, it has been demonstrated that the immunogenic activity of T. pallidum is related to their very labile protein component. Pretty much is also known on the factors influencing the immune response of artificially immunized rabbits, and on the immunological mechanisms underlying the development of syphilis immunity.

Antigen-Antibody Reactions↗
PubMed1996

Periodontal status and detection frequency of bacteria at sites of periodontal health and gingivitis.

It is generally recognized that bacteria in dental plaque at sites of periodontal diseases are not commonly found at sites of periodontal health. One hypothesis to explain the etiology of periodontitis is that pathogenic bacteria from diseased sites infect healthy sites. It has been suggested that gingival inflammation may predispose sites to colonization by bacteria associated with periodontal diseases. The purpose of this cross-sectional study was to determine whether the detection frequency of selected bacteria at sites of periodontal health or gingivitis differed between subjects who were in good periodontal health, subjects who had gingivitis, or subjects with periodontitis. The clinical status of every tooth (except third molars) from 106 subjects was characterized by means of clinical attachment level, probing depth and by signs of inflammation. Subgingival plaque was collected from mesio-facial and disto-lingual surfaces. Specific monoclonal antibodies were used in an immunocytochemical assay to identify Campylobacter rectus, Eikenella corrodens, Porphyromonas gingivalis, pathogen-related oral spirochetes (PROS, using Treponema pallidum subspecies pallidum monoclonal antibodies), T. denticola (serotypes A-D), T. socranskii subspecies buccale and T. socranskii subspecies socranskii. Differences in detection of bacteria between groups of subjects were measured using odds ratios (OR). Results of this study indicate that PROS was the only identified bacterium at sites of both health and gingivitis that demonstrated a significant positive relationship with the presence of periodontitis. These findings do not prove that bacteria spread from periodontitis sites, nor do they imply that disease necessarily results from infection. However, these data do suggest that some bacteria associated with periodontitis are more likely than others to tolerate conditions at healthy sites and that the presence of periodontitis increases risk of infection at healthy sites.

Adult↗
PubMed1990

Experimental neonatal syphilis in a susceptible (C4D) and a resistant (Albany) strain of guinea pig.

Despite similar levels of natural antibodies and treponemicidal activity, 83% of fourth complement component-deficient (C4D) mother guinea pigs developed ulcerative lesions to a challenge of 5 x 10(7) Treponema pallidum, whereas 75% of offspring 1 to 5 days old were temporarily (2-3 months) resistant to development of dermal lesions. In contrast, only 17% of Albany-strain mothers developed small papular lesions, while 68% of 1- to 5-day-old newborns developed large papular or ulcerative lesions within 9-15 days postinfection. These findings, together with the late development of both dermal lesions and antibodies in C4D neonates, preclude the concept of an antibody-associated natural resistance. T. pallidum infection in either C4D or Albany neonates was not associated with depletion of any particular cell population in lymphoid tissue. However, marked age- and strain-dependent histologic differences were noted. Histologic examination of lymph nodes and spleens from 17-day-old and 3- to 4-month-old animals showed that maturation of lymphoid tissues in C4D animals lagged behind the Albany strain at either age. Moreover, 75% of C4D newborns contained significantly higher levels of immunomodulatory alpha 1 fetoprotein than Albany neonates. The possibility that differences in susceptibility to T. pallidum infection between C4D and Albany guinea pigs as neonates and again as adults is the result of genetically associated changes in immunologic recognition is discussed.

Animals↗
PubMed2000

Significance of detection of Porphyromonas gingivalis, Bacteroides forsythus and Treponema denticola in periodontal pockets.

The relationship between the detection of Porphyromonas gingivalis, Bacteroides forsythus and Treponema denticola in subgingival plaque samples of periodontal pockets and periodontal status was evaluated using the polymerase chain reaction (PCR). A total of 165 sites in 60 periodontitis patients were examined, and the relationships between the detection of each of the three bacterial species and the pocket depth and bleeding on probing (BOP) were analyzed. The detection ratios of P. gingivalis, B. forsythus, and T. denticola in samples from adult periodontitis lesions were 75.5%, 69.8%, and 72.6%, respectively. It was found that all sites where all three microorganisms were detected were BOP positive and had greater pocket depths than those where only one or two species were found. The detection rate of B. forsythus and T. denticola decreased with age in the sites in which PD was less than 4 mm. The present study indicates that detection of a mixed infection by P. gingivalis, B. forsythus, and T. denticola strongly correlated with adult periodontitis.

Adult↗
PubMed1994

Demographic factors associated with HTLV-1 infection in a Gabonese community.

An epidemiological study of human T-lymphotropic virus type 1 (HTLV-1) and syphilis has been carried out in a multiethnic community of seven neighbouring villages located in eastern Gabon on 1240 subjects over 5 years old (82.7% of the population in this age range). Antibodies to HTLV-1 (anti-HTLV-1) were detected by ELISA with confirmation by Western Blot and antibodies to syphilis by Venereal Diseases Research Laboratory assay with confirmation by the Treponema pallidum haemaglutination assay. The prevalence rate of anti-HTLV-1 was 8.5% and increased from 3.7% in the 5-14 years age group to 23.8% in the over 60 years age group. Logistic regression showed that the positivity for anti-HTLV-1 was associated with age, ethnic group and sex (higher prevalence in females). The seroprevalence rate of syphilis was 8.2%. Seropositivity for syphilis and HTLV-1 were related but age was a confounding variable in this relationship. This study showing a highly heterogeneous distribution of HTLV-1 in a geographically limited area suggests the role of environmental and behavioural factors in HTLV-1 transmission.

Adolescent↗
PubMed1980

Sulfhydryl oxidation using procedures and experimental conditions commonly used for Treponema pallidum.

Certain reducing agents containing sulfhydryl groups are important to the in-vitro survival of Treponema pallidum. Discrepancies occur, however, concerning the agents and the concentrations that are optimal. To clarify some of this confusion, sulfhydryl oxidation was determined using procedures and experimental conditions commonly used for T pallidum. Sulfhydryl oxidation varied according to the type of culture medium, the size of the culture vessels, the volume of the culture medium, and the gaseous environment within the culture vessels, as well as the method of extracting treponmes from infected testicular tissue. Dithiothreotol maintained highly reduced conditions by reducing disulfide groups to sulfhydryl groups. Lastly, the organisms influenced the sulfhydryl concentration by either direct oxidation or specific uptake. The sulfhydryl content was sharply decreased in the presence of viable preparations of T pallidum compared with heated preparations or membrane filtrates of viable preparations.

Animals↗
PubMed1997

Syphilis exposure in patients with uveitis.

PURPOSE: The purpose of the study is to determine the frequency of syphilis exposure in patients with uveitis, identify patient characteristics associated with serologic fluorescent treponemal antibody assays (FTA-ABS) reactivity, and examine the clinical implications of syphilis exposure in patients with uveitis. METHODS: A retrospective review of the records of 552 consecutive patients examined in the referral uveitis clinic of an urban eye hospital between January 1989 and January 1994 was performed. RESULTS: Forty-four (8%) of 552 consecutive patients with uveitis had serologic evidence of syphilis exposure on the basis of a strongly reactive serum FTA-ABS. Syphilis was presumed to be the sole cause of uveitis in 24 patients (4.3%) over the 5-year period. The racial demographic profile of those patients with serologic evidence of syphilis was consistent with the reported distribution of syphilis cases, but there were relatively few identifiable risk factors for sexually transmitted disease (including only three patients who were positive with human immunodeficiency virus). The choice of antibiotic treatment of these patients was variable and sometimes suboptimal. CONCLUSIONS: This study implicates syphilis exposure as a more common etiology of uveitis than did previous reports, advocates routine serum FTA-ABS testing of patients with uveitis, and indicates a need for a more aggressive role of the ophthalmologist in antibiotic treatment of patients with uveitis and syphilis exposure.

Adult↗
PubMed2005

Bacterial sexually transmitted infections in gay, lesbian, and bisexual adolescents: medical and public health perspectives.

Gay, lesbian, and bisexual adolescents, like all adolescents who engage in high-risk sexual behaviors, are at elevated risk for acquiring sexually transmitted infections (STIs). Personal sexual risk factors and issues related to access to care complicate the lives of youth who engage in same-gender sexual activity and who may or may not self-identify as gay, lesbian, or bisexual. Whereas epidemiologic rates of gonorrhea, chlamydia, and syphilis generally have trended downward in adolescents as a whole during the past 15 years, rates for these common reportable bacterial STIs have increased overall during recent years among men who have sex with men. This article focuses on bacterial STIs in youth with same-gender sexual activity. An understanding of trends among gay, lesbian, and bisexual youth remains incomplete, given the absence of consistent and uniform mechanisms for collecting data on sexual behaviors in adolescents and difficulties in associating these behaviors with reportable STIs. Special attention should be given to the screening, diagnosis, and treatment of bacterial STIs in those who engage in same-sex behavior, as new recommendations from the Centers for Disease Control and Prevention have been made available. It is critical that healthcare providers who work with adolescents be aware of the assortment of specific healthcare needs of gay, lesbian, and bisexual youth and address them appropriately in the clinical setting. Medical providers may be one of few true advocates for this often-marginalized adolescent population and have the power to have a positive influence on health promotion and education efforts.

Adolescent↗
PubMed2000

Syphilis in Atlanta during an era of declining incidence.

BACKGROUND: Syphilis transmission in Atlanta is ongoing despite declining incidence. OBJECTIVES: To identify risk factors and missed opportunities for prevention. STUDY DESIGN: A case-control study design was used. Twenty-five sexually transmitted disease (STD) clinic patients with primary or secondary syphilis by polymerase chain reaction and serology and 49 matched controls were interviewed. RESULTS: Persons with syphilis more frequently had HIV infection (24% versus 2%; P = 0.005), crack-using sex partners (52% versus 18%; odds ratio [OR] = 5.1; 95% CI = 1.7-15.5), and a history of incarceration (80% versus 57%; OR = 3.0; CI = 1.0-9.3). Many cases (48%) and controls (31%) had received drug-abuse treatment. Only 40% of previously incarcerated patients and 74% of those with a history of drug treatment reported receiving STD/HIV education in those settings. Among all patients reporting recent HIV education, 41% were told about STD recognition and treatment. Unprotected sex and delay in seeking care were common. CONCLUSION: To prevent syphilis and associated HIV, more extensive STD education is needed in jails and drug-treatment centers.

Adolescent↗
PubMed2001

Rapidly progressive tabes dorsalis associated with selective IgA deficiency.

Tabes dorsalis is uncommon and progresses slowly from infection to clinical manifestation. We report a rare case of rapidly progressive tabes dorsalis associated with selective IgA deficiency (sIgAD). A 28-year-old man was hospitalized with lightning back pain, nausea, and bladder bowel dysfunction. Serum and cerebrospinal fluid (CSF) revealed high titers of Treponema pallidum antibody, and the serum IgA level was less than 5 mg/dl. Thl-dominant cytokine expression was observed, as is usually seen in neurosyphilis. He was treated with Ceftriaxone and CSF pleocytosis disappeared. We postulate sIgAD influenced the atypical rapid clinical course of tabes dorsalis in this patient.

Adult↗
PubMed1991

Serologic response to treatment of infectious syphilis.

OBJECTIVE: To evaluate the serologic response to treatment of patients with infectious syphilis. DESIGN: Historical cohort study of all cases of infectious syphilis in Alberta from 1981 to 1987. PATIENTS: A total of 1090 patients were entered; 857 with primary syphilis, 183 with secondary syphilis, and 50 with early latent disease. Two hundred and eight patients were excluded who either were pregnant, had negative serologic results before treatment, had clinical relapse, were treatment failures, or were lost to follow-up. INTERVENTIONS: All 882 evaluable patients were treated with a recommended antibiotic regimen for infectious syphilis and returned for re-assessment including repeat serologic testing. MEASUREMENTS AND MAIN RESULTS: Seventy-two percent (95% CI, 66% to 77%) and 56% (CI, 43% to 70%) of patients with initial episodes of primary or secondary syphilis had seroreverted according to rapid plasma reagin (RPR) test results by 36 months. A 2- and 3-tube decline was seen by 6 and 12 months in primary and secondary syphilis. Early latent syphilis resulted in only a 2-tube decrease at 12 months. Serologic response was not affected by sex, age, race, or sexual orientation. Patients with their first infection were more likely to experience RPR seroreversal than those with repeat infections. The RPR reversal rates also depended on the pretreatment titer and stage of disease. At 36 months, 24% (CI, 20% to 28%) of patients had nonreactive fluorescent treponemal antibody absorption tests (FTA-Abs), and 13% (CI, 11% to 15%) had nonreactive microhemoglutination tests for Treponema pallidum (MHA-TP). CONCLUSIONS: Adequate therapeutic response for syphilis must be based on illness episode and the pretreatment RPR titer. Treponemal tests can demonstrate seroreversion after 36 months, and a negative treponemal test does not rule out a past history of syphilis.

Alberta↗
PubMed1992

An enhanced murine model for studies of Serpulina (Treponema) hyodysenteriae pathogenesis.

A defined diet was used to increase the susceptibility of mice to Serpulina hyodysenteriae. BALB/cByJ, C3H/HeN, and C3H/HeJ mice, when fed the defined diet 7 to 14 days prior to and throughout the challenge period, consistently showed higher incidences of disease than mice maintained on normal rodent chow. The use of this defined diet will increase the consistency of in vivo studies following infection with S. hyodysenteriae in the mouse model.

Animals↗
PubMed1974

Clinical and pathological observations on the experimental passage of swine dysentery.

The length of incubation for 36 eight and 12 week old swine in eight experimental passages averaged 11 days and ranged from five to 24 days. The duration of diarrhea for 24 of these swine averaged 6.4 days and ranged from two to 19 days. The consistent macroscopic lesion was a colitis and, subsequently, a typhlitis. In the swine euthanized on the first day of diarrhea, the colitis was most intense in the coils near the apex of the colon and, frequently, these swine had a hyperemia of the fundus of the stomach. The amount of visible blood in the colon varied. Organisms identified microscopically and ultrastructurally as spirochetes were observed commonly in the feces and the mucosal glands of the colon of swine with a diarrhea, but not in the adjacent mesenteric lymph nodes. These spirochetes which were the most numerous on the first day of diarrhea, could not be isolated and propagated in vitro. Swine which recovered naturally or were medicated at the height of a diarrhea, developed a resistance to swine dysentery. Colon from infected swine remained infectious when stored at -77 degrees C for nine months but not when stored at -16 degrees C. Feces from infected swine were not infectious after lyophilization and storage at -12 degrees C.

Animals↗