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PubMed2026

[Syphilis and human treponemes: a long evolutionary history revealed by paleogenomics].

Recent discoveries in paleogenomics have revolutionized our understanding of syphilis and other human treponematoses. Far from being a pathogen that suddenly appeared in Europe in the late Middle Ages, we now know that Treponema pallidum has been circulated among human populations for millennia. Ancient genomes recovered from pre-Columbian contexts in the Americas show that major treponemal lineages had already diversified well before the modern era, often in the absence of recognizable skeletal lesions. Genomic analyses further indicate that treponemal diversity is not the result of extensive genetic acquisition, but rather of small-scale modulation of a highly conserved genome, notably via antigenic variation involving the tpr gene family. Combined with data on endemic treponematoses, congenital syphilis, and historical pathology collections, these findings support a model in which syphilis, yaws, and bejel represent context-dependent expressions of an ancient treponemal continuum, with implications for diagnosis, epidemiology, and vaccine design.

Humans↗

PubMedDate not supplied

A time series aggregation model for predicting the incidence of syphilis.

The incidence of infectious syphilis is much different from the number of reported cases in any given year; therefore, an estimate of the incidence is needed to formulate effective control programs for the future. A time series aggregation model that predicts the incidence of syphilis was developed. The model accounts for the number of treated but unreported cases, and it provides estimates of incidence for different age and racial groups. As an illustration the model was applied for estimation of the incidence of syphilis in the city of Chicago, Illinois. A sensitivity analysis revealed that a 10% variation in input parameters would cause an error of smaller than or equal to 4.1% in the estimates of incidence.

Age Factors↗

PubMed1976

Studies on the Treponema pallidum immobilizing activity in normal human serum. 5. On the protective role against syphilis.

It was shown that T. pallidum immobilized in vitro by normal serum had lost its infectivity in rabbits. This finding suggested that the immobilizing activity of normal serum might play a role in the natural resistance of man against infections with T. pallidum. However, the results of serological studies of acquired early syphilis in man and of experimental syphilis in cynomolgus monkeys did not present evidence that the immobilizing activity of normal serum protected against syphilis infection.

Animals↗

PubMed1975

Lymphocyte transformation in syphilis: an in vitro correlate of immune suppression in vivo?

Suppression of cellular immunity during primary and secondary infection may explain, in part, the unusual clinical evolution of syphilis. We have previously shown that lymphocytes from normal subjects undergo blastic transformation when exposed in vitro to Treponema refringens. This response was suppressed in patients with syphilis. the suppression being unrelated to serum factors. In the present paper we studied lymphocyte response in vitro to T. refringens, T. reiter, and T. pallidum as well as to monilia and trychophytins. The response to these antigens was suppressed in patients with syphilis although the response to phytohemagglutinin. pokeweed mitogen, and streptolysin was normal. These data support the hypothesis that human infection with T. pallidum is followed by a complex interaction between cellular and humoral immunity, the former being suppressed in primary and secondary stages.

Antigens, Bacterial↗

PubMed1978

Counterimmunoelectrophoresis of Reiter Treponeme Axial filaments as a diagnostic test for syphilis.

Purified axial filaments from the cultivable Reiter treponeme, previously shown to share an antigenic component with pathogenic Treponemia pallidum, were evaluated as antigen in a diagnostic test for syphilis. Antibody to the filaments was revealed by counterimmunoelectrophoresis. Conditions that produced optimal results in the test were established. A total of 343 sera from normal individuals, biological false-positive reactors, and from patients in the different stages of syphilis were subjected to the test. The results indicate the test to be sensitive and highly specific for detecting treponemal antibodies in human syphilis.

Antigens, Bacterial↗

PubMed1975

Application of the enzyme-linked immunosorbent assay (ELISA) in the serodiagnosis of syphilis.

The enzyme-linked immunosorbent assay (ELISA) technique, using an ultrasonicate of Treponema pallidum as antigen, has been evaluated as a serological test for syphilis. It is concluded that the test is simple, reliable, and relatively quick and that its sensitivity in all stages of syphilis is equal to the FTAABS test. Because its specificity is probably also high, ELISA might be used in future as a first-line screening test for the serodiagnosis of syphilis.

Adsorption↗

PubMed1976

Radiographic findings in early acquired syphilis: case report and cirtical review.

The radiographic and pathophysiologic features of early acquired syphilis are discussed. Bone changes occur in early acquired syphilis and should not be confused with gummas of late syphilis. The radiographic findings are protean and may exist without a clinical history of a cutaneous lesion. The skull, clavicle, and tibia are the sites most frequently involved.

Adult↗

PubMed1975

The fluorescent treponemal antibody-absorption (FTA-ABS) test for syphilis.

The FTA test was developed at a time when immunofluorescence procedures were not well-defined. Through technique control and research, a modification of the FTA test, the FTA-ABS, has attained a position as one of the leading treponemal tests to confirm the reagin tests for syphilis. In this review of the FTA-ABS test, attention has been focused on reagent development, with the anticipation that reagent standardization may soon become a reality. The T. pallidum antigen obtained by extracting infected rabbit testicular tissue has evolved from a preparation in which the treponemes remained in the initial extracting fluid to a reagent that can be free of rabbit tissue and globulin. These washed antigen preparations improve visibility of the treponemes on the microscope slide, reduce background fluorescence, and reduce or prevent from occurring nonspecific reactions that are a result of tissue and globulin components. Both washed and nonwashed antigens are available commercially, and, to date, little differentiation has appeared on the product label. The predominant immunoglobulin that reacts with T. pallidum in the indirect fluorescent antibody tests appears to be IgG. This is the major immunoglobulin detected in the FTA-ABS test. IgM, although increased in early syphilis, is also increased in other clinical conditions. Several reports suggest that adult IgM detection in the present FTA-ABS test would be nonspecific. Until specific IgM antibody in adult syphilis can be detected without a risk to test specificity, the conjugate for the FTA-ABS test should continue to be an anti-IgG reagent. Class-specific, anti-IgG reagents are more expensive than other reagents; however, their use may eliminate the problem of nonspecificity resulting from IgM detection. Additionally, micromethods can be used to reduce cost, and this possibility should be investigated. The sorbent that contains an antigen to the Reiter treponeme may or may not specifically absorb the reactivity that occurs in normal sera; certainly, there are questionable aspects about this reagent. Group antibodies not related to Reiter treponemes may be responsible for some nonspecific reactivity; additionally, antiglobulin factors have been reported to participate in the reaction. Antigens free of rabbit serum factors and class-specific, antiimmunoglobulin reagents are available, and may lead to a better understanding of nonspecific reactions. These reagents should allow resolution of the possible multiplicity of reactivity. In this interim period, the sorbent, with its possible nonspecific nature, appears to maintain a biological balance between natural or group and immune antibodies when used to detect IgG antibody.

Absorption↗

PubMed1976

Treatment of secondary syphilis.

There are few studies of therapy for secondary syphilis which are adequate by modern standards of scientific design. Penicillin has been the best documented, effective antibiotic, although not all forms and regimens are equally effective. Although both aqueous penicillin G and procaine penicillin G in oil with aluminum monostearate (PAM) appear effective, these are not practical penicillin forms. The first requires injections every 2 to 4 hours for 7 to 10 days and the latter is no longer available in the United Sates. Aqueous procaine penicillin G (APPG) regimes have been evaluated in limited trials, but do appear effective. However, APPG requires daily injections and is impractical for widespread use in the treatment of secondary syphilis. The injection of 2.4 million units of benzathine penicillin G appears to be an effective single session regimen. Although tetracycline is widely accepted as the drug of choice for patients allergic to penicillin, this drug has been less rigorously evaluated for treatment of secondary syphilis. Other antibiotics have been even less well evaluated and none has been clearly shown to be highly effective.

Chloramphenicol↗

PubMed1976

Treatment of late benign syphilis: review of the literature.

The English literature on the treatment of late benign syphilis with penicillin was reviewed. To date there have been no controlled randomized therapeutic trials to support the efficacy of this therapy. This disease responds rapidly to all antisyphilitic drugs including arsphenamine and heavy metals. There are ample case reports and 2 major therapy studies which demonstrate the safety and beneficial effects of penicillin in individual patients. Although the exact dosage and duration of therapy are open to speculation, it is wise to treat patients with late benign syphilis with doses of penicillin judged to be effective for concomitant neuro-or cardiovascular syphilis.

Humans↗

PubMed1975

Macrophage migration inhibition test in untreated syphilis.

Two modifications of macrophage migration inhibition test, one of George and Vaughan and the other one of Svejcar, were performed on a total of 78 cases of untreated syphilis at various stages. As specific antigens were used: Treponema Pallidum ultrasonate and cardiolipin. Inhibition of migration was observed in 87 percent patients with primary syphillis and in all patients with late and late congenital syphilis. After improving and standardisation of the technique of Treponema Pallidum antigen-the migration inhibition test may be recommended as a specific in vitro-test for detection of cell mediated immunity in syphilis.

Adolescent↗

PubMed1975

Serological evidence for syphilis in different population groups in Rwanda.

The prevalence of serological syphilis, based on qualitative VDRL slide test was studied in different population groups in Rwanda. A positive VDRL was found in 0.7% of female students of a social school, in 2.2% of male and female premarital consultants, in 3.2% of prenatal consultants, in 6.5% of soldiers, and in 27.9% of prostitutes. As the first groups were not exposed to venereal disease, VDRL reactivity due to biological false positive reaction or to yaws antecedents is estimated at 0.5 to 2%. Accordingly, VDRL reactivity due to syphilis is estimated at 1 to 2% in prenatal consultants, 5 to 6% in soldiers and 25 to 26% in prostitutes. It is concluded that syphilis is not yet an important public health problem except in certain promiscuous population groups in towns, as soldiers, migrant workers and prostitutes.

Adolescent↗

PubMed1975

Modification of the Rappaport rapid test in large-scale testing for syphilis. Evaluation of the rapid plate and rapid card tests.

The Rappaport rapid (RR) plate and card tests were developed as modifications of the RR tube test to permit rapid and inexpensive screening of large numbers of subjects for the diagnosis of syphilis. More than 2,000 sera were examined in parallel by the Venereal Disease Research Laboratory (VDRL) slide test, the rapid plasma reagin (RPR) card test and the RR plate and card tests. There was complete agreement between the RR plate and card tests and the VDRL slide and RPR card tests in 96.6% of sera. In a selected group of 1,530 sera examined, in addition, by the fluorescent treponemal antibody absorption (FTA-ABS) test, there was agreement between the RR plate and card tests and the FTA-ABS test in 74.3% of sera and between the VDRL and RPR tests and the FTA-ABS test in 73.7% of sera. The RR plate test was found to be sufficiently sensitive and specific for the diagnosis of syphilis, although the VDRL slide test is perhaps more sensitive in primary and late latent syphilis. Since the antigen used in the RR tests is colored and stable and the sera do not require inactivation before the test, the tests are easier to perform than the VDRL slide test: the RR plate and card tests could therefore replace the VDRL test as a screening test, with hardly any loss of accuracy.

Flocculation↗

PubMed1976

[Leucocyte migration-inhibition test in syphilis (author's transl)].

The leucocyte migration-inhibition test was performed on blood from 57 patients with syphilis. Even in the early stages of the disease with lymph-node involvement there were signs of cellular antitreponemic reactivity. But there was an absence of cellular immune response in some patients with secondary syphilis and CNS involvement in the course of tertiary syphilis.

Cell Migration Inhibition↗

PubMed1992

Phenotype of villous stromal cells in placentas with cytomegalovirus, syphilis, and nonspecific villitis.

Villous stromal cells (VSC) play an important role in fetomaternal placental immune function. We studied the phenotype of VSC in infection by cytomegalovirus (CMV) and syphilis as well as nonspecific villitis and compared the findings with gestational age-matched controls. Monoclonal antibodies directed against total leukocytes, T cells, B cells, macrophages, dendritic cells, granulocytes and HLA-DR as well as polyclonal antibodies against S-100, alpha-1 antichymotrypsin, and lysozyme were used. In controls, the immunocytochemical response for each marker was either negative or weakly positive. In contrast, the VSC in CMV-infected and nonspecific villitis showed intense reactivity to various macrophage markers. In syphilis, reactivity with macrophage markers such as lysozyme and MAC387 were weaker, and reactivity to HLA-DR and S-100 was much stronger. Endothelial cells strongly expressed the monocyte/granulocyte marker CD15 in the diseased states, especially in syphilis, relative to controls. We conclude that the phenotype of VSC is altered in disease states and that the changes are dependent to some degree on the specific subset of chronic villitis.

Antibodies, Monoclonal↗

PubMed1977

[The Baie disease: was it syphilis?].

In 1773 an epidemic disease with cutaneous manifestations appeared in Baie Saint-Paul, Québec and spread rapidly from nearby les Eboulements to the entire island of Montreal. The epidemic was in many ways reminiscent of a typical outbreak of syphilis, a condition then well known in Europe. Dr. Charles Blake of Montreal, as well as Drs. James Bowman and Philippe Badelart of Quebec, would not acknowledge any other diagnosis. The latter two physicians were commissioned by General Haldimand, governor of Canada, to investigate and treat this new disease. Patients were often cured by potions or ointments containing mercury if used from the onset of symptoms. However, Dr. Robert Jones, another physician from Montreal, submitted a different opinion: the clinical course of the disease, the anomalies of its transmission, its sometimes intriguing sequelae and its unpredictable response to mercurial therapy led him to believe that it might be an entity entirely different from syphilis as it was then known in Europe. Half a century earlier, in Scotland, a similar outbreak had occurred for which the same reservation had been made with regard to a possible diagnosis of syphilis.

Disease Outbreaks↗

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↗

PubMedDate not supplied

[Passive hemagglutination test in the serodiagnosis of syphilis].

Passive haemagglutination test with pathogenic Treponema pallidum antigen in the serodiagnosis of syphilis, carried out on 752 sera (518 syphilitic patients and 234 subjects without evidence of syphilis) showed a greater general sensitivity as compared the cardiolipin tests and complement fixation test with Reiter protein antigen, and lower, to immunofluorescence (FTA--ABS). Its specificity is relatively lower than that of the cardiolopin and treponemal tests. Associated with the cardiolipin test it may be preferably used for the detection of syphilis, and moreover, passive haemagglutination may confirm the diagnosis in case of weak positive results with the FTA--ABS test. The latter is, however, essential for problem cases.

Antigens, Bacterial↗