Molecular subtyping of Treponema pallidum and associated factors of serofast status in early syphilis patients: Identified novel genotype and cytokine marker

• Published in: PloS one 2017-04, Vol.12 (4), p.e0175477-e0175477
• Main Authors: Zhang, Rui-Li, Wang, Qian-Qiu, Zhang, Jin-Ping, Yang, Li-Jia
• Format: Article
• Language: English
• Subjects: Adult; Age; Age Factors; Agglutination; Analysis; Angiogenesis; Anti-Bacterial Agents - therapeutic use; Antibiotics; Antibodies; Assaying; Azithromycin; Bacterial infections; Biochemistry; Biology and Life Sciences; Biomarkers - metabolism; Blood; Care and treatment; Cell migration; Chancre; Chemokines - blood; Chin; Cities; Control; Cytokines; Cytokines - genetics; Cytokines - metabolism; Defensive behavior; Demographics; Dendritic cells; Dermatology; Diagnosis; Dilution; Disease control; Disease prevention; Diseases; Doxycycline; Eicosapentaenoic acid; Endothelial cells; Enzyme-Linked Immunosorbent Assay; Epidemics; Exudates; Female; Genetic aspects; Genotype; Guidelines; HIV; Hospitals; Human immunodeficiency virus; Humans; Immune response; Immune system; Immunology; Infections; Inflammation; Intercellular Signaling Peptides and Proteins - blood; Interleukin 10; Jaw; Lesions; Logistic Models; Lymphocytes T; Male; Medicine and Health Sciences; Middle Aged; Molecular Typing; Odds Ratio; Patients; Penicillin; People and Places; Peptides; Physiological aspects; Population studies; Prevention; Reagin; Regulations; Research and Analysis Methods; Risk Factors; Sexuality; Sexually transmitted diseases; Skin; Skin diseases; STD; Syphilis; Syphilis - drug therapy; Syphilis - microbiology; Therapy; Tissues; Treatment Outcome; Treponema pallidum; Treponema pallidum - genetics; Treponema pallidum - isolation & purification; Treponema pallidum - metabolism; Ulcers; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0175477

Serofast, a persistent nontreponemal serological response observed in early syphilis patients after conventional treatment, remains a concern of clinicians and syphilis patients. No consensus has been established, however, that defines an effective treatment strategy and clarifies the pathogenesis. In this study, 517 patients with early syphilis were enrolled and treated. Twelve months after treatment, 79.3% (410/517) of patients achieved serological cure, 20.1% (104/517) were serofast, and 0.6% (3/517) were serological failures. Multivariate analysis demonstrated that older age (>40 years) and lower baseline RPR titer (≤ 1:8) were associated with serofast status. We also identified 21 T. pallidum molecular subtypes among early syphilis patients and detected a new subtype, 14i/a. We found that the proportion of 14i/a type in serofast patients was significantly higher than that in patients with serological cure, predicting an increasing risk of serofast status. Levels of chemerin were higher in the serum of serofast cases than serological cure cases, potentially indicating a novel cytokine marker for serofast in early syphilis patients after therapy. We hope that these results contribute to improve guidelines for the management of syphilis patients who experience serofast.