The Application of Cytokine Expression Assays to Differentiate Active From Previously Treated Syphilis

• Published in: The Journal of infectious diseases 2020-07, Vol.222 (4), p.690-694
• Main Authors: Kojima, Noah, Siebert, Janet C, Maecker, Holden, Rosenberg-Hasson, Yael, Leon, Segundo R, Vargas, Silver K, Konda, Kelika A, Caceres, Carlos F, Klausner, Jeffrey D
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - therapeutic use; Bioassays; Brain-derived neurotrophic factor; Brain-Derived Neurotrophic Factor - blood; Cytokines; Decision Trees; Enzyme-Linked Immunosorbent Assay; Humans; Lymphotoxin-alpha - blood; Major and Brief Reports; Prospective Studies; Syphilis; Syphilis - blood; Syphilis - drug therapy; Syphilis Serodiagnosis; Treponema pallidum - immunology
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jiaa127

Abstract To investigate the role of serum cytokine assays to distinguish between active from treated syphilis among serofast patients, we recruited individuals into a prospective cohort study. Participants underwent routine syphilis screening. We selected specimens from a majority cohort of serofast participants with treated and active syphilis. We analyzed specimens with a 62-cytokine multiplex bead-based enzyme-linked immunosorbent assay. Cytokines, brain-derived neurotrophic factor and tumor necrosis factor β, were most predictive. We built a decision tree that was 82.4% accurate, 100% (95% confidence interval, 82%–100%) sensitive, and 45% (18%–75%) specific. Our decision tree differentiated between serum specimens from serofast participants with treated syphilis versus active syphilis. Among a prospective cohort with a majority of serofast participants, we built a highly accurate and sensitive 2-cytokine decision tree that could differentiate between serum specimens from participants with treated versus active syphilis; however, the test had poor specificity.