Reduced Treponema pallidum-Specific Opsonic Antibody Activity in HIV-Infected Patients With Syphilis
Reduced Treponema pallidum-Specific Opsonic Antibody Activity in HIV-Infected Patients With Syphilis
复制标题
DOI：
10.1093/infdis/jiv591
复制
发表时间：
2016-04-15
影响因子：
6.4
通讯作者：
Lukehart, Sheila A.
中科院分区：
文献类型：
--
作者：
Marra, Christina M.;Tantalo, Lauren C.;Lukehart, Sheila A.
背景。人类免疫缺陷病毒（HIV）感染者对梅毒治疗的血清学反应可能较差，并且更有可能患上神经梅毒。梅毒螺旋体通过巨噬细胞的调理作用、摄入和杀灭作用从感染部位清除。方法。对 235 名梅毒患者的血清样本进行了梅毒螺旋体特异性调理活性的测试。通过实时聚合酶链反应扩增 tp0574 基因来测定血液中梅毒螺旋体浓度，并通过 16S 核糖体 RNA 的逆转录酶聚合酶链反应来检测脑脊液 (CSF) 中的梅毒螺旋体。结果。血清快速血浆反应素滴度越高，调理活性越高（P < .001），并且在血清采集前接受无并发症梅毒治疗的患者中（P < .001）。即使考虑到上述因素，HIV 感染者的调理活性也低于未感染 HIV 的个体 (P=.006)。在血液中可检测到梅毒螺旋体的参与者中，调理活性最高的参与者的血液梅毒螺旋体浓度较低。在多变量分析中，调理活性与 CSF 或 CSF-VDRL 反应性中梅毒螺旋体的检测之间没有显着关系。结论。 HIV 感染者血清中梅毒螺旋体特异性调理活性显着降低。梅毒螺旋体特异性免疫反应受损可能导致疾病进程或治疗反应的差异。
Background. Human immunodeficiency virus (HIV)-infected individuals may have poorer serological responses to syphilis treatment and may be more likely to experience neurosyphilis. Treponema pallidum is cleared from sites of infection by opsonization, ingestion, and killing by macrophages.Methods. Serum samples from 235 individuals with syphilis were tested for T. pallidum-specific opsonic activity. Blood T. pallidum concentrations were determined by real-time polymerase chain reaction amplification of the tp0574 gene, and T. pallidum was detected in cerebrospinal fluid (CSF) by reverse-transcriptase polymerase chain reaction of 16S ribosomal RNA.Results. Opsonic activity was higher with higher serum rapid plasma reagin titers (P < .001), and in those treated for uncomplicated syphilis before serum collection (P < .001). Opsonic activity was lower in HIV-infected than in HIV-uninfected individuals even after the above factors were taken into account (P=.006). In participants in whom blood T. pallidum was detectable, those with the highest opsonic activity had lower blood T. pallidum concentrations. In multivariable analyses, there was not a significant relationship between opsonic activity and detection of T. pallidum in CSF or CSF-VDRL reactivity.Conclusions. Serum T. pallidum-specific opsonic activity is significantly lower in HIV-infected individuals. Impaired T. pallidum-specific immune responses could contribute to differences in the course of disease or treatment response.