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A 4-fold or greater decrease in TPPA titers may indicate effective BPG treatment in primary syphilis
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DOI：10.1016/j.intimp.2023.111333.png)
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Background: In the majority of clinical environments, the treponema pallidum particle agglutination (TPPA) test is known for its higher specificity compared to the rapid plasma reagin (RPR) test and is commonly employed for the diagnosis of syphilis, but their use for serological monitoring after syphilis therapy is controversial. Objectives: We aim to evaluate whether the TPPA titers is suitable for monitoring syphilis treatment efficacy. Methods: At first, 232 patients with primary syphilis were recruited. Serological testing was performed at baseline (initial visit) and at 6 months (+/- 1 month) after benzathine penicillin G (BPG) treatment. Second, New Zealand white male rabbits were infected with Treponema pallidum (T. pallidum) to evaluate the changes in TPPA titers after BPG therapy. Finally, we compared the TPPA titers in the culture supernatant of rabbit splenocytes stimulated with T. pallidum with or without BPG. Results: After 6 months of treatment, 150 (64.7%) of 232 primary syphilis patients achieved serological cure, and 82 (35.3%) had adverse outcomes. Among 110 patients with TPPA titers decreased by more than fourfold, 109 of them were serological cure patients (>= 4-fold decrease in RPR titers) (P < 0.0001). In the rabbit model of syphilis, the TPPA titers was significantly decreased in the treatment subgroup (P = 0.016) and remained constant (+/- 2-fold) or increased (>= 4-fold) in the nontreatment subgroup. In addition, T. pallidum resulted in a positive TPPA titers in the culture supernatant of splenocytes (median titers was 1: 80), while BPG could directly reduce the TPPA titers in the culture supernatant (median titers was 1: 40) (P = 0.032). Conclusions: A 4-fold or greater decrease in TPPA titers may indicate effective treatment in primary syphilis. Combining TPPA titers with RPR titers results may potentially aid in the early diagnosis of syphilis.
Keyword:
Syphilis
Treponema pallidum particle agglutination
Treatment efficacy monitoring
Treponema pallidum
期刊
IF:
4.7
论文数:
1.6W
被引数:
4.1W
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引用论文
Performance of novel infection phase-dependent antigens in syphilis serodiagnosis and treatment efficacy determination新型感染时相依赖性抗原在梅毒血清诊断和治疗效果测定中的表现.png)
CLINICA CHIMICA ACTA
CLINICA CHIMICA ACTAIF2.9
PREAI
分享收藏分享收藏Re-evaluating the sensitivity of the rabbit infectivity test for Treponema pallidum in modern era重新评估现代梅毒螺旋体兔感染性试验的敏感性CLINICA CHIMICA ACTA
OAAI
CLINICA CHIMICA ACTAIF2.9
OAAI分享收藏
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