梅毒血清固定相关机制研究进展

Research progress of related mechanisms of sero-resistance in syphilis

梅毒血清固定现象是抗梅毒治疗后患者血清学试验显示的一种特殊表现,亦称"血清固定型梅毒"。血清固定的发生机制不明,且患者的临床预后往往存在多种不确定因素,已经成为预防和控制梅毒,尤其是梅毒的临床诊断和抗梅毒治疗所面临的疑难问题。相关研究显示,年龄大于40岁女性梅毒患者多发生血清固定,与抗梅毒治疗所用药物、剂量、方法等相关,与梅毒螺旋体(treponema pallidun,TP)合并艾滋病病毒(human immunodeficiency virus,HIV)感染、快速血浆反应素环状卡片试验(rapid plasma regain test,RPR)血清滴度等也密切相关。此外,免疫感染机制(感染免疫、免疫抑制、自身免疫等)与梅毒血清固定的相关性亦备受关注。细胞介导免疫和抗体介导的体液免疫在梅毒血清固定免疫学相关机制中可能具有同样重要的作用,应该是一个重要的研究方向。梅毒血清固定相关机制的深入研究具有重要的临床意义及实验诊断学意义。

Syphilis sero-resistance is a special phenomenon in sera-resistant syphilis patients after anti-syphilis treatment, also known as sero-resistant syphilis. The pathogenesis of sero-resistance syphilis has not yet been clearly understood, and the clinical prognosis of the patients is often uncertain. It has become an important issue in prevention and control of syphilis, especially in the clinical diagnosis and anti-syphilis treatment. Related studies have shown that sero-resistance occurs frequently in female syphilis patients older than 40 years, and is related to the anti-syphilis medications, dosages, and treatment methods. It is also closely related to treponema pallidun （TP）-associated HIV infection and rapid plasma regain test （RPR） serum titers. In addition, the correlation between immunological infection mechanisms （infection and immunity, immunosuppression, autoimmunity, etc.） and syphilis sero-resistance is also notable. Cell-mediated immunity and antibody-mediated humoral immunity may play an equally important role in the immunological mechanism of syphilis sero-resistance and should be an important research direction. In-depth studies on the mechanism of syphilis sero-resistance have important clinical significance and laboratory diagnostic signiflcance.