口腔螺旋体新种Treponema putidum的多位点序列分析

目的应用多位点序列分析方法鉴定一种与齿垢密螺旋体(Treponema denticola,T.denticola)近似的新种口腔螺旋体细菌Treponema putidum(T.putidum)。方法选用16S r RNA,rec A和pyr H基因构建5种T.putidum菌株和7种T.denticola菌株以及其他相关临床分离株之间的最大似然进化树和贝叶斯进化树。通过分析两种进化树的拓扑结构,鉴定它们之间的亲缘关系。结果从最大似然进化树和贝叶斯进化树可见,T.putidum和T.denticola菌种几乎为同一系统来源,但是它们又能被彻底分开。结论 T.putidum是一种与口腔致病菌T.denticola相似而又不同的新型菌种。

Construction of the Eukaryotic Expression Vector for Outer Membrane Protein Tp92 from Treponema pallidum and Its Preliminary Study on the Immune Responses in New Zealand Rabbits

To construct the recombinant plasmid of eukaryotic expression containing Tp92 gene from Treponema pallidum and study its immunogenicity in New Zealand white rabbits. Tp92 gene was amplified from the genomic DNA of T. pallidum by polymerase chain reaction (PCR) and subcloned into appropriate site of pcDNA3.1(+) vector. After identification by sequencing and restrictive enzyme digestion, the recombinant plasmid was transfected into HeLa cells using liposome, and the expressed protein was identified by immunocytochemistry and Western blotting. After verifying that the Tp92 antigen gene fragment could be expressed in HeLa cells, 100?μg of recombinant plasmids [pcDNA3.1(+)-Tp92], 100 μg of control plasmids [pcDNA3.1(+)] or 0.5 ml PBS buffer were administered in 3 groups of New Zealand white rabbits (6 rabbits/group), and the booster immunizations were employed at 2-week interval for 3 times. ELISA assay was used for the quantitative detection of the specific antibody in the sera of rabbits, and the proliferation response of spleen cells was detected by MTT assay. It was found that the target gene Tp92 segment about 2103 bp was obtained, and the DNA sequence of Tp92 gene constructed in pcDNA3.1 (+) vector was consistent with the published nucleotide sequence. The homologies of the nucleotide and putative amino acid sequences of Tp92 gene between T.pallidum subsp. pallidum Nichols and various pathogenic treponeme strains were 95.5%-100%. The analysis of immunocytochemistry and Western blotting showed that Tp92 gene segment constructed in pcDNA3.1(+) vector could express a fusion protein with a calculated molecular mass of 77 kDa in HeLa cells and the expressed protein could react with positive blood serum from syphilis patient. The specific antibody IgG titers were observed and the highest titer was 1∶1024 in rabbits after 3 times with pcDNA3.1(+)-Tp92. The proliferation response of spleen cells were significantly higher than that of rabbits injected with pcDNA3.1(+) ( P <0.05). The successful expression of the eukaryotic expression plasmid of Tp92 gene from T. pallidum was obtained in eukaryotic system and strong responses of humoral and cellular immunity was evoked by DNA vaccine of pcDNA3.1(+)-Tp92 in rabbits thus establishing a solid basis for the future studies in the biological activities and for the development of the syphilis DNA vaccine.

CLINICAL EVALUATION OF FOUR RECOMBINANT TREPONEMA PALLIDUM ANTIGEN-BASED RAPID TESTS IN THE DIAGNOSIS OF SYPHILIS

Objective To assess the sensitivity,specificity,and feasibility of 4 recombinant Treponema pallidum antigen-based rapid tests in the diagnosis of syphilis.Methods A total of 970 outpatients were selected from the Sexually Transmitted Diseases Centre of Peking Union Medical College Hospital.Venous blood was collected and serum was extracted.T.pallidum antibodies in whole blood,anticoagulant whole blood,and serum were detected using 4 recombinant T.pallidum antigen-based rapid tests.T.pallidum haemagglutination test(TPHA) was considered as the gold standard for the detection of T.pallidum specific antibodies in serum.The sensitivities and specificities of four methods were analyzed.Results The sensitivities and specificities of Abbott Determine Syphilis TP test,SD-BIOLINE Syphilis 3.0 test,VISITECT-SYPHILIS test,and Syphicheck-WB test for serum specimens were 100% and 98.9%,95.7% and 98.0%,94.6% and 98.2%,68.1% and 98.9%;for whole blood were 74.1% and 99.5%,87.9% and 99.4%,73.2% and 99.7%,64.7% and 99.7%.The observed sensitivities of the 4 rapid diagnosis tests were not significantly different with TPHA(P>0.05).Conclusions The 4 rapid tests show good performance and characteristics in the diagnosis of syphilis.Furthermore,they are more sensitive for serum specimens than whole blood.

Expression and purification of the recombinant outermembrane protein Tp0453 of Treponema pallidum and its characterization of immuno-competence

To clone and express the recombinant outer membrane protein Tp0453 of Treponema pallidum and to analyze the immuno-reactivity and immunogenicity of the expressed protein, the immuno-dominant epitope of the Tp0453 was amplified from the complete genome of T.pallidum by PCR, subcloned into expression vector pQE32 to generate the recombinant plasmid pQE32/Tp0453, then expressed in E.coli M15 and analyzed by SDS/PAGE and Western blotting. The fusion protein expressed was purified with Ni-NTA affinity chromatography. Its immuno-reactivity was assayed by indirect ELISA, and the immunogenicity was determined by immunization with this fusion protein in New Zealand rabbits. In the present study, a fusion protein of molecular weight about 32 kDa was obtained. As demonstrated by Western blotting, the recombinant protein could react specifically with positive IgG sera of patients with syphilis, and the antibodies against T.pallidum in human sera were successfully detected by indirect ELISA. Both the sensitivity and specificity of ELISA based on the Tp0453 fusion protein as were 100% (30/30) when detected with control sera. In comparison with the results of IgG ELISA with those of TPPA. It was found that the sensitivity of ELISA was 96.8% and the specificity was 100%. The difference of ELISA and TPPA was not significant, and the concordance of results between ELISA and TPPA was 98.2%. In addition, specific humoral responses could be elicited by immunization with the recombinant fusion protein in New Zealand rabbits with a specific antibody titer of 1∶1280 after 3 successive doses of immunization. These results demonstrate that the expressed recombinant fusion protein shows excellent immuno-competence and provide foundation to develop a quick diagnostic kid applied to detect the presence of T.pallidum infections.

Eukaryotic expression of outer membrane protein Gpd from Treponema pallidum and preliminary studies on its immune response in rabbits

The Gpd gene was amplified from the genomic DNA of Treponema pallidum and cloned into the appropriate site of pcDNA3.1(+) vector. The expression of pcDNA3.1(+)-Gpd in HeLa cells was tested with Western blotting and technology of immunocytochemistry. New Zealand rabbits were immunized with the eukaryotic expression recombinant pcDNA3.1(+)-Gpd. A fusion protein of Gpd with 4.1 kDa has been effectively expressed in HeLa cells, which were detected by Western blotting and the immunocytochemistry techniques. The New Zealand rabbits were able to elicit the specific antibody after immunization with the nucleic acid vaccine. The antibody titer could reach as high as 1∶1024 after 2 weeks of the third injection; and the splenocytes proliferated evidently due to the Gpd protein stimulation. Both the antibody titer and the splenocytes proliferation were higher substantially than those of controls (P<0.01). All above data will contribute to an experimental basis of further study of the biological function of Gpd protein as well as DNA vaccine for syphilis.

Cloning and Expression of the Tpp17 Gene of Treponema pallidum And Clinical Application

Objective: To obtain recombinant Treponema pallidum subsp, pallidum (TP 17KD) lipoprotein in large quantities by amplification and to further purify antigens for laboratory diagnosis of syphilis and development of a syphilis vaccine. Method: The Tppl7 lipoprotein gene was amplified from the TP(strain Nichols), and then it was recombinated into a plasmid pMAL-2c and cloned within E. coli 12-TB1. The host bacteria containing recombinant plasmids were induced with IPTG. The Tpp 17KD lipoprotein gene was amplified by us-ing PCR and positive clones were screened with double digestion and PCR. Recombinant plasmids were transformed into E. coli and the E. coli carrying recombinant plasmids were induced. The expression of TP 17KD was detected by sodium dedecyl sulfate-polyacrylamide gel electrophoresis(SDS-PAGE) and immunoblot. Results:Gel staining with Coomassie blue G-250 showed that the induced E. coli carrying recombinant plasmid could produce 60KD fusion protein at high levels. Gel scanning showed that 17KD protein expression in E. coli accounted for 10 % of total cellular protein. The recombinant protein antigen reacted with the sera of syphilis patients. Conclusion: Our study lays a cornerstone for developing new techniques of laboratory diagnosis for syphilis and new vaccines. Preliminary clinical application showed that the fusion protein could be used for the diagnosis of syphilis.

The Construction of the Eukaryotic Expression Vector of Glycerophosphodiester Phosphodiesterase Gene from Treponema pallidum and its Expression in Hela Cells

Objective: To construct the recombinant plasmid containing Glycerophosphodiester phosphodiesterase (Gpd) gene from Treponema pallidum and transfect it into Hela cells to express the encoded outer membrane protein. Methods: The Gpd gene was amplified from the genomic DNA of T.pallidum by polymerase chain reaction (PCR) and inserted into cloning vector pUCm-T. The inserted Gpd gene was subcloned into the appropriate site of pcDNA3.1(+) vector. After identification by sequencing and restrictive enzymes digestion, the recombinant plasmid was transfected into Hela cells using liposomes. The expressed protein was identified by immunocytochemistry and Western blot. Results: The target Gpd gene segment was approximately 1059bp. The DNA sequence of the Gpd gene contained in the pcDNA3.1(+) vector was consistent with the published nucleotide sequence. The homology of the nucleotide and putative amino acid sequences of the Gpd gene between T. pallidum subsp. pallidum Nichols and various pathogenic treponemal strains ranged from 98% to 100%. Immunocytochemistry and Western blot analysis showed that the constructed Gpd-pcDNA3.1(+) vector expressed a fusion protein with a calculated molecular mass of 41KDa in Hela cells and that the expressed protein reacted with the sera from syphilis patients. Conclusion: The successful construction and expression of the eukaryotic expression plasmid of the Gpd gene from T.pallidum provide a promising tool to further study the biological activity of T.pallidum and develop a DNA vaccine for syphilis.

Detection of Treponema pallidum,Herpes Simplex Virus,and Haemophilus ducreyi from Genital Ulcers by Multiples Polymerase Chain Reaction

Objective: To evaluate the clinical application of multiplex PCR in the detection of Treponema pallidum, Herpes simplex virus (HSV), and Haemophilus ducreyi. Method: Three standard strains were used to set up a multiplex PCR (MPCR) for detecting syphilis, herpes genitalis, and chancroid simultaneously. Samples from 122 patients with genital ulcer disease(GUD) were subjected to MPCR and the results were compared with these of dark-fidd microscopy and TP serology, HSV anligen ELISA,and H. ducreyi culture, Result: In the 122 patients with GUD, MPCR identified 34 casesof T.pallidum infection, 40 cases of HSV infection, and 2 cases of mixed infection of T.pallidum and herpes. No positive results of H. ducreyi were found. The sensitivity of MPCR to T. pallidum and herpes was 100% and 93.3%, respectivdy. The sensitivities of dark-field microscopy and TP serology, HSV antigen ELISA, and H. ducreyi culture was 35.3%, 50% and 100%, respectively. Conclusion: MPCR showed a relatively higher sensitivity for T.pallidum as compared with the routine techniques. Although its sensitivity for HSV was not as good as that of antigen ELISA, it also yielde da high detection rate. MPCR can detect more than one pathogen. It is simple, quick, sensitive, and suitable for clinical use or epidemiological investigation.

Infectious Disease Update in Obstetrics: A Modern Approach to the Patient with a Positive Screening Test for Syphyilis in Pregnancy

Screening for maternal syphilis has been an essential component of routine antenatal screening tests in most countries for many years. This is not only because of the virulence of the spirochete which causes the infection but also because of its vertical transmission rate and the potential severe adverse complications/morbidity that can result from its transmission to the fetus. Although the incidence of maternal syphilis and its fetal sequalae in low-income countries has been considerable for several years, the disease has been almost non-existent in high income countries with wide antenatal screening coverage and effective treatment programmes for Syphilis. The recent alarming increase in the incidence of maternal syphilis in high income countries has spawned a renewed public health interest in the infection, with several countries updating and strengthening public health guidance in an attempt to stem this dramatic trend. This is a short clinical update for the practising obstetrician on how to manage the antenatal patient with a positive syphilis screening test.

2018-2022年北京市密云区医院孕产妇人类免疫缺陷病毒、梅毒螺旋体、乙型肝炎病毒检测结果分析

目的:分析2018-2022年北京市密云区医院孕产妇人类免疫缺陷病毒(HIV)、梅毒螺旋体、乙型肝炎病毒(HBV)检测结果。方法:选取2018年1月-2022年12月于密云区医院进行孕产期保健及分娩的孕产妇19 327例作为研究对象,收集并分析孕产妇一般资料及HIV、梅毒螺旋体和HBV初筛结果。结果:19 327例孕产妇中,HIV阳性0例,梅毒螺旋体阳性101例(0.52%),HBV阳性175例(0.91%)。2018-2022年梅毒螺旋体和HBV阳性呈小幅度波动,其中以2021年明显降低。孕产妇梅毒螺旋体、HBV阳性率及构成比均以20~29岁最高,40~45岁最低。结论:2018-2022年北京市密云区医院孕产妇HIV、梅毒螺旋体、HBV阳性率较低,以20~29岁最多,临床应针对此情况采取应对措施,消除艾滋病、梅毒、乙型肝炎的母婴传播。

Production of proinflammatory cytokines in the human THP-1 monocyte cell line following induction by Tp0751,a recombinant protein of Treponema pallidum

The tissue destruction characteristic of syphilis infection may be caused by inflammation due to Treponema pallidum and the ensuing immune responses to the pathogen.T.pallidum membrane proteins are thought to be potent inducers of inflammation during the early stages of infection.However,the actual membrane proteins that induce inflammatory cytokine production are not known,nor are the molecular mechanisms responsible for triggering and sustaining the inflammatory cascades.In the present study,Tp0751 recombinant protein from T.pallidum was found to induce the production of proinflammatory cytokines,including TNF-α,IL-1βand IL-6,in a THP-1 human monocyte cell line.The signal transduction pathways involved in the production of these cytokines were then further investigated.No inhibition of TNF-a,IL-1β,or IL-6 production was observed following treatment with the SAPK/JNK specific inhibitor SP600125 or with an ERK inhibitor PD98059.By contrast,anti-TLR2 mAb,anti-CD14 mAb,and the p38 inhibitor SB203580 significantly inhibited the production of all three cytokines.In addition,pyrrolidine dithiocarbamate (PDTC),a specific inhibitor of NF-κB,profoundly inhibited the production of these cytokines.Tp0751 treatment strongly activated NF-κB,as revealed by Western blotting.However,NF-κB translocation was significantly inhibited by treatment with PDTC.These results indicated that TLR2,CD14,MAPKs/p38,and NF-κB might be implicated in the inflammatory reaction caused by T.pallidum infection.

Treponema pallidum-specific antibody expression for the diagnosis of different stages of syphilis

Background Tp15, Tp17, Tp45, and Tp47 are outer-membrane proteins found in Treponema pallidum, the etiologic agent of syphilis. These proteins are potent antigens and are potential markers for the serological detection of syphilis. The present study analyzed antibodies to these protein antigens （TP-IgM and TP-IgG） in human serum and investigated the expression of these antibodies during different stages of syphilis. Methods Serum samples were collected from 69 subjects （male 45, female 24） diagnosed with syphilis and analyzed by Western blotting for the expression of IgM and IgG against the four protein antigens. Expression levels of the target antibodies were compared during the same stage of syphilis as well as between different stages of this disease. Results In subjects with primary syphilis, the positive rate of Tp45 IgM was higher than that of other TP-IgM. Tp15 IgM was detected only in subjects with tertiary syphilis. Similarly, the seroprevalence of Tp45 IgG in primary syphilis was higher than for other TP-IgG. No target TP-IgM was detected in subjects with latent syphilis. In subjects with secondary syphilis, the expression level of Tp15 IgG （138.73±20.16） was higher than for other target TP-IgG. In subjects with tertiary syphilis, all target TP-IgG were detected. In subjects with tertiary or latent syphilis, the expression levels of Tp45 IgG （121.33±11.04 and 110.10±40.19, respectively） were higher than those of other target TP-IgG. The expression levels of all Tp-lgM were similar before or after anti-syphilis treatment. In comparison, the expression levels of all TP-IgG decreased compared with the pre-treatment levels, and this decrease was statistically significant （both P 〈0.05） for Tp17 IgG and Tp47 IgG. Conclusions After Treponema pallidum infection, Tp45 IgM appeared first and Tp15 IgM occurred during later stages. The positive rates of all TP-IgG increased with the duration of this disease. Anti-syphilis treatment reduced the expression levels of Tp17 IgG and Tp47 IgG. Larger-scale studies are required to further validate the value of Tp15, Tp17, Tp45, and Tp47 as markers for the early detection of primary and latent syphilis.

齿垢密螺旋体与慢性牙周炎关系的研究进展

齿垢密螺旋体(Treponema denticola,Td)是一种革兰氏阴性厌氧菌,属解糖密螺旋体。慢性牙周炎(chronic periodontitis,CP)是一种由细菌侵犯牙周组织而引起的慢性炎症,细菌是CP发生发展的始动因子,堆积在牙面及龈沟内的细菌及其产物会诱发炎症反应,为细菌的繁殖提供有利条件,使细菌进一步向龈下扩展,从而破坏牙周组织。Td被认作中等证据的牙周致病菌,其在正常牙周组织中检出率较低,但在CP患者中检测率高,且与牙周袋深度和探诊出血程度密切相关,在CP的发生发展中扮演着重要角色。由于Td在形态学特征上与其他牙周致病菌有明显区别,故本文就Td的生物学特征、在CP中的致病情况、检测情况及治疗情况的研究做一综述。

Seroreactivity and immunogenicity of Tp0965, a hypothetical membrane protein of Treponema pallidum

Background Treponema pallidum （T. pallidum） subsp, pallidum is the causative agent of syphilis. Analysis of recombinant antigens of T. pallidum led to the identification of potential candidate antigens for vaccine development and syphilis serodiagnosis. Tp0965 was predicted to be a membrane fusion protein and was found to be reactive with infected human sera in previous studies, but the results were controversial. In this research, the antigenicity and immunoreactivity of recombinant protein Tp0965 were assessed. Methods T. pallidum subsp, pallidum （Nichols strain） was propagated and isolated and the genomic DNA was extracted. The Tp0965 gene was amplified by polymerase chain reaction （PCR）. Then the recombinant protein Tp0965 was expressed in Escherichia coli and purified by nickel-nitrilotriacetic acid （Ni-NTA） purification system. The reactivities of protein Tp0965 were examined by immunoblot analysis and indirect enzyme-linked immunosorbent assay. The antisera against protein Tp0965 were obtained by immune rabbits and the immunogenicity of antisera were detected by indirect enzyme-linked immunosorbent assay. Results Recombinant protein Tp0965 was expressed successfully in vitro. Immunoblot assay showed that the recombinant protein Tp0965 could be recognized by human syphilitic sera of all stages. Indirect enzyme-linked immunosorbent assay showed there were only 4 of 74 human syphilitic sera that failed to show reactivity to recombinant antigen Tp0965, and lack of reactivity of Tp0965 to all 28 uninfected sera. A low titer of antiserum against Tp0965 in immune rabbits could be detected after the third time of immunization. Conclusions The recombinant antigen Tp0965 shows excellent sensitivity for the reactivity with sera from syphilitic individuals at all stages. The results also demonstrate a potential application for the serodiagnosis of syphilis.

CLIA、RPR、TPPA检测血清中梅毒螺旋体抗体的价值分析

目的 分析化学发光免疫测定法(CLIA)、快速血清反应素试验(RPR)、梅毒螺旋体明胶颗粒凝集试验(TPPA)检测血清中梅毒螺旋体抗体的结果。方法 100例疑似梅毒患者血清样本为研究对象,均采用CLIA、RPR、TPPA进行检测,并以重组免疫印迹法(RIBA)检测结果为金标准,分析三种检测方式的检测结果 ,并比较三种检测方式的诊断效能。结果 CLIA检出阳性59例,阴性41例。RPR检出阳性73例,阴性27例。TPPA检出阳性59例,阴性41例。CLIA诊断准确率为69.00%(69/100),敏感度为68.92%(51/74),特异度为69.23%(18/26);RPR诊断准确率为97.00%(97/100),敏感度为97.30%(72/74),特异度为96.15%(25/26);TPPA诊断准确率为77.00%(77/100),敏感度为74.32%(55/74),特异度为84.62%(22/26)。RPR的诊断准确率、敏感度显著高于CLIA、TPPA(P<0.05);RPR的特异度高于CLIA(P<0.05);CLIA与TPPA的诊断准确率、敏感度、特异度差异较小(P>0.05)。结论 RPR在梅毒螺旋体抗体的临床诊断中具有更佳的诊断准确率,可为梅毒患者的治疗提供可靠的诊疗依据。

2014—2023年HIV/AIDS患者与梅毒螺旋体共感染的文献计量学与可视化分析

目的通过对近10年HIV/AIDS患者与梅毒螺旋体共感染的相关报道文献的可视化分析,了解该领域的研究热点和未来趋势。方法以Web of Science Core Collection数据库作为数据源,检索2014-2023年HIV/AIDS患者合并感染梅毒螺旋体的相关文献,使用VOSviewer和CiteSpace对相关文献进行可视化分析。结果共有81个国家,1171家机构进行了相关研究,其中美国、中国、英国研究者发文较多,且合作紧密,发达国家是研究主力。关键词聚类中流行病学、孕妇、产前护理、神经梅毒、眼梅毒、男男性行为人群等反映了研究热点,其中男男性行为人群、眼梅毒是未来研究趋势。结论近10年HIV/AIDS患者合并梅毒螺旋体感染的研究热点从合并感染的流行病学、对神经梅毒的诊断逐渐转变至对眼梅毒及男男性行为人群的关注。

Association between coinfection of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans and Treponema denticola and periodontal tissue destruction in chronic periodontitis

Background The association between the infection of Porphyromonas gingivalis, Actinobacillus actinomy-cetemcomitans and Treponema denticola in chronic periodontitis (CP) and the severity of periodontal disease remains to be elucidated. The aim of this study was to investigate the subgingival infection frequencies of three periodontopathic bacteria in Chinese CP patients and to evaluate the correlations between infection by these bacteria and periodontal destruction.Methods A multiple PCR assay using primers derived from 16SrDNA genes of P. gingivalis, A. actinomy-cetemitans and T. denticola was established to measure simultaneously the presence of the three microbes in 162 subgingival samples from 81 Chinese CP patients. Results The positive rates of P. gingivalis, A. actinomycetemitans and T. denticola in the subgingival samples were 84.6%, 83.3% and 88.3%, respectively. Of the subgingival samples, 68% revealed the coinfection of all the three microbes. The infection rates with P. gingivalis, A. actinomycetemitans or T. denticola alone was 5.9% (1/17), 17.6% (3/17) and 76.5% (13/17), respectively. A close association was present between the A. actinomycetemitans infection and gingival index (GI) (P<0.01), but not between P. gingivalis or T. denticola infection and GI (P>0.05). P. gingivalis and A. actinomycetemitans were more frequently detectable in middle and deep pockets than in shallow ones (P<0.01), while T. denticola was found remarkably often in deep pockets (P<0.05). The coinfection rate of the three microbes was significantly higher in sites with severe periodontitis than in those with mild periodontitis (P<0.01). Conclusions The multiple PCR established in this study can be used as a sensitive and specific method to simultaneously detect all three microbes in subgingival samples. A. actinomycetemitans infection may be associated with CP and play an important role in the periodontal tissue destruction. The coinfection of P. gingivalis, A. actinomycetemitans and T. denticola can cause more serious periodontal destruction than infection of any one or two of the three microbes.

Relationship between the high frequency of 23S rRNA point mutations in Treponema pallidum and low serological response rate to azithromycin treatment in China

Objective Although azithromycin is effective against Treponema pallidum (T.pallidum),the causative agent of syphilis,recent reports indicate that the prevalence of azithromycin resistance in China is very high,which may result in the failure of treatment.In this study,we aimed to investigate the association between azithromycin resistance and therapeutic outcomes in early syphilis patients.Methods Between February 2010 and December 2014,patients aged 18-65 years with early syphilis were enrolled.T.pallidum DNA were extracted to test the presence of A2058G and A2059G mutations.Then,eligible patients were randomly assigned to receive oral azithromycin (0.5 g,once daily for 15 days) or intramuscular BPG (2.4 million units,once weekly for 3 weeks).All patients were followed up in 2 weeks and 3,6,9,and 12 months after treatment to collect demographic and clinical characteristics and laboratory results.The differences on serological response,serological failure and serofast rate were compared between the two groups by Chi-square test.Results Among the 187 T.pallidum-infected patients enrolled,172 (92.0%) cases had a mutation associated with azithromycin resistance (A2058G,153 cases;A2059G,19 cases).During the 5-year study period,the percentage of cases enrolled with these mutations steadily increased,from 90.9% in 2010 to 95.3% in 2014.Of the 172 patients presenting with these mutations,only 78 (45.3%;all benzathine penicillin G [BPG]-treated) obtained a serological response to treatment;32.6% and 22.1% of patients presented with serological failure and serofast results,respectively.For azithromycin-treated cases,66.3% and 33.7% had serological failure and serofast results,respectively,in contrast with 1.1% and 11.3% of BPG-treated cases.However,among the A2058G-and A2059G-negative patients,the serological response rates between the two treatment groups were similar.In multivariate analyses,patients with lower rapid plasma reagin (RPR) titers (RPR,≤ 1 ∶ 8;odds ratio [OR],0.23;95% confidence interval [CI],0.09-0.37) or who received azithromycin treatment (OR,121.50;95% CI,35.38-386.17) were more likely to display serological failure and serofast results.Conclusion This prospective study found that the 23S rRNA A2058G and A2059G point mutations in T.pallidum are currently circulating with high frequency in China,suggesting a correlation between the high prevalence of macrolide resistance and a lower serolo gical response rate to azithromycin treatment.

梅毒螺旋体与母胎界面细胞相互作用影响妊娠结局的机制研究进展

梅毒是由梅毒螺旋体(Treponema pallidum,Tp)感染引起的一种慢性、性传播疾病[1]。近十年来,梅毒在世界范围内流行,特别是在非洲、东南亚、西欧、俄罗斯和中国,并在这些地区造成了严重的公共卫生问题[2-3]。梅毒发病率逐年上升,先天性梅毒(con-genital syphilis,CS)发生率也一直处于较高水平[4-5]。CS是由Tp经胎盘垂直传播感染胎儿的一种先天感染性疾病,可发生于妊娠任何阶段.

梅毒螺旋体外膜蛋白功能的研究进展

梅毒是一种严重影响人类健康的慢性传播性疾病,是由梅毒螺旋体感染所引起。梅毒螺旋体外膜蛋白(Omp)是一类具有关键性功能的蛋白。Omp在梅毒螺旋体的免疫原性、黏附宿主细胞以及转运营养物质等方面具有非常重要的作用。本文就梅毒螺旋体主要外膜蛋白的结构、功能等特性做一综述。