Pastuszczak Maciej, Gozdzialska Anna, Jakiela Bogdan, Obtulowicz Aleksander, Jaskiewicz Jerzy, Wojas-Pelc Anna
Department of Dermatology, Jagiellonian University School of Medicine, Cracow, Poland.
Andrzej Frycz Modrzewski Cracow University, Cracow, Poland.
Sex Transm Infect. 2017 Feb;93(1):11-14. doi: 10.1136/sextrans-2016-052681. Epub 2016 Jun 29.
Approximately 15% of adequately treated patients with early syphilis remain serofast. Pathogenesis and clinical significance of this phenomenon is unclear. The objective of this study was to determine whether there is any association between host immune response and treatment outcome (serofast state or proper serological response).
Forty-four patients with secondary syphilis were enrolled to this study. Levels of pro-inflammatory cytokines such as interferon-γ, tumour necrosis factor-α and interleukin-6 were measured before treatment and 8 hours after injection of antibiotic.
After 1 year, based on the serological response patients were stratified into two groups: (1) proper serological response (n=31) and (2) serofast state (n=9). The serological cure rate was 77.5% at 12 months after treatment. Patients with proper serological response had significantly higher levels of analysed cytokines (at baseline and 8 hours after treatment) compared with the serofast state group (p<0.05).
We showed that robust host pro-inflammatory immune response to infection may be the predictive factor of serological cure. The treatment outcome may be also associated with the magnitude of immune reaction occurring during the treatment.
在接受充分治疗的早期梅毒患者中，约15%仍血清固定。该现象的发病机制和临床意义尚不清楚。本研究的目的是确定宿主免疫反应与治疗结果（血清固定状态或适当的血清学反应）之间是否存在关联。
44例二期梅毒患者纳入本研究。在治疗前及注射抗生素后8小时测量促炎细胞因子如干扰素-γ、肿瘤坏死因子-α和白细胞介素-6的水平。
1年后，根据血清学反应将患者分为两组：（1）适当的血清学反应（n = 31）和（2）血清固定状态（n = 9）。治疗后12个月血清学治愈率为77.5%。与血清固定状态组相比，具有适当血清学反应的患者分析的细胞因子水平（基线和治疗后8小时）显著更高（p<0.05）。
我们表明，宿主对感染的强大促炎免疫反应可能是血清学治愈的预测因素。治疗结果也可能与治疗期间发生的免疫反应强度有关。
