Zhang Yan, Wang Jun, Wei Yingnan, Liu Huili, Wu Chunli, Qu Bin, Yan Yongxing
Department of Neurology, The Third people's Hospital of Hangzhou, Hangzhou, Zhejiang, China.
Open Med (Wars). 2020 Jul 10;15(1):635-643. doi: 10.1515/med-2020-0204. eCollection 2020.
We aimed to investigate the CXCL13 concentration of the serum and cerebral spinal fluid (CSF) in human immunodeficiency virus (HIV)-negative latent syphilis patients with treatment failure and explore the change in CXCL13 after treatment. Sixty-eight latent syphilis patients with treatment failure (failure group), 68 syphilis patients with successful treatment (seroconversion group) and 18 patients with non-inflammatory diseases of the nervous system (control group) were included and serum and CSF were collected. Enzyme-linked immunosorbent assay was employed to detect the CXCL13 in the serum and CSF. Results showed that the serum CXCL13 concentration was comparable among three groups, and the CSF leukocyte count, IgG index and CXCL13 concentration in the failure group were significantly higher than those in the seroconversion group and control group ( < 0.05, < 0.01). CSF CXCL13 concentration in the failure group was positively related to the CSF leukocyte count ( = 0.3594, < 0.001). Of the 68 patients in the treatment failure group, neurosyphilis was found in 17 (25.0%). In conclusion, involvement of nervous system is one of the reasons for the treatment failure in patients with latent syphilis. Detection of CSF CXCL13 concentration is helpful for the diagnosis and therapeutic evaluation of HIV-negative latent syphilis patients with treatment failure and neurosyphilis.
我们旨在研究治疗失败的人类免疫缺陷病毒(HIV)阴性潜伏梅毒患者血清和脑脊液(CSF)中CXCL13的浓度,并探讨治疗后CXCL13的变化。纳入68例治疗失败的潜伏梅毒患者(失败组)、68例治疗成功的梅毒患者(血清学转换组)和18例神经系统非炎性疾病患者(对照组),采集血清和脑脊液。采用酶联免疫吸附测定法检测血清和脑脊液中的CXCL13。结果显示,三组血清CXCL13浓度相当,失败组脑脊液白细胞计数、IgG指数和CXCL13浓度显著高于血清学转换组和对照组(<0.05,<0.01)。失败组脑脊液CXCL13浓度与脑脊液白细胞计数呈正相关(=0.3594,<0.001)。治疗失败组的68例患者中,17例(25.0%)发现神经梅毒。总之,神经系统受累是潜伏梅毒患者治疗失败的原因之一。检测脑脊液CXCL13浓度有助于诊断和治疗评估HIV阴性潜伏梅毒治疗失败和神经梅毒患者。