Piette F, Wattre P, Dessaint J P, Devemy P, Bergoend H
Ann Dermatol Venereol. 1979 Dec;106(12):967-72.
Some clinical features of syphilis suggest that immune complexes may be a pathogenetic factor in the syphilitic lesions. Recently, circulating immune complexes have been reported in six patients with secondary syphilis by Søling et al. In our study, the presence of circulating immune complexes was investigated in 42 patients with syphilis (primary, secondary, serological) by the method of C1q binding test. Elevated C1q binding activity was demonstrated in two-thirds of the patients with primo-secondary syphilis, with a significant difference between this group and the controls. Only two of the 21 patients with serological syphilis showed elevated C1q binding activity. Circulating immune complexes, often at moderates rates, appear very early and decrease rapidly during treatment. It was not possible to demonstrate a decline in serum complement in association with elevated C1q binding activity. During five Jarisch-Herxheimer reactions, no increase in circulating immune complexes has been noticed compared to pre-treatment values: this suggests that circulating immune complexes have no essential importance in this reaction. The characterization of the components of these circulating immune complexes by the previously described "radioimmunoprecipitation PEG assay" (RIPEGA) will enable us to state their specificity and to conceive their potential responsibility in some lesions of secondary syphilis, such as nephrotic syndrome.
梅毒的一些临床特征表明，免疫复合物可能是梅毒损害的致病因素。最近，索林等人报告了6例二期梅毒患者存在循环免疫复合物。在我们的研究中，采用C1q结合试验方法，对42例梅毒患者（一期、二期、血清学梅毒）的循环免疫复合物存在情况进行了调查。三分之二的一期和二期梅毒患者C1q结合活性升高，该组与对照组之间存在显著差异。21例血清学梅毒患者中只有2例C1q结合活性升高。循环免疫复合物通常以中等速率出现，在治疗期间出现得非常早且迅速下降。无法证明血清补体下降与C1q结合活性升高有关。在5次吉海反应期间，与治疗前的值相比，未发现循环免疫复合物增加：这表明循环免疫复合物在该反应中没有至关重要的作用。通过先前描述的“放射免疫沉淀聚乙二醇测定法”（RIPEGA）对这些循环免疫复合物的成分进行表征，将使我们能够说明它们的特异性，并设想它们在二期梅毒的某些损害（如肾病综合征）中的潜在作用。
