Analysis of Treponema pallidum DNA and CXCL13 in Cerebrospinal Fluid in HIV-Negative Syphilis Patients

Figures & data

Table 1 Primer Sequences for nPCR Amplification of TPP47 Gene

	Primer Name	Primer Sequences
External primers	47KDa-1	5′- GTTGAGGTATTGGGCGAAAA-3′
	47KDa-2	5′- ATACCCGTTCGCAATCAAAG-3′
Internal primers	47KDa-3	5′- GAAGTTTGTCCCAGTTGCGGTT-3′
	47KDa-4	5′- CAGAGCCATCAGCCCTTTTCA-3′

Note: Data from Palmer et al.¹²

Table 2 General Characteristics of 18 NS Patients

Case	Gender (F/M)	Age (Year)	Neurological Symptoms or Signs	Serum TRUST	CSF TPPA	CSF Protein (mg/L)	CSF Nucleated Cell (Cells/uL)	CSF CXCL13 (pg/mL)
1	M	49	–	1:16	+	672.6	146	57,262.0
2	F	53	Memory decline	1:64	+	645.7	28	12,245.21
3	M	27	Memory decline, seizures	1:2	+	546.4	10	5445.25
4	M	37	Memory decline	1:2	+	455.5	2	112.0
5	M	66	Hemiparesis, memory decline	1:16	+	1095.7	10	1540.14
6	F	68	Hemiparesis	1:1	+	1198.1	6	2738.86
7	M	34	Personality change	1:1	+	185.1	8	1709.24
8	M	37	Memory decline	1:16	+	505.5	10	1282.75
9	F	58	Blurred vision	1:2	–	994.4	1080	980.02
10	F	34	Headache	1:2	+	483.6	0	153.54
11	F	45	Headache, vomit	1:4	+	248.7	0	62.05
12	M	48	Hemiparesis	1:8	–	1193.6	15	58.22
13	M	58	Gait abnormalities	1:128	+	834.6	56	143.55
14	M	17	Seizures	1:128	+	276.5	5	40.68
15	F	32	–	1:4	+	800.6	36	35.10
16	M	31	Hemiparesis	1:16	+	470.0	32	5835.75
17	F	28	–	1:64	+	458.1	140	16,557.65
18	M	46	Headache, memory decline	1:64	+	1285.1	180	3469.0

Abbreviations: M, Male; F, Female; –, No neurological symptoms or signs.

Table 3 Characteristic of the Study Population

	Neurosyphilis (n=18)	Non-Neurosyphilis (n=57)	t/χ^2/z	P value
Age (Year)	41 (17–68)	34 (12–76)	1.741	0.086
Gender			1.314	0.252
Female (%)	7 (38.9)	31 (54.4)
Male (%)	11 (61.1)	26 (45.6)
Neurological symptoms (%)	15 (83.3)	8 (14.0)	30.897	0.000
Serum TRUST titer (median)	1:12 (1:1–1:128)	1:2 (negative^a-1:64)	−1.766	0.077
CSF nucleated cells (×10^6/L)	12.5 (0–1080)	2 (0–30)	−4.545	0.000
CSF protein (mg/L)	596.1 (185.1–1285.1)	297.1 (152.1–527.0)	−4.627	0.000
No. (%) CSF TRUST positive	11 (61.1)	0	36.084	0.000
No. (%) CSF TPPA positive	16 (88.9)	9 (15.8)	32.895	0.000
CSF CXCL13 Concentrations (pg/mL)	1411.4 (35.1–57,262.0)	34.6 (2.3–4101.7)	−5.173	0.000
No.(%) CSF nucleated cells> 5 (×10^6/L)	14 (77.8)	13 (22.8)	17.942	0.000
No.(%) CSF protein> 450(mg/L)	15 (83.3)	5 (8.8)	38.891	0.000
No. (%) CSF CXCL13> 57.85 (pg/mL)	16 (88.9)	12 (21.1)	24.086	0.000
No. (%) CSF nPCR positive	3 (16.7)	1 (1.8)	3.434	0.064

Note: ^a12 patients with negative serum TRUST.

Table 4 General Characteristics of CSF TP DNA Positive Patients

Case	Gender (F/M)	Age (Year)	Serum TRUST	CSF TPPA	CSF TRUST	CSF Protein (mg/L)	CSF Nucleated Cells (Cells/uL)	CSF CXCL13 (pg/mL)	Diagnosis
1	M	49	1:16	+	1:1	672.6	146	57,262.0	Late NS
2	M	37	1:16	+	1:2	505.5	10	1282.75	Early NS
3	F	34	1:2	–	–	152.1	2	16.02	Late latent syphilis
4	F	58	1:32	–	–	994.4	1080	980.02	Early NS

Abbreviations: M, Male; F, Female; –, Negative; +, Positive.

Figure 1 Subject operating characteristic (ROC) curve analysis of CSF CXCL13.

Table 5 Characteristics of Non-NS Patients with High CXCL13 Concentrations

Case	Gender (F/M)	Age (Year)	Serum TRUST	CSF TPPA	CSF Protein (mg/L)	CSF Nucleated Cell (Cells/uL)	CSF CXCL13 (pg/mL)
1	F	42	–	–	451.3	5	83.33
2	F	20	1:32	–	252.7	0	89.06
3	M	24	1:64	–	343.1	10	94.07
4	F	56	1:32	–	305.7	14	464.87
5	F	28	1:64	+	407	9	797.13
6	F	31	1:64	–	258.8	6	150.28
7	M	25	1:4	+	371.2	0	58.51
8	F	31	1:1	–	259.1	2	58.80
9	M	22	1:2	+	255.8	0	160.76
10	F	34	–	–	428.0	0	740.25
11	M	43	1:32	+	223.2	8	127.58
12	F	19	1:64	–	298.6	30	4101.70

Abbreviations: M, Male; F, Female; –, Negative; +, Positive.

Palmer HM, Higgins SP, Herring AJ, Kingston MA. Use of PCR in the diagnosis of early syphilis in the United Kingdom. Sex Transm Infect. 2003;79(6):479–483. doi:10.1136/sti.79.6.479

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