■一些报道的自身免疫性疾病,如抗NMDAR脑炎和视神经脊髓炎(AQP4),被认为可能继发于梅毒螺旋体感染。由于免疫损伤在神经梅毒中的作用尚不清楚,在这项回顾性研究中,我们研究了神经梅毒患者的免疫损伤与其临床特征和结局的相关性.
■从2019年1月至2021年12月在我们中心收集了神经梅毒患者的临床信息。脑脊液(CSF)样品在小鼠脑切片上进行基于组织的间接免疫荧光测定(IIF-TBA)和基于细胞的测定(CBA)。比较TBA阳性和阴性患者的临床特征和治疗结果。
■共81例诊断为神经梅毒的患者。CBA检测结果显示,三例有抗NMDAR,AQP4或GAD65抗体,分别。通过TBA测试,38例(38/81,46.9%)免疫阳性,包括神经元细胞染色21例(21/38,55.3%),胶质细胞11例(11/38,28.9%),神经元和神经胶质细胞6例(6/38,15.8%)。然后,我们比较了TBA阳性和阴性患者的临床特征和治疗结果,发现TBA阳性染色与梅毒抗体滴度(血清p=0.027,CSFp=0.006)和头部MRI异常(实质异常p<0.001,白质病变p=0.013)显着相关。TBA阳性神经梅毒患者认知预后明显差于TBA阴性患者(p<0.001)。
■我们的神经梅毒患者的TBA结果与临床数据之间的相关性暗示存在继发性免疫损害,这影响了他们的预后。因此,TBA可用作神经梅毒患者预后的额外生物标志物。
UNASSIGNED: Several reported cases of autoimmune conditions such as anti-NMDAR encephalitis and neuromyelitis optica (AQP4) have been considered to be potentially secondary to Treponema pallidum infection. Since the role of immune impairment in neurosyphilis is unclear, in this retrospective study, we examined the correlation of the immune impairment in patients with neurosyphilis with their clinical characteristics and outcomes.
UNASSIGNED: Clinical information was collected from patients with neurosyphilis in our center from January 2019 to December 2021. Cerebrospinal fluid (CSF) samples were subjected to indirect immunofluorescence tissue-based assay (IIF-TBA) on mouse brain sections and cell-based assay (CBA). The clinical characteristics and treatment outcomes of TBA-positive and-negative patients were compared.
UNASSIGNED: A total number of 81 patients diagnosed with neurosyphilis were included. The results of the CBA tests showed that three cases had anti-NMDAR, AQP4, or GAD65 antibodies, respectively. By TBA test, 38 patients (38/81, 46.9%) had positive immunostains, including staining of neuronal cells in 21 cases (21/38, 55.3%), glial cells in 11 cases (11/38, 28.9%), and neuronal and glial cells in six cases (6/38, 15.8%). We then compared the clinical characteristics and treatment outcomes between the TBA-positive and-negative patients and found that TBA-positive staining was significantly correlated with syphilis antibody titers (p = 0.027 for serum and p = 0.006 for CSF) and head MRI abnormalities (p < 0.001 for parenchymal abnormalities and p = 0.013 for white matter lesions). The cognitive prognosis of TBA-positive neurosyphilis patients was significantly worse than that of TBA-negative patients (p < 0.001).
UNASSIGNED: The correlation between the TBA results and clinical data of our neurosyphilis patients imply the presence of secondary immune damage, which affected their prognosis. Therefore, TBA can be used as an additional biomarker for neurosyphilis patient prognosis.