title: Expression of CXCL2 in the serum and cerebrospinal fluid of patients with HIV and syphilis or neurosyphilis.
abstract: The potential mechanisms for blood-brain barrier damage and the diagnosis of neurosyphilis in HIV patients co-infected with syphilis (HIV-S) are unclear. The aim of the study was to determine the expression of CXCL2 in the serum and cerebrospinal fluid (CSF) of HIV-S patients. A total of 34 HIV patients and 7 controls were enrolled in a HIV clinical cohort for diagnosis of neurosyphilis in Taiwan. Serum and CSF concentrations of CXCL2 were determined by ELISA. Neurosyphilis was defined as a CSF white blood cell count of ≧20 cells/μl or a reactive CSF Venereal Disease Research Laboratory (VDRL). Demographics and medical histories were collected. All the patients with HIV-S were males. Most (80%) had sex with men (MSM) and serum rapid plasma reagin (RPR) titers of ≧1:32. The medium age was 37 (range 21-68) years. The medium CD4 T cell counts at the time of the diagnosis of syphilis were 299 (range 92-434) cells/μl. Eight patients (24%) had neurosyphilis based on a reactive CSF VDRL test (n = 5) or increased CSF white blood cell counts of ≧20 cells/μl (n = 3). The concentrations of CSF CXCL2 were significantly higher in patients with HIV and neurosyphilis as compared to HIV with syphilis, HIV, and controls (p = 0.012). There were no significant differences in serum concentrations between the four groups. There was a correlation between CSF CXCL2 concentrations with neurosyphilis (p = 0.017), CSF white blood cell count (p = 0.001), and CSF protein levels (p = 0.005). The CSF level of CXCL2 can be used to distinguish those with or without neurosyphilis in HIV infected patients.
authors.affiliation: Section of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, #386 Ta-Chung 1st Road, Kaohsiung, 813, Taiwan, Republic of China, hctsai1011@yahoo.com.tw.
authors.forename: Hung-Chin
authors.initials: HC
authors.lastname: Tsai
authors.forename: Shin-Yu
authors.initials: SY
authors.lastname: Ye
authors.forename: Susan Shin-Jung
authors.initials: SS
authors.lastname: Lee
authors.forename: Shue-Ren
authors.initials: SR
authors.lastname: Wann
authors.forename: Yao-Shen
authors.initials: YS
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D001812:Blood-Brain Barrier / Q000382:microbiology / Q000473:pathology / Q000821:virology; D002308:Cardiolipins / Q000134:cerebrospinal fluid; D054426:Chemokine CXCL2 / Q000097:blood* / Q000134:cerebrospinal fluid*; D002784:Cholesterol / Q000134:cerebrospinal fluid; D060085:Coinfection; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000134:cerebrospinal fluid*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009494:Neurosyphilis / Q000097:blood / Q000134:cerebrospinal fluid*; D010713:Phosphatidylcholines / Q000134:cerebrospinal fluid; D013587:Syphilis / Q000097:blood / Q000134:cerebrospinal fluid*; D055815:Young Adult
chemical_list: C499706:CXCL2 protein, human; D002308:Cardiolipins; D054426:Chemokine CXCL2; D010713:Phosphatidylcholines; C054448:VDRL antigen; D002784:Cholesterol