title: Robust pro-inflammatory immune response is associated with serological cure in patients with syphilis: an observational study.
abstract: OBJECTIVE
  Approximately 15% of adequately treated patients with early syphilis remain serofast. Pathogenesis and clinical significance of this phenomenon is unclear. The objective of this study was to determine whether there is any association between host immune response and treatment outcome (serofast state or proper serological response).
  
  
  METHODS
  Forty-four patients with secondary syphilis were enrolled to this study. Levels of pro-inflammatory cytokines such as interferon-γ, tumour necrosis factor-α and interleukin-6 were measured before treatment and 8 hours after injection of antibiotic.
  
  
  RESULTS
  After 1 year, based on the serological response patients were stratified into two groups: (1) proper serological response (n=31) and (2) serofast state (n=9). The serological cure rate was 77.5% at 12 months after treatment. Patients with proper serological response had significantly higher levels of analysed cytokines (at baseline and 8 hours after treatment) compared with the serofast state group (p<0.05).
  
  
  CONCLUSIONS
  We showed that robust host pro-inflammatory immune response to infection may be the predictive factor of serological cure. The treatment outcome may be also associated with the magnitude of immune reaction occurring during the treatment.
authors.affiliation: Department of Dermatology, Jagiellonian University School of Medicine, Cracow, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Pastuszczak
authors.affiliation: Andrzej Frycz Modrzewski Cracow University, Cracow, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Gozdzialska
authors.affiliation: Department of Medicine, Jagiellonian University School of Medicine, Cracow, Poland.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Jakiela
authors.affiliation: Department of Dermatology, Jagiellonian University School of Medicine, Cracow, Poland.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Obtulowicz
authors.affiliation: Andrzej Frycz Modrzewski Cracow University, Cracow, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Jaskiewicz
authors.affiliation: Department of Dermatology, Jagiellonian University School of Medicine, Cracow, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Wojas-Pelc
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010400:Penicillin G / Q000627:therapeutic use*; D011044:Poland; D013587:Syphilis / Q000188:drug therapy / Q000276:immunology* / Q000378:metabolism; D013588:Syphilis Serodiagnosis; D014210:Treponema pallidum / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; C508600:IL6 protein, human; D015850:Interleukin-6; C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha; D010400:Penicillin G
keywords: IMMUNOLOGY; SYPHILIS; TREATMENT