Abstract
Introduction Current diagnostic technology for syphilis is over 100 years old and relies on detection of either reagins or treponemal antibodies. The development of new tests formulated on the basis of host cellular response may allow for improved diagnosis and clinical management. We aimed to pilot an evaluation of sera cytokine profiles as a means to better understand the pathogenesis of early infections. Methods Participants included men who have sex with men and transgender women with and without early syphilis recruited at two sexual health clinics in Lima, Peru. Median fluorescence intensity (MFI) of 63 cytokines in serum collected on day of diagnosis was measured using Luminex (eBioscience). We calculated the relative change in MFI between those with active (RPR titer ≥1:32, TPPA+) versus no syphilis infection (TPPA-) and compared groups using a two-sample t-test. Results Among 5 participants with active syphilis infections and 5 without there were 11 cytokines that differed between the groups with a p-value Conclusion Cytokines associated with cellular immune response might be useful in differentiating those needing treatment for active syphilis from those not requiring treatment. All of the cytokines presented here are higher in the active syphilis group versus syphilis uninfected except for Eotaxin. Larger sample size and longitudinal data are required to characterise cytokine profiles associated with treatment response and cure. Identifying cytokine changes may provide a new opportunity for diagnostic testing for syphilis infection. Disclosure of interest statement None.
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