Dark Field Positive Lesions Research Articles

Protective efficacy of aTreponema pallidumGpd DNA vaccine vectored by chitosan nanoparticles and fused with interleukin-2

In the present study, immunomodulatory responses of a DNA vaccine constructed by fusing Treponema pallidum (Tp) glycerophosphodiester phosphodiesterase (Gpd) to interleukin-2 (IL-2) and using chitosan (CS) nanoparticles as vectors were investigated. New Zealand white rabbits were immunized by intramuscular inoculation of control DNAs, Tp Gpd DNA vaccine, or Gpd-IL-2 fusion DNA vaccine, which were vectored by CS nanoparticles. Levels of the anti-Gpd antibodies and levels of IL-2 and interferon-γ in rabbits were increased upon inoculation of Gpd-IL-2 fusion DNA vaccine, when compared with the inoculation with Gpd DNA vaccine, with CS vectoring increasing the effects. The Gpd-IL-2 fusion DNA vaccine efficiently enhanced the antigen-specific lymphocyte proliferative response. When the rabbits were challenged intradermally with 10(5) Tp (Nichols) spirochetes, the Gpd-IL-2 fusion DNA vaccine conferred better protection than the Gpd DNA vaccine (P< 0.05), as characterized by lower detectable amounts of dark field positive lesions (17.5%), lower ulcerative lesion scores (15%), and faster recovery. Individuals treated with the Tp Gpd-IL-2 fusion DNA vaccine vectored by CS nanoparticles had the lowest amounts of dark field positive lesions (10%) and ulcerations (5%) observed and the fastest recovery (42 days). These results indicate that the Gpd-IL-2 fusion DNA vaccine vectored by CS nanoparticles can efficiently induce Th1-dominant immune responses, improve protective efficacy against Tp spirochete infection, and effectively attenuate development of syphilitic lesions.

Penicillin Treatment of Early Syphilis: II

In a preliminary report 1 the influence of penicillin therapy on the clinical manifestations and serologic reactions of patients with early syphilis was presented. The report was based on the results of a curtailed period of observation of a group of 4 patients. It is our purpose in the present paper to record the findings of post-treatment observation of the original group for periods in excess of three hundred days. It is also desired to record certain items of information which have resulted from the treatment of an additional 100 patients. REVIEW OF ORIGINAL GROUP Of the group of 4 patients the records of whom formed the basis for the preliminary report, 1 all have been maintained under observation. It will be recalled that these patients displayed dark field positive lesions of early syphilis at the time of treatment. The therapy consisted of an intramuscular injection of 25,000 units of penicillin

Cellular and humoral immune response to guinea pig infected with Treponema pallidum.

Guinea pigs infected intradermally with Treponema pallidum Nichols strain were examined for the presence of lesions and for cellular and humoral response. Of the 26 guinea pigs (77%) demonstrated darkfield positive lesions between 6 and 20 days after infection. Animals divided into six groups of 4-5 in each were sacrificed between 2 and 24 weeks. The peritoneal exudate cells, obtained 4 days after injection of oil, were examined by the direct and the cells from lymphoid organs by the indirect capillary leukocyte migration method in the presence of 10 and 30 mug/ml of Reiter antigen. The peritoneal exudate cells responded with enhancement of leukocyte migration, reaching significant values between 6 and 24 weeks after injection. The cells from the lymphoid organs showed enhancement of leukocyte migration until the 4th week of infection. Treponemal antibodies, found in all animals, started to appear at the 4th week reaching a maximum titer at the 12th week after infection. The appearance of the antibodies correlated well (p less than 0.05) with the appearance of the enhancement of leukocyte migration. Wassermann antibodies were not detected throughout the 24 weeks of infection. The unique immune responses are discussed in view of the available data concerning natural acquired and experimental syphilis.

Two Darkfield-Positive Reinfections in Treated Congenital Syphilis

To the Editor:— There are well over 100 case reports in the literature of clinical reinfection in previously treated cases of congenital syphilis. 1-3 Very few reports, however, have mentioned substantiation of reinfections by the finding of Treponema pallidum in the sexually acquired lesions. In the Sing Sing Study of inoculation syphilis, Magnusen et al included five patients who were classified as having been adequately treated for congenital syphilis. 4 However, only one had stigmata of congenital syphilis, and in the other four, the presumption of congenital infection was made on the not too satisfactory basis of a record of a positive serologic test for syphilis early in life. This letter reports two well-documented cases of patients with congenital syphilis, with confirmed treatment early in life, who present with darkfield-positive lesions of sexually acquired reinfections. Report of Cases:— Case1.—The patient was a 25-year-old man seen on May 9, 1967,

Further observations on penicillinase.

THE APPLICATION of the enzyme penicillinase (Neutrapen) as a therapeutic agent in the treatment of penicillin reactions has been reassuring to the patient as well as the physician harassed by penicillin reactions. It has been previously demonstrated that parenteral injection of penicillinase in experimental animals and human subjects given penicillin resulted in rapid disappearance of detectable circulating penicillin.1However, clinical studies on the therapeutic value of the enzyme are often inconclusive since they frequently rely on improvement of subjective symptoms as their criterion. A more objective clinical analysis of penicillinase may be made by determining spirochetal protection when penicillin and penicillinase are injected concurrently into syphilitic patients with darkfield positive lesions. It was reasoned that if penicillinase destroys all penicillin, thenTreponema pallidumwill continue to survive in their chancres or moist eruptions. Materials and Methods Patients with early syphilitic lesions luxuriant inT. pallidumwere selected for this

Reinfection and relapse after treatment of early syphilis with penicillin; analysis of 137 cases of infectious failure in a total series of 1,105 cases.

WE use the term (infectious relapse) to describe all cases in which, months or years after treatment with penicillin for early syphilis, patients exhibited dark field positive lesions morphologically typical of primary and/or secondary syphilis. All other types of failures of penicillin therapy were excluded from the study. During the three and one-half years prior to the time of writing, we have collected a sufficient amount of detailed data on 137 cases of infectious failure to enable us to differentiate reinfection and relapse in the majority of instances. Of the 137 cases subjected to critical, detailed collective and individual analysis, the diagnosis of reinfection was made in 80, leaving 57 in the category of relapse (table 1). CLINICAL AND LABORATORY FACILITIES FOR COLLECTING DATA In November 1943, at the beginning of the study of the penicillin therapy of early syphilis, as a specially trained

PENICILLIN TREATMENT OF EARLY SYPHILIS: II

In a preliminary report 1 the influence of penicillin therapy on the clinical manifestations and serologic reactions of patients with early syphilis was presented. The report was based on the results of a curtailed period of observation of a group of 4 patients. It is our purpose in the present paper to record the findings of post-treatment observation of the original group for periods in excess of three hundred days. It is also desired to record certain items of information which have resulted from the treatment of an additional 100 patients. REVIEW OF ORIGINAL GROUP Of the group of 4 patients the records of whom formed the basis for the preliminary report, 1 all have been maintained under observation. It will be recalled that these patients displayed dark field positive lesions of early syphilis at the time of treatment. The therapy consisted of an intramuscular injection of 25,000 units of penicillin

The Transmission of Yaws from Man to Rabbits by an Insect Vector, Hippelates Pallipes Loew 1

Summary 1. In preliminary studies it was found that mechanical transmission of yaws might occur by the regurgitation of an infected “vomit drop” within seven hours or less of the initial meal. 2. A transmission technic with feeding chambers for flies is described. 3. In Jamaica, rabbits are relatively insusceptible to infection with T. pertenue from patients when these organisms are inoculated directly into granulating wounds. Of 63 animals inoculated in this manner, only 3, or 4.8 per cent, developed yaws. 4. Seven of sixty-eight animals fed on by infected Hippelates flies developed darkfield positive lesions. 5. The infected esophageal diverticulum of a single H. pallipes is at times sufficient to infect a rabbit with yaws.