The clinical significance of antibodies to extractable nuclear antigens in patients with syphilis.

Zhou J1*, Li Y2, Hu S1, Kong C3
1Medical Laboratory, Affiliated Hospital of Jining Medical University, Jining, P.R. China.
2 Medical College, Jining Medical University, Jining, P.R. China.
3Nursing Department, Affiliated Hospital of Jining Medical University, Jining, P.R. China.
*Correspondence: Jianwei Zhou; +86-537-2903218;

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Background: To date, the pathogenic mechanism of Treponema pallidum (TP), the pathogen that causes syphilis remains unclear. Recently, some scholars found that the progression of syphilis infection probably relates to the production of autoantibodies stimulated by TP.
Objective: To determine and compare the presence of serum antibodies to extractable nuclear antigens (ENAs-Ab) between patients with syphilis and healthy controls who do not have syphilis.
Materials and Method: This study was a descriptive comparative study carried out between January 2014 and December 2015 at the Affiliated Hospital of Jining Medical University, Jining, P.R. China; 220 patients with Treponema pallidum particle agglutination assay (TPPA) – confirmed syphilis were included and another 220 healthy persons who were TPPA-negative were included as the controls. Presence of ENAs-Ab (detected by immunoblotting method) were compared in both groups. Differences in presence of ENAs-Ab in patients with syphilis by gender, age and Toluidine Red Unheated Serum Test (TRUST) result was also determined. Statistical significance was pValue <0.05.
Results: Among the patients with syphilis, antibodies to Sjögren’s Syndrome antigen A (SSA), Ro/SSA antigen of 52 000 Molecular Weight (Ro-52), double stranded deoxyribonucleic acid (dsDNA), proliferating cell nuclear antigen (PCNA), Ribosomal P protein (Po) and Sjögren’s Syndrome antigen B (SSB) were present in 10.9%, 16.8%, 4.0%, 7.2%, 3.2% and 7.7% respectively. Significantly higher number of patients with syphilis had ENAs-Ab compared to healthy controls (P<0.05). There was no significant difference in the number of TRUST-positive and TRUST-negative patients who had ENAs-Ab (P>0.05). Significantly more females than males with syphilis had antibodies to SSA, Ro-52 and SSB (P<0.05). The 4 most common ENAs-Ab detected were found more in patients over 45 years with syphilis.
Conclusion: Syphilis infection appears to trigger an autoimmune response and ENAs-Ab may be a suitable clinical index to monitor progression of infection.

Keywords: Treponema pallidum, Autoantibody, Extractable nuclear antigens, Toluidine Red Unheated Serum Test.

Cite this article: Zhou J, Li Y, Hu S, Kong C. The clinical significance of antibodies to extractable nuclear antigens in patients with syphilis. Yen Med J. 2021;3(2):135–138.


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