ArticleMed (New York, N.Y.)2024
Neurosyphilis is characterized by a compartmentalized and robust neuroimmune response but not by neuronal injury.
Article in Med (New York, N.Y.), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 12 citations in OpenAlex.
- Review
- Cerebrospinal Fluid Proteome Reveals Dysregulation of Lysosomal and Axonal Proteins in Neurosyphilis.Journal of proteome research · 2026Article
- Factors associated with cerebrospinal fluid abnormalities suggestive of neurosyphilis in HIV-negative patients with secondary syphilis: a retrospective study.Frontiers in medicine · 2026Article
- Immune-inflammatory-nutritional dysfunction in HIV-negative patients with asymptomatic neurosyphilis: a retrospective comparative study.Frontiers in immunology · 2026Article
- Article
- Epigenetic Changes in Cerebrospinal Fluid and Blood of People With Neurosyphilis.The Journal of infectious diseases · 2025Article
- A Study on the Inflammatory Response of the Brain in Neurosyphilis.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- Mechanisms of Neurosyphilis-Induced Dementia: Insights into Pathophysiology.Neurology international · 2024Review
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Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundNeurosyphilis is increasing in prevalence but its pathophysiology remains incompletely understood. This study assessed for CNS-specific immune responses during neurosyphilis compared to syphilis without neurosyphilis and compared these immune profiles to those observed in other neuroinflammatory diseases.
methodsParticipants with syphilis were categorized as having neurosyphilis if their cerebrospinal fluid (CSF)-venereal disease research laboratory (VDRL) test was reactive and as having syphilis without neurosyphilis if they had a non-reactive CSF-VDRL test and a white blood cell count <5/μL. Neurosyphilis and syphilis without neurosyphilis participants were matched by rapid plasma reagin titer and HIV status. CSF and plasma were assayed for markers of neuronal injury and glial and immune cell activation. Bulk RNA sequencing was performed on CSF cells, with results stratified by the presence of neurological symptoms.
findingsCSF neopterin and five CSF chemokines had levels significantly higher in individuals with neurosyphilis compared to those with syphilis without neurosyphilis, but no markers of neuronal injury or astrocyte activation were significantly elevated. The CSF transcriptome in neurosyphilis was characterized by genes involved in microglial activation and lipid metabolism and did not differ in asymptomatic versus symptomatic neurosyphilis cases.
conclusionsThe CNS immune response observed in neurosyphilis was comparable to other neuroinflammatory diseases and was present in individuals with neurosyphilis regardless of neurological symptoms, yet there was minimal evidence for neuronal or astrocyte injury. These findings support the need for larger studies of the CSF inflammatory response in asymptomatic neurosyphilis.
fundingThis work was funded by the National Institutes of Health, grants K23MH118999 (S.F.F.) and R01NS082120 (C.M.M.).
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