The Analysis of Peripheral Blood Lymphocyte Subsets and Cerebrospinal Fluid of Neurosyphilis Patients
|Keywords||neurosyphilis cellular immunity cerebrospinal fluid|
Neurosyphilis (NS) is caused by Treponema pallidum subspecies pallidum, which can affect the central nervous system during any stage of the disease. There is no standard diagnostic method for NS because of its wide range of clinical symptoms, so it is easy to be misdiagnosed or fails to be examined. It is of very importance for early diagnosis of NS. So far, diagnosis is usually made based on the combination of the history, clinical signs and symptoms, syphilitic serologic and cerebrospinal fluid (CSF) tests. We conducted a case control study of52hospitalized NS patients negative for human immunodeficiency virus (HIV). In order to expore the effect of humoral inmunity and cellular immunity on the disease prognosis, we analyze the change of peripheral blood lymphocyte subsets and CSF routine, biochemistry and immunity index of these NS patients, what’s more, by establishing the rabbit animal model, we studied how Tp affect the CSF RPR, TPPA, routine and biochemistry index in the course of infection. Our results showed that the number of CD3+T lymphocytes and CD3+CD4+T lymphocytes was lowest in the early NS patients in which inflammatory reaction was most serious. The largest ratio of CD3+CD4+/CD3+CD8+reflected immunity imbalance in early NS patients bodys. The increased CD3+CD8+T lymphocytes number and decreased NK cells number were consistent with the development of NS. The concentrations of CSF white blood cell (WBC)、CSF Protein、 CSF albumin、 albumin quotient、CSF IgG、CSF IgA、IgG index and IgA index were significantly elevated in the NS patients than in the control subjects. However, the CSF lactic dehydrogenase (LDH) concentrations were lower. The sensitivity of NS diagnosis could be significantly increased by combining the IgA index, the CSF LDH, the CSF WBC and the albumin quotient, which can predict NS. In addition, the wild strain caused weaker immune response than Nichols strain. After the rabbit infected with Tp wild strain from different clinical sources, the change of CSF WBC, CSF protein, CSF albumin and CSF LDH was consistent with an inflammatory response. In the course of inflammatory response, the level of CSF indexes kept increasing till it reached the maximum and then gradually decreased which was similar with CSF related indexes of NS patients from different clinical stages The syphilitic serologic and CSF tests are very important for diagnosing and monitoring of NS.