The Cellular Immune Function Of Patients With Early Latent Syphilis And The Influence Caused By BCG-PSN Therapy

Part I Detection of T lymphocyte subgroups in peripheral blood with early latent syphilis and the influence caused by BCG-PSN therapyObjective To explore levels of CD3+T,CD4+T,CD8+T lymphocyte subgroups in the peripheral blood with early latent syphilis.To study contrastly levels of T lymphocyte subgroups in peripheral blood with early latent syphilis and secondary dominancy syphilis, explore possible pathogenesis of early latent syphilis.To explore influence of CD3+T,CD4+T,CD8+T lymphocyte subgroups in peripheral blood with early latent syphilis caused by BCG-PSN therapy.Methods Flow cytometry was employed to detect levels of CD3+T,CD4+T,CD8+T lymphocyte subgroups in the peripheral blood of patients with early latent syphilis and secondary dominancy syphilis.Flow cytometry was employed to detect change of CD3+T,CD4+T,CD8+T lymphocyte subgroups in the peripheral blood of patients with early latent syphilis before and after treatment by BCG-PSN.Results Compared with healthy controls, early latent syphilis patients showed a significantly decreased percentage of CD3+T,CD4+T lymphocyte and a decreased of ratio of CD4+/ CD8+(P<0.01), a significantly increased percentage of CD8+T lymphocyte(P<0.05).Compared with healthy controls, secondary dominancy syphilis patients showed a significantly decreased percentage of CD3+T,CD4+T lymphocyte and a decreased of ratio of CD4+/ CD8+(P<0.01).Percentage of CD8+T lymphocyte increased,but exhibited no significant difference(P>0.05).Compared with secondary dominancy syphilis, early latent syphilis showed a decreased percentage of CD3+T lymphocyte and an increased percentage of CD8+T lymphocyte, but exhibited no significant difference(P>0.05). Percentage of CD4+T lymphocyte and ratio of CD4+/ CD8+ significantly decreased(P<0.05).In BCG-PSN group, after treatment with BCG-PSN and bicillin therapy the percentage of CD3+T,CD4+T lymphocyte and ratio of CD4+/ CD8+ significantly increased(P<0.01), but percentage of CD8+T lymphocyte did not changed significantly(P>0.05).In case-control group, the percentage of CD3+T,CD4+T, CD8+T lymphocyte and ratio of CD4+/ CD8+ did not changed significantly after treatment with bicillin therapy(P>0.05).Compared with case-control group, the percentage of CD3+T,CD4+T lymphocyte and ratio of CD4+/ CD8+ significantly increased caused by BCG-PSN therapy(P<0.01), but CD8+T lymphocyte exhibited no significant difference(P>0.05).Conclusion There were different degree decreased percentage of CD3+T,CD4+T lymphocyte, decreased ratio of CD4+/ CD8+ and increased percentage of CD8+T lymphocyte in early latent syphilis and secondary dominancy syphilis.They led to imbalance of T lymphocyte subgroups and suppression of cellular immune function.Compared with secondary dominancy syphilis, early latent syphilis showed a decreased percentage of CD4+T lymphocyte and ratio of CD4+/ CD8+,however exhibited an increased percentage of CD8+T lymphocyte.That demonstrated cellular immune function of early latent syphilis more suppressed than secondary dominancy syphilis, which may help Treponema pallidum to succeed in escaping the immune-monitoring of organism and prolonged survival. BCG-PSN could increase significantly percentage of CD3+T,CD4+T lymphocyte and ratio of CD4+/ CD8+.BCG-PSN could retrieve imbalance of T lymphocyte subgroups of patients with early latent syphilis, improve their cell-immune function. In the clinical cure, it could be necessary to treat early latent syphilis with immuno-modulator like BCG-PSN.Part II Change of serum IgM antibodies to Treponema pallidum in treated early syphilisObjective To explore the variation of serum IgM antibodies to Treponema pallidum in following-up of treated early syphilis. At the same time, we experimented RPR test contrastively for studying the role of Tp-IgM in monitoring state of early syphilis.Methods During the period of 1～2 years, the serum IgM antibodies of 55 patients with early syphilis were measured with ELISA based on antibody capture technology every 3 months since their treatment. At the same time, we experimented RPR test as contrast study.Results Tp-IgM was found to be negative earlier than that of RPR test in all cases. In primary syphilis Tp-IgM became negative in 44.4% at 3 months after treatment, but RPR test just in 5.6% contrastively. Tp-IgM all became negative after 9 months, but RPR test until after 24 months contrastively.In secondary syphilis Tp-IgM became negative in 24.3% at 3 months after treatment, but RPR test just in 5.4% contrastively. Tp-IgM all became negative after 18 months, however RPR test of 3 cases didn't become negative up to 24 months contrastively.Conclusion For treated early syphilis, the rate of seroconversion of Tp-IgM occurred within about 1 year or so. Treated earlier, Tp-IgM became negative faster. Seroconversion was faster in primary syphilis than secondary syphilis. This maybe helpful to following-up of treated early syphilis.Tp-IgM was found to be negative earlier than that of RPR test in all cases. When the quantitative detection of RPR titer was below 1:8, Tp-IgM all turned to negative, and when RPR titer drop to a low level, even if there is a prolonged serum fixed, as long as Tp-IgM has been negative, it indicats elimination of treponema pallidum, the disease has been in non-activity state, the loss of infectivity and treatment can be substituted with follow-up.Tp-IgM lasted 12 months if not negative, may suggest intimate remnants of treponema pallidum or treatment is not completely, with particular attention to the existence of early asymptomatic neurosyphilis.Part III The Efficacy of large dose aqueous penicillin in treatment of early serofast syphilisObjective To explore the efficacy and safety of large dose aqueous penicillin and bicillin therapeutic alliance in serofast early syphilis. Methods 27 patients with serofast early syphilis were given with large dose aqueous penicillin. 2400万U/d(400万U iv drip, q4h) for 14 days, then given with 240万U im, weekly for 3 weeks. RPR qualitation and quantitation test were detected before treatment and at 3,6,9 and 12 months after treatment.Results In each stage of follow-up, RPR test titer descended 2 titers or above in 48.6% at 3 months after treatment; 78.4% at 6 months; 94.6% at 9 months; became negative in 83.8% at 12 months contrastively. There was no side effect.Conclusion Large dose aqueous penicillin and bicillin therapeutic alliance is an effective and safe therapy method in treatment of serofast of patients with early syphilis.In addition to routine antibiotic like penicillin, ceftriaxone et al, it maybe helpful to treat syphilis simultaneously applying with immuno-modulator like BCG-PSN. That can cut down incidence of late syphilis, neurosyphilis and cardiovascular syphilis.