梅毒螺旋体与梅毒血清固定
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摘要
近年来梅毒血清固定的增加导致梅毒治愈面临新的挑战,再加上社会因素的影响,这一现象已成为一个重要的临床和社会问题。虽然已经提出了关于其形成原因的各种理论,但确切的发病机制仍然未知。自梅毒螺旋体完整基因组序列的确定及CDC分型方法创建,距今已有20年,学者们对梅毒菌株分子分型进行了大量的研究,推动了梅毒的研究进展。本文就梅毒菌株类型与梅毒血清固定之间的可能存在的关系做一综述,为其研究及诊疗提供参考。
In recent years, the increase of syphilis serofast has brought new challenges to the cure of syphilis. Coupled with the influence of social factors, this phenomenon has become an important clinical and social problem. Although various theories about the causes of its formation have been proposed, the exact pathogenesis remains unknown. It has been 20 years since the establishment of the complete genome sequence of Treponema pallidum and the establishment of CDC typing method, scholars have carried out a lot of research on the molecular typing of syphilis strains, which promoted the research progress of syphilis. This article reviews the possible relationship between the type of syphilis strain and syphilis serofast, and provides a reference for its research and diagnosis.
In recent years, the increase of syphilis serofast has brought new challenges to the cure of syphilis. Coupled with the influence of social factors, this phenomenon has become an important clinical and social problem. Although various theories about the causes of its formation have been proposed, the exact pathogenesis remains unknown. It has been 20 years since the establishment of the complete genome sequence of Treponema pallidum and the establishment of CDC typing method, scholars have carried out a lot of research on the molecular typing of syphilis strains, which promoted the research progress of syphilis. This article reviews the possible relationship between the type of syphilis strain and syphilis serofast, and provides a reference for its research and diagnosis.
引文
[1]Lafond RE,Lukehart SA.Biological basis for syphilis[J].Clin Microbiol Rev,2006,19(1):29-49.
[2]中华人民共和国国家卫生健康委员会.2017年全国法定传染病疫情概况[EB/OL].http://www.nhc.gov.cn/jkj/s3578/201802/de926bdb046749ab b7b0a8e23d929104.shtmL,2018-02-26.
[3]Workowski KA,Bolan GA.Sexually transmitted diseases treatment guidelines2015[J].MMWR Recomm Rep,2015,64:1-137.
[4]Fisman DN.Syphilis resurgent in China[J].Lancet,2007,369:84-85.
[5]Tong ML,Lin LR,Liu GL,rt al.Factors associated with serological cure and the serofast state of HIV-negative patients with primary,secondary,latent,and tertiary syphilis[J].PLoS One,2013,8(7):e70102.
[6]中国中西医结合学会皮肤性病专业委员会性病学组.梅毒血清固定临床处理专家共识[J].中华皮肤科杂志,2015,48(11):753-755.
[7]张学军,郑捷.皮肤性病学[M].9版.北京:人民卫生出版社,2018.
[8]Se?a AC,Wolff M,Behets F,et al.Response to therapy following retreatment of serofast early syphilis patients with benzathine penicillin[J].Clin Infect Dis,2013,56(3):420-422.
[9]张君,黄涛,郑和平,等.B细胞与梅毒免疫的研究进展[J].中国皮肤性病学杂志,2018,32(07):813-816.
[10]Se?a AC,Zhang XH,Li T,et al.A systematic review of syphilis serologica treatment outcomes in HIV-infected and HIV-uninfected persons:rethinking the significance of serological non-responsiveness and the serofast state after therapy[J].BMC Infect Dis,2015,15:479.
[11]周平玉.梅毒血清固定再认识[J].中华皮肤科杂志,2017,50(5):379-381.
[12]Qin J,Yang T,Wang H,et al.Potential Predictors for Serofast State after Treatment among HIV-Negative Persons with Syphilis in China:A Systematic Review and Meta-Analysis[J].Iran J Public Health,2015,44(2):155-169.
[13]李维,刘双全.梅毒血清固定机制的研究进展[J].微生物学免疫学进展,2018,46(03):82-85.
[14]Tong ML,Lin LR,Liu GL,et al.Factors associated with serological cure and the serofast state of HIV-negative patients with primary,secondary,latent and tertiary syphilis[J].PLoS One,2013,8(7):e70102.
[15]Fraser CM,Norris SJ,Weinstock GM,et al.Complete genome sequence of Treponema pallidum,the syphilis spirochete[J]Science,1998,281(5375):375-388.
[16]Pillay A,Liu H,Chen CY,et al.Molecular subtyping of Treponema pallidum subspecies pallidum[J].Sex Transm Dis,1998,25(8):408-414.
[17]Marra C,Sahi S,Tantalo L,et al.Enhanced molecular typing of treponema pallidum:geographical distribution of strain types and association with neurosyphilis[J].J Infect Dis,2010,202(9):1380-1308.
[18]彭锐锐,Alberta L.Wang,李婧,等.梅毒螺旋体基因分型的系统综述和荟萃分析[C].//第二届全国皮肤病与性病学博士生学术会议论文集.北京协和医学院中国医学科学院皮肤病研究所,2012:7-17.
[19]Oliver S,Sahi SK,Tantalo LC,et al.Molecular Typing of Treponema pallidum in Ocular Syphilis[J].Sex Transm Dis,2016,43(8):524-527.
[20]Wu H,Chang SY,Lee NY,et al.Evaluation of macrolide resistance and enhanced molecular typing of Treponema pallidum in patients with syphilis in Taiwan:a prospective multicenter study[J].J Clin Microbiol,2012,50(7):2299-2304.
[21]MikalováL,GrillováL,Osbak K,et al.Molecular Typing of Syphilis-Causing Strains Among Human Immunodeficiency Virus-Positive Patients in Antwerp,Belgium[J].Sex Transm Dis,2017,44(6):376-379.
[22]Wu H,Chang SY,Lee NY,et al.Evaluation of macrolide resistance and enhanced molecular typing of Treponema pallidum in patients with syphilis in Taiwan:a prospective multicenter study[J].J Clin Microbiol,2012,50(7):2299-2304.
[23]Peng RR,Yin YP,Wei WH,et al.Molecular typing of Treponema pallidum causing early syphilis in China:a cross-sectional study[J].Sex Transm Dis,2012,39(1):42-45.
[24]Grillova L,Jolley K,?majs D,et al.A public database for the new MLSTscheme for Treponema pallidum subsp.pallidum:surveillance and epidemiology of the causative agent of syphilis[J].PeerJ,2019,6:e6182.
[25]杨文林,林文生,杨健,等.梅毒血清固定与梅毒螺旋体tpr基因亚型关系的初步研究[J].中国现代医学杂志,2011,21(16):1821-1825.
[26]Zhang RL,Wang QQ,Zhang JP,Yang LJ.Molecular subtyping of Treponema pallidum and associated factors of serofast status in early syphilis patients:Identified novel genotype and cytokine marker[J].PLoSOne,2017,12(4):e0175477.
[27]王林娜,樊硕,郑和义,等.外周血检测梅毒螺旋体DNA及其分子亚型的初步观察[J].中华医学杂志,2014,94(12):928-931.
[28]汤镇,周维康,李惠,等.重庆地区梅毒螺旋体基因分型及其临床相关性研究[J].重庆医科大学学报,2015,40(10):1372-1377.
[29]崔文冬.新疆梅毒螺旋体基因型研究[D].新疆医科大学,2018.
[30]Giacani L,Ciccarese G,Puga-Salazar C,et al.Enhanced Molecular Typing of Treponema pallidum subspecies pallidum Strains From 4 Italian Hospitals Shows Geographical Differences in Strain Type Heterogeneity,Widespread Resistance to Macrolides,and Lack of Mutations Associated With Doxycycline Resistance[J].Sex Transm Dis,2018,45(4):237-242.
[2]中华人民共和国国家卫生健康委员会.2017年全国法定传染病疫情概况[EB/OL].http://www.nhc.gov.cn/jkj/s3578/201802/de926bdb046749ab b7b0a8e23d929104.shtmL,2018-02-26.
[3]Workowski KA,Bolan GA.Sexually transmitted diseases treatment guidelines2015[J].MMWR Recomm Rep,2015,64:1-137.
[4]Fisman DN.Syphilis resurgent in China[J].Lancet,2007,369:84-85.
[5]Tong ML,Lin LR,Liu GL,rt al.Factors associated with serological cure and the serofast state of HIV-negative patients with primary,secondary,latent,and tertiary syphilis[J].PLoS One,2013,8(7):e70102.
[6]中国中西医结合学会皮肤性病专业委员会性病学组.梅毒血清固定临床处理专家共识[J].中华皮肤科杂志,2015,48(11):753-755.
[7]张学军,郑捷.皮肤性病学[M].9版.北京:人民卫生出版社,2018.
[8]Se?a AC,Wolff M,Behets F,et al.Response to therapy following retreatment of serofast early syphilis patients with benzathine penicillin[J].Clin Infect Dis,2013,56(3):420-422.
[9]张君,黄涛,郑和平,等.B细胞与梅毒免疫的研究进展[J].中国皮肤性病学杂志,2018,32(07):813-816.
[10]Se?a AC,Zhang XH,Li T,et al.A systematic review of syphilis serologica treatment outcomes in HIV-infected and HIV-uninfected persons:rethinking the significance of serological non-responsiveness and the serofast state after therapy[J].BMC Infect Dis,2015,15:479.
[11]周平玉.梅毒血清固定再认识[J].中华皮肤科杂志,2017,50(5):379-381.
[12]Qin J,Yang T,Wang H,et al.Potential Predictors for Serofast State after Treatment among HIV-Negative Persons with Syphilis in China:A Systematic Review and Meta-Analysis[J].Iran J Public Health,2015,44(2):155-169.
[13]李维,刘双全.梅毒血清固定机制的研究进展[J].微生物学免疫学进展,2018,46(03):82-85.
[14]Tong ML,Lin LR,Liu GL,et al.Factors associated with serological cure and the serofast state of HIV-negative patients with primary,secondary,latent and tertiary syphilis[J].PLoS One,2013,8(7):e70102.
[15]Fraser CM,Norris SJ,Weinstock GM,et al.Complete genome sequence of Treponema pallidum,the syphilis spirochete[J]Science,1998,281(5375):375-388.
[16]Pillay A,Liu H,Chen CY,et al.Molecular subtyping of Treponema pallidum subspecies pallidum[J].Sex Transm Dis,1998,25(8):408-414.
[17]Marra C,Sahi S,Tantalo L,et al.Enhanced molecular typing of treponema pallidum:geographical distribution of strain types and association with neurosyphilis[J].J Infect Dis,2010,202(9):1380-1308.
[18]彭锐锐,Alberta L.Wang,李婧,等.梅毒螺旋体基因分型的系统综述和荟萃分析[C].//第二届全国皮肤病与性病学博士生学术会议论文集.北京协和医学院中国医学科学院皮肤病研究所,2012:7-17.
[19]Oliver S,Sahi SK,Tantalo LC,et al.Molecular Typing of Treponema pallidum in Ocular Syphilis[J].Sex Transm Dis,2016,43(8):524-527.
[20]Wu H,Chang SY,Lee NY,et al.Evaluation of macrolide resistance and enhanced molecular typing of Treponema pallidum in patients with syphilis in Taiwan:a prospective multicenter study[J].J Clin Microbiol,2012,50(7):2299-2304.
[21]MikalováL,GrillováL,Osbak K,et al.Molecular Typing of Syphilis-Causing Strains Among Human Immunodeficiency Virus-Positive Patients in Antwerp,Belgium[J].Sex Transm Dis,2017,44(6):376-379.
[22]Wu H,Chang SY,Lee NY,et al.Evaluation of macrolide resistance and enhanced molecular typing of Treponema pallidum in patients with syphilis in Taiwan:a prospective multicenter study[J].J Clin Microbiol,2012,50(7):2299-2304.
[23]Peng RR,Yin YP,Wei WH,et al.Molecular typing of Treponema pallidum causing early syphilis in China:a cross-sectional study[J].Sex Transm Dis,2012,39(1):42-45.
[24]Grillova L,Jolley K,?majs D,et al.A public database for the new MLSTscheme for Treponema pallidum subsp.pallidum:surveillance and epidemiology of the causative agent of syphilis[J].PeerJ,2019,6:e6182.
[25]杨文林,林文生,杨健,等.梅毒血清固定与梅毒螺旋体tpr基因亚型关系的初步研究[J].中国现代医学杂志,2011,21(16):1821-1825.
[26]Zhang RL,Wang QQ,Zhang JP,Yang LJ.Molecular subtyping of Treponema pallidum and associated factors of serofast status in early syphilis patients:Identified novel genotype and cytokine marker[J].PLoSOne,2017,12(4):e0175477.
[27]王林娜,樊硕,郑和义,等.外周血检测梅毒螺旋体DNA及其分子亚型的初步观察[J].中华医学杂志,2014,94(12):928-931.
[28]汤镇,周维康,李惠,等.重庆地区梅毒螺旋体基因分型及其临床相关性研究[J].重庆医科大学学报,2015,40(10):1372-1377.
[29]崔文冬.新疆梅毒螺旋体基因型研究[D].新疆医科大学,2018.
[30]Giacani L,Ciccarese G,Puga-Salazar C,et al.Enhanced Molecular Typing of Treponema pallidum subspecies pallidum Strains From 4 Italian Hospitals Shows Geographical Differences in Strain Type Heterogeneity,Widespread Resistance to Macrolides,and Lack of Mutations Associated With Doxycycline Resistance[J].Sex Transm Dis,2018,45(4):237-242.