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Publications

Journal Article Ahead of print

PubMed: 40929698 DOI: 10.1080/09273948.2025.2552919

Candidate Cytokine Biomarkers for the Diagnosis of Ocular- and Neurosyphilis.

Ocul Immunol Inflamm

Authors: Suret Engelbrecht, Laurie W van der Merwe, Candice I Snyders, Martin Kidd, Gerhard Walzl, Novel N Chegou, Derrick P Smit

Affiliations

  • Division of Ophthalmology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
  • South African Medical Research Council Centre for Tuberculosis Research, Division of Immunology, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
  • Centre for Statistical Consultation, Stellenbosch University, Stellenbosch, South Africa.

Abstract

PURPOSE

To describe differences in the expression of selected host biomarkers, by analysing the aqueous humour (AH), cerebrospinal fluid (CSF) and serum of patients with ocular syphilis, both with and without neurosyphilis and HIV infection, to support the diagnosis of ocular syphilis.

METHODS

A prospective observational descriptive study was conducted at Tygerberg Academic Hospital in Cape Town, South Africa, from February 1, 2018, to January 31, 2021. The study included all patients aged 18 years or older who presented to the eye clinic with ocular syphilis, provided they had a positive serum Treponema pallidum antibodies (TPA) test, an RPR titre of ≥ 8 and confirmed ocular inflammation. The HIV status of each patient was determined and the CRP, IL-2, IL-6, IL-10, IL-12 p70, MIP-1 and IFN- were measured in their AH, CSF and serum samples using a multiplex immunoassay platform. All patients received treatment.

RESULTS

The mean concentrations of biomarkers IL-2, IL-10, MIP-1, IL-6, IL-12 p70 and IFN- were consistently higher in the AH compared to the CSF and serum in patients with ocular syphilis, irrespective of their HIV status and the presence or absence of concurrent neurosyphilis.

CONCLUSION

Our findings showed significant differences in certain cytokine levels across the AH, CSF, and serum, with notably higher concentrations in the AH. This indicates that ocular syphilis triggers a unique immune response within the eye. As a result, further analysis of AH biomarkers is needed to determine if these may enhance the diagnosis of ocular and neurosyphilis.

MeSH

Cytokines, Eye, Syphilis, Serum, Interleukin-12, Biomarkers, Neurosyphilis, Diagnosis, Uveitis