CXCL13, CXCL10 and CXCL8 as indicators of ocular and neurological involvement in patients with ocular syphilis: an observational descriptive study

Date
2022
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Stellenbosch : Stellenbosch University
Abstract
ENGLISH ABSTRACT: Aim To investigate the role of the chemokines CXCL13, CXCL10 and CXCL8 in the diagnosis of ocularā€ and neurosyphilis by examining the serum, aqueous humour (AH) and cerebrospinal fluid (CSF) of patients with ocular syphilis. Methods An observational descriptive study was performed prospectively at Tygerberg Academic Hospital in Cape Town, South Africa from 1 February 2018 till 31 January 2021 which enrolled 23 participants. Upon diagnosis of ocular syphilis, the HIV status of each patient was determined, and 3 samples (AH, serum and CSF) were collected to measure the levels of CXCL13, CXCL10 and CXCL8 in each. Results The mean concentrations of all 3 biomarkers were higher in the AH and CSF than in the serum. The mean concentrations of the 3 measured biomarkers were markedly different when comparing both AH and CSF levels to serum levels. The level of CXCL13 measured in the AH correlated well with the concentrations found in the CSF of patients with neurosyphilis. In patients with neurosyphilis, mean AH levels of CXCL13 and CXCL10 were markedly higher than in serum while mean CSF levels of CXCL10 were also markedly higher than in serum. Also, the AH/serum ratio of CXCL13 and CXCL10, as well as the CSF/serum ratio of CXCL10, was much higher in patients with neurosyphilis than without. In patients with HIV infection, mean AH CXCL13 levels were much higher than in patients without HIV infection. Conclusion The levels of CXCL13, CXCL10 and CXCL8 in the AH of patients with neurosyphilis are similar to previously reported levels in the CSF of patients with neurosyphilis and can potentially be an adjunct in the diagnosis of ocular syphilis. Patients with ocular syphilis who tested negative for neurosyphilis with conventional CSF testing showed features of neurosyphilis when analysing the CSF chemokines.
AFRIKAANSE OPSOMMING: Doelwit Om die rol van die chemokiene CXCL13, CXCL10 en CXCL8 in die diagnose van okulĆŖreā€ en neurosifilis te ondersoek deur die serum, voorkamervog en serebrospinale vog (SSV) van pasiĆ«nte met okulĆŖre sifilis te analiseer. Metode ā€˜n Waarnemende beskrywende studie is prospektief uitgevoer by Tygerberg Akademiese Hospitaal in Kaapstad, Suidā€Afrika, vanaf 1 Februarie 2018 tot 31 Januarie 2021, en 23 pasiĆ«nte is ingesluit. Elke pasiĆ«nte wat met okulĆŖre sifilis gediagnoseer is se MIVā€status is bepaal, en 3 monsters (voorkamervog, SSV en serum) is verkry om die vlakke van CXCL13, CXCL10 en CXCL8 te bepaal. Resultate Die gemiddelde konsentrasie van al 3 biomerkers was hoĆ«r in die voorkamervog en SSV as in die serum. Die gemiddelde konsentrasie van al 3 biomerkers het aansienlik verskil waar die voorkamervog en SSV vergelyk is met die serum. Die voorkamervogvlak van CXCL13 het goed vergelyk met konsentrasies wat gevind word in die SSV van pasiĆ«nte met neurosifilis. In pasiĆ«nte met neurosifilis was die gemiddelde vlakke van CXCL13 en CXCL10 in die voorkamervog aansienlik hoĆ«r as in die serum, en die CXCL10ā€konsentrasie in die SSV was ook aansienlik hoĆ«r as in serum. Die voorkamervog/serum verhouding van CXCL13 en CXCL10, sowel as die SSV/serum verhouding van CXCL10, was hoĆ«r in pasiĆ«nte met neurosifilis as die sonder neurosifilis. In pasiĆ«nte met MIVā€infeksie was die gemiddelde voorkamervog vlakke van CXCL13 baie hoĆ«r as in die pasiĆ«nte wat nie met MIV geĆÆnfekteer is nie. Gevolgtrekkings Die vlakke van CXCL13, CXCL10 en CXCL8 in die voorkamervog van pasiĆ«nte met okulĆŖre sifilis vergelyk goed met voorheen gerapporteerde vlakke in die SSV van pasiĆ«nte met neurosifilis, en kan moontlik gebruik word as ā€˜n merker in die diagnose van okulĆŖre sifilis. PasiĆ«nte met okulĆŖre sifilis wat negatief getoets het vir neurosifilis met konvensionele SSVā€toetse het tekens van neurosifilis getoon met die SSV chemokienā€analise.
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Thesis (MMed)--Stellenbosch University, 2022.
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