Assuntos
Quimiocina CXCL13 , Infecções por HIV , Neurossífilis , Humanos , Neurossífilis/líquido cefalorraquidiano , Neurossífilis/diagnóstico , Infecções por HIV/complicações , Infecções por HIV/líquido cefalorraquidiano , Quimiocina CXCL13/líquido cefalorraquidiano , Masculino , Líquido Cefalorraquidiano/química , Adulto , Feminino , Pessoa de Meia-Idade , Biomarcadores/líquido cefalorraquidianoRESUMO
OBJECTIVES: The study aimed to assess and compare cerebrospinal fluid (CSF)-CXCL13 levels in People with HIV (PWH) with suspected neurosyphilis (NS), those with syphilis but without NS, and patients without treponema infection. Additionally, it aimed to evaluate changes in CSF-CXCL13 concentrations before and after antibiotic treatment. DESIGN: This was a prospective cohort study involving 93 PWH suspected of NS. All participants underwent lumbar puncture, with CSF-CXCL13 levels measured at baseline and during follow-up in patients diagnosed with NS. METHODS: CSF-CXCL13 levels were quantified using ELISA. The Mann-Whitney U test was used to analyze differences between groups, while the Wilcoxon test assessed within subject changes. ROC curve analysis determined the diagnostic efficacy of CSF-CXCL13 for NS. RESULTS: Significantly higher CSF-CXCL13 levels were observed in patients with NS compared to those with syphilis without NS and non-syphilis patients. Posttreatment, a decline in CSF-CXCL13 levels was noted in all NS cases. A CSF-CXCL13 threshold exceeding 60.0 pg/ml, in conjunction with reactive CSF-FTA-ABS, yielded a sensitivity of 88.9% and a specificity of 97.6% for NS diagnosis. CONCLUSIONS: CSF-CXCL13 emerges as a valuable adjunctive biomarker for detecting NS in PWH, especially in cases with nonreactive CSF-VDRL. Monitoring CSF-CXCL13 levels also appears effective in evaluating therapeutic response in PWH undergoing NS treatment.
Assuntos
Infecções por HIV , Neurossífilis , Sífilis , Humanos , Sífilis/complicações , Sífilis/diagnóstico , Sífilis/tratamento farmacológico , Treponema pallidum , Estudos Prospectivos , Infecções por HIV/complicações , Neurossífilis/diagnóstico , Neurossífilis/tratamento farmacológico , Líquido Cefalorraquidiano , Quimiocina CXCL13/líquido cefalorraquidiano , Quimiocina CXCL13/uso terapêuticoRESUMO
This paper presents a hypothesis on the involvement of species of the genus Raillietia Trouessart in the pathology of parasitic otitis in domestic ruminants. The chelicerae and claws of the tarsi are structures that contribute significantly towards producing primary lesions. The movable digits of the chelicerae accidentally injure the epithelium that lines the ear canal, while the claws of the tarsi perforate the epithelium, allowing the mites to affix themselves while feeding. The lesions in the epithelium caused by the chelicerae and the claws favor multiplication of the bacteria that inhabit the ear canal, resulting in typical cases of otitis.
Neste trabalho apresentamos uma hipótese para explicar o envolvimento dos ácaros do gênero Raillietia na patogênese da otite parasitária em ruminantes domésticos. As quelíceras e unhas dos tarsos são estruturas que contribuem significativamente para produzir as lesões primárias no epitélio. Os dígitos móveis das quelíceras acidentalmente causam injúria no epitélio que reveste o canal auditivo, enquanto as unhas dos tarsos perfuram o epitélio para permitir a fixação dos ácaros durante sua alimentação. As lesões no epitélio causadas pelas quelíceras e unhas dos tarsos favorecem a multiplicação das bactérias que habitam o canal auditivo, resultando em casos típicos de otite.
