Clinical and genomic diversity of Treponema pallidum subspecies pallidum to inform vaccine research: an international, molecular epidemiology study

作者：Arlene C. Seña, Mitch Matoga, Ligang Yang, Eduardo López-Medina, Farhang F. Aghakhanian, Jane S. Chen, Everton Burlamarque Bettin, Melissa J. Caimano, Wentao Chen, Jonny Alejandro García Luna, Christopher M. Hennelly, Edward Jere, Yinbo Jiang, Jonathan J. Juliano, Petra Pospíšilová, Lady Giovanna Ramirez, David Šmajs, Joseph D. Tucker, Fabio Vargas Cely, Heping Zheng, Irving Hoffman, Bin Yang, M. Anthony Moody, Kelly L. Hawley, Juan C. Salazar, Justin D. Radolf, Jonathan B. Parr · 发表于：The Lancet Microbe · 年份：2024 · DOI：10.1016/s2666-5247(24)00087-9 · 被引用次数：21 · 研究领域：Syphilis Diagnosis and Treatment、Reproductive tract infections research、Virology and Viral Diseases

BACKGROUND: The increase in syphilis rates worldwide necessitates development of a vaccine with global efficacy. We aimed to explore Treponema pallidum subspecies pallidum (TPA) molecular epidemiology essential for vaccine research by analysing clinical data and specimens from early syphilis patients using whole-genome sequencing (WGS) and publicly available WGS data. METHODS: In this multicentre, cross-sectional, molecular epidemiology study, we enrolled patients with primary, secondary, or early latent syphilis from clinics in China, Colombia, Malawi, and the USA between Nov 28, 2019, and May 27, 2022. Participants aged 18 years or older with laboratory confirmation of syphilis by direct detection methods or serological testing, or both, were included. Patients were excluded from enrolment if they were unwilling or unable to give informed consent, did not understand the study purpose or nature of their participation, or received antibiotics active against syphilis in the past 30 days. TPA detection and WGS were conducted on lesion swabs, skin biopsies, skin scrapings, whole blood, or rabbit-passaged isolates. We compared our WGS data to publicly available genomes and analysed TPA populations to identify mutations associated with lineage and geography. FINDINGS: We screened 2802 patients and enrolled 233 participants, of whom 77 (33%) had primary syphilis, 154 (66%) had secondary syphilis, and two (1%) had early latent syphilis. The median age of participants was 28 years (I...