{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T16:55:45Z","timestamp":1782924945937,"version":"3.54.5"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"National High Level Hospital Clinical Research Funding","award":["2023YC03"],"award-info":[{"award-number":["2023YC03"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antiphospholipid antibodies (aPLs) may arise during infection, including syphilis, creating diagnostic overlap with antiphospholipid syndrome (APS). Research evaluating bidirectional interactions between modern syphilis serology and aPL assays remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Residual sera were grouped as Treponema pallidum chemiluminescent microparticle immunoassay positive (TP-CMIA+)\/rapid plasma reagin positive (RPR+) syphilis (n = 200), aPL-positive specimens tested by syphilis serology (n = 218), and healthy controls (n = 200). aPL testing used EUROIMMUN ELISAs; syphilis testing used Abbott ARCHITECT TP-CMIA and Kehua RPR. Manufacturer kit controls were cross-tested. A proteome-level 3D homology search was conducted following published protocols.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The RPR kit positive control showed no reactivity in any aPL assay. TP-CMIA+\/RPR+ samples had higher anticardiolipin antibody (aCL) IgG than healthy controls (median 2.49 vs 2.00 RU\/mL; P = 1.33 \u00d7 10\u221210), no difference in aCL IgM, and slightly lower anti-\u03b22GPI IgM (P = 0.0183) and IgG (P = 4.0 \u00d7 10\u22126). Of these, 23\/200 (11.5%) were aPL-positive, exhibiting elevated RPR titers (P = 3.3 \u00d7 10\u22126) and TP-CMIA signal-to-cutoff (S\/CO) (median 16.26 vs 14.94; P = 0.004), without correlation between S\/CO and aPL levels. Among 218 autoimmune aPL-positive samples, 1 (0.46%) was TP-CMIA+\/RPR+. In cytokine-assessed samples (n = 44), Interferon-\u03b3-inducible Protein 10 was higher in aCL-positive cases (median 2661 vs 865 pg\/mL; P = 0.0149). aCL IgM and IgG were markedly elevated in pretreatment syphilis vs posttreatment (all P &amp;lt; 0.0001), while anti-\u03b22GPI remained unchanged. 3D homology screening found one \u03b22GPI-domain V-like structure in the T. pallidum proteome but lacked APS-epitope features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>No analytical cross-reactivity between assay reagents was detected. Apparent aCL elevations in untreated syphilis reflect anti-\u03b22GPI-independent, transient reactivity rather than APS-type autoimmunity, and structural analysis provides no strong support for \u03b22GPI epitope mimicry. Combined RPR and TP-CMIA testing remains reliable in patients with preexisting aPL positivity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jalm\/jfag047","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T12:42:53Z","timestamp":1773924173000},"page":"770-785","source":"Crossref","is-referenced-by-count":0,"title":["Syphilis Serology and Antiphospholipid Antibodies: Bidirectional Reactivity Testing across Clinical and Control Samples"],"prefix":"10.1093","volume":"11","author":[{"given":"Xiaomin","family":"Shi","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Peking University First Hospital , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengtian","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Peking University First Hospital , Beijing 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