{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:13:16Z","timestamp":1785420796682,"version":"3.56.0"},"reference-count":29,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2026,6,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Accurately differentiating neurosyphilis (NS) from latent syphilis (LS) is essential, as it directly guides therapeutic decisions and prevents devastating neurological complications. However, this differentiation remains a significant clinical challenge because it currently relies on cerebrospinal fluid analysis\u2014an invasive and resource-intensive procedure that is not suitable for all patients. To address this, we evaluated whether a detailed\n                      <jats:italic toggle=\"yes\">Treponema pallidum<\/jats:italic>\n                      -specific immunoglobulin M (IgM) immunoblot profile could offer a robust non-invasive diagnostic tool. We conducted a comprehensive analysis of serum samples from 319 patients (74 NS and 245 LS), assessing the IgM positive rate, antigen-specific reactivity (TP15, TP17, TP45, and TP47), and antibody reaction intensity (gray value). Our analysis revealed that NS patients exhibited a significantly stronger and broader IgM response, evidenced by a higher overall positive rate (45.9% vs 26.1%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001) and elevated reactivity to TP17, TP45, and TP47 antigens. The antibody reaction intensity for these antigens was also significantly stronger in the NS group. Critically, multivariable analysis identified a higher serum the Toluidine Red Unheated Serum Test titer (odds Ratio [OR] = 1.025 per unit, 95% confidence interval [CI]: 1.009\u20131.041,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003) and a greater number of positive antigens (OR = 1.663, 95% CI: 1.100\u20132.512,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.016) as independent risk factors for NS, while male sex was an independent protective factor (OR = 0.325, 95% CI: 0.179\u20130.591,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). These findings demonstrate that the IgM immunoblot provides a distinct serological signature, offering a valuable non-invasive aid for discriminating NS from LS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>This study addresses a fundamental challenge in syphilis management: determining which patients with latent syphilis are at high risk for neurosyphilis without relying on invasive lumbar puncture. By analyzing a simple blood test that profiles the immunoglobulin M antibody response in detail, we discovered that patients with neurosyphilis have a distinctly stronger and broader immune reaction. We further identified key risk factors, including higher antibody levels and reactivity to multiple targets. These findings are significant because they provide doctors with a practical, non-invasive tool to stratify patient risk more accurately. This can help optimize clinical decision-making, ensuring that lumbar punctures are performed on patients who need them most while avoiding unnecessary procedures for others, ultimately leading to better and more personalized patient care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.04141-25","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T13:02:17Z","timestamp":1777554137000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["A distinct IgM immunoblot signature differentiates neurosyphilis from latent syphilis"],"prefix":"10.1128","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9954-0933","authenticated-orcid":false,"given":"Xue","family":"Yang","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/030sc3x20","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University","place":["Nanning, People's Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiahui","family":"Shen","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/030sc3x20","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University","place":["Nanning, People's Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Liang","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/030sc3x20","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University","place":["Nanning, People's Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Luo","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/030sc3x20","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University","place":["Nanning, People's Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5296-7665","authenticated-orcid":true,"given":"Donghua","family":"Liu","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/030sc3x20","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University","place":["Nanning, People's Republic of 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