{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:58:37Z","timestamp":1790657917563,"version":"4.1.0"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to characterize longitudinal serologic, cerebrospinal fluid (CSF), MRI, and salivary antibody responses after treatment in HIV-negative neurosyphilis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 73 HIV-negative adults treated for neurosyphilis from June 2021 to June 2025. Survival endpoints were defined as time to first documented serologic response or CSF normalization. Paired baseline and 12-month saliva samples were available for 25 patients. Cox models were exploratory, and longitudinal MRI findings were analyzed descriptively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 25 patients with paired saliva samples, salivary antibody OD decreased at 12\u202fmonths (estimated paired decrease, 0.36 OD units; 95% CI, 0.14\u20130.64) and showed a modest correlation with the decline in serum TRUST titer (Spearman\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u202f=\u202f0.396). Of 73 patients, 36 achieved a first documented serologic response. Higher baseline serum TRUST titer was associated with earlier documented response (adjusted HR per twofold increase, 1.34; 95% CI, 1.11\u20131.61), whereas elevated CSF protein was associated with later documented response (adjusted HR, 0.41; 95% CI, 0.20\u20130.86). Median times to first documented normalization were 12\u202fmonths for CSF TRUST, 13\u202fmonths for CSF WBC, and 20\u202fmonths for CSF protein; these estimates were derived from separate endpoint-specific risk sets. Follow-up MRI findings in 13 clinically selected patients were descriptive.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The post-treatment decline in salivary anti-\n                      <jats:italic>T. pallidum<\/jats:italic>\n                      antibody OD provides a preliminary non-invasive signal of treatment-associated change. Prospective validation in larger cohorts is required.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1939496","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:38:35Z","timestamp":1790656715000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Post-treatment serologic, cerebrospinal fluid, MRI, and salivary antibody responses in HIV-negative neurosyphilis: a retrospective study"],"prefix":"10.3389","volume":"17","author":[{"given":"Xuan","family":"Long","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weipeng","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiahui","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueying","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sichan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donghua","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1358","DOI":"10.1056\/NEJMra1906228","article-title":"Neurosyphilis","volume":"381","author":"Ropper","year":"2019","journal-title":"N Engl J Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1159\/000347109","article-title":"Clinical spectrum of neurosyphilis among HIV-negative patients in the modern era","volume":"226","author":"Zhang","year":"2013","journal-title":"Dermatology"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.rr7004a1","article-title":"Sexually transmitted infections treatment guidelines, 2021","volume":"70","author":"Workowski","year":"2021","journal-title":"MMWR Recomm 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neuroimaging alternations and treatment response of 25 HIV-negative general paresis patients","volume":"16","author":"Liu","year":"2023","journal-title":"Infect Drug Resist"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"117478","DOI":"10.1016\/j.biopha.2024.117478","article-title":"Potential mechanisms of Treponema pallidum breaching the blood-brain barrier","volume":"180","author":"Zhou","year":"2024","journal-title":"Biomed Pharmacother"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1086\/382532","article-title":"Normalization of cerebrospinal fluid abnormalities after neurosyphilis therapy: does HIV status matter?","volume":"38","author":"Marra","year":"2004","journal-title":"Clin Infect Dis"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1603596","DOI":"10.3389\/fmed.2025.1603596","article-title":"A retrospective review of nine cases of atypical neurosyphilis","volume":"12","author":"Miao","year":"2025","journal-title":"Front 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Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1939496\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:38:53Z","timestamp":1790656733000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1939496\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":21,"alternative-id":["10.3389\/fneur.2026.1939496"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1939496","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"article-number":"1939496"}}