Autoimmunity in syphilis

The autoimmune response in natural and experimental syphilis, apparently triggered as a secondary reaction to T. pallidum infection, is represented by the production of various antibodies to self-antigens. In addition to the classic Wassermann (cardiolipin) antibodies, the following autoantibodies are associated with the disease: (1) biphasic hemolysin (known also as Donath-Landsteiner antibody), (2) antilymphocytic antibodies, (3) rheumatoid factor, (4) cryoglobulins, (5) antifibronectin, (6) anticollagen, (7) antilaminin, and (8) anticreatine kinase. Although less explored, the autoimmune reaction seems also to involve the cellular arm of the immune response. Transient sensitization of lymphocytes to homologous organ antigens have been reported in T. pallidum-infected rabbits. Questions of whether the humoral and cellular autoimmune responses--which are apparently harmless and of transient nature--play a role in immunoregulation and consequently affect the course of infection remain to be answered.