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An Intracisternal Rabbit Model Reveals Treponema pallidum Egress Across an Intact Blood-Brain Barrier.
Shu-Hao Fan1,2,3, Lin Xie1,2,3, Yue Zhong1,2,3
1Center of Clinical Laboratory, Zhongshan Hospital Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
The Journal of Infectious Diseases
|July 15, 2026
Summary
Treponema pallidum disseminates from the CNS to the periphery without breaching the blood-brain barrier (BBB). This study demonstrates non-disruptive egress pathways for syphilis spirochetes, challenging existing views on CNS invasion.
Area of Science:
- Neuroscience
- Infectious Diseases
- Microbiology
Background:
- Treponema pallidum, the syphilis agent, invades the central nervous system (CNS).
- The necessity of blood-brain barrier (BBB) disruption for spirochetal CNS traversal is unclear.
Purpose of the Study:
- To investigate if Treponema pallidum can exit the CNS to the periphery without disrupting BBB integrity.
Main Methods:
- An intracisternal rabbit model was used to study T. pallidum egress from the CNS.
- BBB integrity was assessed using the albumin quotient (QAlb).
- Systemic serological responses and peripheral T. pallidum DNA confirmed spirochetal dissemination.
Main Results:
- Rabbits inoculated intracisternally with live T. pallidum developed systemic serological responses and had detectable T. pallidum DNA in peripheral tissues.
- BBB integrity, monitored by QAlb, remained intact throughout the study in all experimental groups.
- No significant differences in QAlb were observed, indicating no BBB disruption.
Conclusions:
- Treponema pallidum can disseminate from the CNS to peripheral tissues without compromising BBB integrity.
- This finding suggests the existence of non-disruptive pathways for spirochetal CNS egress.
- The study challenges the paradigm that BBB disruption is essential for Treponema pallidum dissemination from the CNS.
