IMMUNOPATHOGENESIS OF NEUROSYPHILIS: CLINICAL MANAGEMENT PERSPECTIVES



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Abstract

This review provides a comprehensive analysis on the immunopathogenesis of neurosyphilis and discusses the related clinical perspectives. Neurosyphilis remains one of the most complex and variable forms of syphilitic infection, driven by the interaction between T. pallidum and host innate and adaptive immune cells leading to chronic inflammation and damage to the nervous system. The article highlights three major relevant areas: 1). Cellular and molecular mechanisms. The role of different T-lymphocyte subsets, cytokine cascades, macrophages, and microglia in shaping persistent inflammation, disrupting immune control, and contributing to neurodegenerative processes is examined. In particular, it emphasizes the imbalance between pro- and anti-inflammatory cytokines, as well as the strategies by which the pathogen evades immune surveillance. 2). Clinical manifestations and diagnostic approaches. Current knowledge of the wide clinical spectrum of neurosyphilis is summarized, ranging from asymptomatic forms to severe progressive neurological involvement. Special attention is given to biomarkers, including cerebrospinal fluid indices and immunological tests, as well as instrumental methods such as MRI, serological, and molecular assays, which help refine disease staging and assess activity. 3). Therapeutic opportunities and prospective targets. Existing antibiotic regimens are discussed, along with the challenges of limited efficacy and potential antibiotic resistance. The review further explores the potential of immunotherapy and combined strategies aimed at restoring immune control and reducing central nervous system inflammation. Overall, the review integrates fundamental aspects of immunopathogenesis with practical clinical considerations. By linking cellular and molecular insights with diagnostic and therapeutic perspectives, it provides a relevant resource for both clinicians and researchers primarily engaged in the search for innovative therapeutic strategies against neurosyphilis.

About the authors

Vladimir Bekhalo

National Research Center for Epidemiology and Microbiology named after the honorary academician N.F. Gamaleya, Ministry of Health of the Russian Federation, Moscow, Russian Federation

Email: nearmedic_uc@mail.ru
ORCID iD: 0000-0003-4491-9919
SPIN-code: 5573-0265

PhD in biology, Senior Research Scientist, Immunity Regulation and Immunological Tolerance Laboratory

Россия, 123098, Moscow, Gamalei Street, 18

Olga Kazimirovna Loseva

Russian Biotechnological University (ROSBIOTECH), Moscow, Russia

Author for correspondence.
Email: loseva_ok@mail.ru
ORCID iD: 0000-0002-5033-2746

MD, Dr. Sci. (Med.), Professor of the Department of Skin and Venereal Diseases with a Course in Cosmetology

Россия, 125080, Moscow, Volokolamskoye Shosse, 11

References

  1. Лосева О.К., Залевская О.В., Кисель О.В. [и др.]. Поздние формы сифилиса с симптомами и без симптомов. Москва: ГЭОТАР-Медиа, 2023. 184 с.
  2. Пономарева М.В., Левчик Н.К., Зильберберг Н.В. Неспецифический интратекальный синтез иммуноглобулинов у пациентов с сифилитической инфекцией // Инфекция и иммунитет. 2023. Т. 13, № 2. С. 309–318.
  3. Рахматулина М.Р., Мелехина Л.Е., Новоселова Е.Ю. Ретроспективный анализ заболеваемости сифилисом в Российской Федерации в 2009–2023 гг. и тенденции динамического развития эпидемиологического процесса // Вестник дерматологии и венерологии. 2025. Т. 101, № 1. С. 7–27.
  4. Рахматулина М.Р., Порсохонова Д.Ф., Новоселова Е.Ю., Иноятов А.Ш. Эпидемиологические и клинические аспекты заболеваемости сифилисом в Российской Федерации и Республике Узбекистан: сравнительный анализ // Вестник дерматологии и венерологии. 2025. Т. 101, № 2. С. 23–38.
  5. Ajabshir D., Jimenez Garcia J.G., Fernandez C., Izquierdo-Pretel G. Unveiling the Mimicker: A Case Report of Ocular Neurosyphilis. Cureus, 2024, vol. 16, no. 12, e75364.
  6. Alberto C., Lambeng N., Deffert C., Breville G., Gayet-Ageron A., Lalive P., Calmy A., Coste A., Papadimitriou-Olivgeris M., Braun D., Lienhard R., Bosshard P.P., Fontao L., Toutous Trellu L. Multicentric evaluation of a specific intrathecal anti-Treponema pallidum IgG index as a diagnostic biomarker of neurosyphilis: results from a retro-prospective case-control study. Sex. Transm. Infect., 2024, vol. 100, no. 2, pp. 63–69.
  7. Ávila-Nieto C., Pedreño-López N., Mitjà O., Clotet B., Blanco J., Carrillo J. Syphilis vaccine: challenges, controversies and opportunities. Front. Immunol., 2023, vol. 14, 1126170.
  8. Barthel L., Hetze S., Teuber-Hanselmann S., Chapot V., Sure U. Syphilitic gummata in the central nervous system: A narrative review and case report about a noteworthy clinical manifestation. Microorganisms, 2021, vol. 9, no. 5, 906.
  9. Boog G.H.P., Lopes J.V.Z., Mahler J.V., Solti M., Kawahara L.T., Teng A.K., Munhoz J.V.T., Levin A.S. Diagnostic tools for neurosyphilis: a systematic review. BMC Infect. Dis., 2021, vol. 21, no. 1, 568.
  10. Buitrago-Garcia D., Martí-Carvajal A.J., Jimenez A., Conterno L.O., Pardo R. Antibiotic therapy for adults with neurosyphilis. Cochrane Database Syst. Rev., 2019, vol. 5, CD011399.
  11. Caroppo P., Villa C., Del Sole A., Bernardi G., Carradori S., Tiraboschi P., Giaccone G., Prioni S. Neurosyphilis mimicking behavioral variant of frontotemporal dementia in a 59-year-old man. Cogn. Behav. Neurol., 2022, vol. 35, no. 2, pp. 140–146.
  12. Catalano A.A., Yoon J., Fertuzinhos S., Reisert H., Walsh H., Kosana P., Wilson M., Gisslen M., Zetterberg H., Marra C.M., Farhadian S.F. Neurosyphilis is characterized by a compartmentalized and robust neuroimmune response but not by neuronal injury. Med (N.Y.), 2024, vol. 5, no. 4, pp. 321–334.e3.
  13. Chen J.L., Tessema R., Emami-Naeini P., Lim M.C. A vascular syphilitic iris lesion. Am. J. Ophthalmol. Case Rep., 2023, vol. 31, 101858.
  14. Chen H., Li J.J., Guan C.S., Xue M., Xing Y.X., Xie R.M. Investigation of gray matter changes using voxel-based morphometry in HIV-negative patients with general paresis of the insane. Neuropsychiatr. Dis. Treat., 2024, vol. 20, pp. 2529–2539.
  15. Chen X. Research advances in clinical strategies and preclinical models for syphilis relapse. Infect. Drug Resist., 2025, vol. 18, pp. 3395–3407.
  16. Corrêa D.G., de Souza S.R., Freddi T.A.L., Fonseca A.P.A., Dos Santos R.Q., Hygino da Cruz L.C. Jr. Imaging features of neurosyphilis. J. Neuroradiol., 2023, vol. 50, no. 2, pp. 241–252.
  17. Ding D., Gao J., Zhang W., Xu D. The diagnostic performance of laboratory tests of neurosyphilis: a systematic review and network meta-analysis. Eur. Neurol., 2023, vol. 86, no. 6, pp. 418–429.
  18. Drago F., Javor S., Parodi A. Relevance in biology and mechanisms of immune and treatment evasion of Treponema pallidum. G. Ital. Dermatol. Venereol., 2019, vol. 154, no. 5, pp. 573–580.
  19. Du F.Z., Zhang X., Zhang R.L., Wang Q.Q. CARE-NS, a research strategy for neurosyphilis. Front. Med., 2023, vol. 9, 1040133.
  20. Du F.Z., Wu M.Z., Zhang X., Zhang R.L., Wang Q.Q. Ceftriaxone compared with penicillin G for the treatment of neurosyphilis: study protocol for a multicenter randomized controlled trial. Trials, 2022, vol. 23, no. 1, 835.
  21. Du F.Z., Zhang X., Zheng X.L., Zhang R.L., Wang Q.Q. Cerebrospinal fluid CXCL13 concentration for diagnosis of neurosyphilis: a systematic review and meta-analysis. BMJ Open, 2024, vol. 14, no. 5, e078527.
  22. EU sees ‘troubling surge’ in sexually transmitted diseases. Med. Xpress, 2024, March. Retrieved August 27, 2025.
  23. European Centre for Disease Prevention and Control. Syphilis. In: Annual Epidemiological Report for 2023. Stockholm: ECDC, 2025.
  24. Fadel A., Hussain H., Hernandez R.J., Clichy Silva A.M., Estil-Las A.A., Hamad M., Saadoon Z.F., Naseer L., Sultan W.C., Sultan C., Schnepp T., Jayakumar A.R. Mechanisms of neurosyphilis-induced dementia: insights into pathophysiology. Neurol. Int., 2024, vol. 16, no. 6, pp. 1653–1665.
  25. Fang Y., Wu H., Liu G., Li Z., Wang D., Ning Y., Pan S., Hu Y. Secondary immunoreaction in patients with neurosyphilis and its relevance to clinical outcomes. Front. Neurol., 2023, vol. 14, 1201452.
  26. Frater J.L. The usefulness of cerebrospinal fluid white blood cell count in neurosyphilis. Eur. Neurol., 2023, vol. 86, no. 6, pp. 404–406.
  27. Funayama M., Kuramochi S., Kudo S. Neurosyphilis initially misdiagnosed as behavioral variant frontotemporal dementia: life-changing differential diagnosis. J. Alzheimers Dis. Rep., 2023, vol. 7, no. 1, pp. 1077–1083.
  28. Gao Z.X., Gou Y., Liu X.Q., Peng L.W. Advances in laboratory diagnostic methods for cerebrospinal fluid testing for neurosyphilis. Front. Public Health, 2022, vol. 10, 1030480.
  29. Guan H., Di X., Li M., Yu N., Cai R., Chen C., Peng J., Xia Z., Wei H. Lymphocyte to monocyte ratio and lymphocyte to neutrophil ratio in neurosyphilis may affect the response to therapy and diagnostic efficacy. Sci. Rep., 2025, vol. 15, no. 1, 11980.
  30. Gudowska-Sawczuk M., Mroczko B. Chemokine ligand 13 (CXCL13) in neuroborreliosis and neurosyphilis as selected spirochetal neurological diseases: a review of its diagnostic significance. Int. J. Mol. Sci., 2020, vol. 21, no. 8, 2927.
  31. Guo T., Ma J., Sun J., Xu W., Cong H., Wei Y., Ma Y., Dong Q., Kou Y., Yin L., Zhang X., Chang H., Wang H. Soluble TREM2 is a potential biomarker for the severity of primary angiitis of the CNS. Front. Immunol., 2022, vol. 13, 963373.
  32. Hamill M.M., Ghanem K.G., Tuddenham S. State-of-the-art review: neurosyphilis. Clin. Infect. Dis., 2024, vol. 78, no. 5, pp. e57–e68.
  33. He C., Shang X., Liu W., Hang S., Chen J., Ci C. Combination of the neutrophil to lymphocyte ratio and serum toluidine red unheated serum test titer as a predictor of neurosyphilis in HIV-negative patients. Exp. Ther. Med., 2021, vol. 21, no. 3, 185.
  34. Huang X., Ying S., Luo L., Li L., Li D., Xie Y. Intrathecal immunoglobulin synthesis and its role in patients with neurosyphilis. Front. Public Health, 2022, vol. 10, 1008595.
  35. Jaiswal A.K., Rodrigues Gomes L.G., Ferreira Maciel de Oliveira A., de Castro Soares S., Azevedo V. The critical role of penicillin in syphilis treatment and emerging resistance challenges. Diseases, 2025, vol. 13, no. 2, 41.
  36. Janier M., Unemo M., Dupin N., Tiplica G.S., Potočnik M., Patel R. 2020 European guideline on the management of syphilis. J. Eur. Acad. Dermatol. Venereol., 2021, vol. 35, no. 3, pp. 574–588.
  37. Kaminiów K., Kiołbasa M., Pastuszczak M. The significance of the cell-mediated host immune response in syphilis. Microorganisms, 2024, vol. 12, no. 12, 2580.
  38. Kaur B., Khanna D. A narrative review of the many psychiatric manifestations of neurosyphilis: the great imitator. Cureus, 2023, vol. 15, no. 9, e44866.
  39. Ke W.J., Tso L.S., Li D.D. Editorial: Neurosyphilis: epidemiology, clinical manifestations, diagnosis, immunology and treatment. Front. Med., 2023, vol. 10, 1191113.
  40. Li J., Ma J., Liu M., Li M., Zhang M., Yin W., Wu M., Li X., Zhang Q., Zhang H., Zheng H., Mao C., Sun J., Wang W., Lyu W., Yue X., Weng W., Li J., Chen F., Zhu Y., Leng L. Large-scale proteome profiling identifies biomarkers associated with suspected neurosyphilis diagnosis. Adv. Sci. (Weinheim, Baden-Wurttemberg, Ger.), 2024, vol. 11, no. 16, e2307744.
  41. Li W., Chang H., Wu W., Xu D., Jiang M., Gao J., Huang Y., Xu Y., Yin L., Zhang X. Increased CSF soluble TREM2 concentration in patients with neurosyphilis. Front. Neurol., 2020, vol. 11, 62.
  42. Li W., Wu W., Chang H., Jiang M., Gao J., Xu Y., Xu D., Yin L., Zhang X. Cerebrospinal fluid cytokines in patients with neurosyphilis: the significance of interleukin-10 for the disease. Biomed. Res. Int., 2020, 3812671.
  43. Li X.X., Zhang J., Wang Z.Y., Chen S.Q., Zhou W.F., Wang T.T., Man X.Y., Zheng M. Increased CCL24 and CXCL7 levels in the cerebrospinal fluid of patients with neurosyphilis. J. Clin. Lab. Anal., 2020, vol. 34, no. 9, e23366.
  44. Liu A., Giacani L., Hawley K.L., Cameron C.E., Seña A.C., Konda K.A., Radolf J.D., Klausner J.D. New pathways in syphilis vaccine development. Sex. Transm. Dis., 2024, vol. 51, no. 11, pp. e49–e53.
  45. Liu Z., Zhang X., Lin T., et al. Treponema pallidum inhibits CD4+ T-cell proliferation through METAP2: insights from Mendelian randomization analysis. AMB Express, 2025, vol. 15, p. 126.
  46. Liu Z., Zhang X., Xiong S., Huang S., Ding X., Xu M., Yao J., Liu S., Zhao F. Endothelial dysfunction of syphilis: Pathogenesis. J. Eur. Acad. Dermatol. Venereol., 2024, vol. 38, no. 8, pp. 1478–1490.
  47. Luo Y., Xie Y., Xiao Y. Laboratory Diagnostic Tools for Syphilis: Current Status and Future Prospects. Front. Cell. Infect. Microbiol., 2021, vol. 10, p. 574806.
  48. Malla S., Shahreen N., Saha R. Immunometabolism at the Crossroads of Infection: Mechanistic and Systems-Level Perspectives from Host and Pathogen. arXiv, 2025, arXiv:2506.02236v1.
  49. Miao R., Song C., Zhang W., Ma X., Zhang Y., Huang Y. A retrospective review of nine cases of atypical neurosyphilis. Front. Med., 2025, vol. 12, p. 1603596.
  50. Mills K.H.G. IL-17 and IL-17-producing cells in protection versus pathology. Nat. Rev. Immunol., 2023, vol. 23, no. 1, pp. 38–54.
  51. Mizoguchi T., Hara M., Nakajima H. Neurosyphilis presenting as autoimmune limbic encephalitis: A case report and literature review. Medicine, 2022, vol. 101, no. 33, p. e30062.
  52. Mu L., Rong Y., Xin Y.J., Zhang H., Xu Z. Research progress on Th17/Treg cell imbalance in epileptic seizures. J. Inflamm. Res., 2025, vol. 18, pp. 7769–7779.
  53. Naveed M., Ibrahim S., Aziz T., Asim M., Majeed M.N., Khan A.A., El Hadi Mohamed R.A., Alwethaynani M.S., Al-Joufi F.A., Fallatah D. Computational drug design for neurosyphilis disease by targeting phosphoglycerate kinase in Treponema pallidum with enhanced binding affinity and reduced toxicity. Sci. Rep., 2025, vol. 15, no. 1, p. 10311.
  54. Oska N., Saad M., Tokko H. Hypertensive Disc Edema or Ocular Syphilis? A Case Report of the Great Masquerader. Case Rep. Ophthalmol., 2025, vol. 16, no. 1, pp. 346–352.
  55. Otani M., Rowley J., Grankov V., Kuchukhidze G., Bivol S., WHO European Region non-EU/EEA STI Surveillance network. Sexually transmitted infections in the non-European Union and European Economic Area of the World Health Organization European Region 2021–2023. BMC Public Health, 2025, vol. 25, no. 1, p. 1545.
  56. Patel S.S., Blum A.L., Morgan R.T., Piper B.J., Rodriguez A.J., VanVarick R.E. Analysis of neurosyphilis imaging methods and treatment: A focused review. Cureus, 2024, vol. 16, no. 11, p. e72976.
  57. Pospíšilová P., Bosák J., Hrala M., Krbková L., Vrbová E., Šmajs D. Resistance to ceftriaxone and penicillin G among contemporary syphilis strains confirmed by natural in vitro mutagenesis. Commun. Med., 2025, vol. 5, no. 1, p. 224.
  58. Pospíšilová P., Fedrová P., Vrbová E., Hennelly C.M., Aghakhanian F., Hawley K.L., Bettin E.B., Davenport T.C., Bruisten S.M., Zondag H.C.A., Grange P.A., Dupin N., Arora N., Noda A.A., Seña A.C., Caimano M.J., Salazar J.C., Juliano J.J., Moody M.A., Radolf J.D., … Šmajs D. Analysis of Treponema pallidum subsp. pallidum predicted outer membrane proteins (OMPeomes) in 21 clinical samples: Variant sequences are predominantly surface-exposed. mSphere, 2025, advance online publication.
  59. Rosenberg C.R., Pasadhika S. A Vascularized Iris Mass in Ocular Syphilis: A Case Report and Review of Literature. Ocul. Immunol. Inflamm., 2024, vol. 32, no. 8, pp. 1648–1654.
  60. Rosset F., Celoria V., Delmonte S., Mastorino L., Sciamarrelli N., Boskovic S., Ribero S., Quaglino P. The epidemiology of syphilis worldwide in the last decade. J. Clin. Med., 2025, vol. 14, no. 15, p. 5308.
  61. Salauddin M., Bhattacharyya D., Samanta I., Saha S., Xue M., Hossain M.G., Zheng C. Role of TLRs as signaling cascades to combat infectious diseases: A review. Cell. Mol. Life Sci., 2025, vol. 82, no. 1, p. 122.
  62. Sanpei Y., Hanazono A., Funasaka M., Yasuda K., Takahashi Y., Sugawara M. Markedly Elevated IgG Index: A Key to Differentiating Neurosyphilis from Autoimmune Limbic Encephalitis. Intern. Med., 2025, vol. 64, no. 12, pp. 1906–1910.
  63. Sexually transmissible infections on the rise, syphilis triples in a decade: Report. MedicalXpress, 2023, December 19. Retrieved August 27, 2025.
  64. Shi Q., Gutierrez R.A., Bhat M.A. Microglia, Trem2, and neurodegeneration. Neuroscientist, 2025, vol. 31, no. 2, pp. 159–176.
  65. Shrimpton M., Malhotra A. Neurosyphilis presenting as limbic encephalitis. BMJ Case Rep., 2023, vol. 16, no. 12, e258794.
  66. Shuja S.H., Naeem U., Eqbal F., Shuja M.H. Ceftriaxone: A plausible intervention for treating neurosyphilis? Ann. Med. Surg., 2022, vol. 82, 104662.
  67. Skalnaya A., Fominykh V., Ivashchenko R., Averchenkov D., Grazhdantseva L., Frigo N., Negasheva E., Dolya O., Brylev L., Guekht A. Neurosyphilis in the modern era: Literature review and case series. J. Clin. Neurosci., 2019, vol. 69, pp. 67–73.
  68. Sweitzer S., Duncan J.A., Seña A.C. Update on syphilis diagnostics. Curr. Opin. Infect. Dis., 2025, vol. 38, no. 1, pp. 44–53.
  69. The US hasn't seen syphilis numbers this high since 1950. Other STD rates are down or flat. MedicalXpress, 2024, January 30. Retrieved August 27, 2025.
  70. Villarreal D.D., Babalola C.M. Expanding horizons in syphilis treatment: Challenges, advances, and opportunities for alternative antibiotics. Curr. HIV/AIDS Rep., 2025, vol. 22, no. 1, p. 22.
  71. Wang S., Gu W., Cao Y., Zheng H., Zhang L., Guo X., Chen W., Luo X. Comparison of the clinical efficacy of penicillin and ceftriaxone sodium in the treatment of neurosyphilis with psychiatric symptoms. World J. Psychiatry Ment. Health Res., 2022, vol. 5, no. 1, p. 1030.
  72. Waugh S., Cameron C.E. Syphilis vaccine development: Aligning vaccine design with manufacturing requirements. Hum. Vaccin. Immunother., 2024, vol. 20, no. 1, 2399915.
  73. Workowski K.A., Bachmann L.H., Chan P.A., Johnston C.M., Muzny C.A., Park I., Reno H., Zenilman J.M., Bolan G.A. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm. Rep., 2021, vol. 70, no. 4, pp. 1–187.
  74. World Health Organization. Implementation of the global health sector strategies on HIV, viral hepatitis and sexually transmitted infections, 2022–2030. Geneva: WHO, 2022.
  75. Wu S., Ye F., Wang Y., Li D. Neurosyphilis: Insights into its pathogenesis, susceptibility, diagnosis, treatment, and prevention. Front. Neurol., 2024, vol. 14, 1340321.
  76. Wudel B., Purewal R., Hatchette T.F., Stein D., Morshed M., Minion J., Vallée M., Hayden K., Hamula C. Canadian Public Health Laboratory Network (CPHLN) Diagnostic Recommendations for Neurosyphilis in Canada. J. Assoc. Med. Microbiol. Infect. Dis. Can., 2024, vol. 9, no. 4, pp. 219–228.
  77. Xiong S., Liu Z., Zhang X., Huang S., Ding X., Zhou J., Yao J., Li W., Liu S., Zhao F. Resurgence of syphilis: Focusing on emerging clinical strategies and preclinical models. J. Transl. Med., 2023, vol. 21, no. 1, 917.
  78. Yang Y., Gu X., Zhu L., Cheng Y., Lu H., Guan Z., Shi M., Ni L., Peng R.R., Zhao W., Wu J., Qi T., Long F., Chai Z., Gong W., Ye M., Zhou P. Clinical spectrum of late symptomatic neurosyphilis in China: an 11-year retrospective study. Sex. Transm. Infect., 2024, vol. 100, no. 8, pp. 477–483.
  79. Yang L., Fu Y., Li S., Liu C., Liu D. Analysis of Treponema pallidum DNA and CXCL13 in cerebrospinal fluid in HIV-negative syphilis patients. Infect. Drug Resist., 2022, vol. 15, pp. 7791–7798.
  80. Yu Q., Li W., Mo X., Tan F., Yang L. Case report: Microglia composition and immune response in an immunocompetent patient with an intracranial syphilitic gumma. Front. Neurol., 2021, vol. 11, 615434.
  81. Zezetko A., Stallings M., Pastis I. Deciphering the Great Imitator: Syphilis and Neurosyphilis. Cureus, 2024, vol. 16, no. 2, e54563.
  82. Zhang Q., Ma J., Zhou J., Zhang H., Li M., Gong H., Wang Y., Zheng H., Li J., Leng L. A study on the inflammatory response of the brain in neurosyphilis. Adv. Sci., 2025, vol. 12, no. 5, e2406971.
  83. Zhao W., Luo H. Investigation of the role of interleukin 27 in the immune regulation of Treg and Th17 cells in neurosyphilis patients. Folia Neuropathol., 2023, vol. 61, no. 4, pp. 387–395.
  84. Zheng Y.W., Zheng X.Q., Guo Y.F., Xie J.W., Wang M., Xu Q.Y., Zhu X.Z., Lin L.R. Characteristics of immune response and pathogen tissue dissemination during progressive Treponema pallidum infection: Insights from humanized mice. Scand. J. Immunol., 2025, vol. 101, no. 3, e70005.
  85. Zheng Y., Xu L. Bidirectional crosstalk between microglia and serotonin signaling in neuroinflammation and CNS disorders. Front. Immunol., 2025, vol. 16, 1646740.
  86. Zhou J., Zhang H., Tang K., Liu R., Li J. An updated review of recent advances in neurosyphilis. Front. Med., 2022, vol. 9, 800383.
  87. Zhou Y., Xie Y., Xu M. Potential mechanisms of Treponema pallidum breaching the blood-brain barrier. Biomed. Pharmacother., 2024, vol. 180, 117478.

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