Syphilis, a sexually transmitted disease caused by
Treponema pallidum, has undergone a dramatic global resurgence in the past ten years. The World Health Organization estimated 2.2 million (1.3 – 3.1 million) incident cases of syphilis infection in 2020. Congenital syphilis cases are increasing in many countries. These alarming trends underscore the importance of multi-disciplinary syphilis research to inform clinical decisions, public health control measures, surveillance, diagnostics, and prevention strategies. The high burden of syphilis observed in many countries provides unique opportunities for expanded research programs.
Following inoculation,
T. pallidum rapidly disseminates and can invade any organ, including the central nervous system. Host-pathogen interactions during syphilitic infection are complex. As infection proceeds, humans mount robust cellular and humoral immune responses, yet the pathogen often evades clearance and persists for years, while tissue damage due to the local inflammatory response gives rise to myriad clinical manifestations. Many genomes of clinical strains have been sequenced, providing a robust picture of the syphilis spirochete’s genetic diversity. Great progress also has been made in identifying the spirochete’s outer membrane proteins, providing an essential foundation for vaccine development. In recent years, many innovative public health strategies have been developed to control the syphilis epidemic. For example, diagnostic tests now allow syphilis self-testing in which an individual collects a blood sample and interprets the test result. These advances could accelerate the acceptance of self-testing strategies for syphilis in the post-COVID-19 pandemic era.
In this Research Topic, we welcome contributions to highlight the enormous progress made in understanding syphilis infection, spanning a wide range of clinical, epidemiology, basic science, and behavioral research. Multi-disciplinary research is particularly welcome. We invite submissions containing Original Research, Reviews, and Commentaries focusing on, but not limited to, the following themes:
• Clinical management, especially of neurosyphilis
• Epidemiology, surveillance, modeling and implementation research
• Virulence factors of
T. pallidum• Persistence and immune evasion
•
T. pallidum genomics and population biology
• Behavioral research to inform vaccine development
• Structural biology and physiology
• Pathologic immune responses
• Protective immunity, vaccine development and barriers to vaccine acceptance
• Congenital syphilis
• Diagnostics, especially self-testing, self-collection, and decentralized testing
• Health economics
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