Evaluation of leukocytes and inflammatory profile in newborns with
congenital syphilis.
Treponema pallidum; cytokine; chemokine.
Syphilis is caused by the spirochetae bacterium Treponema pallidum and is one of the oldest
recorded sexually transmitted infections. T. pallidum can also be transmitted from mother to fetus
during pregnancy or childbirth, leading to congenital syphilis if the mother does not receive
appropriate treatment. Congenital syphilis can cause severe complications such as miscarriage or
neonatal sequelae, including hepatosplenomegaly, jaundice, anemia, syphilitic gummas, and
neurosyphilis. The immune response to T. pallidum infection in adults involves the production of cytokines such as IL-1, IL-2, IL-6, IL-12, IL-1β, TNF-α, IFN-γ, and IL-17. In a single case study, a
newborn with congenital syphilis exhibited a similar cytokine profile, with higher levels of IL-2, IL-
12, and IFN-γ. Chemokines such as CCL2, CCL4, and CXCL8 were also found at high levels,
playing a key role in recruiting monocytes, macrophages, and neutrophils. In studies on congenital
Zika syndrome, elevated levels of IL-2, IL-5, IL-13, IFN-α, IFN-β, and IFN-γ, along with low levels
of the chemokines CCL2 and CXCL8, were observed. The presence of atypical leukocytes, such
as hypersegmented and vacuolated neutrophils, was also reported. From this perspective, the
objective of this study is to investigate the immunological status of children congenitally infected
with Treponema pallidum. The study will be conducted at the Januário Cicco Maternity School
(MEJC), where mothers infected during pregnancy will be recruited for an evaluation of their
newborns' health. Additionally, mothers who were not infected with T. pallidum will be recruited as
a control group. After recruitment, informed consent (TCLE) will be obtained, medical record data
will be collected, and neonatal blood samples will be drawn using EDTA. These blood samples will
be used to investigate immune system alterations in newborns, focusing on the quantification of
cytokines (IFN-γ, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-10, and TNF-α) and chemokines (CCL2, CCL5,
CXCL8, CXCL9, CXCL10) using the Cytometric Bead Array (CBA) method on the Accuri C6 Plus
flow cytometer. Additionally, an investigation into the quantification and morphological alterations of
leukocytes, with a focus on neutrophils, lymphocytes, and eosinophils, will be conducted through
blood smear analysis. This study aims to provide a better understanding of the impact of T.
pallidum infection on neonatal health and serve as basis for future therapeutic and monitoring
strategies.