Serum glial fibrillar acid protein (GFAP) level as a marker of nerve tissue damage in patients with syphilis
Novikov Yu.A., Zadorozhnaya A.V., Zubareva E.Yu., Pravdina O.V., Radul E.V., Filippov S.O.
Background: Despite the improvement in the epidemiological situation with syphilis in the Russian Federation over the past two decades, there has been an increase in latent and late forms of the disease. One of the most controversial is the question of the state of the nervous system after suffering syphilis, even with full-fledged specific therapy. Pale treponema is vasotropic and neurotropic, but markers of damage to the blood-brain barrier (BBB) and nerve tissue in the absence of confirmed neurosyphilis are not well understood.
Objective: Determination of the blood serum glial fibrillar acid protein (GFAP) level in patients diagnosed with syphilis unspecified as early or late (A 53.0) and in healthy volunteers without a history of syphilis; comparison of results.
Materials and methods: A cross-sectional study was carried out in 2024-2025 in Omsk. 87 people were examined: the main group (n = 46) - patients with syphilis without clinical and laboratory signs of damage to the nervous system; control group (n = 41) - healthy volunteers without a history of syphilis. The age of the participants was 30-65 years. Serum GFAP level was determined by enzyme-linked immunosorbent assay. Statistical analysis was performed using Student’s t-test.
Results: The mean GFAP level in the main group was 384.49 pg/ml, in the control group - 209.57 pg/ml (p <0.05, t = 4.5). Exceeding the reference values of the indicator was recorded in 74% of patients with syphilis and only in 32% of healthy volunteers. The maximum value (698.982 pg/ml) was detected in a 38-year-old woman with a serologically active process. In the control group, high GFAP levels were associated with the age of 50-69 years (senile astrogliosis), while in the main group - with younger patients (40-59 years). There was a significant correlation between high TPHT titers (4+) and GFAP levels (k = 0.76).
Conclusion: In the majority of patients with syphilis, even in the absence of a confirmed specific lesion of the nervous system, a statistically significant increase in GFAP was detected, which indicates the involvement of nerve tissue and damage to the BBB. Determination of serum GFAP concentration can be considered as a promising biomarker for identifying risk groups for the development of vascular neurological complications (discirculatory encephalopathy, early acute cerebrovascular accidents (CVA) and conducting primary prevention as part of precision medicine.
For citations: Novikov Yu.A., Zadorozhnaya A.V., Zubareva E.Yu., Pravdina O.V., Radul E.V., Filippov S.O. Serum glial fibrillar acid protein (GFAP) level as a marker of nerve tissue damage in patients with syphilis. Pharmateca. 2026;33(5):130-136. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2026.5.130-136
Authors’ contribution: Study concept and design – Yu.A. Novikov, A.V. Zadorozhnaya. Material collection and processing – A.V. Zadorozhnaya, E.V. Radul, O.V. Pravdina, S.O. Filippov. Statistical analysis – A.V. Zadorozhnaya, E.Yu. Zubareva. Text writing – Yu.A. Novikov, A.V. Zadorozhnaya. Editing by– Yu.A. Novikov, A.V. Zadorozhnaya.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors’ Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
Keywords
syphilis
neurosyphilis
GFAP
glial fibrillar acidic protein
blood-brain barrier
biomarkers
neurovascular complications
Treponema pallidum
About the Authors
Yuri A. Novikov, Dr. Sci. (Med.), Associate Professor, Chief Physician, Clinical Dermatovenerological Dispensary, Omsk; Head, Department of Dermatovenereology and Cosmetology, Omsk State Medical University, Omsk, Russia; skinandven@omsk-osma.ru, ORCID: https://orcid.org/0000-0003-0391-5372 (corresponding author)Anna V. Zadorozhnaya, Regional Clinical Hospital, Omsk, Russia; ORCID: https://orcid.org/0000-0002-0216-1831
Elena Yu. Zubareva, Omsk State Medical University, Department of Dermatovenereology and Cosmetology, Omsk, Russia; ORCID:
https://orcid.org/0000-0003-1156-682Х
Olga V. Pravdina, Omsk State Medical University, Department of Dermatovenereology and Cosmetology, Omsk, Russia; ORCID:
https://orcid.org/0000-0002-1804-6248
Elena V. Radul, Omsk State Medical University, Department of Dermatovenereology and Cosmetology, Omsk, Russia; ORCID:
https://orcid.org/0000-0002-9395-9792
Sergey O. Filippov, Clinical Dermatovenerologic Dispensary, Venereologic Department, Omsk, Russia
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