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Objective:  To explore cerebrospinal fluid (CSF) levels of soluble triggering receptor expressed on myeloid cells 2 (sTREM2) and neurofilament light proteins (NFL) in patients with neurosyphilis (NS).   Methods:  We enrolled 71 NS patients (41 early-NS and 30 late-NS patients) and 20 syphilis but non-NS patients whose CSF samples were collected. The CSF levels of the microglial activation biomarker sTREM2 and neuronal injury biomarker NFL were measured using ELISA.   Results:  CSF sTREM2 levels were significantly higher in NS patients compared to those in syphilis/non-NS patients ( p  < 0.001). In a subgroup analysis, the CSF sTREM2 levels elevated significantly in late-NS patients than those in early-NS patients ( p  < 0.001). The CSF sTREM2 levels in early-NS group were also significantly higher than those in syphilis/non-NS group ( p  = 0.024). Like CSF sTREM2, similar differences between groups were also found in CSF NFL. There was a moderate correlation between CSF sTREM2 and CSF NFL ( r  = 0.406,  p  < 0.001) in NS group.   Conclusions:  CSF sTREM2 levels elevated in NS and peaked at the late stage, suggesting that CSF sTREM2 may be a useful marker to quantify microglia activation in NS and may play a role in the progression of NS. The positive correlation between CSF sTREM2 and CSF NFL indicates a linkage between microglial activation and neuronal injury in NS.

Increased CSF Soluble TREM2 Concentration in Patients With Neurosyphilis