Michael Marks
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drmichaelmarks.bsky.social
Michael Marks
@drmichaelmarks.bsky.social
NIHR Research Professor
Professor of Medicine at LSHTM.
Lead for Integrated Academic Training at LSHTM.
Consultant in Infectious Diseases at UCLH.

Syphilis & STIs, Neglected Tropical Diseases, Emerging Infectious Diseases, Group A Strep, Pragmatic Trials
Wiping clean the last year of grant applications & preparing for this one.

As always grateful to a stellar group of colleagues & collaborators who keep the show on the road.
January 13, 2026 at 11:02 AM
Out @lancetmicrobe.bsky.social & led @amberbarton.bsky.social We used WGS to look at Treponema population dynamics during community MDA for yaws tinyurl.com/bd6zu6xm

Intriguingly found sublineage associated w longer ulcer duration & lower antibody titres. Whether occurs in syphilis needs exploring
January 7, 2026 at 8:49 AM
As ever from Lorenzo, @nicolelieberman.bsky.social & the team at @uwnews.uw.edu a great paper showing variation in Penicillin Binding Proteins in T.pallidum do not appear to impact susceptibility - consistent with what we have observed clinically for 50+ years.

journals.lww.com/stdjournal/a...
January 3, 2026 at 6:05 PM
We found extremely low levels in semen in our cohort study during the 2022 pandemic & (caveat emptor) always below the level at which we could culture it (see also Table S3 in the Supplementary).

www.thelancet.com/journals/lan...
January 2, 2026 at 6:57 PM
Don't worry I think your position is common (especially in USA). Nagoya is a globally agreed set of rules about ensuring protection of rights related to genetic/biological resources. The USA is not a signatory unlike nearly all European, African, Asian and South American governments (see map).
December 28, 2025 at 5:42 PM
Super proud of my student Philippe Ndzomo awarded PhD today at University of Yaounde.

His work focused on the emergence of Hameophilus ducreyi as a cause of cutaneous ulcers in Cameroon & Globally
pubmed.ncbi.nlm.nih.gov/40338972/
pubmed.ncbi.nlm.nih.gov/39961439/
pubmed.ncbi.nlm.nih.gov/38150487/
December 11, 2025 at 4:12 PM
Incredible retirement talk by Prof. Paul Fine @lshtm.bsky.social Career dedicated to global health, critical enquiry & passion for training next generation in UK & esp Malawi where he left huge legacy. Privilege spend 10+yrs at same institution & humbling to know its not even 1/3 time hes been here.
December 9, 2025 at 10:30 PM
Congratulations to Burrell St Sexual Health: First UK patient into SOS Global - Evaluating mucosal shedding of spirochetes in heterosexual individuals with syphilis.

Great collaboration led by Melbourne Sexual Health Centre focused on understanding syphilis transmission.
December 2, 2025 at 11:38 AM
Great event at the Red Run for World Aids Day - a bracing, wet, windy but highly enjoyable 10km. Still accepting final donations for an excellent cause - @thelovetankcic.bsky.social
November 22, 2025 at 1:34 PM
Fabulous meeting in Zimbabwe @thruzim.bsky.social for PROMISE Trial

Investigating STI screening in 12,000 women in antenatal care thruzim.org/hiv-srh-1/promise

Great team across clinical, stats, economics, social science, genomics & basic science to allow us to tackle a wide range of questions
November 13, 2025 at 1:51 PM
Two syphilis/STI related UK PhD Studentships with our group:

Evaluating near-patient syphilis tests with @uclglobalhealth.bsky.social inyurl.com/aw9sapma deadline 5th Dec 2025

Mathematical models to understand partner notification tinyurl.com/2re7xasj deadline 14th Jan 2026

Please do share
November 10, 2025 at 9:52 AM
A beautiful example of why when assessing growth of a pathogen in a cell culture line that you need to know if the drug is actually just killing the cell line.

For example T.pallidum doesn't grow in culture when you use ivermectin BUT that's because ivermectin is killing the cell line.
October 22, 2025 at 3:03 AM
There is exciting progress in identifying human cell lines which could replace rabbit cells in the culture model & could therefore more accurately recapitulate human syphilis infection.
October 22, 2025 at 2:53 AM
We can use the in-vitro cultivation system to explore the pathogenesis of T.pallidum.

This is helping us understand the interactions between epithelial cells and the pathogen which is critical to transmission and pathogenesis.

Slowly slowly itching towards vaccines...
October 22, 2025 at 2:49 AM
The schema developed by Sheila Lukehart (queen of syphilis immunology) highlights the key role of cellular immune responses alongside humoral responses in controlling and clearing T.pallidum.
October 22, 2025 at 12:21 AM
Kicking off day 3 Shanghai Syphilis Symposium.

There is still a huge amount we can learn from the historic studies to inform our understanding of syphilis immunology and vaccine development.
October 22, 2025 at 12:11 AM
BPG is made up of lots of crystals of penicillin bound to Benzathine. These slowly release penicillin into the blood - so we have a long period of absorption from IM into the blood and then a short elimination half life in the circulation.
October 21, 2025 at 6:54 AM
The lack of evidence means there is massive variation around the world in how asymptomatic infants with congenital syphilis are managed globally.

We need clearer guidelines informed by well done diagnostic and therapeutic studies.
October 21, 2025 at 6:41 AM
At one end of the congenital syphilis spectrum are those infants who have symptomatic disease. These children can be severely unwell and we need drugs that can be easily and safely administered to sick neonates.
October 21, 2025 at 6:38 AM
There remains a depressingly high gap in many LMIC settings between uptake of HIV testing and syphilis testing in Antenatal Care.

And it's not an issue of cost because this is a cheap and hugely cost effective intervention. It's an issue around political will, prioritisation and sustained support.
October 21, 2025 at 4:44 AM
Introducing a new diagnostic test is not enough to address issues - for syphilis RDTs even though they gave a quicker test turn around it required a full health system intervention for that to be accompanied by an increased uptake of Syphilis treatment
October 21, 2025 at 4:41 AM
Fundamental health system barriers remain as the major challenge to the implementation of diagnostics. If we don't fix this then no matter how good your new syphilis test is you will still run in to major road blocks in implementing and improving care pathways.
October 21, 2025 at 4:30 AM
Pregnant women with syphilis are also shedding from their mucosa in a similar fashion to what has been demonstrated in MSM populations.
October 21, 2025 at 3:58 AM
Neurosyphilis criteria vary from country to country. A classic example of the absence of a reference standard to guide diagnostic pathways & inform management.
October 21, 2025 at 3:33 AM
We can leverage social network structure to distribute self-testing kits to contacts & there is evidence this is a more effective method than simply asking individuals to refer their contacts for facility based testing.
October 21, 2025 at 3:14 AM