RECENT DEVELOPMENTS IN THE LABORATORY DIAGNOSIS OF SYPHILIS

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Abstract
A short general review of the precipitous decline in syphilis in this country in the past decade including the recent rise in infectious syphilis is commented upon in relation to the problems posed under such circumstances by the continued use of a non-specific test measuring Wassermann antibody. The problems presented by such circumstances have stimulated the recent developments in the laboratory diagnosis of syphilis utilizing antibodies other than the Wassermann antibody. . Ten of 20 current treponemal tests for syphilis being performed in 28 major laboratories throughout the world, representative of the different approaches investigators have taken to develop more specific tests for syphilis, are presented. These 10 treponemal tests for syphilis are generally described, including the ease or difficulty and time of carrying out the test procedures, the availability of test components, the level of standardization of such components, the reproducibility of the tests themselves, as well as the cost of the test procedures on the following tests: Treponema Pallidum Immobilization (TPI) tests, Treponema Pallidum Agglutination (TPA) tests, Treponema Pallidum Immune-Adherence (TPIA) tests, Treponema Pallidum Complement Fixation (TPCF) tests, Treponema Pallidum Methylene Blue (TPMB) test, Whole-Body Treponema Pallidum Complement-Fixation (WTPCF) test, Reiter Protein Complement-Fixation (RPCF) tests, Treponemal Wassermann Reaction (TWR) test, Fluorescent Treponemal Antibody (FTA) test, Treponema Pallidum Cryolysis Protein (TPCP) tests. The characteristics of the development of the differing relatively specific treponemal antibodies during the natural course of syphilis infection and the relation of adequate treatment to the titer of these differing antibody systems is presented. An understanding of the latter is most important in relation to the interpretation of test results in clinical syphilis by the clinician. The special usefulness and limitations of the various test systems are presented, particularly in relation to biologic false positive reagin reactors. A brief description is presented of developments concerning rapid reagin tests for syphilis. Using such techniques test results can be obtained in less than 10 minutes after the blood specimen is drawn from the patient.