In the s, the major substance used as an antigen in the Wassermann test was identified as a diphosphatidylglycerol called cardiolipin , which is commonly found in normal non-syphilitic tissues, including the heart. Why the detection of anti-phospholipid, non-treponemal antibodies could indicate syphilis has been a subject of debate for the past 6 decades. A study in using a rabbit infection model demonstrated that T. The increase in anti-phospholipid antibody production was suggested to be a result of the combined effects of both the T.
Antigens used in older generations of the non-treponemal assays were crude extracts of diseased tissues processed using various extraction methods, making them difficult to standardize.
In , Mary Pangborn et al. The use of a combination of purified cardiolipin, lecithin, and cholesterol as an antigen for non-treponemal antibody tests allowed for better standardization of assays and improved reproducibility within and between laboratories.
Nowadays, synthetic cardiolipin and lecithin are used to prepare reagents for non-treponemal assays instead of extracts from beef heart. Another technique that played an important role in the development of non-treponemal antibody testing for syphilis is flocculation, which was introduced by German scientists Hans Sachs and Walter Georgi.
Non-treponemal tests utilizing flocculation were much less tedious than those relying on complement fixation, all of which became obsolete by the s. Many non-treponemal tests based on the flocculation method have been developed. One of the first generation of flocculation tests was the Khan Test. This assay, published in , utilized an antigen consisting of beef heart extract and cholesterol suspended in a salinized solution.
This new assay saw an increase in sensitivity compared to the Khan test, and the method was adopted for routine patient testing for many years.
A second brownie point to those who can comment with the name of a culture medium that Dr. The sensitivity and ease-of-use of reagin-type flocculation tests led to the development of many other tests that relied on similar principles. Read about these assays in detail as part of the syphilis diagnostic algorithms discussed in the next article on syphilis diagnostics.
The identification of T. In addition to his work on identification of lipoid substances that serve as antigen in the Wassermann test, Landsteiner and his colleagues also reported that serum of syphilis patients inhibited the movements of T.
This observation formed the basis for the T. Despite the complicated and tedious test procedures, TPI became one of the first treponemal antibody tests and was adopted as a confirmatory test for specimens positive for non-treponemal tests. The fluorescent antibody test for syphilis was first reported in by Deacon, Falcone, and Harris.
In this test, patient sera were incubated on slides that contained antigen smears prepared from an inactivated organism suspension, followed by washing and staining with a fluorescein isothiocyanate FITC conjugated antibody. The presence of treponemal antibodies would result in fluorescence of the organism on the slide. Marine Hospital on Staten Island, in New York, first treated and cured four patients with syphilis by giving them penicillin. To this day, penicillin remains the cure for syphilis.
Syphilis belongs to a group of four diseases known to be caused by bacteria that are members of the Treponema family. The others are yaws, bejel, and pinta , all of which are spread through skin contact, primarily among children living in areas with poor hygiene.
As mentioned above, in the case of syphilis, the culprit is a spiral-shaped organism known as Treponema pallidum. Lukehart, PhD , a professor of medicine and global health at the University of Washington in Seattle and an expert on Treponema pallidum.
Some of its traits make this bacterium extra tricky to address with a vaccine, says Dr. Nonetheless, researchers are trying to find a vaccine that will work against syphilis. By blocking the development of sores, the vaccine could block transmission of the illness from one person to another, since contact with the chancre is how a person without syphilis catches it from an infected person. Lukehart is optimistic, with some reservations. By screening you should be able to do that.
By subscribing you agree to the Terms of Use and Privacy Policy. Health Topics. Health Tools. Reviewed: June 8, Medically Reviewed. Editorial Sources and Fact-Checking.
Frith J. Journal of Military History. December Stratman-Thomas WK. Yaws is mainly a disease of the skin, joints, soft tissue, and bone, transmitted by skin-to-skin contact with no evidence of vertical transmission.
Initial papillomatous lesions usually occur in the lower extremities and subsequently develop into ulcers. Late stage central nervous system CNS complications are rare, but if left untreated, severe destructive osteitis resulting in permanent deformity may occur. On the other hand, syphilis is sexually transmitted in general, with well-characterized vertical transmission, and when left untreated may result in late stage complications in many organ systems including the CNS.
There is still debate over the origin of syphilis and how it spread to different parts of the world. The timing of this event correlates with the first reported outbreaks among the French troops in Europe during the War of Naples in In recent years, a combination of genetic information about pathogenic human treponemes and palaeopathological evidence observed through carbon dating and examination of bone pathology have shed some light on how syphilis came into existence and spread worldwide.
Despite the variation in epidemiology and clinical manifestations among human treponematoses, the etiologic agents of these diseases are not that different genomically, morphologically, and serologically. Their genomes are essentially the same sizes at approximately 1.
DNA-DNA hybridization experiments and subsequent whole-genome sequencing suggested that these organisms may have been clonal in origin with a common ancestor. A study integrating a worldwide map of palaeopathological evidence with evolutionary models based on genetic analysis of Treponema species from all over the world supported the Columbian Hypothesis by suggesting that T. A more recent study using whole genome sequencing demonstrated that T.
As mentioned above, there was essentially no solid evidence of the existence of syphilis in the Old World prior to the s. No unequivocal mention of syphilis has been found before then, not even in ancient Chinese writings where descriptions of many Old World diseases have been identified. The name " the French Disease " was a result of a blame-game initiated by the Italians.
The disease spread throughout Europe like wildfire, resulting in devastating illnesses that have been described by a victim of the disease, German humanist Joseph Grunpeck , as "so cruel, so distressing, so appalling that until now nothing more terrible or disgusting has ever been known on this earth.
Syphilis affected individuals from the bottom to the top rung of society, including priests, cardinals, and even a pope. In Europe, the presence of clinical signs of syphilis, including pustules, chancres, and bone destruction or malformation, became a stigma that was associated with being unclean and led to mistreatment of afflicted individuals that went on for centuries.
Soon after the first reported outbreak in , the disease spread into Asian countries including India, China, and Japan. Interestingly, syphilis in its first century in the Old World seemed to progress more rapidly and resulted in more severe morbidity and mortality compared to the form of the disease that was documented from the 16 th century onward.
This less-severe, slowly progressing form of syphilis likely became what is now known as one of the most common venereal diseases worldwide. During the 16 th century the 2 most popular treatment regimens were potions made from guaiacum gum or mercury. The guaiacum potion proved to be ineffective, as opposed to mercury, which had already been used to treat other diseases and had shown some success in curing syphilis. Despite the illness and death caused by mercury poisoning, mercury administration was used for more than years until the identification of T.
This discovery allowed for screening and development of novel therapeutic agents.
0コメント