Novel Treponema pallidum Serologic Tests: A Paradigm Shift in Syphilis Screening for the 21st Century.
Summary of "Novel Treponema pallidum Serologic Tests: A Paradigm Shift in Syphilis Screening for the 21st Century."
The mainstay of diagnosis for Treponema pallidum infections is based on nontreponemal and treponemal serologic tests. Many new diagnostic methods for syphilis have been developed, using specific treponemal antigens and novel formats, including rapid point-of-care tests, enzyme immunoassays, and chemiluminescence assays. Although most of these newer tests are not yet cleared for use in the United States by the Food and Drug Administration, their performance and ease of automation have promoted their application for syphilis screening. Both sensitive and specific, new screening tests detect antitreponemal IgM and IgG antibodies by use of wild-type or recombinant T. pallidum antigens. However, these tests cannot distinguish between recent and remote or treated versus untreated infections. In addition, the screening tests require confirmation with nontreponemal tests. This use of treponemal tests for screening and nontreponemal serologic tests as confirmatory tests is a reversal of long-held practice. Clinicians need to understand the science behind these tests to use them properly in syphilis management.
Affiliation
Department of Medicine, University of North Carolina at Chapel Hill.
Journal Details
This article was published in the following journal.
Name: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20687840
- DOI: http://dx.doi.org/10.1086/655832
Medical and Biotech [MESH] Definitions
Fluorescent Treponemal Antibody-absorption Test
Serologic assay that detects antibodies to Treponema pallidum, the etiologic agent of syphilis. After diluting the patient's serum to remove non-specific antibodies, the serum is mixed on a glass slide with Nichol's strain of Treponema pallidum. An antigen-antibody reaction occurs if the test is positive and the bound antibodies are detected with fluoresceinated antihuman gamma-globulin antibody.
Treponema Immobilization Test
Syphilis serodiagnosis employing as the antigen Treponema pallidum obtained from rabbit syphilis orchitis. Treponemes are kept alive for a few hours in a special medium. When syphilitic serum and complement are added and incubated, the treponemes are immobilized, i.e., stop moving.
Syphilis Serodiagnosis
Serologic tests for syphilis.
Syphilis, Cardiovascular
Cardiovascular manifestations of SYPHILIS, an infection of TREPONEMA PALLIDUM. In the late stage of syphilis, sometimes 20-30 years after the initial infection, damages are often seen in the blood vessels including the AORTA and the AORTIC VALVE. Clinical signs include syphilitic aortitis, aortic insufficiency, or aortic ANEURYSM.
Syphilis
A contagious venereal disease caused by the spirochete TREPONEMA PALLIDUM.
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