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Reiter 蛋白抗原과 Cardiolipin抗原을 利用한 梅毒 血淸反應의 比較檢討

A comparative study of serological reactions for syphilis using Reiter protein antigen and Cardiolipin anctigen

중앙의학 1964년 7권 6호 p.765 ~ 786
이강순,
소속 상세정보
이강순 (  ) - 국립보건원 미생물연구부

Abstract


Due to the multiplicity of clinical symptoms it is difficult to differentiate syphilis from other diseases, and particularly this has been the case since the introduction of antibiotics, since inadequate use of the remedies has caused an increase of syphilis cases with a non-symptomatic course and a coresponding decrease of the symptomatic cases. Accordingly the diagnosis of the disease by means of serological tests has become more significant.
In Korea the methods for serological tests for syphilis mainly utilize methods using non-treponemal antigens such as the cardiolipin tests(CL tests) ; viz. the venereal disease research laboratory slide flocculation test(VDRL) and the Kolmer complement fixation test (Kolmer CF). However, the CL tests not onyl give positive reaction in the sera of syphilitic patients, but infrequently, also in sera from persons without syphilis, with differences in incidence according to sex, race and other various biological factors. The reactions can be considered as biological false positive reactions (BFP).
It is belived that the Reiter protein (RP) extracted from the Reiter strain of non-pathogenic Treponema is antigenically almost identical with that of the syphilis spirochete, and that this is the reson why this protein also reacts with the syphilitic antibodies.
The author made a study in which the results of serological tests for syphilis, using the CL antigen and the RP antigen are compared from serological, epidemiological and therapeutic points of view. These are the conclusions:
Serologically; 1. The reaction with the Kolmer CF in syphilitic serum was more stronger than that of the RPCF.
2. It was confirmed that the anti-RP antibody and the anti-lipoidal antibody were two different substances.
3. The RP antigen used in this study can be applied to practical use in the clinic.
Epidemiologically; 4. In each test group, the ratio between the rate of positive VDRL and that of positive Kolmer CF was approximatelly 1. 16 and there was no such correlation between the CL tests and RPCF.
5. The rate of BFP in the CL test as controlled by the RPCF in the doubtful venereal disease group (15%) was intermediate between the highest groups, narcotic addict (30%) and leprosy (27%), and the lowest groups, psychopath, professional blood donor and normal healthy persons (5.8%) in average.
6. If the rate of BFP in the normal healthy group in this study (4. 7%) can be assumed to be representative of Korea as a whole, the BFP rate of Koreans is significantly lower than that of the white race and much closer to the non-white.
Therapeutically; 7. The conversion rate to the negativity was higher in VDRL than in the Kolmer CF at any stage of the therapeutic period, and the RPCF is lower than that of the Kolmer CF up to 4 therapeutic weeks, but not different thereafter.
8. The process of disappearance of the anti-lipoidal antibody and of the anti-RP antibody after penicillin therapy seemed to be different from one another, since the former disappeared rapidly and the latter more slowly, and this finding was useful in explaining the various phenomena observed in serological testing for syphilis.
9. When the therapeutic effect on the syphilis is evaluated serologically, the use of antigens of higher specificity is essential.

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