Wassermann test
{{Short description|Antibody test for syphilis}}
{{More medical citations needed|date=November 2021}}
{{Infobox diagnostic
| name = Wassermann test
| image = File:The Road to Ruin (1934) - Eve's Positive Wassermann Test.jpg|thumb|
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| caption = The test was sufficiently familiar to American movie audiences that the 1934 exploitation film The Road to Ruin simply showed a card with a positive Wassermann test (misspelled in the film) without any further explanation to indicate a character had contracted syphilis.
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| purpose =antibody test for syphilis
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| synonyms = Wassermann reaction
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The Wassermann test or Wassermann reaction (WR){{cite journal | doi = 10.1017/S0022172400011943 | last1 = Beck | first1 = A. | title = The role of the spirochaete in the Wassermann reaction | journal = Journal of Hygiene | volume = 39 | issue = 3 | pages = 298–310 | year = 1939| pmc = 2199439 | pmid=20475495}} is an antibody test for syphilis, named after the bacteriologist August Paul von Wassermann, based on complement fixation. It was the first blood test for syphilis and the first in the nontreponemal test (NTT) category. Newer NTTs, such as the RPR and VDRL tests, have mostly replaced it. During the mid-20th century, in many jurisdictions, including most US states, applicants for a marriage license were required by law to undergo a Wassermann test.
Method
A sample of blood or cerebrospinal fluid is taken and introduced to the antigen – cardiolipin extracted from bovine muscle or heart. Syphilis non-specific antibodies (reagin, see RPR) react with the lipid – the Wassermann reaction of antiphospholipid antibodies (APAs). The intensity of the reaction (classed 1, 2, 3, or 4) indicates the severity of the condition.
Uncertainty
File:Taking a Wasserman blood test.jpg
The reaction is not specific to syphilis and will produce a positive reaction to other diseases, including systemic lupus erythematosus, malaria, and tuberculosis. It is possible for an infected individual to produce no reaction and for a successfully treated individual to continue to produce a reaction (known as being "Wassermann fast" or "fixed").{{citation needed|date=July 2017}}
The Wassermann test is ineffective at identifying primary syphilis as sufficient reagin has not yet been produced from tissue destruction at this stage. Therefore, more effective methods have been a common research topic.{{cite web|last1=Stevens|first1=Sara|title=Wassermann Test|url=https://www.stdaware.com/stds/syphilis/treatment/wassermann-test|website=STDAware|access-date=3 July 2017|language=en|archive-date=14 March 2022|archive-url=https://web.archive.org/web/20220314030256/https://www.stdaware.com/stds/syphilis/treatment/wassermann-test|url-status=dead}}
Development and refinement
The antibody test was developed by Wassermann, Julius Citron, and Albert Neisser at the Robert Koch Institute for Infectious Diseases in 1906.{{WhoNamedIt|doctor|2511}}A Wassermann, A. Neisser and C. Bruck. Eine serodiagnostische Reaktion bei Syphilis. Deutsche medicinische Wochenschrift, Berlin, 1906, 32: 745–46. Announcing the test for syphilis. The test was a growth from the work of Bordet and Gengou on complementing-fixation reaction, published in 1901, and the positive reaction is sometimes called the Bordet-Gengou-Wassermann reaction or Bordet-Wassermann reaction.
The Wassermann test has been refined with the Kahn test{{cite journal |author=Gilbert R |title=Standardization of the Wassermann Test: Abstract of Progress Test |journal=Am J Public Health Nations Health |volume=20 |issue=1 |pages=47–48 |date=January 1930 |pmid=18012919 |pmc=1555718 |doi= 10.2105/AJPH.20.1.47}} and the Kolmer test{{Citation needed|date=July 2009}}, and it is rarely used today. Replacement tests such as the VDRL test and the RPR test, initially based on flocculation techniques (Hinton), have been shown to produce far fewer false positive results.{{Citation needed|date=July 2009}} Indeed, the "biologic false positives" of modern tests usually indicate a serious alternate condition, often an autoimmune disease.
References
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- Citron, Dr. Julius, "Immunity" (English translation) 1914 163–64
External links
- {{MeshName|Wassermann+reaction}}
{{Infectious and inflammatory blood tests}}
{{Authority control}}
{{DEFAULTSORT:Wassermann Test}}