Rapid Plasma Reagin
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Rapid Plasma Reagin
The rapid plasma reagin test (RPR test or RPR titer) is a type of rapid diagnostic test that looks for non-specific antibodies in the blood of the patient that may indicate an infection by syphilis or related non-venereal treponematoses. It is one of several nontreponemal tests for syphilis (along with the Wassermann test and the VDRL test). The term ''reagin'' means that this test does not look for antibodies against the bacterium itself, ''Treponema pallidum'', but rather for antibodies against substances released by cells when they are damaged by ''T. pallidum'' ( cardiolipin and lecithin). Traditionally, syphilis serologic testing has been performed using a nontreponemal test (NTT) such as the RPR or VDRL test, with positive results then confirmed using a specific treponemal test (TT) such as TPPA or FTA-ABS. This algorithm is currently endorsed by the U.S. Centers for Disease Control and Prevention (CDC). In addition to screening for syphilis, a titer can be used to t ...
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Treponema Pallidum
''Treponema pallidum'', formerly known as ''Spirochaeta pallida'', is a spirochaete bacterium with various subspecies that cause the diseases syphilis, bejel (also known as endemic syphilis), and yaws. It is transmitted only among humans. It is a helically coiled microorganism usually 6–15 μm long and 0.1–0.2 μm wide. ''T. pallidum'''s lack of either a tricarboxylic acid cycle or oxidative phosphorylation results in minimal metabolic activity. The treponemes have a cytoplasmic and an outer membrane. Using light microscopy, treponemes are visible only by using dark field illumination. ''Treponema pallidum'' consists of three subspecies, ''T. p. pallidum, T. p. endemicum,'' and ''T. p. pertenue,'' each of which has a distinct associated disease. Subspecies Three subspecies of ''T. pallidum'' are known: * ''Treponema pallidum pallidum'', which causes syphilis * ''T. p. endemicum'', which causes bejel or endemic syphilis * ''T. p. pertenue'', which causes yaws T ...
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Treponema Pallidum Particle Agglutination Assay
The ''Treponema pallidum'' particle agglutination assay (also called TPPA test) is an indirect agglutination assay used for detection and titration of antibodies against the causative agent of syphilis, ''Treponema pallidum'' subspecies ''pallidum''. It also detects other treponematoses. In the test, gelatin particles are sensitized with ''T. pallidum'' antigen. Patient serum is mixed with the reagent containing the sensitized gelatin particles. The particles aggregate to form clumps when the patient serum is positive for syphilis. In other words, the patient's serum contains antibodies to ''T. pallidum''. A negative test shows no clumping of gelatin particles. This is a type of specific treponemal test for syphilis. A similar specific treponemal test for syphilis is the ''Treponema pallidum'' hemagglutination assay or TPHA. TPHA is an indirect hemagglutination assay used for the detection and titration of antibodies against the causative agent of syphilis, ''Treponema pal ...
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FTA-ABS
The fluorescent treponemal antibody absorption (FTA-ABS) test is a diagnostic test for syphilis. Using antibodies specific for the ''Treponema pallidum ''Treponema pallidum'', formerly known as ''Spirochaeta pallida'', is a spirochaete bacterium with various subspecies that cause the diseases syphilis, bejel (also known as endemic syphilis), and yaws. It is transmitted only among humans. It is ...'' species, such tests would be assumed to be more specific than non-treponemal testing such as VDRL but have been shown repeatedly to be sensitive but not specific for the diagnosis of neurosyphilis in cerebrospinal fluid (CSF). In addition, FTA-ABS turns positive earlier and remains positive longer than VDRL. Other treponemes, such as ''T. pertenue'', may also produce a positive FTA-ABS. The ABS suffix refers particularly to a processing step used to remove nonspecific antispirochetal antibodies present in normal serum. In general, the test has two roles: # As a confirmatory test f ...
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TPHA
The ''Treponema pallidum'' particle agglutination assay (also called TPPA test) is an indirect agglutination assay used for detection and titration of antibodies against the causative agent of syphilis, ''Treponema pallidum'' subspecies ''pallidum''. It also detects other treponematoses. In the test, gelatin particles are sensitized with ''T. pallidum'' antigen. Patient serum is mixed with the reagent containing the sensitized gelatin particles. The particles aggregate to form clumps when the patient serum is positive for syphilis. In other words, the patient's serum contains antibodies to ''T. pallidum''. A negative test shows no clumping of gelatin particles. This is a type of specific treponemal test for syphilis. A similar specific treponemal test for syphilis is the ''Treponema pallidum'' hemagglutination assay or TPHA. TPHA is an indirect hemagglutination assay used for the detection and titration of antibodies against the causative agent of syphilis, ''Treponema pal ...
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Immunofluorescence
Immunofluorescence is a technique used for light microscopy with a fluorescence microscope and is used primarily on microbiological samples. This technique uses the specificity of antibodies to their antigen to target fluorescent dyes to specific biomolecule targets within a cell, and therefore allows visualization of the distribution of the target molecule through the sample. The specific region an antibody recognizes on an antigen is called an epitope. There have been efforts in epitope mapping since many antibodies can bind the same epitope and levels of binding between antibodies that recognize the same epitope can vary. Additionally, the binding of the fluorophore to the antibody itself cannot interfere with the immunological specificity of the antibody or the binding capacity of its antigen. Immunofluorescence is a widely used example of immunostaining (using antibodies to stain proteins) and is a specific example of immunohistochemistry (the use of the antibody-antige ...
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Monoclonal Antibodies
A monoclonal antibody (mAb, more rarely called moAb) is an antibody produced from a cell Lineage made by cloning a unique white blood cell. All subsequent antibodies derived this way trace back to a unique parent cell. Monoclonal antibodies can have monovalent affinity, binding only to the same epitope (the part of an antigen that is recognized by the antibody). In contrast, polyclonal antibodies bind to multiple epitopes and are usually made by several different antibody-secreting plasma cell lineages. Bispecific monoclonal antibodies can also be engineered, by increasing the therapeutic targets of one monoclonal antibody to two epitopes. It is possible to produce monoclonal antibodies that specifically bind to virtually any suitable substance; they can then serve to detect or purify it. This capability has become an investigative tool in biochemistry, molecular biology, and medicine. Monoclonal antibodies are being used on a clinical level for both the diagnosis and thera ...
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Screening Test
Screening, in medicine, is a strategy used to look for as-yet-unrecognised conditions or risk markers. This testing can be applied to individuals or to a whole population. The people tested may not exhibit any signs or symptoms of a disease, or they might exhibit only one or two symptoms, which by themselves do not indicate a definitive diagnosis. Screening interventions are designed to identify conditions which could at some future point turn into disease, thus enabling earlier intervention and management in the hope to reduce mortality and suffering from a disease. Although screening may lead to an earlier diagnosis, not all screening tests have been shown to benefit the person being screened; overdiagnosis, misdiagnosis, and creating a false sense of security are some potential adverse effects of screening. Additionally, some screening tests can be inappropriately overused. For these reasons, a test used in a screening program, especially for a disease with low incidence, ...
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Titer
Titer (American English) or titre (British English) is a way of expressing concentration. Titer testing employs serial dilution to obtain approximate quantitative information from an analytical procedure that inherently only evaluates as positive or negative. The titre corresponds to the highest dilution factor that still yields a positive reading. For example, positive readings in the first 8 serial, twofold dilutions translate into a titer of 1:256 (i.e., 2−8). Titres are sometimes expressed by the denominator only, for example 1:256 is written 256. The term also has two other, conflicting meanings. In titration, the titer is the ratio of actual to nominal concentration of a titrant, e.g. a titer of 0.5 would require 1/0.5 = 2 times more titrant than nominal. This is to compensate for possible degradation of the titrant solution. Second, in textile engineering, titre is also a synonym for linear density. Etymology Titer has the same origin as the word "title", from the Fr ...
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Fluorescent Treponemal Antibody Absorption Test
The fluorescent treponemal antibody absorption (FTA-ABS) test is a diagnostic test for syphilis. Using antibodies specific for the ''Treponema pallidum ''Treponema pallidum'', formerly known as ''Spirochaeta pallida'', is a spirochaete bacterium with various subspecies that cause the diseases syphilis, bejel (also known as endemic syphilis), and yaws. It is transmitted only among humans. It is ...'' species, such tests would be assumed to be more specific than non-treponemal testing such as VDRL but have been shown repeatedly to be sensitive but not specific for the diagnosis of neurosyphilis in cerebrospinal fluid (CSF). In addition, FTA-ABS turns positive earlier and remains positive longer than VDRL. Other treponemes, such as ''T. pertenue'', may also produce a positive FTA-ABS. The ABS suffix refers particularly to a processing step used to remove nonspecific antispirochetal antibodies present in normal serum. In general, the test has two roles: # As a confirmatory test f ...
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Treponemal Test
''Treponema'' is a genus of spiral-shaped bacteria. The major treponeme species of human pathogens is ''Treponema pallidum'', whose subspecies are responsible for diseases such as syphilis, bejel, and yaws. ''Treponema carateum'' is the cause of pinta. '' Treponema paraluiscuniculi'' is associated with syphilis in rabbits. '' Treponema succinifaciens'' has been found in the gut microbiome of traditional rural human populations. Phylogeny The currently accepted taxonomy is based on the List of Prokaryotic names with Standing in Nomenclature (LPSN) and National Center for Biotechnology Information (NCBI). Unassigned species: * '' Treponema calligyrum'' Noguchi 1913 * ''Treponema carateum ''Treponema carateum'' is a species of spirochete bacteria in the genus ''Treponema ''Treponema'' is a genus of spiral-shaped bacteria. The major treponeme species of human pathogens is ''Treponema pallidum'', whose subspecies are responsibl ...'' Brumpt 1939 ( pinta-causing ''Treponem ...
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Syphilis
Syphilis () is a sexually transmitted infection caused by the bacterium '' Treponema pallidum'' subspecies ''pallidum''. The signs and symptoms of syphilis vary depending in which of the four stages it presents (primary, secondary, latent, and tertiary). The primary stage classically presents with a single chancre (a firm, painless, non-itchy skin ulceration usually between 1 cm and 2 cm in diameter) though there may be multiple sores. In secondary syphilis, a diffuse rash occurs, which frequently involves the palms of the hands and soles of the feet. There may also be sores in the mouth or vagina. In latent syphilis, which can last for years, there are few or no symptoms. In tertiary syphilis, there are gummas (soft, non-cancerous growths), neurological problems, or heart symptoms. Syphilis has been known as " the great imitator" as it may cause symptoms similar to many other diseases. Syphilis is most commonly spread through sexual activity. It may also be tra ...
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Lecithin
Lecithin (, from the Greek ''lekithos'' "yolk") is a generic term to designate any group of yellow-brownish fatty substances occurring in animal and plant tissues which are amphiphilic – they attract both water and fatty substances (and so are both hydrophilic and lipophilic), and are used for smoothing food textures, emulsifying, homogenizing liquid mixtures, and repelling sticking materials. Lecithins are mixtures of glycerophospholipids including phosphatidylcholine, phosphatidylethanolamine, phosphatidylinositol, phosphatidylserine, and phosphatidic acid. Lecithin was first isolated in 1845 by the French chemist and pharmacist Théodore Gobley. In 1850, he named the phosphatidylcholine ''lécithine''. Gobley originally isolated lecithin from egg yolk – λέκιθος ''(lekithos)'' is "egg yolk" in Ancient Greek – and established the complete chemical formula of phosphatidylcholine in 1874; in between, he demonstrated the presence of lecithin in a variety of ...
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