The Wassermann test or Wassermann reaction (WR) is an

antibody An antibody (Ab), also known as an immunoglobulin (Ig), is a large, Y-shaped protein used by the immune system to identify and neutralize foreign objects such as pathogenic bacteria and viruses. The antibody recognizes a unique molecule of the ...

test for

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, an ...

, named after the bacteriologist

August Paul von Wassermann August Paul von Wassermann (21 February 1866 – 16 March 1925) was a German bacteriologist and hygienist. Born in Bamberg, with Jewish origins, he studied at several universities throughout Germany, receiving his medical doctorate in 1888 from ...

, based on

complement fixation The complement fixation test is an immunological medical test that can be used to detect the presence of either specific antibody or specific antigen in a patient's serum, based on whether complement fixation occurs. It was widely used to diagnos ...

. 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 The Venereal Disease Research Laboratory test (VDRL) is a blood test for syphilis and related non-venereal treponematoses that was developed by the eponymous lab. The VDRL test is used to screen for syphilis (it has high sensitivity), whereas othe ...

tests, have mostly replaced it.

Method

A sample of

blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the c ...

cerebrospinal fluid Cerebrospinal fluid (CSF) is a clear, colorless body fluid found within the tissue that surrounds the brain and spinal cord of all vertebrates. CSF is produced by specialised ependymal cells in the choroid plexus of the ventricles of the bra ...

is taken and introduced to the antigen –

cardiolipin Cardiolipin (IUPAC name 1,3-bis(''sn''-3’-phosphatidyl)-''sn''-glycerol) is an important component of the inner mitochondrial membrane, where it constitutes about 20% of the total lipid composition. It can also be found in the membranes of most ...

extracted from bovine muscle or heart. Syphilis non-specific antibodies ( reagin, see RPR) react with the

lipid Lipids are a broad group of naturally-occurring molecules which includes fats, waxes, sterols, fat-soluble vitamins (such as vitamins A, D, E and K), monoglycerides, diglycerides, phospholipids, and others. The functions of lipids include ...

– the Wassermann reaction of

antiphospholipid antibodies Antiphospholipid syndrome, or antiphospholipid antibody syndrome (APS or APLS), is an autoimmune, hypercoagulable state caused by antiphospholipid antibodies. APS provokes blood clots (thrombosis) in both arteries and veins as well as pregnancy-r ...

(APAs). The intensity of the reaction (classed 1, 2, 3, or 4) indicates the severity of the condition.

Uncertainty

The reaction is not specific to syphilis and will produce a positive reaction to other diseases, including

systemic lupus erythematosus Lupus, technically known as systemic lupus erythematosus (SLE), is an autoimmune disease in which the body's immune system mistakenly attacks healthy tissue in many parts of the body. Symptoms vary among people and may be mild to severe. Comm ...

malaria Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. S ...

, and

tuberculosis Tuberculosis (TB) is an infectious disease usually caused by '' Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections show no symptoms, in ...

. 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"). 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.

Development and refinement

The antibody test was developed by Wassermann, Julius Citron, and Albert Neisser at the

Robert Koch Institute for Infectious Diseases The Robert Koch Institute (RKI) is a German federal government agency and research institute responsible for disease control and prevention. It is located in Berlin and Wernigerode. As an upper federal agency, it is subordinate to the Federal ...

in 1906.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 Kahn is a surname of German origin. ''Kahn'' means "small boat", in German. It is also a Germanized form of the Jewish surname Cohen, another variant of which is ''Cahn''.

and the

Kolmer test Kolmer is a German-language surname from a status name originally denoting a yeoman according to Kulm law. It may refer to: * Eva Schmidt-Kolmer (1913–1991), Austrian-German physician *Felix Kolmer Felix Kolmer (3 May 1922 – 5 August 2022) w ...

, and it is rarely used today. Replacement tests such as the

test and the RPR test, initially based on

flocculation Flocculation, in the field of chemistry, is a process by which colloidal particles come out of suspension to sediment under the form of floc or flake, either spontaneously or due to the addition of a clarifying agent. The action differs from pr ...

techniques (Hinton), have been shown to produce far fewer false positive results. Indeed, the "biologic false positives" of modern tests usually indicate a serious alternate condition, often an

autoimmune disease An autoimmune disease is a condition arising from an abnormal immune response to a functioning body part. At least 80 types of autoimmune diseases have been identified, with some evidence suggesting that there may be more than 100 types. Nearly a ...

References

* Citron, Dr. Julius, "Immunity" (English translation) 1914 163–64

External links

* {{DEFAULTSORT:Wassermann Test Infectious disease blood tests Syphilis 1906 in biology 1906 introductions 1906 in Germany