The Wassermann test or Wassermann reaction (WR) is an

antibody An antibody (Ab) or immunoglobulin (Ig) is a large, Y-shaped protein belonging to the immunoglobulin superfamily which is used by the immune system to identify and neutralize antigens such as pathogenic bacteria, bacteria and viruses, includin ...

test for

syphilis Syphilis () is a sexually transmitted infection caused by the bacterium ''Treponema pallidum'' subspecies ''pallidum''. The signs and symptoms depend on the stage it presents: primary, secondary, latent syphilis, latent or tertiary. The prim ...

, 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 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 is com ...

cerebrospinal fluid Cerebrospinal fluid (CSF) is a clear, colorless Extracellular fluid#Transcellular fluid, transcellular body fluid found within the meninges, meningeal tissue that surrounds the vertebrate brain and spinal cord, and in the ventricular system, ven ...

is taken and introduced to the antigen –

cardiolipin Cardiolipin (IUPAC name 1,3-bis(''sn''-3’-phosphatidyl)-''sn''-glycerol, "''sn''" designating stereospecific numbering) is an important component of the inner mitochondrial membrane, where it constitutes about 20% of the total lipid composition. ...

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

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

– 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 can lead to blood clots (thrombosis) in both arteries and veins, pregnancy-relate ...

(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, formally called 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. Common ...

malaria Malaria is a Mosquito-borne disease, mosquito-borne infectious disease that affects vertebrates and ''Anopheles'' mosquitoes. Human malaria causes Signs and symptoms, symptoms that typically include fever, Fatigue (medical), fatigue, vomitin ...

, and

tuberculosis Tuberculosis (TB), also known colloquially as the "white death", or historically as consumption, is a contagious disease usually caused by ''Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can al ...

. 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 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 and the Kolmer test, and it is rarely used today. Replacement tests such as the VDRL test and the RPR test, initially based on

flocculation In colloidal chemistry, flocculation is a process by which colloidal particles come out of Suspension (chemistry), suspension to sediment in the form of floc or flake, either spontaneously or due to the addition of a clarifying agent. The actio ...

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 that results from an anomalous response of the adaptive immune system, wherein it mistakenly targets and attacks healthy, functioning parts of the body as if they were foreign organisms. It is estimated tha ...

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