Serodiagnosis of syphilis by an enzyme-linked immunosorbent assay for IgG subclass antibodies against Treponema pallidum.

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An enzyme-linked immunosorbent assay (ELISA) system has been developed for detection and quantification of IG class and IgG subclasses of antibodies to Treponema pallidum (TP) in serum form patients with syphilis. Patients with various stages of infection were followed by periodic teets with ELISA to determine whether these antibodies might be of any use as diabnostic parameters in evaluating clinical responses of patients of treatment. Assays carried out on 301 patient sera, with 60 negative sera as controles, revealed occurrence of all anti-TP antibodies of IgM, IgA and IgG classes and IgG subclasses 1 to 4 in the patient sera.Serum leveles of anti-TP antibodies in 54 patients with primary syphilis, 30 with secondary syphilis and 18 with early latent syphilis, each stage-group classified into two subgroups : patients who had been treated for less than 3 months and those treated longer, were comparatively assessed to examine their trends in respective stages of infection as well as th … More eir responses to treatment. Levels of IgM and IgA antibodies in serum fell significantly following tratment at primary and early latent stages, and IgG subclasses of antibody also decreased in these patients. However. there were no IgG subclasses peculiar to any disease stage that predominated among the antibodies. The results, together with assay data from 99 patients with tertiary or late syphilis, practically all of whom had previously been treated, suggested that IgG subclass 1 antibody might account for the most part of antibodies long persisting after treatment.Fourteen primary, 8 secondary, 6 early latent and 4 tertiary stage patients were followed by periodic tests from pre-treatment period onwards to examine trends of their antibody responses to treatment. Of 32 patients, pre-treatment serum IgM antibody levels were within the normal limits in 8 patients. IgM antibody decreased following treatment in 62.5% of the remaining 24 cases. All patients exhibited positive serum levels of IgG subclass antibodyes prior to treatment. Of whom 71.9% responded with their decline as treatment progressed. The anti-TP IgM positivity rate was as low as 28.3% for previously treated tertiary syphilis patients, and that 3 out 4 previously untreated late syphilis patients showed decrease of IgG and IgG subclass antibodies after therapy. It is thus concluded that determination of these anti-TP antibodies of IgG subclasses is of value as a means of diagnosing for cure those syphilis patients showing normal IgM antibody level. Particularly in those with late syphilis. Less