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

建立了一种酶联免疫吸附试验（ELISA）系统，用于梅毒患者血清中梅毒螺旋体（TP）抗体的IG类和IgG亚类的检测和定量。对不同感染阶段的患者进行ELISA定期检测，以确定这些抗体是否可能作为评估患者治疗临床反应的糖尿病参数。301例患者血清检测，60例阴性血清作为对照，发现患者血清中IgM、IgA、IgG类及IgG亚类1 ~ 4均存在抗tp抗体。对54例原发性梅毒患者、30例继发性梅毒患者和18例早期潜伏性梅毒患者的血清抗tp抗体水平进行比较评估，每个阶段组分为治疗时间少于3个月和治疗时间长于3个月的两个亚组，研究其在各自感染阶段的趋势以及对治疗的反应。在原发性和早期潜伏期治疗后，血清IgM和IgA抗体水平显著下降，抗体IgG亚类也下降。然而。在抗体中没有任何疾病阶段特有的IgG亚类占主导地位。结果，连同来自99例三期或晚期梅毒患者的分析数据，几乎所有这些患者之前都接受过治疗，表明IgG亚类1抗体可能是治疗后长期存在的抗体的大部分。14例原发性、8例继发性、6例早期潜伏期和4例第三期患者从治疗前开始进行定期检测，以检查他们对治疗的抗体反应趋势。32例患者中，8例患者治疗前血清IgM抗体水平在正常范围内。其余24例中，治疗后IgM抗体下降的占62.5%。所有患者在治疗前血清IgG亚类抗体水平均呈阳性。其中71.9%的人随着治疗的进展而有所缓解。既往治疗过的三期梅毒患者抗tp IgM阳性率低至28.3%，4例晚期梅毒患者中有3例治疗后IgG及IgG亚类抗体下降。因此，对IgM抗体水平正常的梅毒患者，检测这些IgG亚类抗tp抗体具有诊断和治疗的价值。尤其是晚期梅毒患者。少

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