[Recent progress in syphilis serology].

Abstract

Serological investigations for the diagnosis of syphilis have been performed in a special subunit at the Department of Dermatology to Lainz Hospital, Vienna, since 70 years. At present 80,000 to 100,000 sera are tested annually. The classical test systems VDRL, TPHA, AMHA-TP and FTA-ABS demonstrate, in particular, the presence of IgG antibodies and are, thus, suitable for the diagnosis of the disease, but do not permit conclusions on the activity of the disease and the actual need for antisyphilitic treatment. The newly developed IgM diagnosis of syphilis with the IgM-SPHA- and the 19S-IgM-FTA-ABS test solve these problems and can be performed even under routine conditions using the methods of solid phase haemadsorption and computerized high pressure liquid chromatography. In addition, the serological diagnosis of neurosyphilis has been worked out by the determination of the TPHA-index and the detection of antitreponemal IgM-antibodies in the cerebrospinal fluid. The relative frequency of latent syphilis infections has increased over the past years and serodiagnosis of syphilis, thus, become more and more important. The availability of five independent test systems has enabled the elaboration of a test profile which keeps the margin of error to below 0.1%. A further method, the ELISA technique is at present under investigation and renders promising results by the use of recently developed reagents.