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Background: Repeated nontreponemal serologic test for syphilis titers is recommended to evaluate treatment response. However, it is unknown whether serum rapid plasma reagin (RPR) titer can serve as a surrogate for determining the efficacy of treatment in general paresis (GP) remains unknown., Methods: We retrospectively reviewed data from 105 GP patients, who were divided into two groups (62 CSF RPR+ patients and 43 CSF RPR- patients) according to reactive RPR test status in CSF. Clinical assessment included the Mini-Mental State Examination (MMSE) scores, CSF examinations (WBC count, protein concentration and RPR titer), and serum tests (RPR titer and TPPA). Among the 105 GP patients, 13 CSF RPR+ patients and 6 CSF RPR- patients had a 12 months follow-up of CSF, serum measures and MMSE., Results: The median serum RPR titer was significantly higher in CSF RPR+ patients than that in CSF RPR- GP patients, 1:8 [IQR 1:4-1:32] vs. 1:4 [IQR 1:4-1:8] (P < 0.001). The number of CSF RPR+ patients with serum RPR titer≥1:32 was significantly higher when compared with CSF RPR- patients (P = 0.001). For CSF RPR+ patients, the MMSE scores improved or remained constantly after penicillin treatment. For CSF RPR+ patients, the CSF RPR titer declined four-fold in 85% (11/13) of the patients, whereas the serum RPR titer declined four-fold in only 46% (6/13) of the patients, the odds ratio is 6.4 (95% confidence interval 1.0-41.2)., Conclusions: A four-fold decline in CSF RPR titer is a good predictor for treatment efficacy in CSF RPR+ GP patients within 12 months after the completion of therapy.

Reaginic antibodies, mainly of the IgE and some IgG subclasses, play an important role in the induction of type I immediate hypersensitivity reactions. These antibodies bind through their Fc fragment to high affinity receptors (FcεRI) present in the membrane of mast cells and basophils. Previously, several studies have investigated the role of reaginic antibodies in the pathogenesis of RAO. However, whereas immunological aspects of RAO have been extensively studied, the precise sequence of events is still not well understood and role of IgE in this disease still remains controversial. Therefore, in this study a bioassay was developed for reaginic antibody determination in serum from RAO-affected horses in order to determine the etiology of disease. The technique involves measuring in vitro calcium mobilization in RBL-2H3 cells following incubation with horse serum from RAO-affected or unaffected horses and one of the RAO antigens (Faenia rectivirgula). Results demonstrated that 15% of samples from the RAO-affected horses reacted positively in this in vitro bioassay, whereas the samples from unaffected horses did not. This bioassay indicates that reaginic antibodies could be involved in the immunological mechanism leading to RAO; and this technique may facilitate future research in other allergic diseases in horses.

The detection of syphilis among blood donors may reveal high-risk sexual behavior, which can go unreported at the time of donor selection and compromise the safety of the donated blood. In Italy, blood is collected, tested, and distributed by transfusion services (TSs), which also perform outpatient transfusions. Although the TSs must screen for syphilis by law, there are no indications of the specific type of method to be used, generating discrepancies in the results obtained by the different TSs. To determine the proficiency of the TSs in screening for syphilis, we performed an external quality assessment (EQA). The EQA was based on two shipments of serum panels; 133 and 118 of the 326 existing TSs participated in the first and second shipments, respectively. Each panel consisted of both positive and negative serum samples. The results confirmed that the use of a single nontreponemal test (the Venereal Disease Research Laboratory [VDRL] and the rapid plasma reagin [RPR] tests) is the least sensitive means of identifying samples that are positive for syphilis antibodies. We also found that the interpretation of the results of manual techniques, such as the RPR test, the VDRL test, the Treponema pallidum hemagglutination (TPHA) assay, and the T. pallidum particle agglutination (TPPA) assay, can vary greatly among different TSs and operators. Total Ig enzyme immunoassays (EIAs) are the most sensitive. However, the determination of syphilis on the basis of the results of a single test is not sufficient for an accurate screening; and all blood units should thus be assessed by two distinct treponemal tests, that is, a total Ig EIA and the TPHA or the TPPA assay.

A study was carried out to establish an animal model that would be suitable for evaluating the role of the diet in immune cell-mediated atherogenesis. Brown Norway rats were initially treated with hypervitamin D2 for 4 days and then fed on an atherogenic diet for 3 months, during which period the rats were either immunized with ovalubumin plus Al(OH)3 (OVA group) or with Al(OH)3 alone (control group) every 3 weeks. Aortic lesions were mainly composed of foam cells, the lesions evaluated by the intimal thickness of the ascending aorta being more severe in the OVA group than in the control group. The OVA group, in comparison with the control group, showed prominently increased serum levels of OVA-specific IgG and rat chymase, an indicator of mast cell degranulation. The intimal thickness was positively correlated with the level of chymase. Immunization had no effect on the serum lipid levels. These results support the hypothesis that mast cells play a role in the early stage of atherosclerosis and suggest that this animal model could be useful for evaluating the role of the diet in immune-related atherogenesis.

For the treatment of atopic dermatitis, a variety of therapies are used including folk medicine. At present, there is no single treatment which is effective to cure the symptoms of atopic dermatitis completely in all patients. We are drawing attention to the high isolation rate of Staphylococcus aureus when starting disinfectant treatment combined with topical steroid therapies for the purpose of killing S. aureus. As a result, we examined many patients in whom almost a complete remission was obtained even after short periods of therapy, though it had been difficult to obtain improvement by conventional treatments. In many patients, IgE values and reagin antibody titer decrease dramatically soon after starting treatment. As a disinfectant, 10% povidone-iodine solution was used. We investigated also the effect of iodine contained in the povidone-iodine solution on the thyroid gland.

In response to tissue invasion by Treponema pallidum, an antibody complex, called reagin, appears in the serum of the syphilitic patients. Reagin has the ability to combine with cardiolipin, therefore, cardiolipin has traditionally been used as the antigen in different test configurations for the serological detection of syphilis: the VDRL (Venereal Disease Research Laboratory) flocculation test and the RPR (rapid plasma reagin) test. Here we introduce a liposome preparation composed of cardiolipin, lecithin and cholesterol and containing a colored dye which upon mixing with syphilitic serum on a slide or a plastic card results in clearly visible liposome agglutination. We show that the liposomes in the size range of 1-10 micron are essential for proper sensitivity. The liposomes are colored with either a water-soluble dye entrapped in the aqueous space of liposomes or a lipophilic dye embedded in the membrane. By virtue of the liposome size and coloration the agglutination pattern is easily visible within 3-5 min without the use of a mechanical rotator. The approach described here can be extended to the detection of other antibodies and polyvalent antigens.

Twenty-four patients survived life-threatening clinical anaphylaxis due to anesthesia. In each case the diagnosis of anaphylaxis was confirmed and the responsible drug was found by intradermal testing. To determine whether the reactions were anaphylactic or anaphylactoid, serum from each patient was tested for reaginic activity using Prausnitz-Kustner (PK) testing in human subjects and monkeys and passive cutaneous anaphylaxis (PCA) testing at four and 24 hours in monkeys. Positive results of PCA testing at four hours were repeated with serum that had been heated to 56 C for two hours. Drugs used in testing were Althesin, thiopental, succinylcholine, gallamine, d-tubocurarine, and alcuronium. Vehicles and antioxidants were tested separately. Positive tests suggestive of the presence of reaginic antibodies occurred with sera from 15 patients who had had previous exposure to the drug. Nine patients had tests suggestive of IgE antibodies on first exposure, suggesting that cross-sensitivity may be a factor in such reactions to muscle relaxants. Two patients had positive tests for IgG antibodies. This is further evidence of the role of this mechanism in immediate allergy and demonstrates another mechanism by which anaphylaxis can occur without previous sensitization. Four patients had positive tests for IgE antibodies after previous exposure. It was concluded that it is not possible to determine the mechanism of anaphylaxis from a history of previous exposure.

Reaginic antibody in ascitic fluid was isolated from mice immunized with ovalbumin and TAl(OH)3 or with avalbumin and pertussis adjuvant. Partial purification of this reagin by ammonium sulphate precipitation, gel filtration, and ion-exchange column chromatography yielded a gammaglobulin fraction highly active in the passive cutaneous anaphylaxis reaction. This was identical in purity and specific activity to a fraction of partially purified reagin isolated from mouse antiserum. The recovery of reaginic activity after purification from ascitic fluid was 19 per cent compared to the 7-8 per cent recovery from anti-serum. These studies demonstrate that ascitic fluid in mice immunized with methods known to produce reaginic antibody provides an excellent source of mouse IgE.

Mouse antisera were analyzed for the presence of homocytotropic and heterocytotropic antibodies. Two distinct populations of antibodies were detected by the homologous passive cutaneous anaphylaxis (PCA) reaction. The first was active 2 hr after injection, heat-stable, and partially reactive with antisera to mouse IgG1. The second was active 48 hr after injection, was heat-labile, and probably belonged to the IgE class of mouse immunoglobulins. In addition, it was demonstrated that there were also two antibodies active in the heterologous PCA reaction in rats, a heat-stable antibody and a heat=labile antibody. Contrary to results obtained with homocytotropic antibodies, none of the heterocytotropic antibodies detected reacted with antisera to mouse IgG1 or IgG2. These studies suggest that in addition to IgE there may exist another heterocytotropic antibody in mouse antisera and that caution should be employed when using the 2-hr PCA reaction in the rat as a sole criterion for detection of mouse IgE.

An 18-year-old man with solar urticaria is described. The action spectrum ranged from 400 to 500 nm. No inhibition spectrum was found, i.e., the wheal that is induced by visible light was not inhibited by immediate pre- or postirradiation of test sites with light waves longer than 620 nm. The patient developed a wheal at the site of injection of his own serum that had previously been exposed to light in vitro. Though the ordinary passive transfer reaction yielded a positive result, a passive transfer study with the patient's serum preheated at 56 degrees C for 2 h showed a negative result. These data suggest that he had both circulating photoallergen and reaginic antibodies.

Of 105 sera having reagin titers of 1 dilution as determined by the rapid plasma reagin 18-mm circle card test (Hynson, Westcott and Dunning, Baltimore, Md.), 103 (98.1%) were reactive with the Dade rapid plasma reagin card test (Biokit Laboratories, Barcelona, Spain), indicating that the two procedures are comparable in their ability to detect low levels of nontreponemal syphilitic antibody, or reagin.

We have isolated an allergen (Ag Dg1) from Dactylis glomerata pollen which is recognized by the serum of 95% of human patients sensitive to D. glomerata pollen, as has been shown by the nitrocellulose immunoprint technique. After two successive purifications by preparative isoelectric focusing (IEF), Dg1 was characterized as a single band in analytical agarose IEF with a pI of 5.9 and was found to display 3 bands by sodium dodecyl sulfate polyacrylamide gel with the respective molecular weights: 21,000, 31,000 and 33,000 daltons. The high recognition frequency by IgE antibodies of Dg1 in the sera of allergic patients and its ability to trigger histamine release from sensitized human basophils allow to consider that Ag Dg1 is the main major allergen extracted from D. glomerata pollen.

Recent studies have raised questions concerning the specificity of anticardiolipin antibodies and their relationship to anti-DNA antibodies, the lupus anticoagulant, the biological false positive test for syphilis, and reagin, the antibody detected in syphilis. In an attempt to answer some of these questions, 3 IgG and 2 IgM affinity purified anticardiolipin antibodies, as well as 3 affinity purified anti-DNA antibodies were studied. Affinity purified anti-cardiolipin antibodies showed high binding to negatively charged phospholipids but not to ssDNA by solid phase radioimmunoassay. On the other hand, affinity purified anti-DNA antibodies did not bind cardiolipin. Inhibition experiments showed that negatively charged phospholipids and VDRL liposomes inhibited the binding of anticardiolipin antibodies to phosphatidylserine, but ssDNA, alpha-glycerol phosphate and hyaluronic acid did not. Similar studies of sera from patients with high anticardiolipin antibody levels supported the results obtained with affinity purified anticardiolipin antibodies. These results suggest that anticardiolipin antibodies bind negatively charged phospholipids and there appears to be little crossreactivity with DNA or unrelated negatively charged polymers such as hyaluronic acid. Both the negatively charged phosphodiester group and glyceride portions of the phospholipid molecules appear important for their antigenicity. Four of the 5 affinity purified anti-cardiolipin antibodies had lupus anticoagulant activity providing further evidence to suggest that these 2 groups of antibodies have the same or very similar specificities. Studies of sera from 3 patients with syphilis showed that VDRL liposomes inhibited reagin activity to a greater extent than did cardiolipin. On the other hand, in patients with autoimmune disorders, cardiolipin inhibited anticardiolipin antibody activity to a greater extent than did VDRL liposomes.(ABSTRACT TRUNCATED AT 250 WORDS)

One hundred twenty-eight patients who had been treated for late latent syphilis were followed. Benzathine penicillin G (2.4 X 10(6) units given intramuscularly once a week for two weeks) was administered to 123 patients, and five patients were given tetracycline (500 mg orally four times daily for 12 days). Of these patients, 56 (44%) became seronegative within five years, and 72 (56%) had persistently positive reagin tests.

To help determine the role of lumbar puncture in evaluation of patients with asymptomatic late syphilis, we reviewed results of cerebrospinal fluid (CSF) testing of 47 asymptomatic patients with syphilis. Syphilis was of unknown duration (n = 27) or known duration of greater than one year (n = 20), and all patients had reactive rapid plasma reagin (RPR) tests and reactive fluorescent treponemal antibody absorption tests. Thirty-two per cent of subjects had abnormal CSF findings; these included elevated protein in nine (19%) of 47 and pleocytosis in six (13%) of 47. In most cases, the etiology of these abnormalities was uncertain. Asymptomatic neurosyphilis, diagnosed on the basis of a reactive Venereal Disease Research Laboratory (VDRL; Atlanta, GA) test of CSF, was present in three (6%) of 47 patients. Of the eight patients with RPR titers of greater than or equal to 1:128, three (38%) had neurosyphilis. These results suggest that lumbar puncture is indicated for patients with asymptomatic late syphilis or syphilis of unknown duration.

The paper describes the Autotape System, a new piece of apparatus which is automated slide testing equipment, and its successful application to the rapid plasma reagin test.

In order to test the safety of glucagon (GG), the immunogenicity of GG was studied in rabbits and guinea pigs. Any sensitization, as revealed by anaphylactic shock, Arthus reaction, passive cutaneous anaphylaxis (PCA) or radioimmunoassay, was not demonstrated in animals immunized with GG alone. The anti-GG antibodies were detected by PCA and radioimmunoassay in two of the five animals immunized with GG mixed with Freund's complete adjuvant. Anti-GG IgE antibody production in mice was found in one of the ten mice given 570 micrograms and three of the six mice given 1,000 micrograms of GG with aluminum hydroxide gel (Alum), but other doses of GG with Alum produced no IgE antibody. These results indicate that the antigenicity of GG is very weak.

Meticulous antenatal screening for maternal syphilis can prevent congenital syphilis. In the event of inadequate antenatal screening, determination of reagin reactivity on cord blood becomes mandatory. A card test utilising the VDR carbon antigen (Wellcome) was used to screen cord blood samples for reagin reactivity. The same blood was also screened by a reference laboratory, where the VDRL card test was repeated and every result was substantiated by treponemal tests. The VDRL card test done at the local laboratory had a sensitivity of 83,3% and a specificity of 99,8% when compared with the results of the reference laboratory.

A rapid plasma reagin (RPR) test was performed in fifty patients with a clinical diagnosis of pityriasis rosea to determine the frequency of syphilis as the underlying cause of the eruption. In none of the fifty patients was syphilis the cause. Experience in diagnosing skin diseases, frequency of syphilis in the community served, and the characteristics of the individual eruption are important factors in the decision to perform an RPR test.

The unheated serum reagin (USR) test, a standard qualitative test for syphilis, was evaluated for use as a quantitative test for the serodiagnosis of syphilis and as a means of determining the effectiveness of treatment. Tests were performed on 664 syphilitic sera from treated and untreated patients in the primary, secondary, and latent stages of the disease. Also included were 95 false-positive sera and 36 sera from presumably normal donors. The Venereal Disease Research Laboratory slide and rapid plasma reagin 18-mm circle card tests were used as a basis for comparison with the USR test. Results of the USR quantitative test paralleled the Venereal Disease Research Laboratory and rapid plasma reagin card quantitative tests with approximately 84% agreement. The advantages of the USR test make the findings of this study significant in that: (i) less technical manipulation is required to perform the USR test than the Venereal Disease Research Laboratory slide test; (ii) no labor cost is incurred for daily Venereal Disease Research Laboratory antigen preparation; and (iii) the USR antigen is less expensive than the rapid plasma reagin card tests antigen.

A potent antischistosomal drug, Amoscanate, was found to be immunogenic to mice and Cebus apella monkeys. The drug was readily haptenated to proteins under relatively mild conditions. The Amoscanate-protein conjugates were observed to be immunogenic when injected into the footpads of several strains of mice. However, such protein conjugates were not found to raise IgE antibody to the drug in high-responder strains using several procedures. When the formulated drug (dissolved in oil) was fed to CD 1 mice, a rise in serum antibody against the drug was noted 1 week following the primary dose. This is preliminary evidence that the drug, or a cross-reactive metabolite, becomes covalently bound to proteins in vivo. Cebus apella monkeys fed the drug exhibited a rise in anti-Amoscanate antibody one month after a second oral dose. These data suggest that the immunogenicity of Amoscanate is readily detected; furthermore, since there is no lasting immunity to schistosomiasis, thus necessitating multiple administration of the drug, the possibility that serum antibody titers to Amoscanate may interfere with its therapeutic efficacy cannot be overlooked.

Contact urticaria from raw prawns and shrimps was suspected in three housewives with hand eczema who visited our clinic. A practice skin test in which patients stripped the shells from raw prawns and shrimps was positive, but an intradermal skin test with an allergen extracted from a mixture of prawns and shrimps was negative. Results of skin tests with fresh extracts of raw prawns and shrimps were positive. The RAST with a paper disc method with use of a raw prawn and shrimp as antigens was also positive in these three patients. It is evident from the results obtained that some common substances causing a local urticaria exist in raw prawns and shrimps.

Little haemagglutinating antibody was detected in the serum of rats with primary Angiostrongylus cantonensis infections until the juvenile worms left the brain and lodged in the lungs about 35 days after infection. Antibody titres reached a peak 50 days after infection and were maintained for at least a further 95 days. Increasing the infective dose of A. cantonensis larvae increased the peak antibody titres attained by the infected rats. Re-infection temporarily reduced the serum antibody titre, but later it increased and showed an anamnestic response. Reaginic antibody production was transient during primary infections; re-infection failed to stimulate further reaginic antibody production. Antiserum from immune donor rats protected recipients against A. cantonensis. The transferred immune serum suppressed anti-A. cantonensis antibody production in recipient rats.

Repeated topical applications of fluoresceinyl ovalbumin (FL-OA) to the conjunctival sac of guinea pigs sensitized them for conjunctival type 1 hypersensitivity reactions and mast cell degranulation. Guinea pigs infected with Ascaris suum, with high titers of circulating anti-A suum IgE and IgG1 antibody, also produced conjunctival type 1 reactions on topical challenge with A suum antigen. These reactions were no more intense than those of animals topically sensitized and challenged with FL-OA, which in some instances had no detectable serum homocytotropic antibody. Persistently reactive animals that had undergone repeated type 1 conjunctival reactions had histological findings (eg, papillary changes with extensive epithelial eosinophil infiltrates, epithelial thickening or thinning, numerous goblet cells, subepithelial lymphoid cell infiltrates, and new vessel formation) resembling those of human atopic vernal conjunctivitis.

BHK cell derivatives, saponin and aluminium hydroxide, all of which are commonly present in foot-and-mouth disease vaccines, were injected subcutaneously into 10 cattle and the serum levels of anti-BHK reagins and passive haemagglutinating antibodies were followed. The reaginic antibodies rose to a peak titre one to two weeks after the stimuli and waned during the third week. They had a serum half life of about three days, assuming exponential decay, and were generally undetectable four weeks after last contact with antigen. Passive haemagglutinins were slower to develop and two or more stimuli were usually required to produce detectable antibody levels. They were also slower to subside and were demonstrable for at least 10 weeks after last contact with antigen in most cases. Clinical reactions provoked by the intradermal injection of lysate into sensitised cattle were not correlated with the serum reagin or passive haemagglutinin levels or their ratio to one another at time of the reactions. The reasons for this are discussed.

Serologic testing is an important adjunct in the diagnosis and management of syphilis. In this review, the various currently used serologic tests, both non-treponemal and treponemal, are considered. Special emphasis is placed on their relative advantages, applications, and limitations. Conditions under which these tests may be falsely positive are discussed. Additional diagnostic tools cited are the dark-field examination, for use in early-lesion syphilis, and cytological and immunochemical techniques for determining potentially active neurosyphilis. The analysis of every serologic report, and its correlation to the historical, epidemiological, and clinical findings, is highlighted.

A highly potent extract of the histamine sensitizing factor (HSF) of Bordetella pertussis was isolated by extraction of bacterial cells with urea buffer and subsequent gel filtration. This preparation of HSF also contained leukocytosis-promoting activity and adjuvant activity for reaginic and hemagglutinating antibodiesl Digestion of this extract with pronase or trypsin partially destroyed histamine-sensitizing activity, leukocytosis-promoting activity, and adjuvant activity for reaginic antibody, but did not affect adjuvant activity for hemagglutinating antibody. Antisera to HSF was prepared by immunizing rabbits with either whole bacteria or partially purfied extract. These antisera contained several precipitating antibodies to Bordetella pertussis extract demonstrated by immunodiffusion and immunoelectrophoresis. Antisera added in vitro to Bordetella pertussis extracts or passively administered in vivo to mice, reduced or abolished all biologic activities except adjuvant activity for hemagglutinating antibody. These results suggest that HSF might be an antigenic component of Bordetella pertussis which also possesses leukocytosis-promoting activity and adjuvant activity for reaginic antibody.

Brown Norway rats have been actively sensitized against hen ovalbumine mixed with anti Bordella pertussis vaccine. After ten to twelve days, IgE are detected in the blood, but no precipitins. Anaphylactic shock induced by i.v. injection of 1 mg.100 g-1 body weight of ovalbumine is caracterized by a vascular collapse, the animal dying in about 15 minutes. This collapse is identical with the same general anaphylactic reaction as observed in the Wistar rats, which have large amounts of precipitins in the blood.

An enzyme-linked immunosorbent assay (ELISA) employing allergen adsorbed onto the internal surface of a plastic tube, and alkaline phosphatase conjugated anti-IgE was used for the determination of specific IgE antibodies to various inhalant allergens in serum samples from 255 individuals with asthma and/or allergic rhinitis. A total of 541 analyses were carried out and the results were compared with those of provocation tests, skin tests and the RAST. It was found that negative ELISA values with high probability indicated nonallergy and very high ELISA values (class greater than or equal to 5) indicated allergy. However, the proportion of positive ELISA values which did not correspond to clinical allergy was high, as were the number of intermediate, inconclusive values (class 1-2). Although significant correlations between the ELISA values and provocation test, skin test or the RAST were obtained with some allergens, it was concluded that our version of the ELISA has not advantages over currently used methods for allergy diagnosis.

The demonstration of a reagin-like antibody against Culicoides pulicaris extract in the serum of horses and ponies affected with recurrent seasonal dermatitis (sweet itch) is reported. This antibody can confer Prauznitz-Küstner (P-K) sensitivity on homologous skin for up to 5 days and, like human IgE, is thermolabile and susceptible to 2-mercaptoethanol reduction. It is eluted on diethylaminoethyl dextran-52 anion exchange chromatography independently of IgG, IgG(T) and IgM, and its elution characteristics indicate similarity in net molecular charge to human IgE. The P-K response observed in horse skin is biphasic, and is morphologically similar to the late cutaneous anaphylactic response in man. Both phases of the P-K response are dependent upon the reagin-like antibody, although other serum factors appear involved in the delayed phase of the response.