In the previous Chapters of this dissertation the major shortcomings of the current serological tests for syphilis were investigated. These include an insufficient sensitivity and specificity, reactivity of a diagnostic test long after the syphilitic infection had been cured, complexity of operation, high costs, long test duration, unsuitability for automation, no quantifiable test results available and the inability to distinguish between the distinct treponematoses. The aim of this study was to eliminate these shortcomings and to develop and evaluate enzyme immunoassays for serodiagnosis of syphilis. To achieve this, four different performance aspects of the enzyme immunoassays were investigated. These are as follows: 1. A sensitive and a specific treponema! screening test that also permitted treatment monitoring without the phenomenon of serofast test results after adequate treatment and biological false- positive reactions. 2. To reduce the operation time to around 10 to 20 minutes in order to facilitate its use in an outpatient clinic to provide the test results within the course of one consultation. 3. To develop a simple automated confirmation test for syphilis to replace the current confirmation tests that are complex and laborious. 4. To devise a simple, sensitive and specific test for the detection of antitreponemal lgM. Such a test should permit the simultaneous testing of several serum samples and provide automated test results. Integration of tests that meet these objectives will permit simple, sensitive, specific, objective, rapid and automated testing for human antitreponemal lgG and lgM antibodies to detect untreated syphilis, congenital syphilis and to monitor the effect of treatment. Since there are no known antigenic differences between the treponematoses, the distinction between the various treponematoses by serological means was not studied. Therefore, in the experimental chapters of this dissertation the terms "antitreponemal" or "antitreponemal antibody" are used only in relation to syphilis. Enzyme immunoassay methods were investigated in this study in order to exploit their simple operation and extensive possibilities for automation. New acquisitions obtained from modern biochemistry like recombinant-DNA derived antigens, monoclonal antibodies and the newly developed immunofiltration technique for enzyme immunoassays were evaluated to improve syphilis serology.

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Erasmus University Rotterdam
E. Stolz (Ernst) , E.J. Ruitenberg (Joost)
hdl.handle.net/1765/50962
Erasmus MC: University Medical Center Rotterdam

IJsselmuiden, O. E. (1989, June 14). Development and evaluation of modern enzyme immunoassays for comprehensive syphilis serology. Retrieved from http://hdl.handle.net/1765/50962