Antibodies to the causative agent of syphilis, total. Syphilis

syphilis, antibodies to Treponema pallidum lgM,IgG quantitative - method quantification antibodies to antigens of Treponema pallidum, the causative agent of syphilis. Refers to highly sensitive methods for diagnosing syphilis.

Syphilis - infection, caused by pale treponema (Treponema pallidum), transmitted mainly sexually, prone to chronic course and affecting most of the organs and systems of the body. Syphilis is characterized by a slow progressive course. On the late stages it can lead to severe lesions nervous system and internal organs.

Clinical picture with syphilis
Clinical manifestations syphilis are very diverse and depend on the stage of the disease. There are several stages of syphilis. primary stage occurs about 2-3 weeks after infection. At this stage, one or sometimes several ulcers, called chancre, appear, usually on the part of the body that has come into contact with the chancre of the sick person, such as the penis or vagina. In many cases, a chancre is painless and goes unnoticed, especially if it is in the rectum or on the cervix. The chancre disappears in 4-6 weeks.

The second stage of the disease begins 2–8 weeks after the onset of the chancre. It is characterized by the appearance of a rash, often on the palms and soles. Sometimes there are other symptoms, such as fever, fatigue, swelling lymph nodes, sore throat and body aches.

Syphilis can occur in latent form, during which the infected person does not show any symptoms, but at the same time he continues to be a carrier of the infection. This may take years.

Without treatment, about 15% of patients develop symptoms of late, or tertiary, syphilis. This stage sometimes lasts several years, and leads to mental illness, blindness, neurological problems, heart disease and even death.

Syphilis can be treated with antibiotics (penicillin derivatives are preferred). And on early stage the disease is treated more easily and quickly.

When a person comes into contact with Treponema pallidum, the immune system produces antibodies to bacteria. Two types of such antibodies can be detected in the blood: IgM and IgG.

IgM antibodies
Antibodies of the IgM class are produced by the body in the first place. They are detected in the blood serum at the end of the second week of the disease and disappear in untreated patients after about 1–1.5 years, with treatment early syphilis- in 3-6 months, late - in a year. They are present in most patients with primary and secondary syphilis, so an IgM test can be used to distinguish between a long-standing infection and an acquired one.

Patients treated in the past do not have specific treponemal IgM antibodies, but their absence in itself does not indicate the effectiveness of the therapy, since most of those who have not been treated also lack IgM antibodies in the latent stage of syphilis.

Antibodies of the IgG class
Antibodies of the IgG class appear in the blood 3-4 weeks after infection. Their concentration increases and reaches a maximum at the 6th week, at which point their concentration prevails over the concentration of IgM. Class G immunoglobulins are retained at a certain level long time sometimes for life.

Indications:

• diagnosis and confirmation of syphilis;
• pregnancy planning;
• preparation for the operation;
• promiscuity;
• donor verification.

Interpretation of results
Units of measure: UE*

A positive result will be accompanied by an additional comment indicating the sample positivity ratio (PC*).

• KP >= 1.1 - positive;
• KP<= 0,9 - отрицательно;
• KP 0.9–1.1 - doubtful.

*Positivity ratio (PC) is the ratio of the optical density of the patient sample to the threshold value. KP - the coefficient of positivity, is a universal indicator used in enzyme immunoassays. The CP characterizes the degree of positivity of the test sample and may be useful to the doctor for the correct interpretation of the result. Since the positivity coefficient does not correlate linearly with the concentration of antibodies in the sample, it is not recommended to use the CP for dynamic monitoring of patients, including monitoring the effectiveness of treatment.

Treponema pallidum or pale treponema is a microorganism in the form of a spiral with 8-12 curls, which has a cellular membrane, due to which a certain period of time may not lose its pathogenicity under the influence of environmental factors. The bacterium belongs to spirochetes and is the causative agent of a disease such as syphilis.

Characterizing features of the pathogen

Once in the environment with saliva, semen or secretions from erosions and ulcers of the patient, pale treponema is able to maintain its activity until the substance in which the treponema resides dries out.

The pathogen is resistant to high temperatures, 54 degrees above zero destroy the pathogen only after 15 minutes, higher numbers become detrimental to treponema pallidum faster. Even during boiling, the pathogen does not lose its activity for several seconds. An interesting fact is that at a temperature of 42 degrees treponema becomes more active and only dies over time. The causative agent of syphilis is considered pathogenic for three days, even if it is in cadaveric material.

The pale spirochete has a high level of resistance to the effects of low temperatures, even when frozen, it retains its pathogenicity for 12 months. The best living conditions for the pathogen are an oxygen-free environment and low temperature.

Pale treponema dies under the influence of disinfectants and some types of antibacterial agents.

Unfavorable for the pale spirochete (lead to its death) are:

• arsenic and bismuth;
• penicillin;
• mercury;
• influence of acids and alkalis;
• exposure of the microorganism to light and ultraviolet radiation;
• antiseptic solutions.

However, the findings of studies on the resistance of the causative agent of syphilis to adverse environmental factors indicate that in some cases treponema can still retain its activity and cause disease even when oxygen penetrates to it, when dried and exposed to light rays.

Transmission routes

The entrance gate through which the pathogen enters our body is the injured tissue surface of the mucous membranes of the oral cavity or genital organs.

Transmission of pale treponema occurs:

• Sexually - with unprotected sexual relations with the patient.
• Household - as a result of the use of contaminated towels, linen, cosmetics.
• Transplacental - from a sick mother to a child.
• Vertical - when the child passes through the infected birth canal of the mother.
• Hematogenous - during the transfusion of blood and its components, during surgical interventions, the use of a common syringe with a sick person (especially characteristic of drug addicts).

It should be noted that there is a rather high risk of infection among employees of medical and cosmetic establishments, especially if they carry out procedures associated with a violation of the integrity of the skin.

The greatest number of cases of infection is diagnosed in people who have a promiscuous sex life and do not use contraceptives.

Clinical manifestations of the disease

Please note that a high level of contagiousness is observed in patients with primary and secondary syphilis, which is manifested by the formation of the first manifestations of the disease on the skin and mucous genital organs. It is during this period of time that intensive reproduction and release of pale treponema into the surrounding space takes place.

Nowadays, the number of patients in whom syphilis is manifested by extragenital chancres, which are localized on the mucous membrane of the mouth, pharynx, and anus, is growing. Elements of the rash can be observed on the face, and syphilis on the palmar surface of the hands and soles.

• The duration of the incubation period can vary, and range from 3 weeks to 3 months, while the spread of microorganisms with the flow of lymph and blood, as well as their intensive reproduction in the lymph nodes, will be observed.
• In the area of ​​​​introduction of pale treponema, a hyperemic nodule of a dense consistency soon appears, which later forms an ulcer, it is called a hard chancre. In most cases, this pathological symptom is localized on the penis, labia, vagina, chest, fingers, lower abdomen and oral cavity. As for the size of the ulcerative process, they can range from microscopic to very large, there may be several of them. In parallel with this, there is an increase in the size of the lymph nodes in the area of ​​localization of the infection zone.
• After 10 days from the moment of the appearance of a hard chancre, secondary syphilis is formed, characterized by the spread of infection throughout the body by the hematogenous route. Clinically manifested by the appearance of elements of a pink rash, they are called secondary syphilides. A characteristic feature is their independent disappearance and reappearance after a while. There is an addition of signs of intoxication, namely: a feeling of heat, general weakness, pain in the joints, sudden loss of body weight. The secondary form of the pathological process is accompanied by the formation of tonsillitis, stomatitis, warts, which are localized on the genitals and an increase in lymph nodes. Please note that in the absence of adequate and timely therapy, the disease passes into the third stage, which is characterized by damage to nerve fibers.
• The tertiary form of syphilis can manifest itself 3-15 years after infection with pale treponema. Its course is characterized by the appearance of gums and foci of destructive changes. There is a violation of the functioning of internal organs and systems of an irreversible nature. The patient begins to be disturbed by respiratory and speech disorders, the process of swallowing becomes more complicated. Proceeding in this form, the disease leads to disability or even death.

Syphilis of congenital origin, as already noted, is formed as a result of infection of a child from a sick mother while still in her womb. It is characterized by the presence of such pathological symptoms as:

• congenital deafness;
• keratitis;
• Hutchison teeth.

Diagnostics

Before starting to treat the patient, the doctor, in order to make a correct diagnosis and prescribe effective therapy, examines the patient and collects anamnestic data, and also prescribes the following:

• Microscopic and bacterioscopic examination of a smear taken from the surface of the chancre (the material is tissue exudate) or biopsy material of the lymph node (but only in the first month of the disease). For better information content of the smear, the surface of ulcers and erosions is pre-lubricated with saline, the material is taken and the preparation is prepared for microscopic examination. The material is stained according to Romanovsky-Giemsa, while pale treponema acquires a pink tint. It is necessary to focus on the fact that live pale treponemas in an unstained smear are not detected under a light microscope. In this case, the use of dark-field or phase-contrast microscopy is considered justified. Treponema has the ability to lead to the refraction of light rays and looks like a spiral strip of white.
• Serological tests, the purpose of which is to diagnose antibodies to the causative agent of syphilis in blood plasma. Most often, the Wassermann reaction and the reaction of fast plasma reagents are carried out. These studies are considered mandatory and are used even when performing a preventive medical examination in outpatient medical institutions.
• Reactions of immunofluorescence, hemagglutination, immobilization of treponemas. These studies have an extremely high level of sensitivity and accuracy. Allow to detect antibodies in human blood. For example, IgM indicate the presence of an acute inflammatory process, IgG indicate the chronic course of the disease.
• enzyme immunoassay. This examination method, like the previous ones, helps to diagnose the presence of antibodies to pale treponema. After 14 days have passed, IgM and IgA begin to appear in the blood plasma, and after a month - IgG (the peculiarity is that it is during this period that their number is at its peak, over time it decreases).
• PCR diagnostics.

Treatment

When pathological symptoms appear, you should consult a dermatologist. The attending physician will conduct a thorough examination of the patient and prescribe an individual treatment regimen, which will depend on the severity of the clinical manifestations of syphilis and the physiological characteristics of the patient. It should be noted that the correct, full-fledged treatment leads to a complete recovery.

The main direction of therapeutic therapy is the destruction of pale treponema. For this purpose, patients are prescribed antibacterial drugs in considerable doses. In most cases, drugs from the group are used:

• penicillins - benzylpenicillin;
• tetracyclines - Doxacycline;
• macrolides - Clarithromycin or Sumamed;
• cephalosporins - Cefazolin;
• fluoroquinolones - Ciprofloxacin.

Important! The duration of the medication should be at least two months.

In parallel with antibiotic therapy, the following is prescribed:

• immunostimulants;
• vitamin and mineral complexes;
• probiotics;
• physiotherapy procedures.

The sexual partner of the patient must also be treated without fail, this will prevent the risk of re-infection.

An important nuance that requires special attention is that it is strictly forbidden to have sex during the treatment period.

Determining the effectiveness of syphilis treatment is considered quite difficult. This is explained by the fact that almost all clinical manifestations of the disease disappear already during part of the treatment, but this is not yet a confirmation that the pale spirochete has died. To find out if the patient is cured, it is necessary to prescribe the passage of serological tests.

The treatment of the disease must be treated with full responsibility, because it is considered asocial and can cause severe complications and even death.

Prevention measures

In order to prevent the entry of pale treponema into the body, it is necessary:

• Pay special attention to personal hygiene.
• Use only your underwear.
• Use individual cosmetics.
• Avoid casual sex. If an unprotected relationship nevertheless occurred, it is necessary to treat the genital organs as soon as possible with a solution of Albucid or Chlorhexidine, from which the pale spirochete dies.
• Use barrier contraception.

Mandatory preventive measures are carried out:

• donors;
• women during the period of bearing a child;
• persons whose profession is related to the food industry;
• teachers and kindergarten teachers;
• medical workers;
• persons admitted to the hospital for treatment.

Summing up, it should be noted that due to the development of the pharmaceutical industry and the use of antibiotic therapy, the prognosis of syphilis is considered favorable. All that is needed is just to undergo the right treatment and follow all the recommendations of the doctor. In no case do not self-medicate, because this can lead to very disastrous consequences.

Here is practically all the information about what pale treponema and syphilis are and how this pathological condition should be treated. We hope it will be useful for you and will help you deal with exciting issues.

spiral bacterium Treponema pallidum belongs to the Spirochaetaceae family and has 4 subspecies (T. pallidum pallidum, T. pallidum pertenue, T. pallidum carateum, T. pallidum endemicum), the first of which is the most common and is the causative agent of syphilis. The rest cause diseases such as pinta, yaws, bejel.

After infection of the body with a bacterium, the immune system begins to produce antibodies, primarily of the class IgM. They can be detected in a patient by the end of the second week after infection. In the process of reactivation, infections increase markedly. Antibodies of the IgG class begin to be produced after 3-4 weeks, and on the 6th they are dominant. The titer of these immunoglobulins can persist in the blood throughout life. The totality of antibodies is of great importance in the diagnosis, since in the acute phase IgM antibodies, in the chronic course of the disease - class IgG.

Modes of transmission and symptoms of syphilis

The incubation period can be up to 3 months, but in most cases it is about 20 days. The first symptom is the appearance of a painless hard ulcer, called a chancre, up to 3 cm in diameter. This primary syphilis. Secondary (after 4 - 10 weeks) is accompanied by an increase lymph nodes, the appearance rashes, body aches and fever. After 3-6 weeks, the symptoms disappear, but relapses are possible (in 25% of cases).

If treatment is not taken, then syphilis develops in latent form. After 10-15 years, 15% of patients begin to manifest tertiary syphilis, in which the effect of the bacterium Treponema pallidum on any organ or system is possible. Syphilis causes damage to the nervous system ( neurosyphilis), hearts ( cardiovascular syphilis), kidneys, brain, etc. Often so-called syphilitic gums form on the skin.

Indications for testing for total antibodies to the causative agent of syphilis

• a comprehensive examination for the diagnosis of STIs;
• the appearance of symptoms of syphilis;
• preparation for surgery;
• pregnancy;
• procurement of donor blood;
• diagnosis of congenital syphilis;
• treatment at regular intervals.

Anti-Treponema Pallidum Analysis Method

Interpretation of results

When examined under a microscope, you can see that it has a white color, for which it received two more names: pale treponema or pale spirochete.

Treponema pallidum - what is it? This is a special type of spirochete, which differs from its counterparts in a thinner structure, the movements of which resemble the rotation of a pendulum. Due to this, it quickly spreads through the internal organs of a person, destroying their cells and tissues.

An important role in the diagnosis of a bacterium is played by its color: a white tint allows it to be detected using laboratory tests based on the use of contrast dyes. Such methods of microscopy help to distinguish the spirochete from other, less dangerous of its counterparts, living mainly on the mucous membranes of the genital organs and in the oral cavity.

After entering the body, the bacterium does not manifest itself for a long time. This incubation period lasts up to several weeks. At the same time, infected men or women already pose a danger to others, tk. capable of transmitting the infection to others without even knowing it.

Another danger of the incubation period is that treatment is delayed, which means that the bacterium gets the opportunity to infect more and more tissues. At the end of incubation, pathogenic microorganisms are already firmly embedded in the cells of the epidermis, which is manifested by the development of purulent hard chancres and inflammation on the skin. This is the beginning of primary syphilis - the second stage of the disease.

The special characteristics of pale spirochetes include:

• the presence of proteins in the composition of the microorganism, which make it easy to attach to all layers of the epidermis and be resistant to many groups of drugs;
• the thin and small body of the bacterium opens up the possibility for it to penetrate into the intercellular space, where the conditions for reproduction are optimal;
• cysts (larvae) deposited by the bacterium have a dense protective shell that protects them from death and includes a supply of nutrients. This allows them to lead a latent existence for a long time, waiting for favorable conditions for the activation of life processes.

As soon as the activity of the pathogen increases, the immune system will begin to produce antibodies to it, and this is a possible way to detect treponema in the blood.

In the latent state, when the natural defense is strong and does not allow the virus to be active, it is beyond the power of most screening studies to diagnose syphilis to determine the presence of an infection.

How does reproduction take place?

As soon as the incubation period ends, the pathogen begins to penetrate into the deeper layers of the skin and mucous membranes, destroying skin cells. This is how syphilitic ulcers are formed, the first external symptoms of syphilis - at the initial stage they are called hard chancres.

A chancre is an ulcerative formation with smooth edges, up to a centimeter in diameter, which has a dense purulent infiltrate inside. For the first time, their appearance is observed in the place where contact with the pathogen occurred.

The first chancres can be found on the hands, in the oral cavity, on the mucous membranes of the genital organs, incl. quite deep.

At the same time, antibodies begin to appear in the patient's blood, because. the immune system has already turned on protective reactions to neutralize the virus. Skin rashes are a fairly clear symptom of Lewis, but laboratory tests should confirm the diagnosis.

With their help, the type of pathogen is determined and the limitation period of the disease is established, i.e. stages of syphilis. This is required in order for the fight against the virus to be most effective.

Otherwise, the spirochete will continue its destructive activity, affecting the vital systems of the body: the heart and blood vessels, the spinal cord and brain, causing severe allergic reactions and neurological pathologies.

It is important to remove bacteria from the body in the early stages of the development of the disease. Secondary and tertiary syphilis are subject to therapy, but it is difficult, lengthy and not always successful.

Tests for syphilis

There are several studies that help identify antibodies. They are used at various stages of the disease. So, the primary diagnosis (preventive test) helps to identify the bacterium itself and control the ongoing therapy.

Such tests should be taken when registering for pregnancy and before childbirth (1.5-2 months in advance), when applying for a job, during annual medical examinations.

If the reaction is positive or weakly positive, additional tests will be required. Their task is to clarify the results of the previous examination and establish the norm if the diagnosis is confirmed.

In the course of treatment, these tests help track the dynamics of the decrease in antibodies. The third type of diagnosis is carried out two weeks after the completion of antibiotics. The result should be negative, which indicates that the therapy was carried out qualitatively.

Lifelong immunity to syphilis is not developed, so re-infection is possible. But, according to statistics, this happens extremely rarely, and it is easier to treat such patients.

Total antibody score

Often, after screening, the patient receives a referral for the delivery of antipallidum total antibodies - what is it? To determine the stage of the disease and the duration of the disease, antibodies should be counted. For this, class G immunoglobulins are counted separately.

Their number is a direct indicator of the stage of the disease, and they remain in the human body even after the treponema has been removed. If we are talking about congenital Lewis, class M immunoglobulins should be considered.

The total amount of these substances makes it possible to determine with high accuracy the duration of infection and select medicines that will positively affect human health.

If the patient suffers from serious chronic pathologies (HIV infection, hepatitis, autoimmune diseases, diseases of the endocrine system), the diagnostic results may be inaccurate. In this case, the doctor prescribes several secondary tests, the results of which will complement each other.

The nuances of the analysis

The disadvantage of laboratory tests is the fact that they cannot be detected before the end of the incubation period, so the first screening test is carried out no earlier than three weeks after the alleged infection or after chancres began to appear.

The second feature of the tests: total antibodies to treponema pallidum remain positive throughout the year - what does this mean? The fact that it was possible to completely cleanse the body of the remnants of bacteria, but antibodies to them still remained.

Also, other types of pathogens can give such a reaction: Mycobacterium tuberculosis, Giardia, etc., which increase activity in syphilis.

Research can give false results. Therefore, if a person is confident in his status, and the analysis gives the opposite result, it must be retaken a few days later.

Such "failures" often occur in patients with diabetes, oncology, pneumonia, gout, drug addicts and women in a delicate position.

Who should be tested for treponema?

Syphilis is a serious disease, for which intentional infection is criminalized. It is impossible to cope with it with folk methods and self-treatment; an individual antibiotic therapy regimen is required, which involves placing the patient in a hospital.

In order to prevent an outbreak of an epidemic, because Lewis is able to be transmitted by contact - household way, screening for treponema pale is indicated for:

• planning the conception of a baby and registering during pregnancy;
• leading a promiscuous intimate life;
• preparation for surgical interventions;
• donation of biological fluids as a donor.

Regular examinations are required for people who are in close contact with infected treponema: relatives, doctors, as well as people working in childcare facilities and catering establishments.

Syphilis, antibodies to Treponema pallidum lgM, IgG quantitative - a method for the quantitative determination of antibodies to antigens of Treponema pallidum, the causative agent of syphilis. Refers to highly sensitive methods for diagnosing syphilis.

Syphilis- an infectious disease caused by pale treponema (Treponema pallidum), transmitted mainly sexually, prone to chronic course and affecting most organs and systems of the body. Syphilis is characterized by a slow progressive course. In the later stages, it can lead to severe damage to the nervous system and internal organs.

Clinical picture with syphilis
The clinical manifestations of syphilis are very diverse and depend on the stage of the disease. There are several stages of syphilis. The primary stage occurs approximately 2-3 weeks after infection. At this stage, one or sometimes several ulcers, called chancre, appear, usually on the part of the body that has come into contact with the chancre of the sick person, such as the penis or vagina. In many cases, a chancre is painless and goes unnoticed, especially if it is in the rectum or on the cervix. The chancre disappears in 4-6 weeks.

The second stage of the disease begins 2–8 weeks after the onset of the chancre. It is characterized by the appearance of a rash, often on the palms and soles. Sometimes there are other symptoms, such as fever, fatigue, swollen lymph nodes, sore throat, and body aches.

Syphilis is able to proceed in a latent form, during which the infected person does not show any symptoms, but at the same time he continues to be a carrier of the infection. This may take years.

Without treatment, about 15% of patients develop symptoms of late, or tertiary, syphilis. This stage sometimes lasts for several years, and leads to mental illness, blindness, neurological problems, heart disease, and even death.

Syphilis can be treated with antibiotics (penicillin derivatives are preferred). Moreover, at an early stage, the disease is treated easier and faster.

When a person comes into contact with Treponema pallidum, their immune system produces antibodies to the bacteria. Two types of such antibodies can be detected in the blood: IgM and IgG.

IgM antibodies
Antibodies of the IgM class are produced by the body in the first place. They are detected in the blood serum at the end of the second week of the disease and disappear in untreated patients after about 1-1.5 years, in the treatment of early syphilis - after 3-6 months, late - after a year. They are present in most patients with primary and secondary syphilis, so an IgM test can be used to distinguish between a long-standing infection and an acquired one.

Patients treated in the past do not have specific treponemal IgM antibodies, but their absence in itself does not indicate the effectiveness of the therapy, since most of those who have not been treated also lack IgM antibodies in the latent stage of syphilis.

Antibodies of the IgG class
Antibodies of the IgG class appear in the blood 3-4 weeks after infection. Their concentration increases and reaches a maximum at the 6th week, at which point their concentration prevails over the concentration of IgM. Class G immunoglobulins at a certain level persist for a long time, sometimes for life.

Indications:

• diagnosis and confirmation of syphilis;
• pregnancy planning;
• preparation for the operation;
• promiscuity;
• donor verification.

Interpretation of results
Units of measure: UE*

A positive result will be accompanied by an additional comment indicating the sample positivity ratio (PC*).

• KP >= 1.1 - positive;
• KP<= 0,9 - отрицательно;
• KP 0.9–1.1 - doubtful.

*Positivity ratio (PC) is the ratio of the optical density of the patient sample to the threshold value. KP - the coefficient of positivity, is a universal indicator used in enzyme immunoassays. The CP characterizes the degree of positivity of the test sample and may be useful to the doctor for the correct interpretation of the result. Since the positivity coefficient does not correlate linearly with the concentration of antibodies in the sample, it is not recommended to use the CP for dynamic monitoring of patients, including monitoring the effectiveness of treatment.