The diagnosis of syphilis in many patients is, of necessity, made solely on the results of serologic tests of the blood for syphilis (STS). These tests have long been known to be only relatively specific, as they are based on the presence of reagin. This substance not only is developed in the course of treponemal infections but may be found in small amounts in some normal persons, and in larger amounts in certain persons after a variety of infections.
In 1949, Nelson and Mayer1 described the treponemal immobilization test (TPI) based on an antibody that is distinct from reagin. In animal experiments, Khan, Nelson, and Turner2 found this antibody to be developed when they used organisms of the Treponema group (T. pallidum, T. pertenue, and T. cuniculi) but not when they used nonvirulent spirochetes. In essence, the treponemal immobilization test is based on the fact that, in the
Miller JL, Slatkin MH, Feiner RR, Portnoy J, Cannon AB. TREPONEMAL IMMOBILIZATION TEST: RELIABILITY OF RESULTS FOR THE DIAGNOSIS OF SYPHILIS. JAMA. 1952;149(11):987–991. doi:https://doi.org/10.1001/jama.1952.02930280009003
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