Wassermann test
Encyclopedia
The Wassermann test or Wassermann reaction (WR) is an antibody
Antibody
An antibody, also known as an immunoglobulin, is a large Y-shaped protein used by the immune system to identify and neutralize foreign objects such as bacteria and viruses. The antibody recognizes a unique part of the foreign target, termed an antigen...

 test for syphilis
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...

, named after the bacteriologist August Paul von Wassermann, based on complement-fixation.

Method

A sample of blood
Blood
Blood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells....

 or cerebrospinal fluid
Cerebrospinal fluid
Cerebrospinal fluid , Liquor cerebrospinalis, is a clear, colorless, bodily fluid, that occupies the subarachnoid space and the ventricular system around and inside the brain and spinal cord...

 is taken and introduced to the antigen - cardiolipin
Cardiolipin
Cardiolipin is an important component of the inner mitochondrial membrane, where it constitutes about 20% of the total lipid composition. The only other place that cardiolipin can be found is in the membranes of most bacteria. The name ‘cardiolipin’ is derived from the fact that it was first...

 extracted from bovine muscle or heart. Syphilis non-specific antibodies (reagin, see RPR
Rapid Plasma Reagin
Rapid Plasma Reagin refers to a type of test that looks for non-specific antibodies in the blood of the patient that may indicate that the organism that causes syphilis is present...

) react with the lipid
Lipid
Lipids constitute a broad group of naturally occurring molecules that include fats, waxes, sterols, fat-soluble vitamins , monoglycerides, diglycerides, triglycerides, phospholipids, and others...

 - the Wassermann reaction of antiphospholipid antibodies (APAs). The intensity of the reaction (1, 2, 3, or 4) indicates the severity of the condition.

Uncertainty

The reaction is not specific to syphilis and will produce a positive reaction to other diseases, including malaria
Malaria
Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...

, tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...

, and numerous other diseases. It is possible for an infected individual to produce no reaction and for a successfully treated individual to continue to produce a reaction (known as being "Wassermann fast" or "fixed").

Development and refinement

The antibody test was developed by Wassermann, Julius Citron, and Albert Neisser at the Robert Koch Institute for Infectious Diseases in 1906. The test was a growth from the work of Bordet and Gengou
Octave Gengou
Octave Gengou was a Belgian bacteriologist. He researched with Jules Bordet the Bordetella pertussis bacteria.- Biography :...

 on complementing-fixation reaction, published in 1901, and the positive reaction is sometimes called the Bordet-Gengou-Wassermann reaction or Bordet-Wassermann reaction.

The Wassermann test has been refined - the Kahn test, and the Kolmer test - and it is rarely used today. Replacement tests such as the VDRL test and the RPR test, initially based on flocculation
Flocculation
Flocculation, in the field of chemistry, is a process wherein colloids come out of suspension in the form of floc or flakes by the addition of a clarifying agent. The action differs from precipitation in that, prior to flocculation, colloids are merely suspended in a liquid and not actually...

 techniques (Hinton), have been shown to produce far fewer false positive results. Indeed the "biologic false positives" of modern tests usually indicate a serious alternate condition, often an autoimmune disease
Autoimmune disease
Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. In other words, the body actually attacks its own cells. The immune system mistakes some part of the body as a pathogen and attacks it. This may be restricted to...

.
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