Role of IgG fractions with high isoelectric points in the thymol turbidity test in syphilis. Evidence for an increase in basic IgG in early syphilis.

Abstract

The thymol turbidity test (TTT) is a non-specific reaction, which gives results above normal in a variety of diseases (Stillerman, 1948). Chronic infection, for instance syphilis, is one of the conditions associated with increased thymol turbidity (TT) of serum (Weiss, 1969; Menke, 1975).Factors contributing to the TT are discussed by Reinhold (1960). The free lipids of serurm play a part, but proteins have also been found to react with the thymol reagent (Kunkel and Hoagland, 1947;Franklin, 1959).Electrophoresis shows that the proteins precipitated by the thymol reagent behave like the beta and gamma proteins. The addition of gamma globulins to normal serum is followed by an increase in TT, and the removal of these proteins from positive TTT sera is followed by a negative reaction (Kunkel and Hoagland, 1947).As Franklin (1959) has shown, basic fractions of the gamma region are important in the reaction. Although negative when tested alone, these fractions affect the TT when tested in the presence of lipoproteins. Hartmatn, Viallet, and Fauvert (1963) described the so-called 'starter mechanism' of IgM. The addition of IgM myeloma proteins to normal serum was followed by an increase in TT, an effect which was not observed with IgG. However, when both IgM and IgG were added, the increase was larger than could be expected from the amount of IgM alone. These results indicate that some of the immunoglobulins play a part in the TTT. Since we were interested in the course of immunological events taking place after infection with T. pallidum, we investigated some of the factors contributing to the increased thymol turbidity in syphilis. In the experiments described in this communication, we studied the action of IgG isolated from syphilitic sera in the TTT. Material aind methodsAll the chemicals used were of analytical reagent grade. Antisera were obtained from the Central Laboratory of the Dutch Red Cross (Amsterdam, The Netherlands) and Received for publication August 30, 1974 Nordic (Tilburg, The Netherlands). Sera from syphilitic subjects were used either at once or after storage at -700C. for varying lengths of time. In all cases the diagnosis was confirmed by a positive darlfield examination and/or a positive Treponema pallidum immobilization (TPI) reaction. The TTT was performed by diluting 0-1 ml. of serum with 6 ml. of thymol reagent pH = 7-55 to 7 60 (Baker, Deventer, The Netherlands).After 30 min. the turbidity was read on a Vitatron spectrophotometer at 637 nm. Protein content was measured by the biuret reaction, using Lab-Trol (Dade, Miami, Florida, USA) as a standard.Zone electrophoresis in Pevikon blocks was performed according to the method of Bocci (1964) in barbitalbarbital sodium buffer, pH = 8-6, ,u 0-05, in blocks measuring 36 x 16 x 1 cm. 7 to 8 ml. serum from a syphilitic patient was dialysed in barbiturate buffer and applied to the block in a groove 12 cm. from the cathodal end. A voltage gradient of 3 3 V/cm. was applied to the block.After passage of current for 28 hrs, the block was divide...

Uneven distribution of antitreponema antibody acitivity in differing immunoglobulin G fractions from patients with early syphilis

“…As previously reported from our laboratory, increase in serum IgG level in syphilis patients occurred to a large extent in the most basic part of electrophoretically heterogeneous IgG (14,15). The availability of techniques to isolate IgG fractions of different electrical charge and access to various serological procedures to delineate the occurrence of antitreponema antibodies presently enabled us to examine the antitreponema antibody activity in IgG fractions of different charge and to investigate whether this antibody activity had the same preference for the basic part of heterogeneous IgG.…”

Thymol turbidity test is associated with the risk of cyclops syndrome following anterior cruciate ligament reconstruction

“…This suggests that acute vital tissue reactions occurring after ACL injury or in the early phase after reconstruction may be involved in development of cyclops nodules. The continuous contact between the graft and intercondylar notch may produce an irritating stimulus, which may induce an inflammatory response with the production of granulation tissue, which would be transformed into fibrocartilaginous and cartilaginous tissue [ 21 ]. However, because all knees in our cohort achieved full extension at the end of surgery, failure to regain full extension may be due the wound healing process after surgery.…”

“…Although, we did evaluate AST, ALT, and CRP, and there were no differences at the different time points (before reconstruction, at 3 months, and 1 year after reconstruction) (Table 3 ). Previous reports have shown that TTT is associated with immune reaction [ 11 , 21 , 22 ]. Our findings are clinically relevant, since the pathophysiological effect of the presence of a cyclops nodule formation is not fully understood to date.…”