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Reactivity of a lecithin-free cardiolipin preparation (cardchol) in leprosy sera
Insights
Cardchol, a cardiolipin-cholesterol antigen, shows high reactivity with leprosy sera and false-positive reactors in complement-fixation tests. It is less reactive in syphilis, except for primary syphilis.
Area of Science:
- Immunology
- Clinical Chemistry
Background:
- The complement-fixation test is a serological assay used for diagnosing infections.
- Lipoidal antigens, such as cardiolipin, are commonly employed in these tests.
Purpose of the Study:
- To evaluate the reactivity of a novel cardiolipin-cholesterol antigen (cardchol) compared to a standard cardiolipin antigen (CWRM).
- To assess the diagnostic utility of cardchol in distinguishing between syphilis, leprosy, and false-positive reactors.
Main Methods:
- Complement-fixation tests were performed using both cardchol and CWRM antigens.
- Sera from patients with syphilis, leprosy, and healthy individuals were analyzed.
- Quantitative antibody levels were determined.
- Electrophoretic fractionation was used to identify reacting serum components.
Main Results:
- Cardchol demonstrated significantly higher reactivity with sera from leprosy patients and false-positive reactors compared to CWRM.
- In syphilis cases, cardchol showed lower reactivity than CWRM, with an exception for primary syphilis.
- Lepromatous leprosy, especially of shorter duration, showed the highest cardchol reactivity.
- Reactive substances in leprosy sera were primarily located in gamma-globulin and beta-globulin fractions.
Conclusions:
- Cardchol serves as a valuable antigen for differentiating leprosy and syphilis, and identifying false-positive reactors.
- Its distinct reactivity profile offers potential for improved serological diagnostics in infectious diseases.
Abstract:
Previous experiments have shown that a mixture of cardiolipin and cholesterol in absolute ethanol (named "cardchol") might be used as an antigen in complement-fixation tests. The reactivity in the complement-fixation test of CWRM (an "ordinary" cardiolipin antigen) was compared with that of cardchol in several experiments, and it could be demonstrated that the reactivity of cardchol was especially pronounced in sera from false-positive reactors. In about 50% of such cases, quantitative determination of the antibody content showed that cardchol was more reactive than CWRM, whereas in syphilitic cases the reactivity of cardchol was inferior to that of CWRM. An exception was primary syphilis, which showed a reactivity level with cardchol equal to or even superior to that of CWRM.Examinations of a certain number of sera from leprosy patients had shown them to be highly reactive with cardchol and non-reactive or weakly reactive with CWRM; this observation is fully confirmed by examination of a larger number of leprosy sera, on which this paper reports. These sera were examined with a battery of tests using lipoidal antigens and with the TPI test. Testing with cardchol proved to give the highest reactivity with these sera, which were mostly non-treponemal.Subdivision of the material according to the clinical stage of leprosy showed that the highest reactivity of cardchol occurred in patients with lepromatous leprosy, particularly in those with leprosy of relatively short duration.Electrophoretic fractionation of these sera demonstrated that the substances reacting with cardchol were situated in the gamma-globulin or gamma- and beta-globulin serum fractions.
