McManes Laboratory of Experimental Pathology of the University of Pennsylvania, Philadelphia.
J Exp Med. 1916 Oct 1;24(4):333-44. doi: 10.1084/jem.24.4.333.
The results observed with this strain of Treponema pallidum may be stated as follows: 1. Normal human serum did not agglutinate this culture of Treponema pallidum in dilutions of 1:5 or higher; equal parts of treponema culture and normal serum (dilution 1:2) resulted in agglutination in about 50 per cent of the sera. With the strain of Treponema pallidum used in this study specific agglutination was not considered as having occurred unless observed in dilutions of 1:5 or higher. 2. The agglutinating power of the sera of non-syphilitic persons suffering with various infections was not higher than that of normal sera. 3. Traces of specific agglutinin for this culture of Treponema pallidum were found in the sera of persons late in the primary stage of syphilis. 4. In the secondary stage of syphilis about 58 per cent of sera showed the presence of a demonstrable amount of agglutinin in dilutions of 1:5 and higher; in no instance, however, was agglutination in evidence in dilutions higher than 1:20. 5. In tertiary and latent syphilis, mostly infections of the central nervous system, agglutination in dilutions of 1:5 and higher was found with about 84 per cent of sera. The highest concentration of pallida agglutinin in the blood serum was found in the later stages of syphilis. 6. The formation of agglutinin for culture Treponema pallidum in human syphilis is probably tardy and does not reach a state of high concentration. 7. There was no direct relation between the presence of the Wassermann antibody and agglutinin for this strain in the sera of syphilitics. The former appears in the body fluids earlier and is probably in higher concentration in all stages of syphilis; while agglutination is most likely to occur with Wassermann positive sera, it may be occasionally observed with sera yielding negative Wassermann reactions. Likewise strongly Wassermann positive sera may not contain demonstrable amounts of agglutinin. 8. It is probable that different strains of pallida vary in susceptibility to agglutination. For example, in the first investigation on agglutinins for Treponema pallidum by Kolmer, the sera of syphilitics in different stages of the disease did not cause agglutination of one of Noguchi's strains in dilutions of 1:20 and higher, whereas the strain used in the present study was frequently agglutinated in this dilution by sera from a similar group of patients. As shown by Zinsser, Hopkins, and McBurney, virulent pallida from human lesions resist agglutination to a remarkable degree. 9. While further studies are necessary to establish the practical value of agglutination in the diagnosis of human syphilis, we believe that with a suitable culture or cultures well marked agglutination of Treponema pallidum in dilutions of 1:5, or better 1:10 and higher, indicates pallida infection and may prove of value in the diagnosis of isolated cases, particularly in the later stages. Investigations bearing upon the relation of agglutinins for culture pallida to immunity in syphilis will be given in a separate communication (16).
正常人体血清在 1:5 或更高稀释度时不能凝集苍白密螺旋体培养物；等份苍白密螺旋体培养物和正常血清（稀释度 1:2）在约 50%血清中产生凝集。在本研究中使用的苍白密螺旋体菌株中，只有在 1:5 或更高稀释度时观察到特异性凝集，才被认为发生了特异性凝集。
非梅毒患者患有各种感染时的血清凝集能力并不高于正常血清。
在梅毒一期晚期患者的血清中发现了针对该苍白密螺旋体培养物的特异性凝集素。
在梅毒二期，约 58%的血清在 1:5 及更高稀释度时显示出可检测到的凝集素；然而，在任何情况下，都没有在高于 1:20 的稀释度下观察到凝集。
在三期和潜伏梅毒中，主要是中枢神经系统感染，约 84%的血清在 1:5 及更高稀释度时出现凝集。在梅毒的晚期，血清中苍白密螺旋体凝集素的浓度最高。
在人类梅毒中，针对苍白密螺旋体培养物的凝集素的形成可能较晚，并且不会达到高浓度状态。
在梅毒患者的血清中，存在与这种菌株的瓦瑟曼抗体和凝集素之间没有直接关系。前者更早出现在体液中，并且可能在梅毒的所有阶段都处于较高浓度；而凝集最可能发生在瓦瑟曼阳性血清中，但也可能偶尔在瓦瑟曼反应阴性的血清中观察到。同样，强瓦瑟曼阳性血清可能不含有可检测到的凝集素。
不同的苍白密螺旋体菌株可能对凝集有不同的敏感性。例如，在 Kolmer 首次对苍白密螺旋体的凝集素进行研究时，不同阶段梅毒患者的血清在 1:20 及更高稀释度时不能使 Noguchi 的一个菌株发生凝集，而在本研究中使用的菌株在类似患者组的血清中，在这个稀释度经常被凝集。正如 Zinsser、Hopkins 和 McBurney 所表明的，来自人类病变的毒力苍白密螺旋体对凝集具有显著的抵抗力。
虽然需要进一步研究来确定凝集在人类梅毒诊断中的实际价值，但我们相信，使用适当的培养物或培养物，在 1:5 或更好的 1:10 及更高稀释度时，苍白密螺旋体的明显凝集表明苍白密螺旋体感染，并可能在孤立病例的诊断中具有价值，特别是在晚期。关于苍白密螺旋体培养物凝集素与梅毒免疫的关系的研究将在另一份报告（16）中给出。
