This is a draft of an article on VDRL.
VDRL is an abbreviation for the Venereal Disease Research Laboratory, which was a laboratory in the Staten Island Marine Hospital. In modern parlance, however, the initials VDRL almost always refer to an antigen used to test for the presence of syphilis and for the associated test.
The VDRL antigen edit
The VDRL antigen consists of a mixture of 0.03% cardiolipin, 0.9% cholesterol, and approximately 0.2% lecithin, dissolved in alcohol. It was developed in the 1940s by workers in the Laboratory for which it is named.[1], [2]
The VDRL test edit
The RPR test edit
Both tests work by measuring reagins, which word in this context refers to IgM and IgG antibodies to lipoidal material. This material may come either from damaged cells in the patient or possibly from the syphilis bacterium itself.
(refs)
Matthews HM, Yang TK, Jenkin HM. Unique lipid composition of Treponema pallidum (Nichols virulent strain). Infect Immun 1979;24:713-9.
Belisle JT, Brandt ME et al. Fatty acids of Treponema pallidum and Borrelia burgdorferi lipoproteins. J Bacteriol 1994;176:2151-7.
More notes edit
For the RPR test, carbon particles coated by the antigen are used; in the presence of reagins, flocculation of the particles is observed.
More on RPR vs. VDRL tests.
Both tests are non-treponemal, i.e., not specific to the syphilis bacterium.
Mary C. Pangborn was also involved in the development of cardiolipin.
The Marine Hospital is now Bayley-Seton Hospital.
The VDRL is also used on cerebrospinal fluid to test for neurosyphilis (CSF-VDRL.)
References for the RPR test:
Portnoy J, Brewer JH, Harris A. Rapid plasma reagin card test for syphilis and other treponematoses. Public Health Rep 1962;77:645-52.
Portnoy J. Modifications of the rapid plasma reagin (RPR) card test for syphilis, for use in large scale testing. Am J Clin Pathol 1963;40:473-9.
Portnoy J. A note on the performance of modifications of the rapid plasma reagin (RPR) card test for syphilis, for use in large scale testing. Public Hlth Lab 1965;23:43.
Original text edit
The VDRL is a nontreponemal serological screening for syphilis, the monitoring of the response to therapy, the detection of CNS involvement, and as an aid in the diagnosis of congenital syphilis.
A negative ("nonreactive") VDRL is compatible with a person not having syphilis. However, a person may a negative VDRL and still have syphilis since, in the early stages of the disease, the VDRL often gives negative results. This is called a false negative VDRL.
The VDRL test is sometimes positive in the absence of syphilis. For example, a false positive VDRL can be encountered in infectious mononucleosis, lupus, the antiphospholipid antibody syndrome, hepatitis A, leprosy, malaria and, occasionally, pregnancy.
The RPR (rapid plasma reagin) test is similar to the VDRL test. It is also designed to detect an antibody substance in the bloodstream when syphilis is present but, as with the VDRL, early syphilis infections may give a false negative RPR result. The RPR, like the VDRL, can also give false positive results.
References edit
- ^ Harris A, Rosenberg A A, Riedel L M. A microflocculation test for syphilis using cardiolipin antigen. Preliminary report. J Ven Dis Inform. 1946;27:169–174.
- ^ Harris A, Rosenberg A A, Del Vecchio E. The VDRL slide flocculation test for syphilis. II. A supplementary report. J Ven Dis Inform. 1948;29:72–75.