Site of Origin of Syphilitic Reagin in Spinal Fluid of Patients with Neurosyphilis. ∗

Abstract

Two theories have been offered to account for the presence of syphilitic reagin in the spinal fluid of patients with neurosyphilis: (1) that the reagin is derived from the blood by filtration due to impairment of the normal physiologic barrier, 1 (2) that the reagin is largely formed locally. 2

It is generally accepted by immunologists that the syphilitic reagin is a true antibody, this belief being supported by the parallel behavior of syphilitic reagin and other antibodies both in the test-tube and in the body. 3 As an example of the latter, and in relation to the present problem, may be cited the conditions under which syphilitic reagin and other antibodies occur in umbilical cord blood. Thus, it has been shown that the isoagglutinins are not developed in newborn infants, and any present in such serum were derived from the mother by filtration through the placenta. In the course of a few weeks or months these “borrowed” isoagglutinins disappear and then the child forms its own. 4 The behavior of the syphilitic reagin is exactly parallel; a positive Wassermann or flocculative reaction on umbilical cord blood or the blood of newborn infants being diagnostic of syphilis in the mother and not necessarily in the child. 5

Accordingly, one method of attacking the problem whether or not syphilitic reagin present in the spinal fluid was derived from the blood by passive transfer is the comparison of the behavior of the reagin with that of the isoagglutinins.