From Big Medical Encyclopedia

ZAKSA-VITEBSKOGO REACTION ( H. Sachs , it is mute. immunologist, 1877 — 1945; E. Witebsky, is mute. immunologist, sort. in 1901; synonym cytocholic reaction) — precipitation test (flocculations, or sedimentary). It is offered by G. Zaks and Vitebsk in 1928 for serodiagnosis of syphilis.

Principle of reaction it is based on formation of macroscopic precipitated calcium superphosphate in mix of serum of the patient with syphilis with antigen; with serum of healthy faces of precipitated calcium superphosphate it is not formed.

Features of reaction: a) reaction bystry (Citocholreaktion) — is carried out within an hour, the result is read immediately on performance of unlike reaction of Legislative Assembly — Lentocholreaktion offered in 1918, the result a cut is read in a day after statement (nowadays it is not applied); b) antigen — nonspecific hapten with addition of cholesterol (for the first time G. Zaks suggested to add it in 1911); cholesterol in itself is not antigen; increasing a molecule of the last, it increases its sensitivity; in other reactions for this purpose apply tolutansky balm, to - that, etc.

Preparation of antigen

Muscles from 10 — 15 cors bovinum exempt the benzoic from fat and sinews, carefully crush via the meat grinder and extract 5-krat-nym of 96% of alcohol within 15 days at daily 20-minute stirring. The received «main» primary extract is evaporated dry in the enameled or porcelain casserole on the water bath or in a flask under vacuum. For dissolution of the saturated-yellow viscous rest of lipoid add hot alcohol in quantity, equal 1/3 volumes, taken for extraction of a muscle; remained not dissolved ballast substances throw out.

Konts. extract is left for 2 — 3 days at the room temperature, filtered cold and holesterinizirut; in most cases add 0,3 — 0,6% of crystal cholesterol depending on results of titration on positive and negative serums to extract. Cytocholic antigen differs in firmness; it is necessary to store it at the room temperature in the soldered ampoules or under the hard cork stopper.

A technique of reaction

1 ml of cytocholic antigen quickly flow to 2 ml fiziol, solution; the antigenic emulsion is left at the room temperature for 10 — 15 min. before emergence of flakes in it. To 0,2 ml of the inactivated serum add 0,1 ml of an antigenic emulsion to a test tube. After three-minute stirring experience is left for 30 min., then add 1 ml fiziol, solution. In control of antigen (one for all experience) pour 1,2 ml fiziol, solution and 0,1 ml of an antigenic emulsion; in a control test tube there should not be a precipitated calcium superphosphate. Experience can be put in half doses. The accounting of results is carried out by a naked eye or under a magnifying glass. At patients syphilis (see) depending on its stage and treatment flakes, various in size and quantity, are observed (4+, 3+, 2+); at healthy faces contents of test tubes opalestsirut.

Cytocholic reaction was experienced by many researchers, differs in high sensitivity, specificity and was generally recognized; in the USSR it enters the standard complex of reactions to syphilis. Cytocholic reaction at the latent syphilis and syphilis of a nervous system is most sensitive.

In 1931 Legislative Assembly and Vitebsk offered new modification, for a cut dissolve antigen dvukhfazno: to 1 h antigen add 2 h fiziol, solution; mix is left at room t ° for 5 min., then add 9 h fiziol. solution. For sensitization of modification authors dissolved antigen in 2 — 3% solution of sodium chloride. Technique of reaction the same. This modification is checked on a significant amount of serums, but in practical work is not applied.

Cytocholic reaction can be applied as quantitative reaction with different cultivations of ispytuyemy serum (1:4; 1:;; 1: 16; 1: 32 etc.) that gives the chance to judge dynamics of reagins under the influence of therapy (S. M. Ploticher, 1948). It can be put as microreaction on a slide plate (S. L. Shirvindt, 1940).

Cytocholic reaction on the sensitivity, specificity, simplicity of the equipment and ease of reading results is a valuable method for serodiagnosis of syphilis.

Express diagnosis of syphilis was widely used, edges it is carried out by a number of microreactions on glass with use of cardiolipin antigen. Microreactions with a blood plasma, with the active and inactivated serum are applied.

Simplicity of the equipment, ease of reading results, low cost (microreaction is 16 — 17 times cheaper than Wassermann reaction) allow to recommend microreactions for mass inspection of somatic patients and at professional surveys.

See also Wasserman reaction , Precipitation .

Bibliography: Ovchinnikov H. M and d river. Comparative study of some accelerated reactions to syphilis, Vestn, dermas, and veins., No. 1, page 32, 1977, bibliogr.; Reznikova L. S., Lithuanian Jewish Epstein R. V. and Levi M. I. Serological methods of a research at diagnosis of infectious diseases, page 229, M., 1962; Sachs H. u. Witebsky E. Zur Serodiagnostik der Syphilis mittels Ausflockung cholesterinierter Extrakte, Klin. Wschr., S. 1233, 1928; they, Zur Anwendung von Citocholextrakten fiir die Serodiagnostik der Syphilis mittels Ausflockung, ibid., S. 1993, 1931.

L. S. Reznikova.