Friday, 18 December 2015

What is a GMO?

What is a GMO?


o    A genetically modified organism (GMO) is an organism (plant, animal, bacteria or virus) whose genetic makeup has been modified for a        particular purpose.
o    The organism does not occur naturally in this modified state.
o    For example, a plant can be modified to carry an additional gene found in another living thing (such as a bacteria) to protect itself against          insect pests.
o    Genes carry the information or the “recipe”, in the sequences and structures of DNA, which gives the organism its specific characteristics.
o    Genes can be added, removed or changed, using modern biotechnology methods.
o    Because Genes are common to life on earth, genes can be transferred from one organism to another and even between non-related species.
o    This manipulation can produce a product with new characteristics which may have advantages.

How are GMOs useful to us?

  •       GM (genetically modified) plants are already being cultivated as crops and consumed by humans and animals.
  •       Using genetic engineering, new improved varieties of crops can be produced more quickly than with conventional breeding methods.
  •        Crops can be modified to have valuable characteristics such as tolerance to drought and herbicides, resistance to disease and insects, as well      as improved nutritional content.

  • ·          Insulin as a treatment for diabetes was the first commercial healthcare product produced by GMOs.
  • ·          Bacteria were genetically modified to have a copy of the human insulin gene, and the protein is synthesized by the bacteria.
  • ·          GMOs can produce other medicines such asgrowth hormone.
  • ·          GMOs are used in current vaccines such as Hepatitis B (produced by yeast), and new vaccines are being developed using GMO                     technology.  
  • ·          In the future, plants may even be engineered to contain the vaccines so that we may be able to eat our vaccinations rather go for an               injection.
  • ·          In the future, GMOs may be used for gene therapy to correct certain genetic conditions. 

·          Textiles:

  • ·          GM cotton has been created to be resistant to insect attack to improve the yield of the crop.

Adaptive Immunity

Adaptive Immunity

Adaptive immunity is capable of recognizing and selectively eliminating specific foreign microorganisms and  molecules    
(i.e., foreign antigens).

Unlike innate immune responses, adaptive immune responses are not the same in all members
of a species but are reactions to specific antigenic challenges.

Adaptive immunity displays four characteristic attributes:

  • ·         Antigenic specificity
  • ·         Diversity
  • ·         Immunologic memory
  • ·         Self/nonself recognition

        The antigenic specificity of the immune system permits it to distinguish subtle differences among antigens.
Antibodiescan distinguish between two protein molecules that differ in only a single amino acid.
The immune system is capable ofgenerating  tremendous diversity in its recognition molecules,
allowing it to recognize billions of unique structures on foreign antigens.
Once the immune system has recognized and responded to an antigen, it exhibits immunologic memory;
that is, a second encounter with the same antigen induces a heightened state of immune reactivity.
Because of this attribute, the immune system can confer life-long immunity to many infectious agents after an initial encounter.
Finally, the immune system normally responds only to foreign antigens, indicating that it is capable of self/nonself recognition.
                The ability of the immune system to distinguish self from nonself and respond only to nonself molecules is essential, for, as described below, the outcome of an inappropriate response toself molecules can be fatal.
Adaptive immunity is not independent of innate immunity.
The phagocytic cells crucial to nonspecific immune responses are intimately involved in activating the specific immune response.Conversely, various soluble factors produced by a specific immune response have been shown to augment the activity of these phagocytic cells.
 As an inflammatory response develops, for example, soluble mediators are produced
that attract cells of the immune system.
The immuneresponse will, in turn, serve to regulate the intensity of the inflammatory
                Through the carefully regulated interplay of adaptive and innate immunity, the two systems work
together to eliminate a foreign invader.


The Adaptive Immune System Requires Cooperation Between Lymphocytes and Antigen-Presenting Cells

Wednesday, 16 December 2015

Waste water and sewage treatment

Waste water and sewage treatment

     While many ancient civilisations had an appreciation of the need to protect the quality of water to be used for human consumption, it was not until 1855 that it was demonstrated that cholera was transmitted by water contaminated by faeces.   
      A similar route for typhoid fever was shortly to
be demonstrated. By the end of the nineteenth century, the microbial ecology of many human diseases had been shown to have an anal–oral route of transmission, which finally confirmed the health hazards associated with water contaminated with faeces. The introduction of sewage systems in developed societies during the nineteenth century allowed, for the first time, the possibility of treatment of municipal and industrial wastes before
discharging into natural water systems.



     Growth in human populations has generally been matched by a concomitant formation of a wider range of waste products, many of which cause serious environmental pollution if they are allowed to accumulate in the ecosystem. 
     In rural communities recycling of human, animal and
vegetable wastes has been practised for centuries, providing in many cases valuable fertilisers or fuel. However, it was also a source of disease to humans and animals by residual pathogenicity of enteric (intestinal) bacteria.
In urban communities, where most of the deleterious wastes accumulate, efficient waste collection and specific treatment processes have been developed since it is impractical to discharge high volumes of waste into natural land and waters. The introduction of these practices in the last
century was one of the main reasons for the spectacular improvement in health and well-being in the developed countries.
Mainly by empirical means a variety of biological treatment systems have been developed, ranging from cesspits, septic tanks and sewage farms to gravel beds, percolating filters and activated sludge processes coupled with anaerobic digestion. The primary aims of all of these systems or bioreactors is to alleviate health hazards and to reduce the amount of biologically oxidisable organic compounds, producing a final effluent or outflow that can be discharged into the natural environment without any adverse

     Such bioreactor assemblies rely on the metabolic versatility of mixed microbial populations (microbial ecology) for their efficiency. 
     The systems in which they perform their biological functions can be likened to other industrial bioreactors (e.g. antibiotic production); large-scale plants, for example municipal forced aeration tanks   can be extremely complex,
requiring the skills of the engineer and the microbiologist for successful operation. 
    The fundamental feature of these bioreactors is that they
contain a range of microorganisms with the overall metabolic capacity to degrade most organic compounds entering the system.
The development of these systems was an early example of biotechnology.
     Indeed, in volumetric terms biological treatment of domestic waste  waters and sewerage in the industrialised nations is by far the largestbiotechnological industry, and the least recognised by lay people. 
     Controlled use of microorganisms has led to the virtual elimination of such waterborne diseases as typhoid, cholera and dysentery in these communities.
     Yet, if water and sewage treatments are seriously interrupted, major epidemics may quickly develop as witnessed in 1968 in Zermatt, Switzerland, where typhoid developed following the breakdown of the water treatment plant.
     Thus, biotechnology not only generates a whole new range of useful products, it also plays an indispensable part, through water and sewage treatment processes, in the reduction of infectious diseases of humans and animals.
    The biological disposal of organic wastes is achieved in many ways throughout the world widely used practice for sewage treatment is shown in Fig.  

      This complex but highly successful system involves a series of
three stages of primary and secondary processing followed by microbial digestion. 
       An optional tertiary stage involving chemical precipitation may
be included. 
      The primary activity is to remove coarse particles and solubles
leaving the dissolved organic materials to be degraded or oxidised
by microorganisms in a highly aerated, open bioreactor. 
      This secondary process requires considerable energy input to drive the mechanical aerators that actively mix the whole system, ensuring regular contact of the microorganisms with the substrates and air. The microorganisms multiply and form a biomass or sludge, which can either be removed and dumped, or
passed to an anaerobic digester (bioreactor) that will reduce the volume of solids, the odour and the number of pathogenic microorganisms. 
       A further useful feature is the generation of methane or biogas, which can be used as a fuel. 
       However, the value of biogas is marginal because of its content of  carbon dioxide and hydrogen sulphide.
       Another important means of degrading dilute organic liquid wastes is the percolating or trickling filter bioreactor. In this system the liquid flows over a series of surfaces, which may be stones, gravel, plastic sheets, on which attached microbes remove organic matter for essential growth.
       Excessive microbial growth can be a problem, creating blockages and loss of biological activity. Such techniques are widely used in water purification systems.
      Abundant availability of water is vital for modern urban and industrial development. Water makes up more than 70% of the human body and about two litres a day is usually sufficient to keep an adult healthy.
      Water acts as a transport medium for essential nutrients within the body, helps to remove toxins and waste materials, stabilises body temperature and performs a crucial part in the structure and function of the circulatory system. In essence, water is the elixir of life. 
      In the natural world the ecosystem regenerates and recycles water. 
      Increasingly, human intrusion into nature by industrialisation, extensive farming practices, deforestation, etc., has severely unbalanced this process. It is now accepted that two-thirds of the world’s nations are water-stressed – using clean water
faster than it is replenished in aquivers or rivers. 
      Biotechnology will play an important role for reclamation and purification of waste waters for re-use.
      Water must be recycled in the sustainable use of resources. The most important threat mankind faces in the coming decades is not global warming or energy deficiency but an increasing shortage of high-quality water.
      What are the future areas of importance? Microbiological effluent treatment will be a major field of biotechnological interest in the future. 
       Integrated systems will be developed for treating complex wastes. 
       The role of the biocatalyst or microbe will be constantly reassessed. 
       Biotechnologists are now designing increasingly specific and efficient bioreactors to contain selected consortia of microorganisms best adapted to a range of different waste streams.
       In countries with high annual hours of sunlight there has been considerable development of combined algal/bacterial systems for waste and water treatments. Such processes can lead to the formation of relatively pure water and algal/bacterial biomass, which may be used for animal feeding, biogas formation or, perhaps more ambitiously, for bulk organic chemical formation.
      A comparison of several widely used treatment processes for liquid wastes is shown in Table 7.1, while Table 7.2 defines the various operating components.
     Water is now being recognised as an increasingly expensive component  of many industrial processes. Industries worldwide use vast quantities of quality water in their manufacturing procedures, e.g. steel, textiles, food, etc. For example, for each tonne of steel produced approximately 280 tonnes of water will be used. 
      In the past many of these industries simply
discharged the waste water into water courses often resulting in extensive down-river or estuarine pollution. Stringent anti-pollution laws together with greatly increased water charges have prompted such companies to develop new waste-water treatment systems that function in a closed-loop manner.
      Almost two-thirds of water consumption worldwide is utilised for agricultural irrigation. 
      In many cases where water is in short supply raw
domestic sewage is used, which invariably leads to crop contamination



  1. High BOD removal efficiency.
  2. Low operating costs. 
  3. Low operator skills required. 
  4. Sensitive to cold weather.
  5. Activated sludge High BOD removal efficiency. 
  6. Moderate ground requirements.
  7. Trickling filters Low operator costs. 
  8. Moderate space requirements. Resistant to sudden high inputs.




         There is little doubt that modern biology is the most diversified of all the
natural sciences, exhibiting a bewildering array of subdisciplines: microbiology,
plant and animal anatomy, biochemistry, immunology, cell biology,
molecular biology, plant and animal physiology, morphogenesis, systematics,
ecology, genetics and many others.
         The increasing diversity of modern
biology has been derived primarily from the largely post-war introduction
into biology of other scientific disciplines such as physics, chemistry and
mathematics, which have made possible the description of life processes at
the cellular and molecular level. In the last two decades well over 20 Nobel
prizes have been awarded for discoveries in these fields of study.
          This newly acquired biological knowledge has already made vastly
important contributions to the health and welfare of mankind. Yet few
people fully recognise that the life sciences affect over 30% of global economic
turnover by way of healthcare, food and energy, agriculture and
forestry, and that this economic impact will grow as biotechnology provides
new ways of influencing raw material processing.
          Biotechnology will increasingly affect the efficiency of all fields involving the life sciences, and it is now realistically accepted that by the early twenty-first century it will
be contributing many trillions of pounds to world markets.
In the following chapters, biotechnology will be shown to cover a multitude
of different applications ranging from the very simple and traditional,
such as the production of beers, wines and cheeses, to highly complex
molecular processes, such as the use of recombinant DNA technologies to
yield new drugs or to introduce new traits into commercial crops and animals.
          The association of old traditional industries such as brewing with
modern genetic engineering is gaining in momentum, and it is not for
nothing that industrial giants such as Guinness, Carlsberg and Bass are
heavily involved in biotechnology research. Biotechnology is developing at
a phenomenal pace, and will increasingly be seen as a necessary part of the
advance of modern life and not simply a way to make money!
While biotechnology has been defined in many forms (Table 1.1), in
essence it implies the use of microbial, animal or plant cells or enzymes to
synthesise, break down or transform materials.
          The European Federation of Biotechnology (EFB) considers biotechnology
as ‘the integration of natural sciences and organisms, cells, parts
thereof, and molecular analogues for products and services’. 

Sunday, 13 December 2015



  1. Cancer is a tumour.
  2. It is an abnormal growth or enlargement of tissue.
  3.  It has no co-ordination with normal tissue.
  4. It is an independent,autonomus,uncontrolled growth of a tissue containing a mass of abnormal cells.
  5.  A tumour serves no useful purpose but is harmful as it grows at the expense of the host like a parasite.
  6. Cancer now cause the second largest no.of deaths in most countries.
  7. There is no cure for cancer.

Types of tumour:

  1.  The tumour is two types, namely benign tumour and malignant tumour.

Benign tumour:

  1. The benign tumour remains fixed in the place of origin.
  2. It will not spread from one place to other.
  3. It can be cured by surgically removing the tissue.

Malignant tumour:

  1. It spread from one place to another through circulation and invasion.
  2. The spreading of tumour from one place to another is called metastasis.

Characteristics of Cancer:

  1. A tumour arises from an existing tissue or cells of the body.
  2. The growth of tumour is autonomous i.e. it follows
  3. its own laws of growth, it is not regulated by those governing the tissue from
  4. which or in which it grows.
  5. The tumour cells are undifferntiated and anaplastic in nature.
  6. Anaplasia refers to the reversion of differentiated cells into
  7. undifferentiated or embryonic cells.
  8. They have a greater potentially for growth and multiplication.
  9. They carry out none of the function of normal adult cells.
  10. They have large and irregular nuclei.
  11. They lose their contact inhibition.

Thursday, 20 August 2015

Ti plasmid Plant transformation

Plant transformation:

                Plant transformation vector are plasmids that have been specially designed to facilitate the generation of transgenic plant.
                The most commonly used for the vector is binary vector because of their ability to replicate in both E.coli and a common lab bacterium.
And Agarobacterium tumefaciens used to insert the recombinant DNA into plant

Three key elements:

                Plasmid selection
                Plasmid replication
                Transfer DNA

Three major group of gene vectors for plants:

                1.Ti plasmids of Agarobacterium tumefaciens

Organization of Ti plasmid:

                Ti plasmids are large (90-150*10 to power of 6 dalttons) circular double stranded DNA.
                Molecular weight is 120-160 megadaltons.
                When exposed to a temperature above 37*c, it undergoes denaturation and looses its 

tumorogenic property.

                It has an oncogenic region which produces some unusual amino acids.
                Ti plasmid has a region encoding for the synthesis of opine.
                It has also a sequence for opine catabolism which produces some essential enzymes that helps in opine catabolism.


                It induces grown gall disease
                It is a Gram –ve  Rod shape bacteria
                Enter through plant wounds easily
                Also forms tumours
                It is a soil bacterium

T-DNA region:

            T-DNA contains two type of genes.
The oncogenic genes, encoding for enzymes involved in the synthesis of auxins and cytokinins and responsible for tumour formation.
 And the gene encoding for the synthesis of opines.
These compounds, produced by condensation between aminoacids and sugars, are synthesized and excreted by the grown gall cells and consumed by A.tumefacies as carbon and nitrogen sources.
Virulence gene:
          The gene responsible for the transfer of the T-DNA region into the host plant are also situated on the Ti plasmid, in an 40-kb region outside the T-DNA known as the virulence region

Procedure for prevention or protecting:

Leaf (explants)

Surface sterilization
(70% ethanol, 0.1% sodium hypo chloride )

Culture overnight in liquid medium with agarobacterium(Ti-plasmid transferred) to infect the leaf
Cells is grown in suspension medium (add shoot inducing solid medium) high in cytokinin culture for 2days

Shoot including solid medium+kanamycin+carbenicillin culture for about 20days

Shoot formation

                         Shoot callus is transfer to root inducing medium                                                                         

Root inducing solid medium (high in auxin+kanamycin+carbenicillin)                                                  

Transfer plantlets to soil


Agarobacterium cells attached to the leaf. Kanamycin, carbenicillin to kill division and differentiation of the  transformed cells.

Thursday, 6 August 2015

Agrobacterium tumefaciens and crown gall disease

Agrobacterium tumefaciens and crown gall disease

Introduction :

—                      1000’s of plant species are susceptible; they include especially rose, nut trees, grape, many shrubs and vines and perennial garden plants

                       roundish, rough-surfaced galls, several inches or more in diameter, usually at or near the soil line, or on roots and lower stems
The galls,  at first cream coloured or greenish, later turn brown or black.
Crown gall, disease of plants caused by Agrobacterium tumefaciens.

           Avoiding replanting for that period; removing severely infected plants (including as many roots as possible); protecting against injury; keeping down weeds; controlling root-chewing insects and nematodes; cutting away large galls on trees, and disinfecting the wounds

Agrobacterium tumefaciens

Ti plasmid

  —The ability to cause crown gall disease is associated with the presence of the Ti 
     (tumorinducing) plasmid within the bacterial cell. This is a large (greater than 200 kb) plasmid
  —that carries numerous genes involved in the infective process
  —The ability to cause crown gall disease is associated with the presence of the Ti plasmid within the bacterial cell.
  —This is a large (greater than 200 kb) plasmid
That carries numerous genes involved in the infective process
  —This segment, called the T-DNA, is between 15 and 30 kb in size, depending on the strain.
  It is maintained in a stable form in the plant cell and is passed on to daughter cells as an integral part of the chromosomes
  —A remarkable feature of the Ti plasmid is that, after infection, part of the molecule is integrated into the plant chromosomal DNA 
 —But the most remarkable feature of the Ti plasmid is that the T-DNA contains eight or so genes that are expressed in the plant cell and are responsible for the cancerous properties of the transformed cells.
  —These genes also direct synthesis of unusual compounds, called opines, that the bacteria use as nutrients.
  —In short, A. tumefaciens genetically engineers the plant cell for its own purposes

Thursday, 9 July 2015


Infectious Disease Serology


Diagnostic and immune status serologic assays are performed for various viral, rickettsial, bacterial, fungal, chlamydial and mycoplasmal agents. The assay methods vary depending upon the specific agent for which testing is requested. For specific agents and assay methods refer to Chart V - 1 SEROLOGICAL TESTS AVAILABLE FROM TDH LABORATORY.
Serological testing for infectious agents that are not performed by the Tennessee Department of Health (TDH) Laboratory may be available at the Centers for Disease Control and Prevention (CDC). Consult with the appropriate section at the Nashville laboratory before submitting specimens for testing. According to CDC's guidelines, all specimens submitted to the CDC must come through the state laboratory or receive the state laboratory's approval for direct shipment from the provider to the CDC.

Specimen Acceptance Policy

 Serological testing for HIV-1 is available only in support of counseling and testing sites established by the TDH Sexually Transmitted Diseases/HIV (STD/HIV) Control Program.
Other agents -- serological testing is available to all public and private health care providers.
Type of Specimen Required
Immunity Screening
 Immunity screening for rubella is intended for prenatal and family planning patients. Immunity screening for measles and mumps is not routinely available. Arrangements may be made with the TDH Laboratory to perform this screening on a case-by-case basis. A single, whole clotted blood or serum is required for rubella, measles, or mumps immunity screening.
Diagnostic Testing
As a rule, acute and convalescent sera must be submitted for serological testing. The acute serum should be collected as soon after the onset of illness as possible. For the majority of the serological testing offered by the TDH Laboratory, the convalescent serum should be collected 14 days from the time the acute specimen was collected. In most cases, the laboratory requests that the acute and convalescent sera be submitted at the same time. For those agents for which IgM is available, submit the acute specimen when it is collected. See Chart V - 1 SEROLOGICAL TESTS AVAILABLE FROM THE TDH LABORATORY.

 Infectious Disease Serology (Continued)

Chart V - 1
Serological Tests Available from the TDH Laboratory
Testing for infectious agents not listed in this chart may be available at the CDC.

Consult with the TDH Laboratory concerning testing not listed. Agent or Disease Suspected
Specimen Needed
Test Method
Normal Reference Range1
Turn Around Time (days)2
Eastern Equine encephalitis virus
Acute and convalescent(14 days) sera
Ehrlichia chaffeensis

Acute and convalescent(28 days) sera
Human immunodeficiency virus Type 1 (HIV-1)3
Whole, clotted blood or serum
Screening - EIA
Confirmation - WB
LaCrosse (California encephalitis group) virus
Acute and convalescent(14 days) sera
Legionella pneumoniae (Type 1-specific)
Acute and convalescent(28 days) sera
Measles virus4 (Rubeola)
Immunity Screening -- Whole clotted blood or serum
Positive (Immune)
Measles virus (Rubeola)4
Diagnostic -- Acute and convalescent (14 days) sera
Mumps virus4
Immunity Screening -- Whole clotted blood or serum
Mumps virus
Diagnostic -- Acute and convalescent (14 days) sera
Mycoplasma pneumoniae
Acute and convalescent(14 days) sera
Q Fever (Coxiella burnetii) Phases 1 and 2
Acute and convalescent(28 days) sera
Rocky Mountain Spotted Fever (Rickettsia rickettsii)
Acute and convalescent(28 days) sera
Rubella virus
Immunity Screening -- Whole clotted blood or serum
Infectious Disease Serology (Continued)
Chart V - 1 (continued)


Infectious Disease Serology (Continued)
Specimen Collection
1. Collect an acute serum as soon after the onset of the illness as possible. A convalescent serum should be collected 14 days after the collection of the acute serum. Exceptions to this general rule of collection of specimens are noted in Chart V - 1 SEROLOGICAL TESTS AVAILABLE FROM TDH LABORATORY
2. Draw at least 5 to 7 ml of blood into a red-top vacuum tube allowing the tube to fill completely. Allow the tube to stand at room temperature to ensure complete clotting of blood. Blood should not be taken for 1 hour after a meal to avoid chylous serum.
3. Store the specimen in a refrigerator until it is sent to the laboratory. If a sample of serum is to be sent to the laboratory, separate the serum from the blood clot by centrifuging the whole clotted blood at 1,500 to 2,000 rpm at room temperature for 10 minutes. Pipette the serum into a new red-top vacuum tube or a sterile plastic screw-capped vial. A minimum of 1 ml of serum should be sent to the laboratory for testing.
Serum-separating tubes may be used to collect the specimens for serological testing. These specimens should be sent to arrive in the testing laboratory within 48 to 72 hours of collection to avoid having the red blood cells hemolyze and "spill" into the upper portion of the tube.
4. Acute serum that is held until the collection of a convalescent serum should be separated from the blood clot and stored frozen until collection of the convalescent serum. Acute serum will not be tested routinely unless the TDH Laboratory offers testing for the IgM class of antibody for the analytic testing requested. Convalescent specimens may be run as stand alone specimens in limited situations. Consultation with the supervisor of the Serology Unit is required before the convalescent serum will be tested singly.
Spinal Fluid
Prior arrangement must be made with the TDH Laboratory before cerebrospinal fluid (CSF) specimens are submitted for serologic testing. The VDRL test for syphilis is routinely performed on CSF. The EIA test for West Nile Virus (WNV) IgM is performed on CSF seasonally.
Specimen Identification
1. Use the appropriate form for the test requested: Rubella
Rubella Form PH-1917
HIV-1 Serology Form PH-3173
Other non-syphilis serology
Immunoserology Form PH-1589

Infectious Disease Serology (Continued)
2. Using indelible ink, label each specimen with the patient's first and last name and the date of collection. Attach the tear strip number from the test request form to the specimen and secure it with transparent tape. Those providers submitting electronic test requests should affix a label produced by Laboratory Order Entry (LOE) to the associated specimen. Unlabeled specimens or specimens containing information that does not exactly match the information on the accompanying test request form or electronic record will not be tested.
Shipment of Specimens
1. Packing and shipping specimens to the state public health laboratory requires personnel trained in current regulations. Follow the shipping guidelines of your current carrier or shipping method.
2. Affix the mailing label (PH-0838), return address and other labeling required by pertinent regulations to the outer container.
1.     Ship to the Tennessee Department of Health Laboratory Services.

Syphilis Serology

Syphilis is a disease caused by infection with the spirochete Treponema pallidum. Serological tests greatly aid in the diagnosis of syphilis. Serologic assays used to screen patients for syphilis are non-treponemal tests. The non-treponemal test performed by the Tennessee Department of Health (TDH) Laboratory is the Rapid Plasma Reagin test (RPR). Quantitative RPR results may be used to monitor therapy for T. pallidum infections.
Confirmation of reactive RPR screening test results is obtained with specific treponemal tests for syphilis. The Treponema pallidum-Particle Agglutination test (TP-PA) is the TDH Laboratory's primary confirmatory test for T. pallidum-specific antibody. Suspected biologically false-positive results sometimes produced in the RPR test may be investigated with a TP-PA test. The Fluorescent Treponemal Antibody-Absorption-Double Stain Test (FTA-ABS-DS) also detects T. pallidum-specific antibody. It is available in limited circumstances. The TP-PA and FTA-ABS-DS are not screening procedures and are only performed when required for proper patient management.
The Venereal Disease Research Laboratory (VDRL) test is a non-treponemal test used to test cerebrospinal fluids (CSF). Positive test results are quantitated to aid in monitoring therapy for neurosyphilis. The RPR, TP-PA and FTA-ABS-DS tests are not performed on CSF.
Specimen Acceptance Policy
The TDH Laboratory performs serological procedures for syphilis in support of:
                The state prenatal law.
                The TDH Sexually Transmitted Disease Control Program.
                The private medical community for which the state laboratories serve as reference laboratories.
                Other State agencies for which the TDH Laboratory has contracted or agreed to perform tests.

Testing for syphilis, non-treponemal and treponemal-specific, is available to all health care providers.
Tennessee does not require premarital testing for syphilis.
Syphilis screening tests will be performed for persons who intend to be married in a state requiring premarital syphilis testing. The TDH Laboratory will send appropriate premarital forms for the state in which the wedding will be performed with the results of the laboratory tests. Other states may not accept premarital syphilis testing performed by laboratories other than state public heath laboratories such as the TDH Laboratory.
Type of Specimen Required

For the tests performed at the TDH Laboratory, the specimen required and the application of the test refer to Chart V - 2 SEROLOGICAL TESTS FOR SYPHILIS.