Improved immunoglobulin M serodiagnosis in Lyme borreliosis by using a mu-capture enzyme-linked immunosorbent assay with biotinylated Borrelia burgdorferi flagella.

Abstract

A mu-capture enzyme-linked immunosorbent assay (ELISA) for detection of serum immunoglobulin M (IgM) antibodies to Borrelia burgdorferi by using biotinylated purified B. burgdorferi flagella was developed. The diagnostic performance of the mu-capture ELISA was compared with that of a conventional indirect ELISA. Sera from untreated patients with erythema migrans (n = 50), neuroborreliosis (n = 100), and acrodermatitis chronica atrophicans (ACA; n = 48) were investigated. The cutoff of the ELISAs was adjusted to a diagnostic specificity of 98% on the basis of examination of 200 serum specimens from healthy controls. The mu-capture ELISA increased the diagnostic sensitivity in patients with erythema migrans from 32 to 48% (P less than 0.01) and in patients with neuroborreliosis from 37 to 57% (P less than 0.001). Because of an increased signal/noise ratio, the mu-capture ELISA yielded a significantly better quantitative discrimination of individual positive measurements from the cutoff (P less than 0.001). The increased signal/noise ratio was most likely a consequence of the elimination of IgG competition for the test antigen. This may also explain why 12% of patients with ACA showed significantly increased specific IgM levels only by the mu-capture ELISA. Of patients with ACA, 27% had IgM rheumatoid factor. The mu-capture principle with a directly labeled antigen showed no interference with IgM rheumatoid factor, in contrast to the indirect ELISA. The high diagnostic performance and ease of this three-step mu-capture ELISA make it suitable for routine anti-B. burgdorferi IgM serodiagnosis.

• Authors: K Hansen, K Pii, A M Lebech
• Journal: Journal of clinical microbiology (J Clin Microbiol) Vol. 29 Issue 1 Pg. 166-73 (Jan 1991) ISSN: 0095-1137 [Print] United States
• PMID: 1993753 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antigens, Bacterial
• Immunoglobulin M
• Biotin

Topics

• Adolescent
• Adult
• Aged
• Antigens, Bacterial (immunology)
• Binding, Competitive
• Biotin
• Borrelia burgdorferi Group (immunology)
• Child
• Dermatitis (complications)
• Enzyme-Linked Immunosorbent Assay
• Erythema Chronicum Migrans (complications)
• Female
• Humans
• Immunoglobulin M (analysis)
• Lyme Disease (complications, diagnosis)
• Male
• Middle Aged
• Sensitivity and Specificity