Evaluation of in vivo expressed Borrelia burgdorferi antigens for improved IgM serodiagnosis of early Lyme disease.

Abstract

Improved serologic tests are needed for accurate diagnosis and proper treatment of early stage Lyme disease. We evaluated the 3 antigens currently used for 2-tiered IgM immunoblot testing (FlaB, OspC, and BmpA) in combination with 3 additional antigens (BBA65, BBA70, and BBA73) and measured the sensitivity and specificity against a serum repository of positive and negative controls. Using 3 statistical methods for positivity cutoff determinations and scoring criteria, we found increased sensitivities for early Lyme disease when 2 of 6 antigens were positive as compared with the 2 of 3 antigen IgM criteria currently used for second-tier immunoblot scoring. Specificities for negative controls were comparable or superior to using 2 of 3 antigens. These results indicate that IgM sensitivity and specificity of serological testing for Lyme disease in the early stages of illness can be improved by employing antigens that target the initial host antibody responses.

• Authors: Kevin S Brandt, Amy J Ullmann, Claudia R Molins, Kalanthe Horiuchi, Brad J Biggerstaff, Robert D Gilmore
• Journal: Diagnostic microbiology and infectious disease (Diagn Microbiol Infect Dis) Vol. 93 Issue 3 Pg. 196-202 (Mar 2019) ISSN: 1879-0070 [Electronic] United States
• PMID: 30344068 (Publication Type: Comparative Study, Evaluation Study, Journal Article)
• Copyright: Copyright © 2018 Elsevier Inc. All rights reserved.

Chemical References

• Antibodies, Bacterial
• Antigens, Bacterial
• Immunoglobulin M
• Recombinant Proteins

Topics

• Antibodies, Bacterial (blood)
• Antigens, Bacterial (genetics, immunology)
• Borrelia burgdorferi (immunology, isolation & purification)
• Enzyme-Linked Immunosorbent Assay (standards)
• Erythema Chronicum Migrans (diagnosis)
• Humans
• Immunoglobulin M (blood)
• Lyme Disease (diagnosis)
• Recombinant Proteins (immunology)
• Sensitivity and Specificity
• Serologic Tests