Western blot method as a necessary step of serodiagnostics of Lyme disease
More details
Hide details
Online publication date: 2012-11-06
Reumatologia 2012;50(5):397-402
Introduction: Concerning the variety of clinical symptoms of Lyme disease, and their subsequent health consequences, serological diagnosis of Lyme disease requires an absolute confirmation of the presence of specific antibodies. The only use of the screening ELISA test, very sensitive but not specific, may lead to false-positive results. Use of the much more specific Western blot method, based on recombinant B. Burgdorferi antigens, increases the reliability of diagnosis.
Material and methods: The study included 354 positive sera in the ELISA screening test for the presence of IgG and/or IgM anti B. Burgdorferi antibodies. Positivity of sera was confirmed by Western blot, with specific recombinant antigens.
Results: The results varied significantly depending on the confirmed class of antibodies. The presence of specific antibodies against B. Burgdorferi was confirmed in about 79.4% of positive sera in ELISA for IgG class and in 34.2% for IgM class (Fig. 1). In both classes of antibodies (IgG and IgM), a correlation between the percentage of anti-Borrelia antibodies confirmed by Western blot and their level in the ELISA test was found (Fig. 2). Detailed analysis showed that the most common antibodies to recombinant antigens were VlsE (96.9%) in IgG class and OspC (96.8%) for genospecies of B. garinii and B. afzeliiin IgM class (Fig. 3).
Conclusions: The results were discussed regarding usefulness in the diagnosis and determination of the stage of possible infection of B. Burgdorferi. The reasons for the low (especially in IgM class) confirmation of positive results obtained in the ELISA screening method were also discussed.
Schnarr S, Franz JK, Krause A, et al. Lyme borreliosis. Best Pract Res Clin Rheum 2006; 20: 1099-1118.
Zajkowska J. Transmisja i krążenie patogenów odkleszczowych (KZM i boreliozy) i rola zmieniającego się środowiska. Przegl Epidem 2010; 64: 525-531.
Steere AC, Coburn J, Glickstein L. The emergence of Lyme disease. J Clin Invest 2004; 113: 1093-1101.
Steere AC, Bartenhagen NhH, Draft IE, et al. The early clinical manifestations of Lyme disease. Ann Intern Med 1983; 99: 76-82.
Marques A. Chronic Lyme disease: a review. Infect Dis Clin North Am 2008; 22: 341-360.
Chmielewski T, Tylewska-Wierzbanowska S. Borelioza z Lyme, laboratoryjne metody rozpoznania zakażenia. Diagn Lab 2007; 14: 5-7.
Witecka-Knysz E, Klimczak M, Lakwa K i wsp. Borelioza: dlaczego diagnostyka jest taka trudna. Diagnosta Lab 2007; 13: 11-13;.
Asbrink E, Hovmark A. Early and late cutaneus manifestations of Ixodes – borne borreliosis (erythema migrans borreliosis, Lyme borreliose). Ann N Y Acad Sci 1988; 4-5.
Richter D, Schlee DB, Algower R, et al. Relationships of a novel Lyme disease spirochete, Borrelia spielmani sp. nov. with its hosts in Central Europe. Appl Environ Microbiol 2004; 70: 6414-6419.
Wormser GP, Bittker S, Cooper D, et al. Yield of large-volume blood cultures in patients with early Lyme disease. J Infect Dis 2001; 184: 1070-1072.
Nocton JJ, Dressler F, Rutledge BJ, et al. Detection of Borrelia burgdorferi DNA by polymerase chain reaction in synovial fluid from patients with Lyme arthritis. New Engl J Med 1994; 330: 229-234.
Schmidt BL. PCR in laboratory diagnosis of human Borrelia burgdorferi infections. Clin Microbiol Rev 1997; 10: 185-201.
Robertson J, Guy E, Andrews N, et al. A European multicenter study of immunobloting in serodiagnosis of Lyme borreliosis .J Clin Microbiol 2000; 38: 2097-2102.
Dinser R, Jendro MC, Schnarr S, et al. Antibiotic treatment of Lyme borreliosis: what is the evidence? Ann Rheum Dis 2005; 64: 519-523.
Borg R, Dotevall L, Hagberg L, et al. Intravenous ceftriaxone compared with oral doxycycline for the treatment of Lyme neuroborreliosis. Scand J Infect Dis 2005; 37: 449-454.
Coleman JL, Benach JL. Identification and characterization of an endoflagellar antigen of Borrelia burgdorferi. J Clin Invest 1989; 84: 322-330;.
Bruckbauer HR, Preac-Mursic V, Fuchs R, et al. Cross-reactive proteins of Borrelia burgdorferi. Eur J Clin Microbiol Infect Dis 1992; 11: 224-232.
Wallich R, Moter SE, Simon MM, et al. The Borrelia burgdorferi flagellum – associated 41-kilodalton antigen (flagellin): molecular cloning, expression, and amplification of the gene. Infect Immun 1990; 58: 1711-1719.
Schutzer SE, Coyle PK, Belman AL, et al. Sequestration of antibody to Borrelia burgdorferi in immune complexes in seronegative Lyme disease. Lancet 1990; 335: 312-315.
Miąskiewicz K, Walczak E, Rogulska K i wsp. Propozycja nowego podejścia metodycznego i interpretacji wyników oznaczania przeciwciał przeciwko Borrelia burgdorferi – analiza składu przeciwciałowego krążących kompleksów immunologicznych. Reumatologia 2011; 49: 1-7.
Wilske B, Preac-Mursic V, Fuchs R, et al. Immunodominant proteins of Borrelia burgdorferi: implications for improving serodiagnosis of Lyme borreliosis. In: New Antibacteriological Strategies Neu HC (ed.). Churchill Livingstone, London 1990; 47-63.
Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Journals System - logo
Scroll to top