Antibody Response to IR₆, a Conserved Immunodominant Region of the VlsE Lipoprotein, Wanes Rapidly after Antibiotic Treatment ofBorrelia burgdorferiInfection in Experimental Animals and in Humans

Abstract

Invariable region (IR)(6), an immunodominant conserved region of VlsE, the antigenic variation protein of Borrelia burgdorferi, is currently used for the serologic diagnosis of Lyme disease in humans and canines. A longitudinal assessment of anti-IR(6) antibody levels in B. burgdorferi-infected rhesus monkeys revealed that this level diminished sharply after antibiotic treatment (within 25 weeks). In contrast, antibody levels to P39 and to whole-cell antigen extracts of B. burgdorferi either remained unchanged or diminished less. A longitudinal analysis in dogs yielded similar results. In humans, the anti-IR(6) antibody titer diminished by a factor of > or =4 in successfully treated patients and by a factor of <4 in treatment-resistant patients. This result suggests that the quantification of anti-IR(6) antibody titer as a function of time should be investigated further as a test to assess response to Lyme disease therapy or to determine whether a B. burgdorferi infection has been eliminated.

C 6 Test as an Indicator of Therapy Outcome for Patients with Localized or Disseminated Lyme Borreliosis

“…In humans, the anti-C 6 antibody titer diminished by a factor of Ն4 for successfully treated patients (n ϭ 30) and by a factor of Ͻ4 for treatment-resistant patients (n ϭ 4) (19). These preliminary results indicated that quantification of the anti-C 6 antibody titer as a function of time should be investigated as a test to assess the response to Lyme disease treatment (19).…”

“…It has been reported recently that levels of the antibody to C 6 declined after successful antibiotic treatment of either Lyme borreliosis patients or animals that had been experimentally infected with B. burgdorferi (19). In humans, the anti-C 6 antibody titer diminished by a factor of Ն4 for successfully treated patients (n ϭ 30) and by a factor of Ͻ4 for treatment-resistant patients (n ϭ 4) (19).…”

“…It has been reported recently that levels of the antibody to C 6 declined after successful antibiotic treatment of either Lyme borreliosis patients or animals that had been experimentally infected with B. burgdorferi (19). In humans, the anti-C 6 antibody titer diminished by a factor of Ն4 for successfully treated patients (n ϭ 30) and by a factor of Ͻ4 for treatment-resistant patients (n ϭ 4) (19). These preliminary results indicated that quantification of the anti-C 6 antibody titer as a function of time should be investigated as a test to assess the response to Lyme disease treatment (19).…”

Dogs Vaccinated with Common Lyme Disease Vaccines Do Not Respond to IR6, the Conserved Immunodominant Region of the VlsE Surface Protein ofBorrelia burgdorferi

“…Recently, a short segment of a B. burgdorferi surface protein named VlsE (Vmp-like sequence, expressed) has been used (9)(10)(11)(12)(13)(14)(15)(16), in addition to the full-length protein (7), to construct antibody detection assays that have excellent sensitivity and virtually eliminate false-positive results. This peptide, named C 6 , is 25 amino acids in length and reproduces the sequence of an immunodominant and conserved region (IR 6 ) of VlsE (12).…”

ROLE OF VlsE/C6 ANTIGEN AS A MARKER FOR EARLY LYME BORRELIOSIS DIAGNOSIS AND MONITORING THE EFFECTIVENESS OF ITS TREATMENT

“…Unlike the other IgG antibodies, anti-VlsE / C6 disappear relatively quickly after the antibiotic therapy is introduced, which prompted researchers to think of monitoring them in order to assess the effectiveness of the treatment. In one of the first publications on this subject, Philipp et al examined antibody titers against C6 in rhesus monkeys and dogs infected with Borrelia [24]. The study included 7 adult rhesus, in whom there was observed a rise of anti-C6 IgG antibody titer for 12 weeks after the infection to the antibiotic therapy.…”