C6 peptide ELISA test in the serodiagnosis of Lyme borreliosis in Sweden

Tjernberg, Ivar; Krüger, Gerhard; Eliasson, Ingvar

doi:10.1007/s10096-006-0239-3

Cited by 40 publications

(40 citation statements)

References 14 publications

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“…All this together may explain why the seroprevalence was higher among the participants from the Åland Islands compared to the participants from South Central Sweden and from Southernmost Sweden. The seroprevalence in the TBD STINGstudy (20%) is within the range of those reported from other Europe-an studies: in healthy blood donors the seroprevalence ranged between 2 and 24% (Ekerfelt et al, 2001;Fahrer et al, 1991a;Gustafson et al, 1993a;Hristea et al, 2001;Tjernberg et al, 2007;Tomao et al, 2005); in people living in endemic regions between 7 and 29% (Berglund & Eitrem, 1993;Carlsson et al, 1998;Gustafson et al, 1993b;Werner et al, 2001); and for people in high-risk groups (outdoor workers, orienteers and hunters) between 9 and 54% (Cetin et al, 2006;Fahrer et al, 1991a;Gustafson et al, 1993a;Hristea et al, 2001;Tomao et al, 2005).…”

Section: Are There Gender-and Geographical Differences In the Borrelisupporting

confidence: 65%

A STING from a Tick : Epidemiology, Ecology and Clinical Aspects of Lyme Borreliosis

Wilhelmsson¹

2014

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Section: Are There Gender-and Geographical Differences In the Borrelisupporting

confidence: 65%

A STING from a Tick : Epidemiology, Ecology and Clinical Aspects of Lyme Borreliosis

Wilhelmsson¹

2014

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“…Although LB and multiple episodes of LB are primarily related to a certain part of the population with behavioural habits generating a higher risk of tick bites, the population which previously had LB will expand and may cause further difficulties that must be taken into account when interpreting borrelia serology. A known problem of borrelia serology in our area is a high seroprevalence (8-14%) in the healthy adult population most probably generated by a previous exposure to Borrelia with a persisting detectable antibody response for many years not related to clinical symptoms or signs (Tjernberg et al 2007). In this sense, seropositivity rates for all IR 6 peptides were indeed significantly higher in patients with self-reported previous LB as compared to those who did not report previous LB.…”

Section: Discussionmentioning

confidence: 65%

“…Patients with LB in Kalmar County in Sweden were prospectively included in a clinical study in 2003 (Tjernberg et al, 2007). Clinical data was recorded in a study protocol and serum samples were drawn at the first consultation (sample I), at 2-3 months (sample II) and 6 months (sample III), see Table 1 and Table 2.…”

Section: Methodsmentioning

confidence: 99%

“…Recently, a commercial ELISA using a synthetic 26-mer peptide antigen called C6 has been evaluated and introduced in the serodiagnosis of LB (Cinco and Murgia, 2006;Smismans et al, 2006;Nyman et al, 2006;Tjernberg et al, 2007;Sillanpää et al, 2007). The C6 antigen is based on the sixth invariant region (IR 6 ) of the variable major protein-like sequence, expressed (VlsE) by B. garinii (Liang et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

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Antibody responses to borrelia IR6 peptide variants and the C6 peptide in Swedish patients with erythema migrans

Tjernberg

Sillanpää

Seppälä

et al. 2009

International Journal of Medical Microbiology

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The aim of this study was to evaluate the antibody responses to different VlsE protein IR6 peptide variants and the synthetic C6 peptide in acute and convalescent (2-3 and 6 months) serum samples from Swedish patients with clinical erythema migrans (EM). Serum samples were prospectively collected from 148 patients with EM and compared to serum samples obtained from 200 healthy blood donors. The IgG responses to 3 IR6 peptide variants originating from Borrelia burgdorferi (B. burgdorferi) sensu stricto, B. garinii, and B. afzelii were measured by enzyme-linked immunosorbent assays (ELISAs) and compared to a commercial C6 peptide ELISA. Seropositivity rate in the IR6 or C6 peptide ELISAs ranged from 32% to 58% at presentation, 30-52% after 2-3 months, and 20-36% after 6 months. At presentation, positive antibodies in any of the 4 ELISAs were found in 66%. In 7/52 (13%), C6-negative EM cases, serological reaction was found to the B. burgdorferi sensu stricto-derived IR6 peptide. In patients reporting previous LB compared to those without previous LB, significantly higher seropositivity rates were noted for all IR6 peptides, but not for the C6 peptide. In the serology of EM in Europe, C6 ELISA does not seem to cover all cases. An ELISA using a mixture of B. burgdorferi sensu stricto IR6 peptide and the C6 peptide could be of value in the serodiagnosis of LB in Europe. Further studies on combinations of variant IR6 peptides and the C6 peptide in other manifestations of LB are needed to address this issue.Original Publication:Ivar Tjernberg, H. Sillanpaa, I. Seppala, I. Eliasson, Pia Forsberg and P. Lahdenne, Antibody responses to borrelia IR6 peptide variants and the C6 peptide in Swedish patients with erythema migrans, 2009, International Journal of Medical Microbiology, (299), 6, 439-446.http://dx.doi.org/10.1016/j.ijmm.2008.10.006Copyright: Elsevier Science B. V. Amsterdamhttp://www.elsevier.com

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“…The C6 assay does not distinguish between IgG and IgM antibodies. Both assays have been described in previous publications from Scandinavian studies (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). The C6 assay was implemented on a Bio-Rad Coda microplate processor, and the IDEIA ELISA was performed manually.…”

Section: Methodsmentioning

confidence: 99%

Study of a Cohort of 1,886 Persons To Determine Changes in Antibody Reactivity to Borrelia burgdorferi 3 Months after a Tick Bite

Dessau¹,

Fryland²,

Wilhelmsson³

et al. 2015

Clin. Vaccine Immunol.

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Lyme borreliosis is a tick-borne disease caused by the bacterium Borrelia burgdorferi. The most frequent clinical manifestation is a rash called erythema migrans. Changes in antibody reactivity to B. burgdorferi 3 months after a tick bite are measured using enzyme-linked immunosorbent assays (ELISAs). One assay is based on native purified flagellum antigen (IgG), and the other assay is based on a recombinant antigen called C6 (IgG or IgM). Paired samples were taken at the time of a tick bite and 3 months later from 1,886 persons in Sweden and the Åland Islands, Finland. The seroconversion or relative change is defined by dividing the measurement units from the second sample by those from the first sample. The threshold for the minimum level of significant change was defined at the 2.5% level to represent the random error level. The thresholds were a 2.7-fold rise for the flagellar IgG assay and a 1.8-fold rise for the C6 assay. Of 1,886 persons, 102/101 (5.4%) had a significant rise in antibody reactivity in the flagellar assay or the C6 assay. Among 40 cases with a diagnosis of Lyme borreliosis, the sensitivities corresponding to a rise in antibodies were 33% and 50% for the flagellar antigen and the C6 antigen, respectively. Graphical methods to display the antibody response and to choose thresholds for a rise in relative antibody reactivity are shown and discussed. In conclusion, 5.4% of people with tick bites showed a rise in Borrelia-specific antibodies above the 2.5% threshold in either ELISA but only 40 (2.1%) developed clinical Lyme borreliosis. Borrelia burgdorferi sensu lato is transmitted by hard ticks (Ixodes ricinus or Ixodes persulcatus) throughout Europe, especially in the temperate climate zone. Both the vector and the bacterium are prevalent in southern Scandinavia, and ticks frequently attach to humans and occasionally transmit B. burgdorferi (1-4). Lyme borreliosis (LB) is also common in parts of the United States. The term B. burgdorferi sensu lato denotes a species complex belonging to the genus Borrelia and is herein designated simply B. burgdorferi or Borrelia. The most frequent species infecting humans in Europe are B. afzelii, B. garinii, and B. burgdorferi sensu stricto. In the United States, the only prevalent species is B. burgdorferi sensu stricto. The infections may involve the nervous system, the skin, the joints, and the heart. The most frequent manifestation is a characteristic skin lesion called erythema migrans (EM).This study was based on data from the tick-borne diseases (TBD) STING study (www.stingstudien.se). Ticks that had bitten humans in the Åland Islands, Finland, and different parts of Sweden were collected and analyzed at Linköping University (2-5). The focus of this study was to analyze the differences in the measurements of B. burgdorferi-specific antibodies in the paired samples and propose methods for detecting changes in antibody reactivity. Although the concept of antigen-induced stimulation and seroconversion has broad application in diagnostic medicine, epidem...

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C6 peptide ELISA test in the serodiagnosis of Lyme borreliosis in Sweden

Cited by 40 publications

References 14 publications

A STING from a Tick : Epidemiology, Ecology and Clinical Aspects of Lyme Borreliosis

A STING from a Tick : Epidemiology, Ecology and Clinical Aspects of Lyme Borreliosis

Antibody responses to borrelia IR6 peptide variants and the C6 peptide in Swedish patients with erythema migrans

Study of a Cohort of 1,886 Persons To Determine Changes in Antibody Reactivity to Borrelia burgdorferi 3 Months after a Tick Bite

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