Cross-Reactivity in Serological Tests for Lyme Disease and Other Spirochetal Infections

Abstract

Serum specimens from 163 persons with Lyme disease, tick-borne or louse-borne relapsing fever, yaws, syphilis, leptospirosis, or Rocky Mountain spotted fever were analyzed to assess the specificity of indirect fluorescent antibody (IFA) tests, an enzyme-linked immunosorbent assay (ELISA), and microscopic agglutination (MA) procedures. Strong cross-reactivity occurred when sera from individuals with Lyme disease, tick-borne relapsing fever, and louse-borne relapsing fever were tested against heterologous Borrelia antigens. Antibodies to Borrelia burgdorferi bound to Treponema pallidum in immunofluorescence tests for syphilis. Sera from subjects with syphilis cross-reacted in IFA tests and the ELISA for Lyme disease. Immunoglobulin antibodies to Borrelia or Treponema spirochetes, however, did not react with serovars of Leptospira interrogans in MA or IFA tests, and the prevalence of false-positive results in the reciprocal analyses was negligible.

Antibodies to Borrelia burgdorferi in Dogs in Hokkaido

“…Cross-reactivity occurred in both tests with sera from human patients with other spirochetal diseases, because the causative organisms are taxonomically related and common antigens have been described for various spirochetes (12). It can not be a diagnostic problem with canine leptospirosis, because cross-reactivity is not a diagnostic problem with leptospiral infection in man.…”

Comparative reactivity of human sera to recombinant VlsE and other Borrelia burgdorferi antigens in class-specific enzyme-linked immunosorbent assays for Lyme borreliosis

“…All HGE patients in the second and third groups had thrombocytopenia or leukopenia; serum samples were obtained 3-5 weeks after onset of illness. To further assess specificities, human sera were also selected from frozen collections representing the following study groups: syphilis (24 serum samples), louse-borne relapsing fever (11), acute necrotising ulcerative gingivitis or periodontitis (6), and rheumatoid arthritis (7). Clinical findings, sources of sera and serological reactivities for the specimens in these four groups have been reported previously [6,9].…”

“…Difficulties associated with the sensitivities and specificities of these assays, inter-laboratory discrepancies due to nonstandardised tests, complications due to co-migration of proteins of similar molecular masses in blots, and higher costs of performing immunoblot analyses are important limitations. Moreover, the use of whole-cell, sonicated antigens of B. burgdorferi in ELISAs can yield false positive results [6,7] due to cross-reactivity of antibodies to treponemes or other bacteria.…”

Canine surveillance system for Lyme borreliosis in Wisconsin and northern Illinois: geographic distribution and risk factor analysis.

“…Sera were diluted 1:320 to reduce crossreactivity with heterologous antibodies. 7,[29][30][31][32] The antigen used in the ELISA was a heat-killed, sonicated B. burgdorferi spirochete suspension (Kirkegaard and Perry, Gaithersburg, MD) diluted 1:100 in carbonate-bicarbonate coating buffer (27.6 mM Na 2 CO 3 , 19 mM NaHCO 3 , pH 9.6). Test sera were diluted in blocking buffer (5% wt/vol blotting grade dehydrated milk [Bio-Rad, Hercules, CA] in phosphate-buffered saline).…”