Detection of IFN-γ Secretion in Blood Samples Collected Before and After Treatment of Varying Stages of Lyme Disease

Abstract

Background QuantiFERON ELISA with Borrelia burgdorferi peptide antigens was previously shown to reliably detect IFN-γ in blood samples from adult patients with early Lyme disease and the response disappeared rapidly after treatment. We evaluated the response before and after appropriate antibiotic therapy in adolescent and adult subjects with more diverse stages of the illness. Methods Blood was obtained from clinician-identified Lyme disease patients with constitutional complaints, erythema migrans, nerve palsy, cardiac abnormality, or arthritis before (n = 68) and 6 weeks (n = 46) and 6 months (n = 45) after therapy. The sera were tested for Lyme disease by standard two-tiered testing (STTT) and anti-C6 antibodies by ELISA and the levels of IFN-γ in the blood samples were detected by QuantiFERON ELISA. Results A positive STTT result supported the clinical diagnosis of 37 (54%) subjects and anti-C6 antibodies were detected in 45 (66%) subjects, including 36 (97%) STTT-positive subjects, and the responses often persisted or expanded after antibiotic therapy. IFN-γ was detected in 49 (72%) subjects prior to treatment and the response most often significantly decreased 6 weeks (P = 0.007) or 6 months (P = 0.001) after treatment. Conclusions The QuantiFERON ELISA reliably detected IFN-γ in blood samples from adult and adolescent patients with varying stages of Lyme disease and the response disappeared rapidly after treatment. Additional studies to more critically evaluate clinical utility as a laboratory test for diagnosis and confirmation of effective therapy are warranted.

Borrelia burgdorferi Is a Poor Inducer of Gamma Interferon: Amplification Induced by Interleukin-12

“…For latent tuberculosis, the IGRA is widely accepted as a diagnostic tool (91), and studies have suggested similar techniques to discriminate active from past Q-fever using whole blood IFN-g assays (92,93). Two studies performed in Northern America reported a higher sensitivity for a whole blood IFN-g assay in EM patients compared to serology (37,94). However, we could not reproduce these findings in a European cohort (95), where B. afzelii is the most common cause of EM, in contrast to B. burgdorferi s.s. in Northern America.…”

Borrelia Burgdorferi Specific Serum and Cerebrospinal Fluid Antibodies in Lyme Neuroborreliosis

“…The results of the present study further strengthen the view that there are no serologic markers, which would unambiguously identify patients with ongoing LNB and, thus, in need of antibiotic treatment, although the absence of serum IgG VlsE reactivity to some degree argues against acute LNB. Therefore, novel approaches both in the direct detection of Borrelia, such as detection of cell-free DNA in human plasma [16], and in non-antibody based indirect methods, such as metabolite-profiling [17], or analysis of leucocyte response [18], are needed.…”