Measurement of antibodies to the Borrelia burgdorferi flagellum improves serodiagnosis in Lyme disease

Abstract

The isolation of Borrelia burgdorferi flagella and an enzyme-linked immunosorbent assay (ELISA) for detection of immunoglobulin G (IgG) and IgM to the B. burgdorferi flagellum are described. The diagnostic performance of the flagellum ELISA for serodiagnosis of Lyme disease was compared with the performance of a traditional whole cell B. burgdorferi sonic extract ELISA. We examined sera and cerebrospinal fluid (CSF) from 56 patients with lymphocytic meningoradiculitis (Bannwarth's syndrome), the most frequent secondarystage manifestation of Lyme disease in Europe. Two hundred healthy individuals and patients with aseptic meningitis, encephalitis, Guillain-Barré syndrome, and syphilis served as controls. The flagellum ELISA was significantly more sensitive than the sonic extract ELISA. The diagnostic sensitivities were increased from 41.1 to 76.8% (P < 0.01) for IgG and from 35.7 to 67.9% (P < 0.05) for IgM detection in serum. The increase in sensitivity was most pronounced in patients with a short duration of disease (<20 days after onset). The diagnostic specificity increased for IgG detection but was almost unaltered for IgM. The flagellum ELISA did not improve the diagnostic sensitivity of measuring antibodies to borreliae in CSF, most likely owing to the low level of unspecific antibodies in CSF compared with serum. The cross-reactivity of sera and CSF from patients with syphilis decreased significantly. The flagellum antigen of B. burgdorferi shows no strain variation, is easy to purify in sufficient quantity, and is therefore a suitable reference antigen for routine serodiagnosis of Lyme disease.

Lyme Neuroborreliosis: Evidence for Persistent Up‐Regulation of Borrelia Burgdorferi‐Reactive Cells Secreting Interferon‐γ

“…Antigens and mitogens. B. burgdorferi strain ACA 1 isolated from the skin of a Swedish patient with acrodermatitis chronica atrophicans was provided by Dr K. Hansen (Statens Seruminstitute, Copenhagen, Denmark) and prepared as described previously [9]. A dilution of this antigen preparation to I ^g of protein/ml was used for coating in the ELlspot assays.…”

Light Chain Distribution of Anti‐Borrelia burgdorferi IgG Antibodies in Lyme Arthritis

“…Sonicated whole B. burgdorferi antigen was obtained from Dr K. Hansen (Stalens Seruminstitute. Copenhagen, Denmark) and prepared as previously described [10].…”

“…Anti-fi. burgdorferi IgG aniibodies were measured by enzyme-linked immunosorbenl assay as previously described[10]: the upper reference OD value was 0.160…”

Characterization of an anti‐Borrelia burgdorferi OspA conformational epitope by limited proteolysis of monoclonal antibody‐bound antigen and mass spectrometricpeptide mapping

“…The native OspA was obtained from B. burgdorferi type strain B31 ATCC 35210! cultures and purified according to Hansen et al 1988!. The protein was then immunopurified to homogeneity with the mouse monoclonal anti-OspA 4C10C2.…”