Serological Follow-up after Treatment of Borrelia Arthritis and Acrodermatitis Chronica Atrophicans

Hammers-Berggren, Susanne; Lebech, Anne‐Mette; Karlsson, M.; Andersson, Ulf; Hansen, Klaus; Stiernstedt, Göran

doi:10.3109/00365549409011804

Cited by 16 publications

(7 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In 16 patients a late scrum sample was obtained on average 9 years after treatment, and 14 patients still showed IgG antiflagellum antibodies. This clearly illustrates that such antibodies are present in a considerable number of patients several years after successful treatment and clinical regression, and thereby corroborates and extends the findings of several previous studies (15,17,(21)(22)(23)(24).…”

Section: Discussionsupporting

confidence: 90%

Long-term Serological Follow-up of Patients Treated for Chronic Cutaneous Borreliosis or Culture-positive Erythema Migrans

Lomholt

Lebech²,

Hansen³

et al. 2000

Acta Dermato-Venereologica

View full text Add to dashboard Cite

The kinetics of antibodies to Borrelia burgdorferi following successful treatment of early and late cutaneous borreliosis were analysed in consecutive serum samples by an enzyme-linked immunosorbent assay (ELISA) technique. Twenty-three patients with culture positive erythema migrans were followed for 23+/-14 months: 41% stayed seronegative, 35% showed an isolated immunoglobulin M (IgM) response, 8% an isolated IgG response and 16% a combined IgM and IgG responses. In general, antibody levels peaked within the first 3 months of symptom onset, whereafter a gradual decline was observed within 1 year. Twenty-two patients with chronic cutaneous borreliosis were followed for 23+/-11 months and all patients stayed IgG positive. Nearly three-quarters showed a clear decline in IgG levels over the years, while the rest did not. After 9+/-1 years 88% of 16 patients examined were still IgG positive. In conclusion, treatment of erythema migrans should be initiated on clinical appearance as a substantial number of patients stayed seronegative. Treatment success may in part be monitored serologically for both seropositive erythema migrans and chronic cutaneous borreliosis as most patients show declining titres after successful treatment. However, continuously high titres do not necessarily indicate treatment failure.

show abstract

Section: Discussionsupporting

confidence: 90%

Long-term Serological Follow-up of Patients Treated for Chronic Cutaneous Borreliosis or Culture-positive Erythema Migrans

Lomholt

Lebech²,

Hansen³

et al. 2000

Acta Dermato-Venereologica

View full text Add to dashboard Cite

show abstract

“…Con¬ sequently, the presence or absence of circulating anti¬ bodies to B burgdorferi after antibiotic therapy is not a reliable indicator of cure.36 However, in European stud¬ ies in which consecutive samples from the same pa¬ tients were tested at the same time, the decrease in an¬ tibody titers seemed to be a reliable indicator of cure. 37,38 In contrast, in a study from the United States, no corre¬ lation between the persistence or recurrence of signs and symptoms of Lyme borreliosis and the persistence of an¬ tibodies to B burgdorferi determined by ELISA or immunoblot could be found.34 We could not compare past and present antibody titers because we had no information about previous laboratory methods or antibody concen¬ trations at that time.…”

Section: Antibiotic Treatmentmentioning

confidence: 96%

Long-term Prognosis in Patients Treated for Erythema Chronicum Migrans and Acrodermatitis Chronica Atrophicans

Hulshof¹

1997

Arch Dermatol

View full text Add to dashboard Cite

“…Secondly, viral infections cause false-positive IgM results in several LB tests (4). Thirdly, in a subgroup of patients antibody levels may stay high after successful treatment of LB even for prolonged periods (6,15).…”

mentioning

confidence: 99%

Recombinant Flagellin A Proteins from Borrelia burgdorferi Sensu Stricto, B . afzelii , and B. garinii in Serodiagnosis of Lyme Borreliosis

Panelius¹,

Lahdenne

Saxén

et al. 2001

J Clin Microbiol

View full text Add to dashboard Cite

Genes for flagellin A (FlaA) proteins from European borrelial strains of Borrelia burgdorferi sensu stricto, B. afzelii, and B. garinii were cloned and sequenced. An identity of 92 to 93% was observed in the flaA sequences of the different species. Polyhistidine-tagged recombinant FlaA (rFlaA) proteins were produced in Escherichia coli and used as antigens in Western blotting (WB) and enzyme-linked immunosorbent assay (ELISA). In immunoglobulin G (IgG) WB, 71% (10 of 14) of the sera from neuroborreliosis and 86% (12 of 14) of those from Lyme arthritis patients reacted with one to three rFlaAs. In IgG ELISA, 74% (14 of 19) and 79% (15 of 19) of patients with neuroborreliosis and arthritis, respectively, were positive. The immunoreactivity in local European patient sera was stronger against rFlaA from B. garinii and B. afzelii than against rFlaA from B. burgdorferi sensu stricto. Neither IgG nor IgM ELISA was sensitive in the serodiagnosis of erythema migrans. Serum samples from patients with syphilis and systemic lupus erythematosus showed mild cross-reactivity in IgG tests. Sera from Yersinia enterocolitica or beta-hemolytic Streptococcus infections showed only occasional responses. With IgM ELISA, 58% (11 of 19) and 37% (7 of 19) of patients with neuroborreliosis and arthritis, respectively, were positive. Cross-reactive antibodies to FlaA, especially in serum samples from patients with rheumatoid factor positivity and Epstein-Barr virus infection, reduced the specificity of IgM serodiagnosis. Therefore, rFlaA seems to have a limited role for IgM serodiagnosis, yet rFlaA might be useful in the IgG serodiagnosis of disseminated Lyme borreliosis.Laboratory diagnosis of Lyme borreliosis (LB) is mainly based on serology, although the present serologic tests have unsatisfactory sensitivity and specificity (34). Routine laboratory testing uses enzyme-linked immunosorbent assays (ELISA) with borrelial whole-cell lysate (WCL) or flagella (consisting mainly of polymerized FlaB protein) as the most commonly used antigens. A two-step approach with ELISA followed by a confirmatory Western blot (WB) has been recommended for positive or borderline results (19,36). Especially in Europe, the applicability of this procedure has, however, remained doubtful (3, 14) because three or more borrelial species cause LB (38). Several difficulties complicate LB serology. Firstly, immunoglobulin G (IgG) antibody responses are often delayed during the early stages of LB. Even at late-stage LB, 5 to 10% of patients do not have elevated antibody levels (29), perhaps due to diversion of the host immune response towards Th1 immunity by borrelial factors (17). Secondly, viral infections cause false-positive IgM results in several LB tests (4). Thirdly, in a subgroup of patients antibody levels may stay high after successful treatment of LB even for prolonged periods (6, 15).Several recombinant borrelial antigens (OspA, OspB, OspC, OspE, OspF, p22, BmpA, BBK32, BBK50, VlsE, p100, 14-kDa internal flagellin fragment) (5,7,16,21,22,24,25,31,35) and...

show abstract

Serological Follow-up after Treatment of Borrelia Arthritis and Acrodermatitis Chronica Atrophicans

Cited by 16 publications

References 15 publications

Long-term Serological Follow-up of Patients Treated for Chronic Cutaneous Borreliosis or Culture-positive Erythema Migrans

Long-term Serological Follow-up of Patients Treated for Chronic Cutaneous Borreliosis or Culture-positive Erythema Migrans

Long-term Prognosis in Patients Treated for Erythema Chronicum Migrans and Acrodermatitis Chronica Atrophicans

Recombinant Flagellin A Proteins from Borrelia burgdorferi Sensu Stricto, B . afzelii , and B. garinii in Serodiagnosis of Lyme Borreliosis

Contact Info

Product

Resources

About