scholarly journals 2‐Tiered Antibody Testing for Early and Late Lyme Disease Using Only an Immunoglobulin G Blot with the Addition of a VlsE Band as the Second‐Tier Test

2010 ◽  
Vol 50 (1) ◽  
pp. 20-26 ◽  
Author(s):  
John A. Branda ◽  
Maria E. Aguero‐Rosenfeld ◽  
Mary Jane Ferraro ◽  
Barbara J. B. Johnson ◽  
Gary P. Wormser ◽  
...  
Keyword(s):  
Lyme Disease ◽  
Immunoglobulin G ◽  
Antibody Testing ◽  
Second Tier

scholarly journals Arthritis and Diagnostics in Lyme Disease

2021 ◽  
Vol 6 (1) ◽  
pp. 18
Author(s):  
Javier A. Quintero ◽  
Raluchukwu Attah ◽  
Reena Khianey ◽  
Eugenio Capitle ◽  
Steven E. Schutzer
Keyword(s):  
Lyme Disease ◽  
Borrelia Burgdorferi ◽  
Diagnostic Tests ◽  
Laboratory Tests ◽  
Diagnostic Methods ◽  
Lyme Arthritis ◽  
Differential Diagnoses ◽  
Antibody Testing ◽  
Active Infection ◽  
Indirect Measure

The diagnosis of Lyme disease, caused by Borrelia burgdorferi, is clinical but frequently supported by laboratory tests. Lyme arthritis is now less frequently seen than at the time of its discovery. However, it still occurs, and it is important to recognize this, the differential diagnoses, and how laboratory tests can be useful and their limitations. The most frequently used diagnostic tests are antibody based. However, antibody testing still suffers from many drawbacks and is only an indirect measure of exposure. In contrast, evolving direct diagnostic methods can indicate active infection.

scholarly journals Evaluation of bioMérieux's Dissociated Vidas Lyme IgM II and IgG II as a First-Tier Diagnostic Assay for Lyme Disease

2017 ◽  
Vol 55 (6) ◽  
pp. 1698-1706 ◽  
Author(s):  
Claudia R. Molins ◽  
Mark J. Delorey ◽  
Adam Replogle ◽  
Christopher Sexton ◽  
Martin E. Schriefer
Keyword(s):  
United States ◽  
Lyme Disease ◽  
Enzyme Immunoassay ◽  
The United States ◽  
Statistical Analyses ◽  
Diagnostic Approach ◽  
Diagnostic Assay ◽  
Western Immunoblotting ◽  
Testing Strategies ◽  
Second Tier

ABSTRACTThe recommended laboratory diagnostic approach for Lyme disease is a standard two-tiered testing (STTT) algorithm where the first tier is typically an enzyme immunoassay (EIA) that if positive or equivocal is reflexed to Western immunoblotting as the second tier. bioMérieux manufactures one of the most commonly used first-tier EIAs in the United States, the combined IgM/IgG Vidas test (LYT). Recently, bioMérieux launched its dissociated first-tier tests, the Vidas Lyme IgM II (LYM) and IgG II (LYG) EIAs, which use purified recombinant test antigens and a different algorithm than STTT. The dissociated LYM/LYG EIAs were evaluated against the combined LYT EIA using samples from 471 well-characterized Lyme patients and controls. Statistical analyses were conducted to assess the performance of these EIAs as first-tier tests and when used in two-tiered algorithms, including a modified two-tiered testing (MTTT) approach where the second-tier test was a C6 EIA. Similar sensitivities and specificities were obtained for the two testing strategies (LYT versus LYM/LYG) when used as first-tier tests (sensitivity, 83 to 85%; specificity, 85 to 88%) with an observed agreement of 80%. Sensitivities of 68 to 69% and 76 to 77% and specificities of 97% and 98 to 99% resulted when the two EIA strategies were followed by Western immunoblotting and when used in an MTTT, respectively. The MTTT approach resulted in significantly higher sensitivities than did STTT. Overall, the LYM/LYG EIAs performed equivalently to the LYT EIA in test-to-test comparisons or as first-tier assays in STTT or MTTT with few exceptions.

scholarly journals Diagnostic parameters of modified two-tier testing in European patients with early Lyme disease

2020 ◽  
Vol 39 (11) ◽  
pp. 2143-2152
Author(s):  
ME Baarsma ◽  
JFP Schellekens ◽  
BC Meijer ◽  
AH Brandenburg ◽  
T. Souilljee ◽  
...  
Keyword(s):  
General Practice ◽  
Lyme Disease ◽  
General Population ◽  
Lyme Borreliosis ◽  
Erythema Migrans ◽  
Diagnostic Parameters ◽  
Second Tier ◽  
Population Controls ◽  
Higher Sensitivity ◽  
Better Than

Abstract Modified two-tier testing (MTTT) for Lyme borreliosis (i.e. confirmation with an EIA instead of an immunoblot) has been shown to have improved sensitivity compared with standard two-tier testing (STTT) in samples from American patients, without losing specificity. The current study assesses the sensitivity and specificity of various algorithms of MTTT in European patients with erythema migrans (EM) as a model disease for early Lyme borreliosis, and in appropriate controls. Four different immunoassays were used in the first tier, followed by either an immunoblot or the C6-EIA, or were used as standalone single-tier test. These tests were performed on consecutively collected sera of 228 Dutch patients with physician-diagnosed EM in the setting of general practice, 231 controls from the general population, and 50 controls with potentially cross-reactive antibodies. All the variants of MTTT that were studied had significantly higher sensitivity compared with their equivalent STTT, while retaining comparable specificity. Within the MTTT algorithms, classifying equivocal results as positive yielded better diagnostic parameters than classifying equivocal results as negative. The best diagnostic parameters were found using the Enzygnost-2 assay in the first tier, followed by a C6-ELISA in the second tier (sensitivity 77.6%, 95% CI 71.7–82.9; specificity 96.1%, 95% CI 92.7–98.2). This algorithm performed significantly better than the equivalent STTT algorithm in terms of sensitivity (p < 0.001), while maintaining comparable specificity (population controls p = 0.617). Our results show that MTTT can be a useful tool for the serodiagnosis of European patients with early Lyme borreliosis.

scholarly journals Evaluation of Modified Two-Tiered Testing Algorithms for Lyme Disease Laboratory Diagnosis Using Well-Characterized Serum Samples

2018 ◽  
Vol 56 (8) ◽  
Author(s):  
Adoracion Pegalajar-Jurado ◽  
Martin E. Schriefer ◽  
Ryan J. Welch ◽  
Marc R. Couturier ◽  
Tiffany MacKenzie ◽  
...  
Keyword(s):  
Lyme Disease ◽  
Laboratory Testing ◽  
Laboratory Diagnosis ◽  
Serum Samples ◽  
Chemiluminescence Immunoassay ◽  
Testing Algorithms ◽  
Second Tier ◽  
Testing Algorithm ◽  
Low Sensitivity ◽  
Recommended Algorithm

ABSTRACTStandard two-tiered testing (STTT) is the recommended algorithm for laboratory diagnosis of Lyme disease (LD). Several limitations are associated with STTT that include low sensitivity in the early stages of disease, as well as technical complexity and subjectivity associated with second-tier immunoblotting; therefore, modified two-tiered testing (MTTT) algorithms that utilize two sequential first-tier tests and eliminate immunoblotting have been evaluated. Recently, a novel MTTT that uses a VlsE chemiluminescence immunoassay followed by a C6 enzyme immunoassay has been proposed. The purpose of this study was to evaluate the performance of the VlsE/C6 MTTT using well-characterized serum samples. Serum samples from the CDC Lyme Serum Repository were tested using three MTTTs, VlsE/C6, whole-cell sonicate (WCS)/C6, and WCS/VlsE, and three STTTs (immunoblotting preceded by three different first-tier assays: VlsE, C6, and WCS). Significant differences were not observed between the results of the MTTTs assessed; however, the VlsE/C6 MTTT resulted in the highest specificity (100%) when other diseases were tested and the lowest sensitivity (75%) for LD samples. Significant differences were present between the results for various MTTTs and STTTs evaluated. Specifically, all MTTTs resulted in higher sensitivities than the STTTs for all LD groups combined and were significantly more accurate (i.e., higher proportion of correct classifications) for this group, with the exception of the WCS/ViraStripe STTT. Additionally, when other diseases were tested, only the results of the VlsE/C6 MTTT differed significantly from those of the WCS/ViraStripe STTT, with the VlsE/C6 MTTT resulting in a 6.2% higher accuracy. Overall, the VlsE/C6 MTTT offers an additional laboratory testing algorithm for LD with equivalent or enhanced performance compared to that of the other MTTTs and STTTs evaluated in this study.

scholarly journals Immunoblot analysis of immunoglobulin G response to the Lyme disease agent (Borrelia burgdorferi) in experimentally and naturally exposed dogs.

1988 ◽  
Vol 26 (4) ◽  
pp. 648-653 ◽  
Author(s):  
R T Greene ◽  
R L Walker ◽  
W L Nicholson ◽  
H W Heidner ◽  
J F Levine ◽  
...  
Keyword(s):  
Lyme Disease ◽  
Borrelia Burgdorferi ◽  
Immunoglobulin G ◽  
Immunoblot Analysis ◽  
Disease Agent ◽  
Lyme Disease Agent

scholarly journals Persistence of Immunoglobulin M or Immunoglobulin G Antibody Responses toBorrelia burgdorferi10–20 Years after Active Lyme Disease

2001 ◽  
Vol 33 (6) ◽  
pp. 780-785 ◽  
Author(s):  
Robert A. Kalish ◽  
Gail McHugh ◽  
John Granquist ◽  
Barry Shea ◽  
Robin Ruthazer ◽  
...  
Keyword(s):  
Lyme Disease ◽  
Immunoglobulin G ◽  
Immunoglobulin M ◽  
Antibody Responses

scholarly journals Antibody Testing and Lyme Disease Risk

2005 ◽  
Vol 11 (5) ◽  
pp. 722-724 ◽  
Author(s):  
Elizabeth G. Stone ◽  
Eleanor H. Lacombe ◽  
Peter W. Rand
Keyword(s):  
Lyme Disease ◽  
Disease Risk ◽  
Antibody Testing ◽  
Lyme Disease Risk

scholarly journals Comparison of Western Immunoblotting and the C6 Lyme Antibody Test for Laboratory Detection of Lyme Disease

2004 ◽  
Vol 11 (5) ◽  
pp. 924-929 ◽  
Author(s):  
Elena Mogilyansky ◽  
Chien Chang Loa ◽  
Martin E. Adelson ◽  
Eli Mordechai ◽  
Richard C. Tilton
Keyword(s):  
Lyme Disease ◽  
Disease Control ◽  
Immunoglobulin G ◽  
False Positive ◽  
Antibody Test ◽  
Enzyme Linked Immunosorbent Assay ◽  
Igg Antibodies ◽  
Western Immunoblotting ◽  
Elisa Kit ◽  
Control And Prevention

ABSTRACT Three commercial Lyme disease Western immunoblotting (WB) kits and the C6 Borrelia burgdorferi (Lyme) enzyme-linked immunosorbent assay (ELISA) kit were compared using two commercially available performance panels from the Centers for Disease Control and Prevention (CDC) and Boston Biomedica (BBI). Combined, the panels consisted of 52 characterized specimens. Immunoglobulin G (IgG) sensitivity was similar for the three WB products. The BBI and Marblot WBs were more specific for IgG antibodies, while the Virablot was the most sensitive for IgM antibody. The BBI WB was 100% specific for IgM, while Marblot was 97% and Virablot was 77% specific for IgM. The C6 ELISA was found to be 100% sensitive. Four false-positive C6 results were identified in patients that had clinically and microbiologically confirmed Lyme disease but were not detected by the CDC reference methods. No one WB product showed overall superiority. The C6 ELISA shows promise as the first ELISA for Lyme disease that would not require a supplemental test such as a WB.

Bromelin for Liquefaction of Cervical Mucus in Sperm Antibody Testing: Its Effect on Spermagglutinating Immunoglobulin G

1980 ◽  
Vol 33 (1) ◽  
pp. 61-63 ◽  
Author(s):  
Hans Jakob Ingerslev ◽  
Fritz Poulsen
Keyword(s):  
Immunoglobulin G ◽  
Cervical Mucus ◽  
Antibody Testing
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