scholarly journals Lyme borreliosis: Diagnostic difficulties in interpreting serological results

2010 ◽  
Vol 63 (11-12) ◽  
pp. 839-843 ◽  
Author(s):  
Olgica Gajovic ◽  
Zoran Todorovic ◽  
Ljiljana Nesic ◽  
Zorica Lazic
Keyword(s):  
Immune Response ◽  
Borrelia Burgdorferi ◽  
Antibody Response ◽  
Western Blot ◽  
Disease Activity ◽  
Lyme Borreliosis ◽  
Serological Test ◽  
Clinical Signs ◽  
Borrelia Burgdorferi Sensu Lato ◽  
Western Blot Test

Introduction. Lyme borreliosis is a multi-systemic disease caused by spirochete Borrelia burgdorferi sensu lato. The specific response is influenced by phenotypic characteristics of Borrelia, different antigen structure, their different geographic distribution, and the patient?s capability to react to the infection. The immune response to Borrelia burgdorferi sensu lato develops relatively late, whereas in some patients it never develops. The immune response in the early phase of Lyme borreliosis is very similar to the one of healthy population. Diagnosis of borrelia. Clinical manifestation, detailed anamnesis and epidemiological data are crucial for making the diagnosis. The majority of patients in the late phase of Lyme borreliosis have IgG antibody response, which could be followed by IgM also throughout this period of time. The number of serologically positive findings increases with the duration of the infection. Specific borrelial antigens can be detected by a Western blot test. In patients with neuroborreliosis, antibodies could be synthesized only intrathecally. IgG and IgM antibody response can persist for many years after the treatment. There is no positive serological test, which could be the indicator of the disease activity on its own; even if it demonstrates high antibody titre. If there are no clinical signs of Lyme borreliosis, the diagnosis of Lyme borreliosis should be primarily based on clinical findings, and serological results should be used only to confirm but not to make the diagnosis of Lyme borreliosis. Specific antibodies from the IgM class can be proved in about 50% of patients, 2 to 4 weeks after the onset of primary infection, but an early administration of the antibiotics can postpone or inhibit that response. Interpretation of serological results. When interpreting the serological test results with high level of sensitivity and specificity used for making diagnosis of lyme borreliosis, it is necessary to take into consideration the seroprevalence in a certain region. In the population with a low prevalence of the disease, the tests will have a low positive predicative value, i.e. the probability of indicating the real disease will be lower. According to the recommendations given by the Centre for Disease Control in North America, all extreme and positive results of EA and IFA are to be confirmed by a Western blot test. Diagnostic problems. The main problem in making diagnosis of lyme borreliosis is underestimation and overrating of the diagnosis. Not a single positive serologic test is the indicator of the disease activity on its own, regardless of the antibodies titre level, when clear clinical signs are scarce. <br><br><font color="red"><b> This article has been retracted. Link to the retraction <u><a href="http://dx.doi.org/10.2298/MPNS1212531U">10.2298/MPNS1212531U</a><u></b></font>

scholarly journals Differential Immune Response to the Variable Surface Loop Antigen of P66 of Borrelia burgdorferi Sensu Lato Species in Geographically Diverse Populations of Lyme Borreliosis Patients

2002 ◽  
Vol 9 (6) ◽  
pp. 1382-1384 ◽  
Author(s):  
Katharina Ornstein ◽  
Yngve Östberg ◽  
Jonas Bunikis ◽  
Laila Noppa ◽  
Johan Berglund ◽  
...  
Keyword(s):  
Immune Response ◽  
Membrane Protein ◽  
Borrelia Burgdorferi ◽  
Lyme Borreliosis ◽  
Sensu Stricto ◽  
Borrelia Burgdorferi Sensu Lato ◽  
Diverse Populations ◽  
Surface Loop ◽  
Loop Region ◽  
Variable Surface

ABSTRACT We have studied the immune response to a variable surface-exposed loop region of the P66 outer membrane protein from Borrelia burgdorferi sensu lato by using an enzyme immunoassay. Lyme borreliosis populations found in North America and Sweden were preferentially more seroreactive to P66 from their respective regional species, namely, B. burgdorferi sensu stricto and B. garinii and B. afzelii, respectively.

scholarly journals Humoral Immune Response in Dogs Naturally Infected with Borrelia burgdorferi Sensu Lato and in Dogs after Immunization with a Borrelia Vaccine

2010 ◽  
Vol 17 (5) ◽  
pp. 828-835 ◽  
Author(s):  
Michael W. Leschnik ◽  
Georges Kirtz ◽  
Gelas Khanakah ◽  
Georg Duscher ◽  
Ernst Leidinger ◽  
...  
Keyword(s):  
Immune Response ◽  
Western Blot ◽  
Real Time ◽  
Real Time Pcr ◽  
Natural Infection ◽  
Clinical Signs ◽  
Lyme Arthritis ◽  
Borrelia Burgdorferi Sensu Lato ◽  
Pcr Analysis ◽  
Case Definitions

ABSTRACT Lyme arthritis in dogs can be induced under experimental and natural conditions. However, the veterinary relevance of canine borreliosis is still under extensive investigation. The prevalence of symptoms is clearly low, although the risk of tick exposure is high. Current research focuses on case definitions, methods for diagnosing clinical disease in dogs, and discrimination between an immune response to a natural infection and an immune response to vaccination. In this experimental study, 23 dogs raised under tick-free conditions were allocated to two groups. The 11 dogs in the first group were vaccinated with a commercial borrelia vaccine and subsequently developed detectable antibody titers. The 12 dogs in the second group were walked on two consecutive days in an area where ticks were endemic. On day 5 after exposure, engorged ticks were removed from the 12 dogs and were analyzed for Borrelia DNA by a real-time PCR assay. Blood samples were taken before exposure/vaccination and at defined time points thereafter. Antibody responses were evaluated using an immunofluorescence antibody test (IFAT) and Western blotting. Seven dogs from which Borrelia-positive ticks were removed seroconverted and developed individual immune responses. Blood and urine samples taken from the tick-exposed group at weeks 1 and 3 for real-time PCR analysis and culture were always negative for bacterial DNA. In conclusion, despite serological evidence of infection/immunization, no clinical signs of disease were observed. The antibody patterns in a single Western blot did not permit differentiation between the different antigen sources (vaccine versus natural infection). However, repeated Western blot analyses may be useful for the confirmation of infection or vaccination status, since the time courses of the levels of specific antibodies seem to be different.

scholarly journals Tick exposure and prevalence of Borrelia burgdorferi antibodies among hunters and other individuals exposed to vector ticks in eastern Poland

2019 ◽  
pp. 161-168
Author(s):  
Anna Pańczuk ◽  
Małgorzata Tokarska-Rodak ◽  
Dorota Plewik ◽  
Justyna Paszkiewicz
Keyword(s):  
Borrelia Burgdorferi ◽  
Western Blot ◽  
Lyme Borreliosis ◽  
The Body ◽  
Elisa Assay ◽  
Tick Bites ◽  
Western Blot Test ◽  
Body Regions ◽  
Prophylactic Measures ◽  
Prophylactic Method

Background. Lyme borreliosis is the most frequent tick-borne disease in Europe and North America, and the number of registered cases is on the increase. Frequent presence in the habitats of ticks enhances the risk of tick bites and possible infection with Borrelia burgdorferi spirochetes. Objective. The aim of the study was to assess the risk of B. burgdorferi infection posed to hunters and other individuals exposed to activity-related contact with ticks. Material and methods. The study was carried out in the northern part of the Lublin Province (eastern Poland) and involved 150 individuals exposed to tick bites (110 hunters and 40 individuals exposed to activity-related contact with ticks). The analysis of sera for the presence of B. burgdorferi IgM and IgG antibodies was carried out. All 150 individuals were tested with the ELISA assay, and positive and borderline results of the assay were verified with the Western blot test. All study participants completed a questionnaire, which provided information about exposure to ticks, application of prophylactic measures, and awareness of Lyme borreliosis. Results. The ELISA assay revealed a positive or borderline result in at least one of the classes of B. burgdorferi antibodies in 63.3% (95/150) of the individuals (IgM 14.0%, IgG 63.3%). Verification carried out with the Western blot test showed a positive or borderline result in at least one of the antibody classes in 38.0% (57/150) of the examined persons (IgM 2.7%, IgG 36.7%). Abdomen (56.0%) and legs (53.7%) were the most frequently bitten body regions. Tick bites on the abdomen were significantly more frequently declared by hunters. Inspection of the body after returning from natural areas was more popular prophylactic method than use of repellents. Inspection of the body was significantly more often used in the group of the hunters. Conclusions. The risk of B. burgdorferi infection among hunters and other individuals undertaking activities associated with exposure to tick bites in the study area is high.

scholarly journals Seroprevalence of antibodies against Borrelia burgdorferi sensu lato in healthy blood donors in Romania: an update

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Zsuzsa Kalmár ◽  
Violeta Briciu ◽  
Mircea Coroian ◽  
Mirela Flonta ◽  
Amanda-Lelia Rădulescu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Borrelia Burgdorferi ◽  
Western Blot ◽  
Lyme Borreliosis ◽  
Blood Donors ◽  
Clinical Manifestations ◽  
Borrelia Burgdorferi Sensu Lato ◽  
Serum Samples ◽  
Igm Antibodies ◽  
Associated Risk Factors

Abstract Background The Borrelia burgdorferi sensu lato (s.l.) genogroup is the causative agent responsible for Lyme borreliosis, a common tick-borne infectious disease in some temperate regions of the Northern Hemisphere. In humans, the clinical manifestations of Lyme borreliosis vary from dermatological infection to severe systemic manifestations. In Romania, data on the seroprevalence of Lyme borreliosis and associated risk factors are scarce and outdated, as the only seroprevalence study with a large dataset was published more than 20 years ago. Therefore, the aim of the present study was to evaluate the seroprevalence for Borrelia burgdorferi s.l. in healthy blood donors from six Romanian counties and identify the associated risk factors. Methods The study was conducted among 1200 healthy blood donors aged between 18 and 65 years during November 2019 and September 2020 from six counties in the northwestern and central parts of Romania. A two-tiered testing strategy was applied. Positive and equivocal immunoenzymatic test results for IgG and IgM antibodies were further confirmed by Western blot. Results Serum samples from 20% of the blood donors had positive or equivocal IgG and IgM ELISA index values. In total, 2.3% of the serum samples for IgG and 1.8% for IgM were positive by Western blot. The seroprevalence for both antibodies varied between 1.5% (Satu-Mare) and 6.5% (Bistrița-Năsăud) in the six counties investigated. The highest seroprevalence was observed in men (4.7%), in blood donors performing their professional activities outdoors (4.2%), and in those aged  ≥ 56 years (8%). Conclusions These findings confirm the presence of specific IgG and IgM antibodies to B. burgdorferi s.l. among healthy blood donors from Romania. Furthermore, potential risk factors, such as gender, age, and behavior, associated with the presence of positive B. burgdorferi s.l. antibodies among healthy blood donors were identified. Graphical Abstract

More specific bands in the IgG western blot in sera from Scottish patients with suspected Lyme borreliosis

2010 ◽  
Vol 63 (8) ◽  
pp. 719-721 ◽  
Author(s):  
Roger Evans ◽  
Sally Mavin ◽  
Susan McDonagh ◽  
Jean M W Chatterton ◽  
Rachel Milner ◽  
...  
Keyword(s):  
Borrelia Burgdorferi ◽  
Western Blot ◽  
Lyme Borreliosis ◽  
F Test

AimsTo identify further Western blot bands that may be specific in the diagnosis of Lyme borreliosis.MethodsThe Borrelia burgdorferi antibody profiles of 270 western blot positive patients and 241 western blot negative patients from 2008 were examined.Results27 different non-specific bands were detected in both groups. Six of 27 (22%) of the non-specific bands were detected significantly more in the western blot positive patients compared to the western blot negative patients (20 kDa, p<0.0001; 28 kDa, p<0.002; 36 kDa, p<0.002; 37 kDa, p<0.007; 48 kDa, p<0.023; 56 kDa, p<0.028; two-tailed F test).ConclusionResults suggest that the 20, 28 and 48 kDa bands should be regarded as specific.

scholarly journals Differential Transmission of the Genospecies of Borrelia burgdorferi Sensu Lato by Game Birds and Small Rodents in England

1998 ◽  
Vol 64 (4) ◽  
pp. 1169-1174 ◽  
Author(s):  
Klaus Kurtenbach ◽  
Mick Peacey ◽  
Sjoerd G. T. Rijpkema ◽  
Andrew N. Hoodless ◽  
Patricia A. Nuttall ◽  
...  
Keyword(s):  
Borrelia Burgdorferi ◽  
Lyme Borreliosis ◽  
Sensu Stricto ◽  
Rrna Genes ◽  
Borrelia Burgdorferi Sensu Lato ◽  
Internal Organs ◽  
Borrelia Garinii ◽  
Game Birds ◽  
5S Rrna Genes ◽  
Pcr Targeting

ABSTRACT The genetic diversity of Borrelia burgdorferi sensu lato was assessed in a focus of Lyme borreliosis in southern Britain dominated by game birds. Ticks, rodents, and pheasants were analyzed for spirochete infections by PCR targeting the 23S-5S rRNA genes, followed by genotyping by the reverse line blot method. In questingIxodes ricinus ticks, three genospecies of B. burgdorferi sensu lato were detected, with the highest prevalences found for Borrelia garinii and Borrelia valaisiana. B. burgdorferi sensu stricto was rare (<1%) in all tick stages. Borrelia afzelii was not detected in any of the samples. More than 50% of engorged nymphs collected from pheasants were infected with borreliae, mainly B. garinii and/orB. valaisiana. Although 19% of the rodents harboredB. burgdorferi sensu stricto and/or B. gariniiin internal organs, only B. burgdorferi sensu stricto was transmitted to xenodiagnostic tick larvae (it was transmitted to 1% of the larvae). The data indicate that different genospecies of B. burgdorferi sensu lato can be maintained in nature by distinct transmission cycles involving the same vector tick species but different vertebrate host species. Wildlife management may have an influence on the relative risk of different clinical forms of Lyme borreliosis.

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