Borrelia burgdorferi-specific immune complexes in acute Lyme disease.
BACKGROUND
Diagnosis of infection with Borrelia burgdorferi, the cause of Lyme disease (LD), has been impeded by the lack of effective assays to detect active infection.


OBJECTIVE
To determine whether B. burgdorferi-specific immune complexes are detectable during active infection in LD.


METHODS
Cross-sectional analysis of serum samples from 168 patients fulfilling Centers for Disease Control and Prevention surveillance criteria for LD and 145 healthy and other disease controls conducted over 8 years. Tests were performed blinded.


METHODS
Detection of B. burgdorferi immune complexes by enzyme-linked immunosorbent assay and Western blot.


RESULTS
The B. burgdorferi immune complexes were found in 25 of 26 patients with early seronegative erythema migrans (EM) LD; 105 of 107 patients with seropositive EM LD; 6 of 10 samples that were seronegative [corrected] with culture-positive EM; 0 of 12 patients who were treated and recovered from LD; and 13 of 13 patients with neurologic LD without EM. Among 147 controls, B. burgdorferi immune complex was found in 0 of 50 healthy individuals; 0 of 40 patients with persistent fatigue; 0 of 7 individuals with frequent tick exposure; and 2 of 50 patients with other diseases.


CONCLUSIONS
These data suggest that B. burgdorferi immune complex formation is a common process in active LD. Analysis of the B. burgdorferi immune complexes by a simple technique has the potential to support or exclude a diagnosis of early as well as active LD infection.
Schutzer
S E
SE
Department of Medicine, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark 07103, USA. schutzer@umdnj.edu
Coyle
P K
PK
Reid
P
P
Holland
B
B
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000032:analysis*; D000936:Antigen-Antibody Complex / Q000032:analysis*; D015153:Blotting, Western; D015748:Borrelia burgdorferi Group / Q000276:immunology*; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012698:Serologic Tests
D000907:Antibodies, Bacterial; D000936:Antigen-Antibody Complex