Diagnostic and biological significance of anti-p41 IgM antibodies against Borrelia burgdorferi.
We performed a prospective study to investigate the biological significance and diagnostic specificity of anti-p41 immunoglobulin (Ig)M antibodies against Borrelia burgdorferi. During a 1-year interval 2403 patients were referred to our department for B. burgdorferi serology. Sixty-three patients had repetitive positive tests for IgM anti-p41 antibodies and negative tests for anti-p41 IgG antibodies. Ten of the 63 patients recently had symptoms of erythema migrans. A confirmatory IgM Western blot gave a positive reaction in 5 patients out of 53 patients with little or no clinical evidence of B. burgdorferi infection. The remaining 48 patients were negative in this test and were considered as false-positives. Two whole cell enzyme-linked immunosorbent assay (ELISAs), two immunofluorescence assays and Western blotting were not useful as confirmatory tests. Sera from 330 blood donors and 72 cord sera were also screened for anti-p41 IgM. Five blood donor sera and five cord sera showed an IgM reactivity against p41. Based on our data we hypothesize that up to 1.5% of the population may have natural IgM antibodies against p41 in their sera. We observed that six out of nine sera with such antibodies could immobilize a B. afzelii reference strain in vitro. Whether anti-p41 IgM antibodies are capable of inactivating infective spirochetes and thereby prevent infection in vivo is, however, not yet clarified. The paradoxical conclusion that anti-p41 IgM antibodies may be a sign of resistance to infection rather than a sign of infection should be given consideration.
Ulvestad
E
E
Department of Microbiology and Immunology, The Gade Institute, Haukeland University Hospital, Armauer Hansen Building, N-5021 Bergen, Norway. elling.ulvestad@haukeland.no
Kanestrøm
A
A
Sønsteby
L J
LJ
Jureen
R
R
Omland
T
T
Edvardsen
B
B
Lundervik
J
J
Kristoffersen
E
E
van Dam
A P
AP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood*; D000942:Antigens, Bacterial; D015153:Blotting, Western; D015748:Borrelia burgdorferi Group / Q000276:immunology*; D002648:Child; D005189:False Positive Reactions; D005260:Female; D005408:Flagellin / Q000276:immunology*; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007113:Immunity, Innate; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood*; D066298:In Vitro Techniques; D008193:Lyme Disease / Q000175:diagnosis* / Q000276:immunology*; D008297:Male; D008875:Middle Aged
D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D007074:Immunoglobulin G; D007075:Immunoglobulin M; C075511:flagellin p41; D005408:Flagellin