title: Serodiagnosis of Lyme disease by kinetic enzyme-linked immunosorbent assay using recombinant VlsE1 or peptide antigens of Borrelia burgdorferi compared with 2-tiered testing using whole-cell lysates.
abstract: In a study of US patients with Lyme disease, immunoglobulin (Ig) G and IgM antibody responses to recombinant Borrelia burgdorferi antigen VlsE1 (rVlsE1), IgG responses to a synthetic peptide homologous to a conserved internal sequence of VlsE (C6), and IgM responses to a synthetic peptide comprising the C-terminal 10 amino acid residues of a B. burgdorferi outer-surface protein C (pepC10) were evaluated by kinetic enzyme-linked immunoassay. At 99% specificity, the overall sensitivities for detecting IgG antibody to rVlsE1 or C6 in samples from patients with diverse manifestations of Lyme disease were equivalent to that of 2-tiered testing. When data were considered in parallel, 2 combinations (IgG responses to either rVlsE1 or C6 in parallel with IgM responses to pepC10) maintained high specificity (98%) and were significantly more sensitive than 2-tiered analysis in detecting antibodies to B. burgdorferi in patients with acute erythema migrans. In later stages of Lyme disease, the sensitivities of the in parallel tests and 2-tiered testing were high and statistically equivalent.
authors.affiliation: Division of Vector-Borne Infectious Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA.
authors.forename: Rendi Murphree
authors.initials: RM
authors.lastname: Bacon
authors.forename: Brad J
authors.initials: BJ
authors.lastname: Biggerstaff
authors.forename: Martin E
authors.initials: ME
authors.lastname: Schriefer
authors.forename: Robert D
authors.initials: RD
authors.lastname: Gilmore
authors.forename: Mario T
authors.initials: MT
authors.lastname: Philipp
authors.forename: Allen C
authors.initials: AC
authors.lastname: Steere
authors.forename: Gary P
authors.initials: GP
authors.lastname: Wormser
authors.forename: Adriana R
authors.initials: AR
authors.lastname: Marques
authors.forename: Barbara J B
authors.initials: BJ
authors.lastname: Johnson
mesh_terms: D000907:Antibodies, Bacterial / Q000032:analysis / Q000276:immunology; D000942:Antigens, Bacterial / Q000276:immunology*; D001426:Bacterial Proteins / Q000276:immunology*; D025065:Borrelia burgdorferi / Q000166:cytology* / Q000276:immunology*; D002457:Cell Extracts / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D008074:Lipoproteins / Q000276:immunology*; D008193:Lyme Disease / Q000097:blood / Q000175:diagnosis* / Q000276:immunology*; D012680:Sensitivity and Specificity; D012698:Serologic Tests
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D002457:Cell Extracts; D007074:Immunoglobulin G; D008074:Lipoproteins; C105546:VlsE protein, Borrelia burgdorferi