New antigens for serologic diagnosis of neuroborreliosis in children.
OBJECTIVE
To evaluate serology with novel Borrelia-specific protein or peptide antigens in the laboratory diagnosis of neuroborreliosis (NB) in children.


METHODS
The performance of enzyme-linked immunosorbent assays with several recombinant borrelial protein antigens and invariable region 6 synthetic peptide antigen and of a commercial enzyme-linked immunosorbent assay with the flagella antigen were evaluated in the serodiagnosis and follow-up of children with clinical suspicion of NB. Serum samples were obtained from 20 children with neurologic symptoms indicative of NB. The patients were retrospectively divided into 2 groups based on the laboratory tests at presentation indicating definite (n = 7) or probable (n = 13) NB.


RESULTS
In addition to cerebrospinal fluid (CSF) lymphocytic pleocytosis and CSF antiflagella antibodies, all 7 patients with definite NB had serum IgG antibodies to at least 2 of the 3 novel antigens at presentation. The 13 patients with probable NB had variable laboratory findings: CSF pleocytosis (n = 7), CSF antiflagella IgM antibodies (n = 4), serum antiflagella IgM and/or IgG antibodies (n = 10). Of these 13 patients, 7 had serum IgG antibodies to 2 of the 3 novel antigens at presentation. During long term follow-up, serum anti-invariable region 6 antibodies disappeared.


CONCLUSIONS
The present study suggests that assessment of serum antibodies to a panel of Borrelia-specific antigens could improve the laboratory diagnosis of NB at presentation.
Heikkilä
Tero
T
Hospital for Children and Adolescents, University of Helsinki, Finland.
Saxen
Harri
H
Seppälä
Ilkka
I
Lönnqvist
Tuula
T
Sillanpää
Heidi
H
Lahdenne
Pekka
P
D000293:Adolescent; D000907:Antibodies, Bacterial / Q000097:blood / Q000134:cerebrospinal fluid; D000942:Antigens, Bacterial / Q000276:immunology*; D025065:Borrelia burgdorferi / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000134:cerebrospinal fluid; D007075:Immunoglobulin M / Q000097:blood / Q000134:cerebrospinal fluid; D007223:Infant; D020852:Lyme Neuroborreliosis / Q000175:diagnosis*; D011994:Recombinant Proteins / Q000276:immunology
D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D011994:Recombinant Proteins