Immunoblot analysis of the seroreactivity to recombinant Borrelia burgdorferi sensu lato antigens, including VlsE, in the long-term course of treated patients with erythema migrans.
OBJECTIVE
We evaluated whether immunoblotting is capable of substantiating the posttreatment clinical assessment of patients with erythema migrans (EM), the hallmark of early Lyme borreliosis.


METHODS
In 50 patients, seroreactivity to different antigens of Borrelia burgdorferi sensu lato was analyzed by a recombinant immunoblot test (IB) in consecutive serum samples from a minimum follow-up period of 1 year. Antigens in the IgG test were decorin-binding protein A, internal fragment of p41 (p41i), outer surface protein C (OspC), p39, variable major protein-like sequence expressed (VlsE), p58 and p100; those in the IgM test were p41i, OspC and p39. Immune responses were correlated with clinical and treatment-related parameters.


RESULTS
Positive IB results were found in 50% before, in 57% directly after therapy and in 44% by the end of the follow-up for the IgG class, and in 36, 43 and 12% for the IgM class. In acute and convalescence phase sera, VlsE was most immunogenic on IgG testing (60 and 70%), and p41i (46 and 57%) and OspC (40 and 57%) for the IgM class. By the end of the follow-up, only the anti-p41i IgM response was significantly decreased to 24%.


CONCLUSIONS
No correlation was found between IB results and treatment-related parameters. Thus, immunoblotting does not add to the clinical assessment of EM patients after treatment.
Glatz
Martin
M
Department of Dermatology, Medical University of Graz, Graz, Austria.
Fingerle
Volker
V
Wilske
Bettina
B
Ambros-Rudolph
Christina
C
Kerl
Helmut
H
Müllegger
Robert R
RR
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000888:Antibodies, Anti-Idiotypic / Q000276:immunology; D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial / Q000276:immunology*; D001426:Bacterial Proteins / Q000276:immunology*; D025065:Borrelia burgdorferi / Q000276:immunology*; D002648:Child; D004797:Enzyme-Linked Immunosorbent Assay; D015787:Erythema Chronicum Migrans / Q000188:drug therapy* / Q000276:immunology / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015151:Immunoblotting / Q000379:methods*; D007074:Immunoglobulin G / Q000276:immunology; D007075:Immunoglobulin M / Q000276:immunology; D008074:Lipoproteins / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000888:Antibodies, Anti-Idiotypic; D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D008074:Lipoproteins; C105546:VlsE protein, Borrelia burgdorferi