title: Antibodies to decorin-binding protein B (DbpB) in the diagnosis of Lyme neuroborreliosis in children.
abstract: BACKGROUND
  Laboratory support is needed to confirm the clinical diagnosis of Lyme neuroborreliosis (LNB). Antibodies to Borrelia-specific proteins have been used to improve serological diagnostics. The aims of this study were to assess the occurrence of antibodies to decorin-binding protein B (DbpB) in serum and cerebrospinal fluid (CSF) in children with LNB and to evaluate the performance of DbpB variants in the diagnosis of LNB in children.
  
  
  METHODS
  Serum and CSF sample pairs were available from 57 children evaluated for LNB. Based on the presence of anti-flagella antibodies and pleocytosis in the CSF, patients were divided into three different groups: confirmed LNB (n=24), possible LNB (n=16), and non LNB (n=17). Recombinant DbpBs from three Borrelia burgdorferi sensu lato species - Borrelia burgdorferi sensu stricto, Borrelia garinii, and Borrelia afzelii - were used in an ELISA to detect IgG antibodies.
  
  
  RESULTS
  The sensitivity of variant recombinant DbpBs in serum and CSF samples varied between 0% and 46% and between 0% and 42%, respectively. In CSF, the most sensitive antigen was the DbpB variant from B. garinii.
  
  
  CONCLUSIONS
  Serum or CSF antibodies to DbpB do not appear to be beneficial in the laboratory diagnosis of LNB in children.
authors.affiliation: Immunobiology, Research Program Unit, University of Helsinki, Helsinki, Finland; Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, Helsinki, Finland. Electronic address: Heidi.Sillanpaa@helsinki.fi.
authors.forename: Heidi
authors.initials: H
authors.lastname: Sillanpää
authors.affiliation: Center for Clinical Research Dalarna, Falun, Sweden.
authors.forename: Barbro H
authors.initials: BH
authors.lastname: Skogman
authors.affiliation: Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, Helsinki, Finland.
authors.forename: Heikki
authors.initials: H
authors.lastname: Sarvas
authors.affiliation: Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, Helsinki, Finland.
authors.forename: Ilkka J T
authors.initials: IJ
authors.lastname: Seppälä
authors.affiliation: Children's Hospital, University of Helsinki, Helsinki, Finland.
authors.forename: Pekka
authors.initials: P
authors.lastname: Lahdenne
mesh_terms: D018829:Adhesins, Bacterial / Q000276:immunology*; D000293:Adolescent; D000907:Antibodies, Bacterial / Q000032:analysis* / Q000097:blood / Q000134:cerebrospinal fluid; D015748:Borrelia burgdorferi Group / Q000276:immunology* / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D006801:Humans; D020852:Lyme Neuroborreliosis / Q000175:diagnosis*
chemical_list: D018829:Adhesins, Bacterial; D000907:Antibodies, Bacterial; C112557:DdpB protein, Borrelia burgdorferi
keywords: Borrelia burgdorferi sensu lato; CSF; Children; DbpB; Lyme neuroborreliosis