Diagnosis of Lyme borreliosis: non-specific serological reactions with sonicate antigen caused by IgG2 antibodies Free

Abstract

Summary

ELISA methods that measure IgG class antibodies to sonicated may give false positive results. These errors could be traced to non-specific reactivity in subclass IgG2 in several instances. Sera were sampled randomly from two adult populations, which differed in having a high and low incidence of Lyme disease. If the binding of IgG2 subclass antibodies was left unrecorded in the test by the use of monoclonal reagent antibodies selective for IgGl and IgG3, the frequency of positivity in the ELISA test decreased in samples from the low risk group. Twenty-one samples were found to be positive in an immunoblot confirmatory test. Correct prediction of positivity was obtained for 15 sera by ELISA restricted to IgGl plus IgG3, for only four sera by ELISA restricted to IgG2 and for only six sera by IgG subclass non-restricted ELISA. A non-restricted ELISA with purified flagella of as the antigen predicted correctly 14 of the immunoblot-positive sera. The results of this ELISA correlated well with those of the IgGl plus IgG3 subclass restricted ELISA in the high risk population (r = 0·95, prevalence of seropositivity 12%), but was significantly worse for the low risk group (r = 0·47, prevalence 2·9 %). IgG subclass restriction also decreased cross-reactions of syphilitic sera in the ELISA with sonicated antigen.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/00222615-40-4-293
1994-04-01
2024-03-28
Loading full text...

Full text loading...

/deliver/fulltext/jmm/40/4/medmicro-40-4-293.html?itemId=/content/journal/jmm/10.1099/00222615-40-4-293&mimeType=html&fmt=ahah

References

  1. Baranton G, Postic D, Saint Girons I. Delineation of Bonella burgdorferi sensu stricto, Bonella gannii sp. nov., and group VS461 associated with Lyme borreliosis. Int J Syst Bacteriol 1992; 42:378–383
    [Google Scholar]
  2. Lane RS, Lennette ET, Madigan JE. Interlaboratory and intralaboratory comparisons of indirect immunofluor-escence assays for serodiagnosis of Lyme disease. J Clin Mlcroblol 1990; 28:1774–1779
    [Google Scholar]
  3. Golightly MG, Thomas JA. Lyme borreliosis serologies in perspective. Clin Immunol Newsletter 1991; 11:113–118
    [Google Scholar]
  4. Magnarelli LA, Anderson JF, Barbour AG. Enzyme-linked immunosorbent assays for Lyme disease: reactivity of subunits of Borrelia burgdorferi. J Infect Dis 1989; 159:43–49
    [Google Scholar]
  5. Hansen K, Hindersson P, Strandberg Pedersen N. Measurement of antibodies to the Borrelia burgdorferi flagellum improves serodiagnosis in Lyme disease. J Clin Mlcroblol 1988; 26:338–346
    [Google Scholar]
  6. Coleman JL, Benach JL. Identification and characterization of an endoflagellar antigen of Bonella burgdorferi. J Clin Invest 1989; 84:322–330
    [Google Scholar]
  7. Lefebvre RB, Perng GC, Johnson RC. The 83-kilodalton antigen of Bonella burgdorferi which stimulates immuno-globulin M (IgM) and IgG responses in infected hosts is expressed by a chromosomal gene. J Clin Microbiol 1990; 28:1673–1675
    [Google Scholar]
  8. Simpson WJ, Burgdorfer W, Schrumpf ME, Karstens RH, Schwan TG. Antibody to a 39-kilodalton Borrelia burgdorferi antigen (P39) as a marker for infection in experimentally and naturally infected animals. J Clin Microbiol 1991; 29:236–243
    [Google Scholar]
  9. Hechemy KE, Harris HL, Duerr MJ, Benach JL, Reimer CB. Immunoglobulin G subclasses specific to Borrelia burgdorferi in patients with Lyme disease. Ann NY Acad Sci 1988; 539:162–169
    [Google Scholar]
  10. Regueiro JR, Perez-Aciego P, Aparicio P, Martinez C, Morales P, Arnaiz-Villena A. Low IgG2 and polysaccharide response in a T cell receptor expression defect. Eur J Immunol 1990; 20:2411–2416
    [Google Scholar]
  11. Ijsselmuiden OE, Schouls LM, Stolz E. Sensitivity and specificity of an enzyme-linked immunosorbent assay using the recombinant DNA-derived Treponema pallidum protein TmpA for serodiagnosis of syphilis and the potential use of TmpA for assessing the effect of antibiotic therapy. J Clin Mlcroblol 1989; 27:152–157
    [Google Scholar]
  12. Schauman K, Kovanen J, Seppälä I. Lyme borreliosis in Finland 1986–1988. Biomed Pharmacother 1989; 43:427–430
    [Google Scholar]
  13. Gustafson R, Svenungsson B, Gardulf A, Stiernstedt G, Forsgren M. Prevalence of tick-borne encephalitis and Lyme borreliosis in a defined Swedish population. ScandJ Infect Dis 1990; 22:297–306
    [Google Scholar]
  14. Wahlberg P. Incidence of tick-bite in man in Aland islands: reference to the spread of Lyme borreliosis. Scand J Infect Dis 1990; 22:59–62
    [Google Scholar]
  15. Kroneld R, Meurman O, Forsen K-O, Lassenius R. The prevalence of antibodies against viruses causing Kumlinge and Pogosta diseases on the islands of Iniö on the southwest coast of Finland. Scand J Infect Dis 1989; 21:9–13
    [Google Scholar]
  16. Marconi RT, Garon CF. Development of polymerase chain reaction primer sets for diagnosis of Lyme disease and for species-specific identification of Lyme disease isolates by 16S rRNA signature nucleo tide analysis. J Clin Microbiol 1992; 30:2830–2834
    [Google Scholar]
  17. Berger BW, Kaplan MH, Rothenberg IR, Barbour AG. Isolation and characterization of the Lyme disease spirochete from the skin of patients with erythema chronicum migrans. J Am Acad Dermatol 1985; 13:444–449
    [Google Scholar]
  18. Sarnesto A. Monoclonal antibodies reacting with isotypic and/or allotypic determinants of human IgG. Med Biol 1983; 61:126–132
    [Google Scholar]
  19. Seppälä I, Sarvas H, Makela O, Mattila P, Eskola J, Kayhty H. Human antibody responses to two conjugate vaccines of Haemophilus influenzae type b saccharides and diphtheria toxin. Scand J Immunol 1988; 28:471–479
    [Google Scholar]
  20. Stiernstedt GT, Granström M, Hederstedt B, Sköldenberg B. Diagnosis of spirochetal meningitis by enzyme-linked immunosorbent assay and indirect immunofluorescence assay in serum and cerebrospinal fluid. J Clin Microbiol 1985; 21:819–825
    [Google Scholar]
  21. Seppälä IJT, Routonen N, Sarnesto A, Mattila PA, Makela O. The percentages of six immunoglobulin isotypes in human antibodies to tetanus toxoid : standardization of isotype-specific second antibodies in solid-phase assay. Eur J Immunol 1984; 14:868–875
    [Google Scholar]
  22. Magnarelli LA, Anderson JF, Johnson RC. Cross-reactivity in serological tests for Lyme disease and other spirochetal infections. J Infect Dis 1987; 156:183–188
    [Google Scholar]
  23. Raoult D, Hechemy KE, Baranton G. Cross-reaction with Bonella burgdorferi antigen of sera from patients with human immunodeficiency virus infection, syphilis and leptospirosis. J Clin Microbiol 1989; 27:2152–2155
    [Google Scholar]
  24. Magnarelli LA, Miller JN, Anderson JF, Riviere GR. Cross- reactivity of nonspecific treponemal antibody in serologie tests for Lyme disease. J Clin Microbiol 1990; 28:1276–1279
    [Google Scholar]
  25. Olsson I, Hammarström L, Smith CIE, Hovmark A, Asbrink E. IgG subclasses of specific antibodies in Ixodes ricinus-borne borreliosis. Clin Exp Immunol 1987; 69:618–623
    [Google Scholar]
  26. Hansen K, Bangsborg JM, Fjordvang H, Strandberg Pedersen N, Hindersson P. Immunochemical characterization of and isolation of the gene for a Borrelia burgdorferi immunodominant 60-kilodalton antigen common to a wide range of bacteria. Infect Immun 1988; 56:2047–2053
    [Google Scholar]
  27. Artsob H, Huibner S. Complement fixation test for the diagnosis of Lyme disease. J Clin Microbiol 1990; 28:637–638
    [Google Scholar]
  28. Baughn RE, Jorizzo JL, Adams CB, Musher DM. Ig class and IgG subclass responses to Treponema pallidum in patients with syphilis. J Clin Immunol 1988; 8:128–139
    [Google Scholar]
  29. Callister SM, Schell RF, Case KL, Lovrich SD, Day SP. Characterization of the borreliacidal antibody response to Borrelia burgdorferi in humans: a serodiagnostic test. J Infect Dis 1993; 167:158–164
    [Google Scholar]
  30. Karlsson M, Stiernstedt G, Granström M, Åsbrink E, Wretlind B. Comparison of flagellum and sonicate antigens for serological diagnosis of Lyme borreliosis. Eur J Clin Microbiol Infect Dis 1990; 9:169–177
    [Google Scholar]
  31. Wahlberg P, Granlund H, Nyman D, Panelius J, Seppalâ I. Late Lyme borreliosis: epidemiology, diagnosis and clinical features. Ann Med 1993; 25:349–352
    [Google Scholar]
  32. Berek C, Ziegner M. The maturation of the immune response. Immunol Today 1993; 14:400–404
    [Google Scholar]
  33. Huycke MM, D'Alessio DD, Marx JJ. Prevalence of antibody to Borrelia burgdorferi by indirect fluorescent antibody assay, ELISA and Western immunoblot in healthy adults in Wisconsin and Arizona. J Infect Dis 1992; 165:1133–1137
    [Google Scholar]
  34. Zöller L, Burkard S, Schafer H. Validity of Western immuno- blot band patterns in the serodiagnosis of Lyme borreliosis. J Clin Microbiol 1991; 29:174–182
    [Google Scholar]
  35. Karlsson M, Möllegård I, Stiernstedt G, Wretlind B. Com- parison of Western blot and enzyme-linked immuno-sorbent assay for diagnosis of Lyme borreliosis. Eur J Clin Microbiol Infect Dis 1989; 8:871–877
    [Google Scholar]
  36. Dressier F, Whalen JA, Reinhardt BN, Steere AC. Western blotting in the serodiagnosis of Lyme disease. J Infect Dis 1993; 167:392–400
    [Google Scholar]
  37. Rasiah C, Schiltz E, Reichert J, Vogt A. Purification and characterization of a tryptic peptide of Borrelia burgdorferi flagellin, which reduces cross-reactivity in immunoblots and ELISA. J Gen Microbiol 1992; 138:147–154
    [Google Scholar]
  38. Robinson JM, Pilot-Matias TJ, Pratt SD, Patel CB, Bevirt TS, Hunt CJ. Analysis of the humoral response to the Flagellin protein of Borrelia burgdorferi: Cloning of regions capable of differentiating Lyme disease from syphilis. J Clin Microbiol 1993; 31:629–635
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/00222615-40-4-293
Loading
/content/journal/jmm/10.1099/00222615-40-4-293
Loading

Data & Media loading...

Most cited Most Cited RSS feed