Sensitive and Specific Serodiagnosis of Lyme Disease by Enzyme-Linked Immunosorbent Assay with a Peptide Based on an Immunodominant Conserved Region of Borrelia burgdorferi VlsE

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Journal of Clinical Microbiology, December 1999, p. 3990-3996, Vol. 37, No. 12
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Sensitive and Specific Serodiagnosis of Lyme Disease by Enzyme-Linked Immunosorbent Assay with a Peptide Based on an Immunodominant Conserved Region of Borrelia burgdorferi VlsE

Fang Ting Liang,¹ Allen C. Steere,² Adriana R. Marques,³ Barbara J. B. Johnson,⁴ James N. Miller,⁵ and Mario T. Philipp¹^,^*

Department of Parasitology, Tulane Regional Primate Research Center, Tulane University Medical Center, Covington, Louisiana 70433;¹ Division of Rheumatology, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02111²; National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892³; Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado 80522⁴; and Department of Microbiology and Immunology, University of California at Los Angeles, Los Angeles, California 90095⁵

Received 30 June 1999/Returned for modification 12 August 1999/Accepted 19 August 1999

VlsE, the variable surface antigen of Borrelia burgdorferi, contains an immunodominant conserved region named IR₆. In thepresent study, the diagnostic performance of a peptide enzyme-linkedimmunosorbent assay (ELISA) based on a 26-mer synthetic peptide(C₆) with the IR₆ sequence was explored. Sensitivity was assessedwith serum samples (n = 210) collected from patients with clinicallydefined Lyme disease at the acute (early localized or early disseminateddisease), convalescent, or late disease phase. The sensitivitiesfor acute-, convalescent-, and late-phase specimens were 74% (29of 39), 85 to 90% (34 of 40 to 35 of 39), and 100% (59 of 59),respectively. Serum specimens from early neuroborreliosis patientswere 95% positive (19 of 20), and those from an additional groupof patients with posttreatment Lyme disease syndrome yielded asensitivity of 62% (8 of 13). To assess the specificity of thepeptide ELISA, 77 serum samples from patients with other spirochetalor chronic infections, autoimmune diseases, or neurologic diseasesand 99 serum specimens from hospitalized patients in an area whereLyme disease is not endemic were examined. Only two potentialfalse positives from the hospitalized patients were found, andthe overall specificity was 99% (174 of 176). Precision, whichwas assessed with a panel of positive and negative serum specimensarranged in blinded duplicates, was 100%. Four serum samples withvery high anti-OspA antibody titers obtained from four monkeysgiven the OspA vaccine did not react with the C₆ peptide. Thissimple, sensitive, specific, and precise ELISA may contributeto alleviate some of the remaining problems in Lyme disease serodiagnosis.Because of its synthetic peptide base, it will be inexpensiveto manufacture. It also will be applicable to serum specimensfrom OspA-vaccinatedsubjects.

^* Corresponding author. Mailing address: Tulane Regional Primate Research Center, Tulane University Medical Center, 18703 ThreeRivers Rd., Covington, LA 70433. Phone: (504) 871-6221. Fax: (504)871-6390. E-mail: philipp{at}tpc.tulane.edu.

Journal of Clinical Microbiology, December 1999, p. 3990-3996, Vol. 37, No. 12
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

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