Serologic Diagnosis of Lyme Borreliosis by Using Enzyme-Linked Immunosorbent Assays with Recombinant Antigens

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Journal of Clinical Microbiology, May 2000, p. 1735-1739, Vol. 38, No. 5
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Serologic Diagnosis of Lyme Borreliosis by Using Enzyme-Linked Immunosorbent Assays with Recombinant Antigens

Louis A. Magnarelli,¹^,^* Jacob W. Ijdo,² Steven J. Padula,³ Richard A. Flavell,⁴ and Erol Fikrig²

Department of Entomology, The Connecticut Agricultural Experiment Station, New Haven, Connecticut 06504¹; Section of Rheumatology, Department of Medicine,² and Section of Immunobiology and Howard Hughes Medical Institute,⁴ Yale University School of Medicine, New Haven, Connecticut 06520; and Division of Rheumatic Diseases, Department of Medicine, University of Connecticut Health Center, Farmington, Connecticut 06030³

Received 19 October 1999/Returned for modification 28 December 1999/Accepted 21 February 2000

Class-specific enzyme-linked immunosorbent assays (ELISAs) with purified recombinant antigens of Borrelia burgdorferi sensustricto and Western blot analyses with whole cells of this spirochetewere used to test human sera to determine which antigens werediagnostically important. In analyses for immunoglobulin M (IgM)antibodies, 14 (82%) of 17 serum samples from persons who haderythema migrans reacted positively by an ELISA with one or morerecombinant antigens. There was frequent antibody reactivity toprotein 41-G (p41-G), outer surface protein C (OspC), and OspFantigens. In an ELISA for IgG antibodies, 13 (87%) of 15 serumsamples had antibodies to recombinant antigens; reactivity top22, p39, p41-G, OspC, and OspF antigens was frequent. By bothELISAs, serum specimens positive for OspB, OspE, and p37 wereuncommon. Analyses of sera obtained from persons who were suspectedof having human granulocytic ehrlichiosis (HGE) but who lackedantibodies to ehrlichiae revealed IgM antibodies to all recombinantantigens of B. burgdorferi except OspB and IgG antibodies to allantigens except OspE. Immunoblotting of sera from the study groupof individuals suspected of having HGE reaffirmed antibody reactivityto multiple antigens of B. burgdorferi. There was minor cross-reactivitywhen sera from healthy subjects or persons who had syphilis, oralinfections, or rheumatoid arthritis were tested by ELISAs withp37, p41-G, OspB, OspC, OspE, and OspF antigens. Although theresults of class-specific ELISAs with recombinant antigens werecomparable to those recorded for assays with whole-cell antigenand for individuals with confirmed clinical diagnoses of Lymeborreliosis, immunoblotting is still advised as an adjunct procedure,particularly when there are low antibody titers by anELISA.

^* Corresponding author. Mailing address: Department of Entomology, The Connecticut Agricultural Experiment Station, P.O. Box1106, New Haven, CT 06504-1106. Phone: (203) 974-8466. Fax: (203)974-8502. E-mail: louis.magnarelli{at}po.state.ct.us.

Journal of Clinical Microbiology, May 2000, p. 1735-1739, Vol. 38, No. 5
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

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