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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 sensu stricto and Western blot analyses with whole cells of this spirochete were used to test human sera to determine which antigens were diagnostically important. In analyses for immunoglobulin M (IgM) antibodies, 14 (82%) of 17 serum samples from persons who had erythema migrans reacted positively by an ELISA with one or more recombinant antigens. There was frequent antibody reactivity to protein 41-G (p41-G), outer surface protein C (OspC), and OspF antigens. In an ELISA for IgG antibodies, 13 (87%) of 15 serum samples had antibodies to recombinant antigens; reactivity to p22, p39, p41-G, OspC, and OspF antigens was frequent. By both ELISAs, serum specimens positive for OspB, OspE, and p37 were uncommon. Analyses of sera obtained from persons who were suspected of having human granulocytic ehrlichiosis (HGE) but who lacked antibodies to ehrlichiae revealed IgM antibodies to all recombinant antigens of B. burgdorferi except OspB and IgG antibodies to all antigens except OspE. Immunoblotting of sera from the study group of individuals suspected of having HGE reaffirmed antibody reactivity to multiple antigens of B. burgdorferi. There was minor cross-reactivity when sera from healthy subjects or persons who had syphilis, oral infections, or rheumatoid arthritis were tested by ELISAs with p37, p41-G, OspB, OspC, OspE, and OspF antigens. Although the results of class-specific ELISAs with recombinant antigens were comparable to those recorded for assays with whole-cell antigen and for individuals with confirmed clinical diagnoses of Lyme borreliosis, immunoblotting is still advised as an adjunct procedure, particularly when there are low antibody titers by an ELISA.

* Corresponding author. Mailing address: Department of Entomology, The Connecticut Agricultural Experiment Station, P.O. Box 1106, 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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