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Comparative Study
. 2003 Apr 15;187(8):1187-99.
doi: 10.1086/374395. Epub 2003 Apr 2.

Serodiagnosis of Lyme disease by kinetic enzyme-linked immunosorbent assay using recombinant VlsE1 or peptide antigens of Borrelia burgdorferi compared with 2-tiered testing using whole-cell lysates

Rendi Murphree Bacon  1 , Brad J Biggerstaff, Martin E Schriefer, Robert D Gilmore Jr, Mario T Philipp, Allen C Steere, Gary P Wormser, Adriana R Marques, Barbara J B Johnson
Affiliations
Comparative Study

Serodiagnosis of Lyme disease by kinetic enzyme-linked immunosorbent assay using recombinant VlsE1 or peptide antigens of Borrelia burgdorferi compared with 2-tiered testing using whole-cell lysates

Rendi Murphree Bacon et al. J Infect Dis. .

Abstract

In a study of US patients with Lyme disease, immunoglobulin (Ig) G and IgM antibody responses to recombinant Borrelia burgdorferi antigen VlsE1 (rVlsE1), IgG responses to a synthetic peptide homologous to a conserved internal sequence of VlsE (C6), and IgM responses to a synthetic peptide comprising the C-terminal 10 amino acid residues of a B. burgdorferi outer-surface protein C (pepC10) were evaluated by kinetic enzyme-linked immunoassay. At 99% specificity, the overall sensitivities for detecting IgG antibody to rVlsE1 or C6 in samples from patients with diverse manifestations of Lyme disease were equivalent to that of 2-tiered testing. When data were considered in parallel, 2 combinations (IgG responses to either rVlsE1 or C6 in parallel with IgM responses to pepC10) maintained high specificity (98%) and were significantly more sensitive than 2-tiered analysis in detecting antibodies to B. burgdorferi in patients with acute erythema migrans. In later stages of Lyme disease, the sensitivities of the in parallel tests and 2-tiered testing were high and statistically equivalent.

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Figures

Table 1
Table 1
Performance of single-antigen kinetic ELISAs and 2-tiered testing for detecting antibodies to Borrelia burgdorferi in serum
Figure 1
Figure 1
SDS-PAGE of purified recombinant VlsE1 stained with Coomassie brilliant blue. Lane 1 Molecular mass marker; lane 2 recombinant VlsE1. The approximate mass in kilodaltons is noted to the left
Table 2
Table 2
Performance of in parallel kinetic ELISAs for detecting antibodies to Borrelia burgdorferi in serum
Figure 2
Figure 2
Receiver-operator characteristic curves for single-antigen kinetic ELISAs. C6, 26 aa of VlsE; pepC10, C-terminal 10 aa of Borrelia burgdorferi outer-surface protein C; rVlsE1, recombinant VlsE1
Figure 3
Figure 3
Sensitivity (%) of single-antigen kinetic ELISA, 2-tiered analysis, and in parallel kinetic ELISA. Test performances with serum samples from patients with acute Lyme disease for whom the interval between the date of onset of erythema migrans and the date of first treatment was reported are compared with all Lyme disease serum samples. C6, 26 aa of VlsE; pepC10, C-terminal 10 aa of Borrelia burgdorferi outer-surface protein C; rVlsE1, recombinant VlsE1
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References

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