A decrease in the immunoglobulin G antibody response against the VlsE protein of Borrelia burgdorferi sensu lato correlates with the resolution of clinical signs in antibiotic-treated patients with early Lyme disease

Abstract

The purpose of this study was to evaluate the diagnostic performance of the LIAISON Borrelia Screen (Diasorin, Saluggia, Italy), a new automated immunoassay based on the chemiluminescent technology (chemiluminescence immunoassay). To assess whether a decrease in a negative value in the anti-VlsE immunoglobulin G (IgG) antibody titer was correlated with a positive response to treatment, a group of serially collected serum samples from 67 patients with culture-confirmed erythema migrans was retrospectively studied. All the patients had been treated with antibiotics and were free of disease within 3 to 6 months of follow-up. All the 15 patients who were found to be IgG positive at the time of enrollment and who were bled at least four times during the follow-up became IgG seronegative at 2 to 6 months posttreatment. These results indicate that a decline in the anti-VlsE antibody titer coincides with effective antimicrobial therapy in patients with early localized Lyme disease.

FIG. 1.

Results obtained by LIAISON Borrelia Screen assay when the 67 serum specimens drawn at the enrollment were tested. The x axis shows the duration of EM at the time that the patients entered the study. The number of samples is indicated by the number above each individual bar in the graph.

FIG. 2.

Decrease in IgG response observed in the 15 patients studied during the follow-up, as detected by LIAISON Borrelia Screen IgG assay. Samples with IgG concentrations below 10 AU/ml were negative, samples with IgG concentrations ranging from 10 to 15 AU/ml were equivocal (as indicated by the horizontal bar), and samples with IgG concentrations equal to or greater than 15 AU/ml were positive.