Can ELISPOT Be Applied to A Clinical Setting as A Diagnostic Utility for Neuroborreliosis?

Abstract

The aim of this prospective study was to investigate the diagnostic performance of Borrelia (Bb)-induced interferon (IFN)-γ secretion detected by ELISPOT modified to be feasible for clinical laboratories as a supplementary test to the laboratory diagnosis of Lyme neuroborreliosis (LNB) in an endemic setting. Between 2002 and 2004, patients with symptoms of suspected clinical LNB were included in a study conducted on the Åland islands in the Finnish archipelago, which is a hyper-endemic area for Lyme borreliosis (LB). Fourteen patients with confirmed LNB and 103 patients with non-LNB were included, and the numbers of spontaneous and Bb-induced IFN-γ-secreting cells were assayed by the ELISPOT test. The ELISPOT assay showed a weak diagnostic performance with a sensitivity of 36% and a specificity of 82%. The findings in this study show that this ELISPOT-assay modified to be feasible in clinical routine laboratories is not useful as a supplementary diagnostic tool in the laboratory diagnosis of patients with clinically suspected LNB.

Figure 1

Spontaneous (A) and Borrelia-induced IFN-γ secretion (B) in cerebrospinal fluid from patients with Lyme neuroborreliosis and non-Lyme borreliosis. Medians are shown. The P-value represents the difference between the groups when compared using a Mann-Whitney U-test.

Figure 2

Receiver operating characteristics (ROC)-curve. The true positive rate (sensitivity) was plotted as a function of the false positive rate (1- specificity) for different cut-off points of number of Borrelia induced IFN-γ secreting cells.