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. 2023 Nov 28;13(23):3547.
doi: 10.3390/diagnostics13233547.

Diagnostic Precision in Lyme borreliosis: Assessing VlsE and C6 Antigens in a Pediatric Cohort

Marta Wozinska  1 , Kacper Toczylowski  1 , Dawid Lewandowski  1 , Ewa Bojkiewicz  1 , Robert Milewski  2 , Artur Sulik  1
Affiliations

Diagnostic Precision in Lyme borreliosis: Assessing VlsE and C6 Antigens in a Pediatric Cohort

Marta Wozinska et al. Diagnostics (Basel). .

Abstract

(1) Background: Lyme borreliosis (LB) is a tick-borne disease known for its diagnostic challenges. Conventional two-tiered testing (CTTT) for antibodies is time-consuming, has low sensitivity in the early stages of disease, and sometimes generates false-positive IgM immunoblots. To tackle this issue, modified two-tiered testing (MTTT) was introduced, incorporating recombinant VlsE and C6 antigens to enhance diagnostic accuracy. (2) Methods: In this prospective study, we enrolled children exhibiting symptoms indicative of LB. We collected serum samples at various intervals and subjected them to analysis using standard enzyme immunoassays. We then compared these results with the outcomes from the VlsE and C6 assays. (3) Results: In our study, all 33 patients displaying erythema migrans (EM), a characteristic symptom of LB, exhibited positive responses to the C6 antigen. This finding underscores the potential utility of the C6 antigen as a reliable diagnostic tool for LB. Additionally, we observed a significant reduction in anti-VlsE antibody levels following antibiotic treatment in EM patients. (4) Conclusions: The utilization of recombinant VlsE and C6 antigens in LB diagnostics and monitoring has yielded promising results. Nonetheless, it is imperative for clinicians to exercise caution and interpret results in conjunction with clinical findings, considering the dynamic nature of medical guidelines. Even with recombinant antigen tests, some children with EM tested negative, highlighting the importance of clinical diagnosis for treatment decisions. Furthermore, clinicians should be mindful of the possibility of persistently positive VlsE/C6 test results during LB treatment monitoring.

Keywords: Borrelia burgdorferi; Lyme borreliosis; diagnostic precision; pediatric diagnosis; prevention; recombinant antigens.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Anti-VlsE and standard Lyme EIA IgG antibody levels in monitoring erythema migrans and Lyme neuroborreliosis treatment.
See this image and copyright information in PMC

References

    1. Steere A.C., Strle F., Wormser G.P., Hu L.T., Branda J.A., Hovius J.W., Li X., Mead P.S. Lyme Borreliosis. Nat. Rev. Dis. Primers. 2016;2:16090. doi: 10.1038/nrdp.2016.90. - DOI - PMC - PubMed
    1. Aguero-Rosenfeld M.E., Wang G., Schwartz I., Wormser G.P. Diagnosis of Lyme Borreliosis. Clin. Microbiol. Rev. 2005;18:484–509. doi: 10.1128/CMR.18.3.484-509.2005. - DOI - PMC - PubMed
    1. Rudenko N., Golovchenko M., Grubhoffer L., Oliver J.H. Updates on Borrelia Burgdorferi Sensu Lato Complex with Respect to Public Health. Ticks Tick Borne Dis. 2011;2:123–128. doi: 10.1016/j.ttbdis.2011.04.002. - DOI - PMC - PubMed
    1. Lohr B., Fingerle V., Norris D.E., Hunfeld K.-P. Laboratory Diagnosis of Lyme Borreliosis: Current State of the Art and Future Perspectives. Crit. Rev. Clin. Lab. Sci. 2018;55:219–245. doi: 10.1080/10408363.2018.1450353. - DOI - PubMed
    1. Cardenas-de la Garza J.A., De la Cruz-Valadez E., Ocampo-Candiani J., Welsh O. Clinical Spectrum of Lyme Disease. Eur. J. Clin. Microbiol. Infect. Dis. 2019;38:201–208. doi: 10.1007/s10096-018-3417-1. - DOI - PubMed

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