Evaluation of Patient IgM and IgG Reactivity Against Multiple Antigens for Improvement of Serodiagnostic Testing for Early Lyme Disease

Serologic testing is the standard for laboratory diagnosis and confirmation of Lyme disease. Serodiagnostic assays to detect antibodies against Borrelia burgdorferi, the agent of Lyme borreliosis, are used for detection of infection. However, serologic testing within the first month of infection is...

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Main Authors: Kevin S. Brandt (Author), Kalanthe Horiuchi (Author), Brad J. Biggerstaff (Author), Robert D. Gilmore (Author)
Format: Book
Published: Frontiers Media S.A., 2019-12-01T00:00:00Z.
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042 |a dc 
100 1 0 |a Kevin S. Brandt  |e author 
700 1 0 |a Kalanthe Horiuchi  |e author 
700 1 0 |a Brad J. Biggerstaff  |e author 
700 1 0 |a Robert D. Gilmore  |e author 
245 0 0 |a Evaluation of Patient IgM and IgG Reactivity Against Multiple Antigens for Improvement of Serodiagnostic Testing for Early Lyme Disease 
260 |b Frontiers Media S.A.,   |c 2019-12-01T00:00:00Z. 
500 |a 2296-2565 
500 |a 10.3389/fpubh.2019.00370 
520 |a Serologic testing is the standard for laboratory diagnosis and confirmation of Lyme disease. Serodiagnostic assays to detect antibodies against Borrelia burgdorferi, the agent of Lyme borreliosis, are used for detection of infection. However, serologic testing within the first month of infection is less sensitive as patients' antibody responses continue to develop. Previously, we screened several B. burgdorferi in vivo expressed antigens for candidates that elicit early antibody responses in patients with Stage 1 and 2 Lyme disease. We evaluated patient IgM seroreactivity against 6 antigens and found an increase in sensitivity without compromising specificity when compared to current IgM second-tier immunoblot scoring. In this study, we continued the evaluation using a multi-antigen panel to measure IgM plus IgG seroreactivity in these early Lyme disease patients' serum samples. Using two statistical methods for calculating positivity cutoff values, sensitivity was 70 and 84-87%, for early acute and early convalescent Lyme disease patients, respectively. Specificity was 98-100% for healthy non-endemic control patients, and 96-100% for healthy endemic controls depending on the statistical analysis. We conclude that improved serologic testing for early Lyme disease may be achieved by the addition of multiple borrelial antigens that elicit IgM and IgG antibodies early in infection. 
546 |a EN 
690 |a Borrelia burgdorferi 
690 |a Lyme disease 
690 |a serodiagnostics 
690 |a multiantigen testing 
690 |a in vivo-expressed antigens 
690 |a Public aspects of medicine 
690 |a RA1-1270 
655 7 |a article  |2 local 
786 0 |n Frontiers in Public Health, Vol 7 (2019) 
787 0 |n https://www.frontiersin.org/article/10.3389/fpubh.2019.00370/full 
787 0 |n https://doaj.org/toc/2296-2565 
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