Advances in Serodiagnostic Testing for Lyme Disease Are at Hand

Clin Infect Dis. 2018 Mar 19;66(7):1133-1139. doi: 10.1093/cid/cix943.

Abstract

The cause of Lyme disease, Borrelia burgdorferi, was discovered in 1983. A 2-tiered testing protocol was established for serodiagnosis in 1994, involving an enzyme immunoassay (EIA) or indirect fluorescence antibody, followed (if reactive) by immunoglobulin M and immunoglobulin G Western immunoblots. These assays were prepared from whole-cell cultured B. burgdorferi, lacking key in vivo expressed antigens and expressing antigens that can bind non-Borrelia antibodies. Additional drawbacks, particular to the Western immunoblot component, include low sensitivity in early infection, technical complexity, and subjective interpretation when scored by visual examination. Nevertheless, 2-tiered testing with immunoblotting remains the benchmark for evaluation of new methods or approaches. Next-generation serologic assays, prepared with recombinant proteins or synthetic peptides, and alternative testing protocols, can now overcome or circumvent many of these past drawbacks. This article describes next-generation serodiagnostic testing for Lyme disease, focusing on methods that are currently available or near-at-hand.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Antibodies, Bacterial / blood*
  • Antigens, Bacterial / immunology
  • Bacterial Proteins / immunology
  • Borrelia burgdorferi / immunology
  • Enzyme-Linked Immunosorbent Assay
  • Europe
  • Humans
  • Immunoenzyme Techniques
  • Immunoglobulin G / blood
  • Immunoglobulin M / blood
  • Lyme Disease / diagnosis*
  • Recombinant Proteins
  • Sensitivity and Specificity
  • Serologic Tests / methods*
  • Serologic Tests / trends
  • United States

Substances

  • Antibodies, Bacterial
  • Antigens, Bacterial
  • Bacterial Proteins
  • Immunoglobulin G
  • Immunoglobulin M
  • Recombinant Proteins