Mikkilä H, Karma A, Viljanen M, Seppälä I
Department of Ophthalmology, Helsinki University Central Hospital, Finland.
Graefes Arch Clin Exp Ophthalmol. 1999 Mar;237(3):225-30. doi: 10.1007/s004170050223.
A study was carried out to evaluate indirect enzyme-linked immunosorbent assay (ELISA), immunoblot analysis, and polymerase chain reaction (PCR) in the diagnostic work-up of ocular Lyme borreliosis.
Twenty patients with ocular Lyme borreliosis were examined. IgG and IgM antibodies to Borrelia burgdorferi were measured by ELISA in serum, and in cerebrospinal fluid (CSF) when indicated, and immunoblot analysis of B. burgdorferi IgG antibodies in serum was performed. A nested PCR was used to detect a segment of a gene coding for B. burgdorferi endoflagellin. The samples used in PCR testing were serum and CSF and in isolated cases conjunctiva and vitreous.
Seventeen patients had elevated Borrelia antibodies in serum or CSF by ELISA. Seven patients, including two with negative ELISA, had a positive immunoblot. Seven of the 13 patients in whom PCR was examined during clinically active disease had a positive PCR result. Immunoblot analysis gave a negative result from the sera of five PCR-positive patients.
For efficient diagnosis of ocular Lyme borreliosis, immunoblot analysis and PCR should be used in addition to ELISA. A positive PCR seems to be associated with a negative immunoblot.
开展了一项研究，以评估间接酶联免疫吸附测定（ELISA）、免疫印迹分析和聚合酶链反应（PCR）在眼部莱姆病诊断检查中的作用。
对20例眼部莱姆病患者进行了检查。通过ELISA检测血清中以及必要时脑脊液（CSF）中抗伯氏疏螺旋体的IgG和IgM抗体，并对血清中伯氏疏螺旋体IgG抗体进行免疫印迹分析。采用巢式PCR检测编码伯氏疏螺旋体内鞭毛蛋白的一段基因。PCR检测所用样本为血清、脑脊液，个别病例还包括结膜和玻璃体。
17例患者血清或脑脊液中的伯氏疏螺旋体抗体通过ELISA检测呈升高。7例患者免疫印迹呈阳性，其中2例ELISA检测为阴性。在临床活动期接受PCR检测的13例患者中，7例PCR结果呈阳性。5例PCR阳性患者的血清免疫印迹分析结果为阴性。
为有效诊断眼部莱姆病，除ELISA外，还应使用免疫印迹分析和PCR。PCR阳性似乎与免疫印迹阴性相关。
