Lencáková Daniela, Fingerle Volker, Stefancíková Astéria, Schulte-Spechtel Ulrike, Petko Branislav, Schréter Ivan, Wilske Bettina
Department of Natural Foci Diseases, Parasitological Institute, Slovak Academy of Sciences, Kosice, Slovakia.
Vector Borne Zoonotic Dis. 2008 Jun;8(3):381-90. doi: 10.1089/vbz.2007.0216.A.
In the present study the sensitivity and the specificity of three serological tests (enzyme-linked immunosorbent assay [ELISA], indirect fluorescent antibody test [IFA], and recombinant line immunoblot) were compared by examining 74 sera from patients diagnosed with Lyme disease in Eastern Slovakia. In addition, the reactivity to each of the recombinant proteins in the immunoblot was examined in order to evaluate their diagnostic value. Generally, the immunoblot (93.2%) and the ELISA (90.5%) were significantly more sensitive than the IFA (64.9%; df = 1; p < or = 0.001). Correlation between results of the ELISA, IFA, and immunoblot for IgM or IgG, when two tests were always compared, one to the other, ranged from r(s) = 0.673 to r(s) = 0.905. In the immunoblot, the highest sensitivity was observed in DbpA and VlsE proteins (76.9% and 84.6%, respectively) in IgG testing of the sera from the patient group of Lyme arthritis. VlsE proteins, together with OspC proteins, were also shown to be useful for IgM antibody detection in erythema migrans patients (up to 44.4% and 53.7% sensitivity, respectively). Our results indicate that both the ELISA and the recombinant immunoblot test were more satisfactory for seroconfirmation of Lyme disease than IFA. Moreover, the reseach confirmed diagnostic value of the in-vivo expressed proteins (VlsE and DbpA), which might have the potential to play an important role in improving whole-cell antigen-based testing.
在本研究中，通过检测来自斯洛伐克东部确诊为莱姆病患者的74份血清，比较了三种血清学检测方法（酶联免疫吸附测定[ELISA]、间接荧光抗体试验[IFA]和重组线性免疫印迹）的敏感性和特异性。此外，还检测了免疫印迹中每种重组蛋白的反应性，以评估其诊断价值。总体而言，免疫印迹（93.2%）和ELISA（90.5%）的敏感性显著高于IFA（64.9%；自由度=1；p≤0.001）。当总是将两种检测方法相互比较时，ELISA、IFA和免疫印迹检测IgM或IgG结果之间的相关性范围为r(s)=0.673至r(s)=0.905。在免疫印迹中，在莱姆关节炎患者组血清的IgG检测中，观察到DbpA和VlsE蛋白的敏感性最高（分别为76.9%和84.6%）。VlsE蛋白与OspC蛋白一起，也被证明对游走性红斑患者的IgM抗体检测有用（敏感性分别高达44.4%和53.7%）。我们的结果表明，ELISA和重组免疫印迹检测对于莱姆病的血清学确诊比IFA更令人满意。此外，该研究证实了体内表达蛋白（VlsE和DbpA）的诊断价值，它们可能在改进基于全细胞抗原的检测中发挥重要作用。
