Tjernberg Ivar, Sillanpää Heidi, Seppälä Ilkka, Eliasson Ingvar, Forsberg Pia, Lahdenne Pekka
Department of Clinical Chemistry, Kalmar County Hospital, S-391 85 Kalmar, Sweden.
Int J Med Microbiol. 2009 Aug;299(6):439-46. doi: 10.1016/j.ijmm.2008.10.006. Epub 2009 Jan 9.
The aim of this study was to evaluate the antibody responses to different VlsE protein IR(6) peptide variants and the synthetic C6 peptide in acute and convalescent (2-3 and 6 months) serum samples from Swedish patients with clinical erythema migrans (EM). Serum samples were prospectively collected from 148 patients with EM and compared to serum samples obtained from 200 healthy blood donors. The IgG responses to 3 IR(6) peptide variants originating from Borrelia burgdorferi (B. burgdorferi) sensu stricto, B. garinii, and B. afzelii were measured by enzyme-linked immunosorbent assays (ELISAs) and compared to a commercial C6 peptide ELISA. Seropositivity rate in the IR(6) or C6 peptide ELISAs ranged from 32% to 58% at presentation, 30-52% after 2-3 months, and 20-36% after 6 months. At presentation, positive antibodies in any of the 4 ELISAs were found in 66%. In 7/52 (13%), C6-negative EM cases, serological reaction was found to the B. burgdorferi sensu stricto-derived IR(6) peptide. In patients reporting previous LB compared to those without previous LB, significantly higher seropositivity rates were noted for all IR(6) peptides, but not for the C6 peptide. In the serology of EM in Europe, C6 ELISA does not seem to cover all cases. An ELISA using a mixture of B. burgdorferi sensu stricto IR(6) peptide and the C6 peptide could be of value in the serodiagnosis of LB in Europe. Further studies on combinations of variant IR(6) peptides and the C6 peptide in other manifestations of LB are needed to address this issue.
本研究的目的是评估瑞典临床游走性红斑（EM）患者急性期和恢复期（2 - 3个月及6个月）血清样本中针对不同VlsE蛋白IR(6)肽变体及合成C6肽的抗体反应。前瞻性收集了148例EM患者的血清样本，并与200名健康献血者的血清样本进行比较。通过酶联免疫吸附测定（ELISA）检测针对源自狭义伯氏疏螺旋体（B. burgdorferi sensu stricto）、伽氏疏螺旋体（B. garinii）和阿氏疏螺旋体（B. afzelii）的3种IR(6)肽变体的IgG反应，并与一种商用C6肽ELISA进行比较。IR(6)或C6肽ELISA的血清阳性率在就诊时为32%至58%，2 - 3个月后为30 - 52%，6个月后为20 - 36%。就诊时，4种ELISA中任何一种呈阳性抗体的比例为66%。在7/52（13%）例C6阴性的EM病例中，发现对狭义伯氏疏螺旋体来源的IR(6)肽有血清学反应。与无既往莱姆病（LB）病史的患者相比，有既往LB病史的患者中，所有IR(6)肽的血清阳性率显著更高，但C6肽的血清阳性率无显著差异。在欧洲EM的血清学检测中，C6 ELISA似乎不能涵盖所有病例。使用狭义伯氏疏螺旋体IR(6)肽和C6肽混合物的ELISA在欧洲LB的血清诊断中可能具有价值。需要进一步研究IR(6)肽变体与C6肽的组合在LB其他表现中的情况，以解决这一问题。
