Dessau Ram B, Fryland Linda, Wilhelmsson Peter, Ekerfelt Christina, Nyman Dag, Forsberg Pia, Lindgren Per-Eric
Department of Clinical Microbiology, Slagelse Hospital, Region Zealand, Slagelse, Denmark
Infectious Medicine, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Clin Vaccine Immunol. 2015 Jul;22(7):823-7. doi: 10.1128/CVI.00026-15. Epub 2015 May 20.
Lyme borreliosis is a tick-borne disease caused by the bacterium Borrelia burgdorferi. The most frequent clinical manifestation is a rash called erythema migrans. Changes in antibody reactivity to B. burgdorferi 3 months after a tick bite are measured using enzyme-linked immunosorbent assays (ELISAs). One assay is based on native purified flagellum antigen (IgG), and the other assay is based on a recombinant antigen called C6 (IgG or IgM). Paired samples were taken at the time of a tick bite and 3 months later from 1,886 persons in Sweden and the Åland Islands, Finland. The seroconversion or relative change is defined by dividing the measurement units from the second sample by those from the first sample. The threshold for the minimum level of significant change was defined at the 2.5% level to represent the random error level. The thresholds were a 2.7-fold rise for the flagellar IgG assay and a 1.8-fold rise for the C6 assay. Of 1,886 persons, 102/101 (5.4%) had a significant rise in antibody reactivity in the flagellar assay or the C6 assay. Among 40 cases with a diagnosis of Lyme borreliosis, the sensitivities corresponding to a rise in antibodies were 33% and 50% for the flagellar antigen and the C6 antigen, respectively. Graphical methods to display the antibody response and to choose thresholds for a rise in relative antibody reactivity are shown and discussed. In conclusion, 5.4% of people with tick bites showed a rise in Borrelia-specific antibodies above the 2.5% threshold in either ELISA but only 40 (2.1%) developed clinical Lyme borreliosis.
莱姆病是一种由伯氏疏螺旋体引起的蜱传疾病。最常见的临床表现是一种名为游走性红斑的皮疹。通过酶联免疫吸附测定（ELISA）来测量蜱叮咬3个月后对伯氏疏螺旋体抗体反应性的变化。一种测定基于天然纯化的鞭毛抗原（IgG），另一种测定基于一种名为C6的重组抗原（IgG或IgM）。在瑞典和芬兰奥兰群岛，对1886人在蜱叮咬时和3个月后采集配对样本。血清转化或相对变化通过将第二个样本的测量单位除以第一个样本的测量单位来定义。显著变化的最低水平阈值定义为2.5%水平，以代表随机误差水平。鞭毛IgG测定的阈值是升高2.7倍，C6测定的阈值是升高1.8倍。在1886人中，102/101（5.4%）在鞭毛测定或C6测定中抗体反应性有显著升高。在40例诊断为莱姆病的病例中，鞭毛抗原和C6抗原抗体升高对应的敏感性分别为33%和50%。展示了用于呈现抗体反应以及选择相对抗体反应性升高阈值的图形方法并进行了讨论。总之，5.4%的蜱叮咬者在任何一种ELISA中显示伯氏疏螺旋体特异性抗体升高超过2.5%阈值，但只有40人（2.1%）发展为临床莱姆病。
