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一种用于莱姆病血清学诊断的新型多参数微斑点阵列的评估

Evaluation of a New Multiparametric Microspot Array for Serodiagnosis of Lyme Borreliosis.

作者信息

Schenk Jana, Doebis Cornelia, Küsters Uta, von Baehr Volker

出版信息

Clin Lab. 2015;61(11):1715-25. doi: 10.7754/clin.lab.2015.150310.

Abstract

BACKGROUND

Laboratory diagnosis of Lyme borreliosis follows a two-step algorithm, starting with a screening assay with maximum sensitivity followed by a confirmatory assay of positive results with respect to specificity. Line immunoassays with single recombinant antigen lines are the established confirmatory test method, although result interpretation is not standardized. The present study evaluates suitability of the multiplex test SeraSpot Anti-Borrelia IgG/IgM (SeraSpot) as confirmatory test in serodiagnosis of Lyme disease.

METHODS

For this retrospective study, serum samples from patients with suspicion of Lyme borreliosis were analyzed. For determination of specificity, blood donor samples as well as rheumatoid factor (RF), ANA, and EBV positive sera were investigated. The SeraSpot IgG/IgM results were compared with the recomBead Borrelia IgG/IgM (recomBead) test as alternative multiplex-based method.

RESULTS

In comparison to the recomBead test the sensitivity of SeraSpot was determined 95% for IgG/IgM detection. The analysis of blood donors revealed a specificity of ≥ 96.0% for SeraSpot IgG/IgM and of 97.3% for recomBead IgG/IgM. RF positive samples tested negative by both assays (specificity of 100%). ANA and EBV antibody positive samples resulted in specificities of 90% (SeraSpo IgG/IgM) and ≥ 94% (recomBead IgG/IgM) and ≥ 91% (SeraSpot IgG/IgM) and ≥ 91% (recomBead IgG/IgM). The intra- and interassay coefficient of variation (CV) and the lot-to-lot reproducibility of the SeraSpot assay ranged between 1 - 9% for the different Borrelia IgG and IgM antigens. Potentially interfering substances (bilirubin F, bilirubin C, hemoglobin, lipid factor, and rheumatoid factor) did not influence the SeraSpot assays.

CONCLUSIONS

Our evaluation data confirm that new multiplex assay generations such as SeraSpot Anti-Borrelia IgG/IgM are reliable and robust test systems suitable for application as confirmatory tests for serodiagnosis of Lyme borreliosis.

摘要

背景

莱姆病的实验室诊断采用两步法,首先进行具有最大灵敏度的筛查试验,然后对阳性结果进行特异性确认试验。单重组抗原条带的线性免疫测定是既定的确认试验方法,尽管结果解释尚未标准化。本研究评估了多重检测血清斑点抗伯氏疏螺旋体IgG/IgM(血清斑点)作为莱姆病血清学诊断确认试验的适用性。

方法

对于这项回顾性研究,分析了疑似莱姆病患者的血清样本。为了确定特异性,对献血者样本以及类风湿因子(RF)、抗核抗体(ANA)和EB病毒阳性血清进行了研究。将血清斑点IgG/IgM结果与作为替代多重检测方法的重组珠伯氏疏螺旋体IgG/IgM(重组珠)检测进行比较。

结果

与重组珠检测相比,血清斑点检测IgG/IgM的灵敏度为95%。对献血者的分析显示,血清斑点IgG/IgM的特异性≥96.0%,重组珠IgG/IgM的特异性为97.3%。RF阳性样本在两种检测中均呈阴性(特异性为100%)。ANA和EB病毒抗体阳性样本的特异性分别为90%(血清斑点IgG/IgM)和≥94%(重组珠IgG/IgM)以及≥91%(血清斑点IgG/IgM)和≥91%(重组珠IgG/IgM)。血清斑点检测针对不同伯氏疏螺旋体IgG和IgM抗原的批内和批间变异系数(CV)以及批次间再现性在1%至9%之间。潜在干扰物质(胆红素F、胆红素C、血红蛋白、脂质因子和类风湿因子)不影响血清斑点检测。

结论

我们的评估数据证实,新型多重检测方法如血清斑点抗伯氏疏螺旋体IgG/IgM是可靠且稳健的检测系统,适用于作为莱姆病血清学诊断的确认试验。

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