Magnarelli L A
Department of Entomology, Connecticut Agricultural Experiment Station, New Haven.
Rheum Dis Clin North Am. 1989 Nov;15(4):735-45.
Different techniques have been developed to aid in laboratory diagnosis of Lyme disease. The detection of serum antibodies, in particular, is relied on heavily by the medical community and is currently the most practical means of confirming B. burgdorferi infections. Although most assays may not detect low amounts of IgM antibody during the initial weeks of infection, application of a capture ELISA method has been reported to improve test sensitivity. Antibodies to Borrelia and Treponema spirochetes will cross-react in conventional assays being used for Lyme disease, but in most cases, these problems can be eliminated by performing other serologic tests or by reviewing clinical and epidemiologic data. Further improvements in the laboratory diagnosis of Lyme disease should be made by standardizing current methods (including commercial test kits), establishing reference laboratories in the United States and Europe, and by developing rapid antigen detection procedures. Finally, serologic determination of B. burgdorferi infections should remain secondary to clinical diagnosis.
已经开发出不同的技术来辅助莱姆病的实验室诊断。特别是血清抗体的检测，在医学界被大量依赖，并且目前是确认伯氏疏螺旋体感染的最实用手段。尽管大多数检测方法在感染最初几周可能无法检测到少量的IgM抗体，但据报道，应用捕获ELISA方法可提高检测灵敏度。在用于莱姆病的传统检测中，针对疏螺旋体属的博氏疏螺旋体和梅毒螺旋体的抗体将会发生交叉反应，但在大多数情况下，通过进行其他血清学检测或审查临床和流行病学数据，这些问题可以得到解决。莱姆病实验室诊断的进一步改进应通过规范当前方法（包括商业检测试剂盒）、在美国和欧洲建立参考实验室以及开发快速抗原检测程序来实现。最后，伯氏疏螺旋体感染的血清学测定应次于临床诊断。
