Brandt Kevin S, Ullmann Amy J, Molins Claudia R, Horiuchi Kalanthe, Biggerstaff Brad J, Gilmore Robert D
Division of Vector Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States of America.
Division of Vector Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, United States of America.
Diagn Microbiol Infect Dis. 2019 Mar;93(3):196-202. doi: 10.1016/j.diagmicrobio.2018.09.012. Epub 2018 Oct 3.
Improved serologic tests are needed for accurate diagnosis and proper treatment of early stage Lyme disease. We evaluated the 3 antigens currently used for 2-tiered IgM immunoblot testing (FlaB, OspC, and BmpA) in combination with 3 additional antigens (BBA65, BBA70, and BBA73) and measured the sensitivity and specificity against a serum repository of positive and negative controls. Using 3 statistical methods for positivity cutoff determinations and scoring criteria, we found increased sensitivities for early Lyme disease when 2 of 6 antigens were positive as compared with the 2 of 3 antigen IgM criteria currently used for second-tier immunoblot scoring. Specificities for negative controls were comparable or superior to using 2 of 3 antigens. These results indicate that IgM sensitivity and specificity of serological testing for Lyme disease in the early stages of illness can be improved by employing antigens that target the initial host antibody responses.
为了准确诊断和恰当治疗早期莱姆病，需要改进血清学检测方法。我们评估了目前用于两层IgM免疫印迹检测的3种抗原（FlaB、OspC和BmpA），并将其与另外3种抗原（BBA65、BBA70和BBA73）联合使用，针对阳性和阴性对照血清库测量其敏感性和特异性。使用3种统计方法来确定阳性临界值和评分标准，我们发现，与目前用于第二层免疫印迹评分的3种抗原中的2种呈阳性的IgM标准相比，当6种抗原中的2种呈阳性时，早期莱姆病的敏感性有所提高。阴性对照的特异性与使用3种抗原中的2种时相当或更高。这些结果表明，通过使用针对初始宿主抗体反应的抗原，可以提高疾病早期莱姆病血清学检测的IgM敏感性和特异性。
