Wilske B
Max-von-Pettenkofer-Institut für Hygiene und Medizinische Mikrobiologie, Ludwig-Maximilians-Universität München.
Z Hautkr. 1988 Jun 15;63(6):511-4.
There are various serodiagnostic tests available for the detection of antibodies against Borrelia burgdorferi. An indirect hemagglutination assay, which can detect both IgM and IgG antibodies, was developed for antibody screening. Regarding the confirmation and differentiation of IgM and IgG, we use the indirect immunofluorescence assay (most specific when performed with sera previously absorbed with Treponema phagedenis) as well as the ELISA test. The detection of significantly elevated antibody titers depends on the stage of the disease. In erythema migrans, only 20-50% of the patients are seropositive (with a prevalence of IgM); in neuroborreliosis, the figures amount to 70-90% of the patients (prevalence of IgM in early stages and IgG in advanced stages); and 90-100% of the cases with acrodermatitis and arthritis show elevated titers of IgG (IgM antibodies usually are not detectable in late manifestations). The clinical manifestations of the disease is serologically marked by IgM antibodies or--in neuroborreliosis--by intrathecal production or antibodies which can be detected on account of an increased CSF/serum index.
有多种血清学诊断测试可用于检测抗伯氏疏螺旋体的抗体。为了进行抗体筛查，开发了一种间接血凝试验，该试验可以检测IgM和IgG抗体。关于IgM和IgG的确认和区分，我们使用间接免疫荧光试验（用噬菌密螺旋体预先吸收的血清进行检测时最具特异性）以及酶联免疫吸附测定。抗体滴度显著升高的检测取决于疾病的阶段。在游走性红斑中，只有20%至50%的患者血清呈阳性（IgM占优势）；在神经莱姆病中，这一比例为70%至90%的患者（早期IgM占优势，晚期IgG占优势）；90%至100%的肢端皮炎和关节炎病例显示IgG滴度升高（在晚期表现中通常检测不到IgM抗体）。该疾病的临床表现血清学上以IgM抗体为特征，或者在神经莱姆病中以鞘内产生的抗体或由于脑脊液/血清指数增加而可检测到的抗体为特征。
