Grodzicki R L, Steere A C
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.
J Infect Dis. 1988 Apr;157(4):790-7. doi: 10.1093/infdis/157.4.790.
We compared immunoblotting and indirect enzyme-linked immunosorbent assay (ELISA) using different antigen preparations to test for antibody to Borrelia burgdorferi in patients with early Lyme disease. With immunoblotting, 16 (53%) of 30 patients had positive tests in acute-phase sera and 25 (83%) had them in convalescent-phase sera. Among 64 controls, false-positive results were obtained in only three individuals with syphilis and in one hospitalized patient with renal allograft rejection. Among the patients with Lyme disease, both IgM and IgG antibodies most commonly bound to the 41-kilodalton (kDa) flagellar antigen, but many patients had binding to other components, particularly those of 25, 55, 58, or 66 kDa, and the order of their appearance was variable. Compared with indirect ELISA (using sonicated whole spirochetes or a flagellin-enriched fraction as the antigen preparation), more patients with Lyme disease had positive tests by immunoblotting, and fewer control subjects had false-positive results. Our results indicate that immunoblotting is superior to indirect ELISA for diagnosing early Lyme disease.
我们使用不同的抗原制剂比较了免疫印迹法和间接酶联免疫吸附测定（ELISA），以检测早期莱姆病患者血清中抗伯氏疏螺旋体的抗体。采用免疫印迹法时，30例患者中有16例（53%）急性期血清检测呈阳性，25例（83%）恢复期血清检测呈阳性。在64名对照者中，仅3例梅毒患者和1例肾移植排斥反应住院患者出现假阳性结果。在莱姆病患者中，IgM和IgG抗体最常与41千道尔顿（kDa）鞭毛抗原结合，但许多患者也与其他成分结合，特别是25、55、58或66 kDa的成分，且其出现顺序不一。与间接ELISA（使用超声破碎的全螺旋体或富含鞭毛蛋白的组分作为抗原制剂）相比，更多莱姆病患者免疫印迹法检测呈阳性，而对照者中假阳性结果较少。我们的结果表明，免疫印迹法在诊断早期莱姆病方面优于间接ELISA。
