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[我们环境中莱姆病血清学诊断的蛋白质印迹解释标准的比较研究]

[A comparative study of western blot interpretation criteria for Lyme disease serological diagnosis in our environment].

作者信息

Núñez Murillo E, Gutiérrez Fernández J, Guerrero Fernández M, Piedrola Angulo G, Maroto Vela C

机构信息

Departamento de Microbiología, Hospital Universitario San Cecilio, Universidad de Granada.

出版信息

An Med Interna. 1998 Jan;15(1):8-12.

PMID:9580180
Abstract

We have studied the WB reliability for the Lyme disease (LD) serological diagnosis. Twenty five samples (20 sera and 5 CSF) from 5 patients with LD, according to CDC criteria were analyzed. The syphilis was excluded in every patient. Borrelia burgdorferi antibodies were assessed by an indirect ELISA (IgG + IgM, B31 strain). Intrathecal antibodies in CSF were studied in patients with neurological diseases. Positive samples by ELISA were reanalyzed by WB according to the manufacturer, Tilton and Dressler criteria and presence either 93, 39, 34 or 23 kDa band for IgG. Four patients were controlled and one of them (25%) became negative the antibodies (serorreversion). Three of them, who had neurological symptoms, displayed intrathecal antibodies. WB sensibility for LD according to the manufacturer, Tilton, Dressler and any of the four IgG bands was 26.31%, 42.1%, 21% and 84% for IgG and 52.6%, 47.3% and 42.1% for IgM respectively. Tilton and Dressler criteria may not be as sensible as 93, 39, 34 or 23 kDa IgG bands for the diagnosis of LD in our environment.

摘要

我们研究了用于莱姆病(LD)血清学诊断的免疫印迹法(WB)的可靠性。根据美国疾病控制与预防中心(CDC)标准,对5例LD患者的25份样本(20份血清和5份脑脊液)进行了分析。所有患者均排除梅毒感染。通过间接酶联免疫吸附测定法(ELISA,检测B31菌株的IgG + IgM)评估伯氏疏螺旋体抗体。对患有神经疾病的患者的脑脊液中的鞘内抗体进行了研究。ELISA检测呈阳性的样本根据制造商、蒂尔顿(Tilton)和德雷斯勒(Dressler)标准通过WB重新分析,且存在针对IgG的93、39、34或23 kDa条带。对4例患者进行了随访,其中1例(25%)抗体转阴(血清学逆转)。他们中有3例有神经症状,显示存在鞘内抗体。根据制造商、蒂尔顿、德雷斯勒标准以及四条IgG条带中的任何一条,WB对LD的IgG敏感性分别为26.31%、42.1%、21%和84%,对IgM的敏感性分别为52.6%、47.3%和42.1%。在我们的环境中,对于LD的诊断,蒂尔顿和德雷斯勒标准可能不如93、39、34或23 kDa IgG条带敏感。

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