Serological Diagnostics of Lyme Borreliosis: Comparison of Universal and Borrelia Species-Specific Tests Based on Whole-Cell and Recombinant Antigens
Language English Country United States Media electronic-print
Document type Comparative Study, Journal Article, Research Support, Non-U.S. Gov't
PubMed
30185509
PubMed Central
PMC6204684
DOI
10.1128/jcm.00601-18
PII: JCM.00601-18
Knihovny.cz E-resources
- Keywords
- Borrelia burgdorferi, Lyme disease, comparative studies, immunoassays, serology,
- MeSH
- Antigens, Bacterial immunology MeSH
- Borrelia burgdorferi immunology isolation & purification MeSH
- Borrelia immunology isolation & purification MeSH
- Immunoassay methods MeSH
- Humans MeSH
- Lyme Disease blood classification diagnosis MeSH
- Antibodies, Bacterial blood MeSH
- Reagent Kits, Diagnostic MeSH
- Sensitivity and Specificity MeSH
- Serologic Tests methods MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Comparative Study MeSH
- Names of Substances
- Antigens, Bacterial MeSH
- Antibodies, Bacterial MeSH
- Reagent Kits, Diagnostic MeSH
The study compares diagnostic parameters of different commercial serological kits based on three different antigen types and correlates test results with the status of the patient's Borrelia infection. In total, 8 IgM and 8 IgG kits were tested, as follows: enzyme-linked immunosorbent assay (ELISA) (Euroimmun) based on whole-cell antigen, 3 species-specific enzyme immunoassays (EIAs) (TestLine), Liaison chemiluminescence (DiaSorin), ELISA-Viditest (Vidia), EIA, and Blot-Line (TestLine) using recombinant antigens. All tests were performed on a panel of 90 samples from patients with clinically characterized borreliosis (53 with neuroborreliosis, 32 with erythema migrans, and 5 with arthritis) plus 70 controls from blood donors and syphilis patients. ELISA based on whole-cell antigens has superior sensitivity and superior negative predictive value and serves as an excellent screening test, although its specificity and positive predictive values are low. Species-specific tests have volatile parameters. Their low sensitivity and low negative predictive value handicap them in routine diagnostics. Tests with recombinant antigens are characterized by high specificity and high positive predictive value and have a wide range of use in diagnostic practice. Diagnostic parameters of individual tests depend on the composition of the sample panel. Only a small proportion of contradictory samples giving both negative and positive results is responsible for discrepancies between test results. Correlation of test results with the patient's clinical state is limited, especially in the erythema migrans group with high proportions of negative and contradictory results. In contrast, IgG test results in the neuroborreliosis group, which are more concordant, show acceptable agreement with Borrelia status.
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Reply to Lacout et al., "Value of Patient Population Selection and Lyme Borreliosis Tests"
