Tick-borne infections are the most common vector-borne diseases in the USA. Ticks harbor and transmit several infections with Lyme disease being the most common tickborne infection in the US and Europe. Lack of awareness about tick populations, specific diagnostic tests, and overlapping signs and symptoms of tick-borne infections can often lead to misdiagnosis affecting treatment and the prevalence data reported especially for non-Lyme tick-borne infections. The diagnostic tests currently available for tick-borne diseases are severely limited in their ability to provide accurate results and cannot detect multiple pathogens in a single run. The multiplex protein microarray developed at Vibrant was designed to detect multiple serological antibodies thereby detecting exposure to multiple pathogens simultaneously. Our microarray in its present form can accommodate 400 antigens (molecules that can bind to specific antibodies) and can multiplex across antigen types, whole cell lysates, recombinant proteins, and peptides. A designed array containing multiple antigens of several microbes including Borrelia burgdorferi, the Lyme disease spirochete, was manufactured and evaluated. The immunoglobulin M (IgM) and G (IgG) responses against several tick-borne microbes and other infectious agents were analyzed for analytical and clinical performance. The microarray improved IgM and IgG sensitivities and specificities of individual microbes when compared with the respective gold standards. The testing was also performed in a single run in comparison to multiple runs needed for comparable testing standards. In summary, our study presents a flexible multiplex microarray platform that can provide quick results with high sensitivity and specificity for evaluating exposure to varied infectious agents especially tick-borne pathogens.

Biomedical Sciences Department College of Health Sciences Qatar University P O Box 2713 Doha Qatar

Department of Immunopathology of Infectious and Parasitic Diseases Medical University of Warsaw 3C Pawińskiego Street 02 106 Warsaw Poland

Department of Infectious Diseases Hospital Ceske Budejovice Ceske Budejovice Czech Republic

Department of Parasitology Faculty of Biology Diagnostic Laboratory of Parasitic Diseases and Zoonotic Infections Biological and Chemical Research Centre University of Warsaw Warsaw Poland

Division of Infectious Diseases Department of Internal Medicine University of Texas Medical Branch Galveston TX 77555 USA

Institute of Parasitology Biology Centre of the Czech Academy of Sciences Ceske Budejovice Czech Republic

Irving Medical Center Department of Pathology and Cell Biology Columbia University New York USA

Laboratory of Biotechnology at Institute of Biomedical Science University of Ciudad Juárez Ciudad Juárez Mexico

Laboratory of Clinical Microbiology and Microbial Pathogenesis School of Medicine University of Crete 70013 Heraklion Crete Greece

Microbiologia E Virologia Fondazione IRCCS Policlinico San Matteo 27100 Pavia Italy

University of Helsinki Haartmaninkatu 3 00290 Helsinki Finland

Veterinary Research Institute Brno Czech Republic

Veterinary Research Institute Faculty of Science Masaryk University Brno Czech Republic

Vibrant America LLC San Carlos CA USA

Vibrant Sciences LLC San Carlos CA USA

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