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Chapter 57 : Lyme Disease: Serologic Assays for Antibodies to

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Abstract:

Lyme disease is the most common tick-borne bacterial disease in the northern hemisphere. The disease is caused by three genomic groups or genospecies of sensu lato: sensu stricto, , and . Only sensu stricto is known to cause Lyme disease in North America, whereas all three genospecies are responsible for the disease in Europe. Serology is the most useful type of laboratory test that is widely available to support a clinical diagnosis of Lyme disease. Positive serologic test results, however, should not be used by themselves to establish this diagnosis. Laboratory testing of samples from such patients also is not recommended, since testing will result in more false-positive results than true positives. Serum specimens first should be evaluated by a sensitive enzyme immunoassay (EIA) or immunofluorescent assay (IFA). During the first month of infection, both immunoglobulin M (IgM) and immunoglobulin G (IgG) antibody responses should be determined. A strain used as an antigen in a serologic test should express appropriate amounts of the immunoreactive proteins of diagnostic interest. Positive-control serum samples from patients with well-characterized Lyme disease are required, preferably four samples that possess a range of anti- antibody levels from low to high.

Citation: Johnson B. 2006. Lyme Disease: Serologic Assays for Antibodies to , p 493-500. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch57

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Figures

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FIGURE 1

Example of immunoblot calibration. Lanes: 1, monoclonal antibodies defining selected antigens of B31 separated in a linear sodium dodecyl sulfate-polyacrylamide gel (Marblot; MarDx Diagnostics, Carlsbad, Calif.); 2, human serum (IgG) reactive with the 10 antigens scored in the currently recommended criteria for blot interpretation. Arrowheads mark the bands recommended for scoring; lines indicate other calibrating antibodies. Molecular masses are in kilodaltons.

Citation: Johnson B. 2006. Lyme Disease: Serologic Assays for Antibodies to , p 493-500. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch57
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References

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Tables

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TABLE 1

Performance of serologic tests for detecting antibodies to sensu stricto in serum

Citation: Johnson B. 2006. Lyme Disease: Serologic Assays for Antibodies to , p 493-500. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch57

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