Chapter 11.6 : Detection of Antibodies

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Zoom in

Detection of Antibodies, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555817435/9781555815271_Chap11_6-1.gif /docserver/preview/fulltext/10.1128/9781555817435/9781555815271_Chap11_6-2.gif


Lyme disease, or Lyme borreliosis (LB), is a multisystem disease caused by and transmitted through the bite of infected ticks ( ). It is currently the most frequent vector- borne infectious disease in the United States, with the highest incidence in the northeastern and midwestern states ( ). LB is also prevalent in Europe, where evidence of the disease existed in the early 1900s and where it is transmitted by complex.

Citation: Garcia L. 2010. Detection of Antibodies, p 173-182. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch11.6
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


1. Agger, W. A.,, and K. L. Case. 1997. Clinical comparison of borreliacidal-antibody test with indirect immunofluorescence and enzymelinked immunosorbent assays for diagnosis of Lyme disease. Mayo Clin. Proc. 72:510514.
2. Aguero-Rosenfeld, M. E.,, J. Nowakowski,, D. F. McKenna,, C. A. Carbonaro,, and G. P. Wormser. 1993. Serodiagnosis in early Lyme disease. J. Clin. Microbiol. 31:30903095.
3. Aguero-Rosenfeld, M. E.,, J. Nowakowski,, S. Bittker,, D. Cooper,, R. B. Nadelman,, and G. P. Wormser. 1996. Evolution of the serologic response to Borrelia burgdorferi in treated patients with culture-confirmed erythema migrans. J. Clin. Microbiol. 34:19.
4. Aguero-Rosenfeld, M. E.,, J. Roberge,, C. A. Carbonaro,, J. Nowakowski,, R. B. Nadelman,, and G. P. Wormser. 1999. Effects of OspA vaccination on Lyme disease serologic testing. J. Clin. Microbiol. 37:37183721.
5. Aguero-Rosenfeld, M. E.,, G. Wang,, I. Schwartz,, and G. P. Wormser. 2005. Diagnosis of Lyme borreliosis. Clin. Microbiol. Rev. 18:484509.
6.American College of Physicians. 1997. Guidelines for laboratory evaluation in the diagnosis of Lyme disease. Clinical guideline part 1. Ann. Intern. Med. 127:11061108.
7. Bacon, R. M.,, B. J. Biggerstaff,, M. E. Schriefer,, R. D. Gilmore, Jr.,, M. T. Philipp,, A. C. Steere,, G. P. Wormser,, A. R. Marques,, and B. J. Johnson. 2003. Serodiagnosis of Lyme disease by kinetic enzyme-linked immunosorbent assay using recombinant VlsE1 or peptide antigens of Borrelia burgdorferi compared with 2-tiered testing using wholecell lysates. J. Infect. Dis. 187:11871199.
8. Bakken, L. L.,, S. M. Callister,, P. J. Wand,, and R. F. Schell. 1997. Interlaboratory comparison of test results for detection of Lyme disease by 516 participants in the Wisconsin State Laboratory of Hygiene/College of American Pathologists proficiency testing program. J. Clin. Microbiol. 35:537543.
9. Barbour, A. G. 1984. Isolation and cultivation of Lyme disease spirochetes. Yale J. Biol. Med. 57:521524.
10. Barbour, A. G.,, and S. F. Hayes. 1986. Biology of Borrelia species. Microbiol. Rev. 50:381400.
11. Brown, S. L.,, S. L. Hansen,, and J. J. Langone. 1999. Role of serology in the diagnosis of Lyme disease. JAMA 282:6266.
12. Brunner, M.,, and L. H. Sigal. 2001. Use of serum immune complexes in a new test that accurately confirms early Lyme disease and active infection with Borrelia burgdorferi. J. Clin. Microbiol. 39:32133221.
13. Burkert, S.,, D. Rossler,, P. Munchhoff,, and B. Wilske. 1996. Development of enzymelinked immunosorbent assays using recombinant borrelial antigens for serodiagnosis of Borrelia burgdorferi infection. Med. Microbiol. Immunol. 185:4957.
14. Callister, S. M.,, R. F. Schell,, L. C. L. Lim,, D. A. Jobe,, K. L. Case,, G. L. Bryant,, and P. E. Molling. 1994. Detection of borreliacidal antibodies by flow cytometry. Arch. Intern. Med. 154:16251632.
15. Callister, S. M.,, D. A. Jobe,, W. A. Agger,, R. F. Schell,, T. J. Kowalski,, S. D. Lovrich,, and J. A. Marks. 2002. Ability of the borreliacidal antibody test to confirm Lyme disease in clinical practice. Clin. Diagn. Lab. Immunol. 9:908912.
16. Casjens, S.,, N. Palmer,, R. van Vugt,, H. W. Mun,, B. Stevenson,, P. Rosa,, R. Lathigra,, G. Sutton,, J. Peterson,, R. J. Dodson,, D. Haft,, E. Hickey,, M. Gwinn,, O. White,, and M. Fraser. 2000. A bacterial genome in flux: the twelve linear and nine circular extrachromosomal DNAs in an infectious isolate of the Lyme disease spirochete Borrelia burgdorferi. Mol. Microbiol. 35:490516.
17.Centers for Disease Control and Prevention. 1995. Recommendations for test performance and interpretation from the second national conference on serologic diagnosis of Lyme disease. MMWR Morb. Mortal. Wkly. Rep. 44:590591.
18.Centers for Disease Control and Prevention. 2007. Lyme disease—United States, 2003-2005. MMWR Morb. Mortal. Wkly. Rep. 56:573576.
19.Centers for Disease Control and Prevention. 2005. Notice to readers: caution regarding testing for Lyme disease. MMWR Morb. Mortal. Wkly. Rep. 54:125.
20. Coleman, J. L.,, and J. L. Benach. 1987. Isolation of antigenic components from the Lyme disease spirochete: their role in early diagnosis. J. Infect. Dis. 155:756765.
21. Craft, J. E.,, D. K. Fischer,, G. T. Shimamoto,, and A. C. Steere. 1986. Antigens of Borrelia burgdorferi recognized during early Lyme disease. J. Clin. Investig. 78:934939.
22. Crother, T. R.,, C. I. Champion,, X. Y. Wu,, D. R. Blanco,, J. N. Miller,, and M. A. Lovett. 2003. Antigenic composition of Borrelia burgdorferi during infection of SCID mice. Infect. Immun. 71:34193428.
23. Dressler, F.,, J. A. Whalen,, B. N. Reinhardt,, and A. C. Steere. 1993. Western blotting in the serodiagnosis of Lyme disease. J. Infect. Dis. 167:392400.
24. Engstrom, S. M.,, E. Shoop,, and R. C. Johnson. 1995. Immunoblot interpretation criteria for serodiagnosis of early Lyme disease. J. Clin. Microbiol. 33:419427.
25. Fawcett, P. T.,, K. M. Gibney,, C. D. Rose,, S. B. Dubbs,, and R. A. Doughty. 1992. Frequency and specificity of antibodies that crossreact with Borrelia burgdorferi antigens. J. Rheumatol. 19:582587.
26. Feder, H. M., Jr.,, M. A. Gerber,, S. W. Luger,, and R. W. Ryan. 1992. Persistence of serum antibodies to Borrelia burgdorferi in patients treated for Lyme disease. Clin. Infect. Dis. 15:788793
27. Fikrig, E.,, W. Feng,, S. W. Barthold,, S. R. Telford III,, and R. A. Flavell. 2000. Arthropod- and host-specific Borrelia burgdorferi bbk32 expression and the inhibition of spirochete transmission. J. Immunol. 164:5344 5351.
28. Gilmore, R. D., Jr.,, R. L. Murphree,, A. M. James,, S. A. Sullivan,, and B. J. B. Johnson. 1999. The Borrelia burgdorferi 37-kilodalton immunoblot band (P37) used in serodiagnosis of early Lyme disease is the flaA gene product. J. Clin. Microbiol. 37:548552.
29. Gomes-Solecki, M. J. C.,, J. J. Dunn,, B. J. Luft,, J. Castillo,, D. E. Dykhuizen,, X. Yang,, J. D. Glass,, and R. J. Dattwyler. 2000. Recombinant chimeric borrelia proteins for diagnosis of Lyme disease. J. Clin. Microbiol. 38:25302535.
30. Gomes-Solecki, M. J. C.,, L. Meirelles,, J. Glass,, and R. J. Dattwyler. 2007. Epitope length, genospecies dependency, and serum panel effect in the IR6 enzyme-linked immunosorbent assay for detection of antibodies to Borrelia burgdorferi. Clin. Vaccine Immunol. 14:875879.
31. Hauser, U.,, G. Lehnert,, and B. Wilske. 1999. Validity of interpretation criteria for standardized Western blots (immunoblots) for serodiagnosis of Lyme borreliosis based on sera collected throughout Europe. J. Clin. Microbiol. 37:22412247.
32. Johnson, B. J.,, B. J. Biggerstaff,, R. M. Bacon,, and M. E. Schriefer. 2004. Cost-effectiveness of peptide-antigen immunoassays for Lyme disease. J. Infect. Dis. 189:19621964.
33. Klempner, M. S.,, C. H. Schmid,, L. Hu,, A. C. Steere,, G. Johnson,, B. McCloud,, R. Noring,, and A. Weinstein. 2001. Intralaboratory reliability of serologic and urine testing for Lyme disease. Am. J. Med. 110:217219.
34. Lawrenz, M. B.,, J. M. Hardham,, R. T. Owens,, J. Nowakowski,, A. C. Steere,, G. P. Wormser,, and S. J. Norris. 1999. Human antibody responses to VlsE antigenic variation protein of Borrelia burgdorferi. J. Clin. Microbiol. 37:39974004.
35. Ledue, T. B.,, M. F. Collins,, and W. Y. Craig. 1996. New laboratory guidelines for serologic diagnosis of Lyme disease: evaluation of the two-test protocol. J. Clin. Microbiol. 34:23432350.
36. Liang, F. T.,, A. C. Steere,, A. R. Marques,, B. J. B. Johnson,, J. N. Miller,, and M. T. Philipp. 1999. Sensitive and specific serodiagnosis of Lyme disease by enzyme-linked immunosorbent assay with a peptide based on an immunodominant conserved region of Borrelia burgdorferi VlsE. J. Clin. Microbiol. 37:39903996.
37. Magnarelli, L. A.,, J. W. IJdo,, S. J. Padula,, R. A. Flavell,, and E. Fikrig. 2000. Serologic diagnosis of Lyme borreliosis by using enzyme- linked immunosorbent assays with recombinant antigens. J. Clin. Microbiol. 38:17351739.
38. Marangoni, A.,, M. Sparacino,, and F. Cavrini. 2005. Comparative evaluation of three different ELISA methods for the diagnosis of early culture-confirmed Lyme disease in Italy. J. Med. Microbiol. 54:361367.
39. Massarotti, E. M.,, S. W. Luger,, D. W. Rahn,, R. P. Messner,, J. B. Wong,, R. C. Johnson,, and A. C. Steere. 1992. Treatment of early Lyme disease. Am. J. Med. 92:396403.
40. Miller, J. C.,, K. von Lackum,, K. Babb,, J. D. McAlister,, and B. Stevenson. 2003. Temporal analysis of Borrelia burgdorferi Erp protein expression throughout the mammal-tick infectious cycle. Infect. Immun. 71:69436952.
41. Mogilyansky, E.,, C. C. Loa,, M. E. Adelson,, E. Mordechai,, and R. C. Tilton. 2004. Comparison of Western immunoblotting and the C6 Lyme antibody test for laboratory detection of Lyme disease. Clin. Diagn. Lab. Immunol. 11:924929.
42. Molloy, P. J.,, V. P. Verardi,, D. H. Persing,, and L. H. Sigal. 1999. Detection of multiple reactive protein species by immunoblotting after recombinant outer surface protein A Lyme disease vaccination. Clin. Infect. Dis. 31:4247.
43. Nachamkin, I.,, D. L. Riddle,, M. Feldman,, and P. H. Edelstein. 1996. Utilization of tests for Lyme disease antibody at a university hospital. Clin. Diagn. Lab. Immunol. 3:287289.
44.NCCLS. 2000. Western Blot Assay for Antibodies to Borrelia burgdorferi. Approved guideline M34-A, vol. 20, no. 20. NCCLS, Wayne, PA.
45. Nichol, G.,, D. T. Dennis,, A. C. Steere,, R. Lightfoot,, G. Wells,, B. Shea,, and P. Tugwell. 1998. Test-treatment strategies for patients suspected of having Lyme disease: a cost-effectiveness analysis. Ann. Intern. Med. 128:3748.
46. Nocton, J. J.,, F. Dressler,, B. J. Rutledge,, P. N. Rys,, D. H. Persing,, and A. C. Steere. 1994. Detection of Borrelia burgdorferi DNA by polymerase chain reaction in synovial fluid from patients with Lyme arthritis. N. Engl. J. Med. 330:229234.
47. Nyman, D.,, L. Willen,, C. Jansson,, S. A. Carlsson,, H. Granlund,, and P. Wahlberg. 2006. VlsE C6 peptide and IgG ELISA antibody analysis for clinical diagnosis of Lyme borreliosis in an endemic area. Clin. Microbiol. Infect. 12:496497.
48. Padula, S. J.,, F. Dias,, A. Sampieri,, R. B. Craven,, and R. W. Ryan. 1994. Use of recombinant OspC from Borrelia burgdorferi for serodiagnosis of early Lyme disease. J. Clin. Microbiol. 32:17331738.
49. Richter, D.,, D. Postic,, N. Sertour,, I. Livey,, F. R. Matuschka,, and G. Baranton. 2006. Delineation of Borrelia burgdorferi sensu lato species by multilocus sequence analysis and confirmation of the delineation of Borrelia spielmanii sp. nov. Int. J. Syst. Evol. Microbiol. 56:873881.
50. Robertson, J.,, E. Guy,, N. Andrews,, B. Wilske,, P. Anda,, M. Granstrom,, U. Hauser,, Y. Moosmann,, V. Sambri,, J. Schellekens,, G. Stanek,, and J. Gray. 2000. A European multicenter study of immunoblotting in serodiagnosis of Lyme borreliosis. J. Clin. Microbiol. 38:20972102.
51. Schutzer, S. E.,, P. K. Coyle,, P. Reid,, and B. Holland. 1999. Borrelia burgdorferi-specific immune complexes in acute Lyme disease. JAMA 282:19421946.
52. Schwan, T. G.,, J. Piesman,, W. T. Golde,, M. C. Dolan,, and P. A. Rosa. 1995. Induction of an outer surface protein on Borrelia burgdorferi during tick feeding. Proc. Natl. Acad. Sci. USA 92:29092913.
53. Schwan, T. G.,, and J. Piesman. 2000. Temporal changes in outer surface proteins A and C of the Lyme disease-associated spirochete, Borrelia burgdorferi, during the chain of infection in ticks and mice. J. Clin. Microbiol. 38:382388.
54. Schwartz, I.,, G. P. Wormser,, J. J. Schwartz,, D. Cooper,, P. Weissensee,, A. Gazumyan,, E. Zimmermann,, N. S. Goldberg,, S. Bittker,, G. L. Campbell,, and C. S. Pavia. 1992. Diagnosis of early Lyme disease by polymerase chain reaction amplification and culture of skin biopsies from erythema migrans lesions. J. Clin. Microbiol. 30:30823088.
55. Seder, R. H.,, and V. P. Verardi. 1996. Proficiency testing program for Lyme disease. Arch. Pathol. Lab. Med. 120:323325. (Letter.)
56. Steere, A. C.,, V. Sikand,, F. Meurice,, D. L. Parenti,, E. Fikrig,, R. T. Schoen,, J. Nowakowski,, C. H. Schmid,, S. Laukamp,, C. Buscarino,, D. S. Krause, and the Lyme Disease Vaccine Study. 1998. Vaccination against Lyme disease with recombinant Borrelia burgdorferi outer surface lipoprotein A with adjuvant. N. Engl. J. Med. 339:209215.
57. Steere, A. C. 2001. Lyme disease. N. Engl. J. Med. 345:115125.
58. Trevejo, R. T.,, P. J. Krause,, V. K. Sikand,, M. E. Schriefer,, R. Ryan,, T. Lepore,, and D. T. Dennis. 1999. Evaluation of two-test serodiagnostic method for early Lyme disease in clinical practice. J. Infect. Dis. 179:931938.
59. Tugwell, P.,, D. T. Dennis,, A. Weinstein,, G. Wells,, B. Shea,, G. Nichol,, R. Hayward,, R. Lightfoot,, P. Baker,, and A. C. Steere. 1997. Laboratory evaluation in the diagnosis of Lyme disease. Ann. Intern. Med. 127:11091123.
60. Van Dam, A. P.,, H. Kuiper,, K. Vos,, A. Widjojokusumo,, B. M. De Jongh,, I. Spanjaard,, A. C. P. Ramselaar,, M. D. Kramer,, and J. Dankert. 1993. Different genospecies of Borrelia burgdorferi are associated with distinct clinical manifestations of Lyme borreliosis. Clin. Infect. Dis. 17:709717.
61. Wilske, B.,, V. Fingerle,, and U. Schultze- Spechtel. 2007. Microbiological and serological diagnosis of Lyme borreliosis. FEMS Immunol. Med. Microbiol. 49:1321.
62. Wormser, G. P.,, D. Liveris,, J. Nowakowski,, R. B. Nadelman,, F. L. Cavaliere,, D. Mc- Kenna,, D. Holmgren,, and I. Schwartz. 1999. Association of specific subtypes of Borrelia burgdorferi with hematogenous dissemination in early Lyme disease. J. Infect. Dis. 180:720725.
63. Wormser, G. P.,, D. Liveris,, K. Hanincova,, D. Brisson,, S. Ludin,, V. J. Stracuzzi,, M. E. Embers,, M. T. Philipp,, A. Levin,, M. Aguero-Rosenfeld,, and I. Schwartz. 2008. Effect of B. burgdorferi genotype on the sensitivity of C6 and 2-tier testing in North American patients with culture-confirmed Lyme disease. Clin. Infect. Dis. 47:910914.
64. Wormser, G. P.,, S. Bittker,, D. Cooper,, J. Nowakowski,, R. B. Nadelman,, and C. Pavia. 2001. Yield of large-volume blood cultures in patients with early Lyme disease. J. Infect. Dis. 184:10701072.
65. Wormser, G. P.,, J. Nowakowski,, R. Nadelman,, P. Visintainer,, A. Levin,, and M. E. Aguero-Rosenfeld. 2008. Impact of clinical variables on Borrelia burgdorferi-specific antibody seropositivity in acute-phase sera from patients in North America with culture-confirmed early Lyme disease. Clin. Vaccine Immunol. 15:15191522.
66. Yang, X.,, T. G. Popova,, K. E. Hagman,, S. K. Wikel,, G. B. Schoeler,, M. J. Caimano,, J. D. Radolf,, and M. V. Norgard. 1999. Identification, characterization, and expression of three new members of the Borrelia burgdorferi Mlp (2.9) lipoprotein gene family. Infect. Immun. 67:60086018.


Generic image for table
Table 11.6-1

Lyme disease stages

ACA, achrodermatitis chronica atrophicans.

Citation: Garcia L. 2010. Detection of Antibodies, p 173-182. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch11.6

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error