AUTHOR=Brandt Kevin S. , Horiuchi Kalanthe , Biggerstaff Brad J. , Gilmore Robert D. 

TITLE=Evaluation of Patient IgM and IgG Reactivity Against Multiple Antigens for Improvement of Serodiagnostic Testing for Early Lyme Disease

JOURNAL=Frontiers in Public Health

VOLUME=Volume 7 - 2019

YEAR=2019

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2019.00370

DOI=10.3389/fpubh.2019.00370

ISSN=2296-2565

ABSTRACT=
2729	Serologic testing is the standard for laboratory diagnosis and confirmation of Lyme disease. Serodiagnostic assays
28	to detect antibodies against Borrelia burgdorferi, the agent of Lyme borreliosis, are used for detection of infection. reliable in the later
2930	stages of infectionH, however, serologic testing within the first month of infection is less sensitive as
3031	patients’ antibody responses continue to develop. Previously, we screened several B. burgdorferi in
3132	vivo expressed antigens for candidates that elicit early antibody responses in patients with Stage 1 and 2
3233	Lyme disease. We evaluated patient IgM seroreactivity against 6 antigens and found an increase in
3334	sensitivity without compromising specificity when compared to current IgM second-tier immunoblot
3435	scoring. In this study, we continued the evaluation using a multi-antigen panel to measure IgM plus IgG
3536	seroreactivity in these early Lyme disease patients’ serum samples. Using two statistical methods for
3637	calculating positivity cutoff values, sensitivity was 70% and 84-87%, for early acute and early
3738	convalescent Lyme disease patients respectively. Specificity was 98-100% for healthy non-endemic
3839	control patients, and 96-100% for healthy endemic controls depending on the statistical analysis. We
3940	conclude that improved serologic testing for early Lyme disease may be achieved by the addition of
4041	multiple borrelial antigens that elicit IgM and IgG antibodies early in infection.