Serologische Aktivitaetsparameter bei der Neuroborreliose Schlussbericht

The suspected diagnosis of neuroborreliosis should always be confirmed by serological tests and investigations of the cerebrospinal fluid. In certain areas the number of healthy subjects, sero-positive for Borrelia burgdorferi sensu lato, is considerably high. Therefore, positive findings in serological assays are of restricted use. The main objective of our study was to investigate the advantage of recombinantly expressed borrelial proteins and the role of IgG subclass antibodies to differentiate between symptomatic and asymptomatic infections with B. burgdorferi sensu lato. For this purpose, samples from patients with neuroborreliosis, neurosyphilis, recent EBV-infection and healthy sero-positive volunteers were investigated for specific antibodies by ELSIA and immunoblotting. As antigens, sonicated B. burgdorferi spirochetes and three recombinantly expressed borrelial proteins (OspC, 14 kD fragment of the flagellin, p83) were employed. The so called RECO-ELISA proved to be more sensitive and more specific than the sonicate ELISA to confirm a B. burgdorferi infection. Both, the RECO-ELISA immunoblot showed comparable sensitivity and specificity, if the immunoblot was evaluated according to the criteria of Hauser et al.. For the evaluation of the intrathecal synthesis of agent-specific antibodies, the sonicate ELISA was more sensitive, but less specific than the RECO-ELISA. Avidity determination of borrelial specific IgG antibodies revealed, that it seems possible to differentiate between early stages of Lyme disease from sero-positive healthy controls. This finding might have implications for standard serology. However, neither the subclass specificity of IgG antibodies nor specificity of antibodies in immunoblotting were useful to differentiate between symptomatic from asymptomatic infections. (orig.)SIGLEAvailable from TIB Hannover: DtF QN1(78,56) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Bildung und Forschung (BMBF), Bonn (Germany)DEGerman