Increasing of informational content of serological diagnosis of acute Lyme- borreliosis

Abstract

Aim. To improve the serological diagnosis of erythematous form of Lyme borreliosis by detecting antibodies to the Borrelia burgdorferi sensu lato (B. burgdorferi sensu stricto, B. afzelii and B. garinii), using a two­-stage diagnostic scheme: ELISA and immunoblot. Material and Methods. The tested group consisted of 113 patients with erythema migrans of Lyme disease, who were treated in Ternopil regional clinical dermato-venereologic dispensary during 2017-2019 yrs. The average age of the examined individuals was (42,65±13,91) years. The group of examined patients comprised 49 men and 64 women. A two-step algorithm consisting of ELISA and immunoblot tests was used in the study. During the first phase of the tests, the presence of anti-Borrelia burgdorferi s.l IgM/IgG antibodies was marked using ELISA method; positive and intermediate results were confirmed by immunoblot (EUROLINE Borrelia RN­AT). Results and Discussion. Positive or intermediate ELISA results for at least one class of IgM and / or IgG to B. burgdorferi s. l. (B. burgdorferi s. S., B. afzelii and B. garinii) were detected in 80 (70.8%) patients with erythema migrans. The application of the immunoblot method (EUROLINE Borrelia RN-AT) allowed to detect specific IgM antibodies in 52 (46.0%) individuals diagnosed in the first stage. Specific IgG antibodies in the immunoblot were diagnosed in 62 (54.9%) patients. It should be noted that only 33 (29.2%) patients confirmed the presence of anti-Borrelia burgdorferi s.l Ig G detected in the first stage of the examination in ELISA, while the remaining 29 (25.7%) individuals diagnosed with this method were negative or intermediate in the first stage. It is established that erythema migrans in patients of Ternopil region is caused by 3 genotypes of B. burgdorferi s.s., B. garinii and B. afzelii. Conclusion. IgM and IgG antibodies to B. burgdorferi s. l. (B. burgdorferi s. S., B. afzelii and B. garinii) were not found in the ELISA tests of 29.2% of patients with erythema migrans. The immunoblot method (EUROLINE Borrelia RN-AT) confirmed the presence of IgM antibodies to the B. burgdorferi s. l. complex (positive or intermediate results) in all 52 (46.0%) of 113 respondents who had positive and intermediate results in the ELISA. The frequency of detection of specific IgG antibodies by immunoblot (EUROLINE Borrelia RN-AT) in patients with erythema migrans was twice that of ELISA (61.4 and 32.4%) (p <0.05), which requires a two-stage serological diagnosis of Lyme borreliosis. Determination of specific IgG antibodies using the immunoblot method with EUROLINE Borrelia RN-AT test systems for Lyme borreliosis is more informative than the detection of specific IgM by the mentioned method. Erythema migrans in patients of Ternopil region was caused by three genotypes of B. burgdorferi s. l. (B. burgdorferi s. s., B. afzelii and B. garinii).

Keywords

• lyme borreliosis, erythema migrans, elisa, immunoblot