Nature Communications (Aug 2024)

Rapid single-tier serodiagnosis of Lyme disease

  • Rajesh Ghosh,
  • Hyou-Arm Joung,
  • Artem Goncharov,
  • Barath Palanisamy,
  • Kevin Ngo,
  • Katarina Pejcinovic,
  • Nicole Krockenberger,
  • Elizabeth J. Horn,
  • Omai B. Garner,
  • Ezdehar Ghazal,
  • Andrew O’Kula,
  • Paul M. Arnaboldi,
  • Raymond J. Dattwyler,
  • Aydogan Ozcan,
  • Dino Di Carlo

DOI
https://doi.org/10.1038/s41467-024-51067-5
Journal volume & issue
Vol. 15, no. 1
pp. 1 – 13

Abstract

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Abstract Point-of-care serological and direct antigen testing offers actionable insights for diagnosing challenging illnesses, empowering distributed health systems. Here, we report a POC-compatible serologic test for Lyme disease (LD), leveraging synthetic peptides specific to LD antibodies and a paper-based platform for rapid, and cost-effective diagnosis. Antigenic epitopes conserved across Borrelia burgdorferi genospecies, targeted by IgG and IgM antibodies, are selected to develop a multiplexed panel for detection of LD antibodies from patient sera. Multiple peptide epitopes, when combined synergistically with a machine learning-based diagnostic model achieve high sensitivity without sacrificing specificity. Blinded validation with 15 LD-positive and 15 negative samples shows 95.5% sensitivity and 100% specificity. Blind testing with the CDC’s LD repository samples confirms the test accuracy, matching lab-based two-tier results, correctly differentiating between LD and look-alike diseases. This LD diagnostic test could potentially replace the cumbersome two-tier testing, improving diagnosis and enabling earlier treatment while facilitating immune monitoring and surveillance.