Rapid, Simple, Quantitative, and Highly Sensitive Antibody Detection for Lyme Disease

Neurobiology and Pain Therapeutics Section, 49 Convent Drive, Building 49, Room 1C20, NIDCR, NIH, Bethesda, MD 20892-4410, USA.
Clinical and vaccine Immunology: CVI (Impact Factor: 2.47). 06/2010; 17(6):904-9. DOI: 10.1128/CVI.00476-09
Source: PubMed


There is currently a need for improved serological tests for the diagnosis and monitoring of Lyme disease, an infection caused
by Borrelia burgdorferi. In the present study, we evaluated luciferase immunoprecipitation systems (LIPSs) for use for profiling of the antibody
responses to a panel of B. burgdorferi proteins for the diagnosis of Lyme disease. Initially, serum samples from a cohort of patients and controls (n = 46) were used for training and were profiled by the use of 15 different B. burgdorferi antigen constructs. For the patient sera, the antibody responses to several B. burgdorferi antigens, including VlsE, flagellin (FlaB), BmpA, DbpA, and DbpB, indicated that the antigens had high levels of immunoreactivity.
However, the best diagnostic performance was achieved with a synthetic protein, designated VOVO, consisting of a repeated
antigenic peptide sequence, VlsE-OspC-VlsE-OspC, Analysis of an independent set of serum samples (n = 139) used for validation showed that the VOVO LIPS test had 98% sensitivity (95% confidence interval [CI], 93% to 100%;
P < 0.0001) and 100% specificity (95% CI, 94% to 100%; P < 0.0001). Similarly, the C6 peptide enzyme-linked immunosorbent assay (ELISA) also had 98% sensitivity (95% CI, 93% to 100%;
P < 0.0001) and 98% specificity (95% CI, 90% to 100%; P < 0.0001). Receiver operating characteristic analysis revealed that the rates of detection of Lyme disease by the LIPS test
and the C6 ELISA were not statistically different. However, the VOVO LIPS test displayed a wide dynamic range of antibody
detection spanning over 10,000-fold without the need for serum dilution. These results suggest that screening by the LIPS
test with VOVO and other B. burgdorferi antigens offers an efficient quantitative approach for evaluation of the antibody responses in patients with Lyme disease.

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    • "In resource-limited settings wherein health-care infrastructure is weak, there is an urgent need for rapid, sensitive and cost affordable point-of-care tests (POCT) for the detection of diseases 1-3. This challenge is particularly important for preventing the transfer of infectious diseases such as hepatitis B virus infection and for improving the standards of living 4-6. "
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