Immunoblot reactivity at follow-up in treated patients with Lyme neuroborreliosis and healthy controls
Immunoblot reactivity at follow-up in treated patients with Lyme neuroborreliosis and healthy controls
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DOI：
10.1016/j.ttbdis.2018.09.011
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发表时间：
2019-01-01
影响因子：
3.2
通讯作者：
Rauer, S.
中科院分区：
文献类型：
--
作者：
Dersch, R.;Sarnes, A.;Rauer, S.
在流行地区，大约5%-20%的普通人群有抗疏螺旋体抗体的血清阳性。以前的研究表明，在接受治疗的莱姆神经疏螺旋体病(LNB)患者的随访中，持续抗疏螺旋体抗体的比率高达25%-97%。这些研究使用了免疫印迹和来自全细胞超声波的抗原，这种抗原可能没有现代重组抗原那么特异。我们使用高度特异的重组抗原线免疫印迹法评估了明确LNB患者和健康对照组血清中抗疏螺旋体抗体的血清阳性率。我们回顾了在弗莱堡医学中心接受治疗的明确LNB患者。用重组抗原线免疫印迹法检测45例确诊LNB患者和40例健康对照血清中的抗疏螺旋体抗体，平均随访时间为4.9年。10例LNB患者(22.7%)在随访时血清中有持续抗体(Ig G和/或Ig M)。6名健康对照(15%)的血清标本中有抗螺旋体抗体(Ig G和/或Ig M)阳性。随访时LNB患者血清中IgM、Ig G抗体阳性率与正常对照组比较差异无统计学意义(Ig M p=0.32，Ig G p=0.54)。LNB患者在随访时的免疫印迹反应模式与健康对照组没有统计学上的显著差异。与早期报告的LNB患者持续抗体水平较高的研究不同，可能是由于重组免疫印迹中使用的抗原比其他免疫印迹(例如，全细胞超声波)具有更高的特异性。我们的研究结果应该在一项更大规模的前瞻性多中心研究中重复。
About 5-20% of the general population in endemic areas have seroprevalence for anti-borrelial antibodies. Previous studies have shown a high rate of 25-97% of persisting anti-borrelial antibodies in patients with treated Lyme neuroborreliosis (LNB) at follow-up. These studies used immunoblots with antigens from whole-cell sonicates, which could be less specific than modern recombinant antigens. We assessed the seroprevalence of anti-borrelial antibodies in serum from patients with definite LNB and healthy controls with a line immunoblot using highly specific recombinant antigens.We retrospectively identified patients with treated definite LNB who were treated at the Medical Center-University of Freiburg. Serum from LNB patients at a mean follow-up period of 4.9 years (SD: 3.3) and serum from healthy controls were assessed for anti-borrelial antibodies with a line immunoblot with recombinant antigens.A total of 45 patients with definite LNB and 40 healthy controls were included. Ten LNB patients (22.7%) had persisting antibodies (IgG and/or IgM) in serum at follow-up. Serum samples from six healthy controls (15%) were positive for anti-borrelial antibodies (IgG and or IgM). Prevalence of positive IgM or IgG antibodies showed no statistically significant difference between LNB patients at follow-up and healthy controls (IgM p = 0.32, IgG p = 0.54). Immunoblot reactivity patterns at follow-up in LNB patients did not have statistically significant differences from healthy controls.The discrepancy regarding earlier studies reporting higher amounts of LNB patients with persisting antibodies could be due to a higher specificity of the antigens used in recombinant immunoblots compared to other immunoblots (e.g., whole-cell sonicates). The results of our study should be replicated in a larger prospective multicenter study.