COMPLEXED ANTIBODY IN EARLY DIAGNOSIS AND COURSE OF LYME

由伯氏疏螺旋体引起的莱姆病6例 (Bb)，正在增加。需要准确的实验室测试来确定或 排除莱姆病的早期诊断并监测其疗效 心理治疗。该提案的总体目标是评估BB特定的 免疫复合体(IC)作为早期诊断的敏感和特异标记物 莱姆病的诊断、活动性感染和治疗效果 疾病。具体目的是确定(1)抗BB抗体(Ab)是否在 IC(带有相应的BB抗原)比游离抗BB更早被检测到 AB，在临床有用的时间段内；以及(2)对 治疗与复杂的BB抗体的相对量相关(即， 感染早期较多，根除后较少或无 恢复)使用来自个别患者的连续血清样本。 这项研究的基本原理是，普遍观察到，在许多 可检测到与其抗原(Ag)靶标结合的复杂抗体感染 在免费之前，Ab.此外，与游离抗体不同的是，络合抗体 很可能反映了活动性疾病。我们的数据支持这些概念 莱姆病。除了一个巨大的冷冻血清库外，我们还将 系列血清中IC和游离抗体、Ag组分的纵向研究 样本，来自符合严格定义的患者(每年25-50人) 莱姆病及其控制。我们将用一种实用而简单的， 聚乙二醇法分离和解离IC，以及 其他检测，结合酶联免疫吸附试验和免疫印迹试验。结果将是 通过统计分析来证明或反驳特定的假设 目标。

Cases of Lyme disease (LD), due to the spirochete, Borrelia burgdorferi (Bb), are increasing. Accurate laboratory tests are needed to establish or exclude an early diagnosis of Lyme disease and to monitor the efficacy of therapy. The overall objective of this proposal is to assess Bb specific immune complexes (IC) as a sensitive and specific marker for: early diagnosis, for active infection, and for the efficacy of therapy in Lyme disease. Specific Aims are to determine (1) whether antibody (Ab) to Bb in IC (with corresponding Bb antigen) is detectable earlier than free anti-Bb Ab, within a clinically useful time period; and (2) whether the response to therapy correlates with the relative quantity of complexed Bb Ab (i.e., more early in the infection, with less or none after eradication and recovery) using serial serum samples from individual patients. The rationale for this study is the general observation that in many infections complexed Ab, bound to its antigen (Ag) target, can be detected before free Ab. In addition, in contradistinction to free Ab, complexed Ab is likely to reflect active disease. Our data supports these concepts in Lyme disease. In addition to a huge frozen serum bank, we will longitudinally study IC and free Ab and Ag components, in serial serum samples, from patients (25-50 per year) who fulfill a rigid definition of Lyme disease and controls. We will use a practical and simple, polyethylene glycol, assay to isolate and dissociate the IC, as well as other assays, in conjunction with ELISA and Western blots. Results will be statistically analyzed to prove or disprove the hypotheses of the specific aims.