COMPLEXED ANTIBODY IN EARLY DIAGNOSIS AND COURSE OF LYME

莱姆病（LD）病例，由于螺旋体，伯氏疏螺旋体 (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 疗法 本提案的总体目标是评估Bb特定 免疫复合物（IC）作为一种敏感和特异性的标志物：早期 莱姆病的诊断、活动性感染和治疗效果 疾病 特异性目的是确定（1）Bb的抗体（Ab）是否在 IC（具有相应的Bb抗原）比游离抗Bb更早检测到 Ab，在临床上有用的时间段内;和（2）是否对 治疗与复合的BbAb的相对量相关（即， 在感染早期，根除后很少或没有， 回收）。 这项研究的基本原理是，在许多国家， 可以检测到与其抗原（Ag）靶标结合的感染复合抗体 在免费Ab之前 此外，与游离Ab相比，复合Ab 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，我们将 纵向研究IC和游离Ab和Ag组分，在系列血清中 样本，来自符合以下严格定义的患者（每年25-50例） 莱姆病及其控制 我们将使用一个实用而简单的， 聚乙二醇，测定以分离和解离IC，以及 其他试验，结合ELISA和Western印迹。 结果将 统计分析，以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.