The immunoglobulin (IgG) antibody response to OspA and OspB correlates with severe and prolonged Lyme arthritis and the IgG response to P35 correlates with mild and brief arthritis

In an effort to implicate immune responses to specific Borrelia burgdorferi proteins that may have a role in chronic Lyme arthritis, we studied the na tural history of the antibody response to B. burgdorferi in serial serum sa mples from 25 patients monitored throughout the course of Lyme disease. In these patients, the immunoglobulin G (IgM) and Ige antibody responses to 10 recombinant B. burgdorferi proteins, determined during early infection, ea rly arthritis, and maximal arthritis, were correlated with the severity and duration of maximal arthritis. The earliest responses were usually to oute r surface protein C (OspC), P35, P37, and P41; reactivity with OspE, OspF, P39, and P93 often developed weeks later: and months to years later, 64% of patients had responses to OspA and OspB. During early infection and early arthritis, the levels of IgG antibody to P35 correlated inversely with the subsequent severity or duration of maximal arthritis. In contrast, during p eriods of maximal arthritis, the levels of IgG antibody to OspA and OspB, e specially to a C-terminal epitope of OspA, correlated directly with the sev erity and duration of arthritis. Thus, the higher the IgG antibody response to P35 earlier in the infection, the milder and briefer the subsequent art hritis, whereas during maximal arthritis, the higher the IgG response to Os pA and OspB, the more severe and prolonged the arthritis.