DIAGNOSTIC-VALUE OF PROTEINS OF 3 BORRELIA SPECIES (BORRELIA-BURGDORFERI SENSU-LATO) AND IMPLICATIONS FOR DEVELOPMENT AND USE OF RECOMBINANT ANTIGENS FOR SERODIAGNOSIS OF LYME BORRELIOSIS IN EUROPE

More and more assays for the serodiagnosis of Lyme borreliosis (LB) ar e based on recombinant antigens. However, so far, there is no consensu s as to which are the most specific and sensitive proteins and how the y should be used in combination to obtain tests with the best discrimi nation abilities. The present study was preceded by a detailed analysi s of Western blots (WB) using whole-cell lysates of Borrelia burgdorfe ri sensu stricto strain PKa2, B. afzelii PKo, and B. garinii PBi (U. H auser, G. Lehnert, R. Lobentanzer, and B. Wilske, J. Clin. Microbiol. 35:1433-1444, 1997). For the present work, the data bank from that stu dy, containing information about the reactivities of 330 sera (from pa tients at different stages of LB [n = 189]; control group, n = 141), w as reused. The specificities and sensitivities of various combinations of proteins from different strains were calculated for different inte rpretation criteria. For immunoglobulin G (IgG) WE, the recommended co mbination of antigens available to date as recombinant proteins includ ed p83/100 of PKa2, p83/100 of PKo, p39 of PKo, p39 of PBI, and OspC o f PBi (interpretation criterion, at least one reactive band required f or a positive WE; specificity, 96.5%; sensitivity, 56.1%). The further addition of p58 of PKo, p17 of PKo, or p14 of PKo was most favorable in terms of both a considerable gain of sensitivity and little loss of specificity. IgG Western blotting with a whole-cell lysate of strain PKo might be improved by the addition of OspC of PBi. For IgG WE, the best combination, out of all bands, was p83/100, p58, p39, p30, and p2 1 of all three strains and OspC of PBI, p17b of PBi, p56 of PKa2, p43 of PKo, p17 of PKo, and p14 of PKo (interpretation criterion, at least two reactive bands required for a positive WB; specificity, 97.2%; se nsitivity, 61.4%). An interpretation criterion of at least two reactiv e bands is more reliable than one of only one reactive band. For IgM W B, the best combination was OspC of PKo, OspC of PBi, p39 of all three strains, p17 of PKo, and strong reactions with p41 of all three strai ns (interpretation criterion, at least one reactive band required; spe cificity, 97.9%; sensitivity, 47.0%).