J. Panelius et al., Evaluation of treatment responses in late Lyme borreliosis on the basis ofantibody decrease during the follow-up period, EUR J CL M, 18(9), 1999, pp. 621-629
Citations number
38
Categorie Soggetti
Microbiology
Journal title
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
The purpose of this study was to identify a serological marker of successfu
l treatment as distinct from treatment failure in late Lyme borreliosis, Co
nsecutive serum samples from 68 treated patients with late Lyme borreliosis
were analyzed during a 1-2 year follow-up period after the start of treatm
ent. End-point enzyme immunoassay titres of IgG1, IgG2, IgG3, and combined
IgG1+3 subclasses against a sonicate antigen of Borrelia burgdorferi were d
etermined and compared to the IgG antibody response against Borrelia burgdo
rferi flagella, Individual half-lives of the antibody levels were calculate
d for each patient. The half-life values were compared to the patients' cli
nical outcome in order to find a serological marker of remaining disease ac
tivity or relapse. The levels of combined IgG1+3 subclass antibodies agains
t the sonicate antigen and the individual levels of IgG1, IgG2, and IgG3 an
tibodies did not change significantly after treatment, In contrast, antibod
ies to flagella decreased markedly after successful treatment, with a half-
life of 112+/-92 days (arithmetic mean value +/-SD). This was significantly
shorter than the half-life after unsuccessful treatment (271+/-151 days),
(P<0.0001), The decrease was observed mainly in IgG1 and IgG4 responses to
flagella, less so for IgG2 or IgG3. The results suggest that a rapid decrea
se in flagella antibodies can serve as a marker for a successful treatment
of Lyme borreliosis.