Scored antibody reactivity determined by immunoblotting shows an association between clinical manifestations and presence of Borrelia burgdorferi sensu stricto, B-garinii, B-afzelii, and B-Valaisiana in humans

An immunoglobulin G immunoblot was developed with antigenic extracts of Bor relia burgdorferi sensu stricto, B. garinii, B. afzelii, and B. valaisiana genospecies and was reacted with sera from patients with neuroborreliosis, acrodermatitis, and Lyme arthritis. A detailed analysis of the reactivities of the protein bands was performed, and a two-step scoring procedure was s elected to determine the preferential reactivity of sera to one particular genospecies. The discriminative potential of 5 proteins (12-kDa, 16-kDa, 18 -kDa, OspA, and 66-kDa proteins) was used as a rapid first-step scoring met hod, followed by scoring of 14 additional protein bands if necessary, The a dvantage of this procedure is the low percentage of serum samples with inco nclusive results for one of the four species (10% for patients with neurobo rreliosis, 6% for patients with acrodermatitis chronica atrophicans, and 6% for patients with Lyme arthritis). Among 31 serum samples from patients wi th neuroborreliosis, 16 were more reactive to B. garinii, 7 were more react ive to B, afzelii, 3 were more reactive to B. valaisiana, and 2 were more r eactive to B. burgdorferi sensu stricto. Of 31 serum samples from patients with acrodermatitis, 26 showed a higher level of reactivity to B. afzelii. Of 34 serum samples from patients with Lyme arthritis, 21 were more reactiv e to B. burgdorferi sensu stricto, 10 were more reactive to B. afzelii, and 1 was more reactive to B. valaisiana, Our results suggest an organotropism of Borrelia species and provide some evidence of a pathogenic potential of B. valaisiana in humans.