Serologic diagnosis of lyme borreliosis by using enzyme-linked immunosorbent assays with recombinant antigens

Class-specific enzyme-linked immunosorbent assays (ELISAs) with purified re combinant antigens of Borrelia burgdorferi sensu stricto and Western blot a nalyses with whole cells of this spirochete were used to test human sera to determine which antigens were diagnostically important, In analyses for im munoglobulin M (IgM) antibodies, 14 (82%) of 17 serum samples from persons who had erythema migrans reacted positively by an ELISA with one or more re combinant antigens, There was frequent antibody reactivity to protein 41-G (p41-G), outer surface protein C (OspC), and OspF antigens. In an ELISA for IgG antibodies, 13 (87%) of 15 serum samples had antibodies to recombinant antigens; reactivity to p22, p39, p41-G, OspC, and OspF antigens was frequ ent, By both ELISAs, serum specimens positive for OspB, OspE, and p37 were uncommon, Analyses of sera obtained from persons who were suspected of havi ng human granulocytic ehrlichiosis (HGE) but who lacked antibodies to ehrli chiae revealed IgM antibodies to all recombinant antigens of B. burgdorferi except OspB and IgG antibodies to all antigens except OspE, Immunoblotting of sera from the study group of individuals suspected of having HGE reaffi rmed antibody reactivity to multiple antigens of B. burgdorferi. There was minor cross-reactivity when sera from healthy subjects or persons who had s yphilis, oral infections, or rheumatoid arthritis were tested by ELISAs wit h p37, p41-G, OspB, OspC, OspE, and OspF antigens, Although the results of class-specific ELISAs with recombinant antigens were comparable to those re corded for assays with whole-cell antigen and for individuals with confirme d clinical diagnoses of Lyme borreliosis, immunoblotting is still advised a s an adjunct procedure, particularly when there are low antibody titers by an ELISA.