Cellular and humoral immune responses to Borrelia burgdorferi antigens in patients with culture-positive early Lyme disease

We determined cellular and humoral immune responses to Borrelia burgdorferi lysate and to recombinant flagellin (FlaB), OspC, and OspA in acute- and c onvalescent-phase samples from 39 culture-positive patients with erythema m igrans and in 20 healthy control subjects. During the acute illness, a medi an of 4 days after the onset of erythema migrans, 51% of the patients had p roliferative cellular responses and 72% had antibody responses to at least one of the borrelial antigens tested. During convalescence, at the conclusi on of antibiotic therapy, 64% of the patients had proliferative cellular re activity and 95% had antibody reactivity with at least one of the spirochet al antigens tested. In both acute- and convalescent-phase samples, cellular immune responses were found as frequently to OspA as to OspC and FlaB. Alt hough antibody responses were also frequently seen to OspC and FlaB, only a few patients had marginal antibody reactivity with OspA. The percentage of patients with proliferative responses was similar in those with clinical e vidence of localized or disseminated infection, whereas humoral reactivity was found more often in those with disseminated disease. We conclude that c ellular and humoral responses to B. burgdorferi antigens are often found am ong patients with early Lyme disease. In contrast with the other antigens t ested, cellular but not Immoral reactivity was often found with OspA.