Immunoblot analysis of the seroreactivity to recombinant Borrelia burgdorferi sensu lato antigens, including VlsE, in the long-term course of treated patients with Erythema migrans

Objective: We evaluated whether immunoblotting is capable of
substantiating the posttreatment clinical assessment of patients
with erythema migrans ( EM), the hallmark of early Lyme
borreliosis. Methods: In 50 patients, seroreactivity to different
antigens of Borrelia burgdorferi sensu lato was analyzed by a
recombinant immunoblot test (IB) in consecutive serum samples from
a minimum follow-up period of 1 year. Antigens in the IgG test were
decorin- binding protein A, internal fragment of p41 (p41i), outer
surface protein C (OspC), p39, variable major protein-like sequence
expressed (VlsE), p58 and p100; those in the IgM test were p41i,
OspC and p39. Immune responses were correlated with clinical and
treatment-related parameters. Results: Positive IB results were
found in 50% before, in 57% directly after therapy and in 44% by
the end of the follow-up for the IgG class, and in 36, 43 and 12%
for the IgM class. In acute and convalescence phase sera, VlsE was
most immunogenic on IgG testing 60 and 70%), and p41i (46 and 57%)
and OspC (40 and 57%) for the IgM class. By the end of the
follow-up, only the anti-p41i lgM response was significantly
decreased to 24%. Conclusions: No correlation was found between IB
results and treatment-related parameters. Thus, immunoblotting does
not add to the clinical assessment of EM patients after treatment.
Copyright (c) 2008 S. Karger AG, Basel.