NYMC Faculty Publications

Development of a Multiantigen Panel for Improved Detection of Borrelia Burgdorferi Infection in Early Lyme Disease

Author Type(s)

Faculty

DOI

10.1128/JCM.02111-15

Journal Title

Journal of Clinical Microbiology

First Page

3834

Last Page

3841

Document Type

Article

Publication Date

12-1-2015

Department

Pathology, Microbiology and Immunology

Keywords

Adult, Aged, Antibodies, Bacterial, Antigens, Bacterial, Borrelia burgdorferi, Cohort Studies, Diagnostic Tests, Routine, Early Diagnosis, Female, Humans, Immunoassay, Immunoglobulin G, Immunoglobulin M, Lyme Disease, Male, Membrane Proteins, Middle Aged, Sensitivity and Specificity, United States, Young Adult

Disciplines

Medicine and Health Sciences

Abstract

The current standard for laboratory diagnosis of Lyme disease in the United States is serologic detection of antibodies against Borrelia burgdorferi. The Centers for Disease Control and Prevention recommends a two-tiered testing algorithm; however, this scheme has limited sensitivity for detecting early Lyme disease. Thus, there is a need to improve diagnostics for Lyme disease at the early stage, when antibiotic treatment is highly efficacious. We examined novel and established antigen markers to develop a multiplex panel that identifies early infection using the combined sensitivity of multiple markers while simultaneously maintaining high specificity by requiring positive results for two markers to designate a positive test. Ten markers were selected from our initial analysis of 62 B. burgdorferi surface proteins and synthetic peptides by assessing binding of IgG and IgM to each in a training set of Lyme disease patient samples and controls. In a validation set, this 10-antigen panel identified a higher proportion of early-Lyme-disease patients as positive at the baseline or posttreatment visit than two-tiered testing (87.5% and 67.5%, respectively; P < 0.05). Equivalent specificities of 100% were observed in 26 healthy controls. Upon further analysis, positivity on the novel 10-antigen panel was associated with longer illness duration and multiple erythema migrans. The improved sensitivity and comparable specificity of our 10-antigen panel compared to two-tiered testing in detecting early B. burgdorferi infection indicates that multiplex analysis, featuring the next generation of markers, could advance diagnostic technology to better aid clinicians in diagnosing and treating early Lyme disease.

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