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Polymerase chain reaction in Lyme borreliosis
L Buffrini1, M C Grignolo, G Rovetta
1Rheumatology Center, University of Genova, Bruzzone Institute, Italy.
Abstract:
Many bacterial and/or viral infections can affect several organs and apparatuses. Some of these infectious agents may be implicated in the pathogenesis and evolution of chronic connective and articular diseases. Such agents may trigger the start of articular chronic diseases or may play a role in maintaining the symptoms. In this study, we evaluated the sensitivity and specificity of polymerase chain reaction (PCR) in Lyme borreliosis, in patients with a confirmed diagnosis of the disease after clinical examination and standard serologic tests. There were 18 true positive results from nine samples from patients with present clinical signs, positive PCR, negative Western blot and/or enzyme-linked immunosorbent assay (ELISA) and nine samples with present clinical signs and positive ELISA and/or Western blot. The 51 true negative results were negative in all three methods used. There were 24 false positive results, positive for clinical signs, ELISA and/or Western blot but negative for PCR.
Insights
Polymerase chain reaction (PCR) shows potential for diagnosing Lyme borreliosis, especially when standard tests are inconclusive. This molecular method aids in identifying infectious agents contributing to chronic joint diseases.
Area of Science:
- Infectious Diseases
- Immunology
- Molecular Biology
Background:
- Bacterial and viral infections can impact multiple organs and contribute to chronic connective and articular diseases.
- Infectious agents may initiate or perpetuate symptoms in chronic joint conditions.
Purpose of the Study:
- To evaluate the sensitivity and specificity of polymerase chain reaction (PCR) for diagnosing Lyme borreliosis.
- To assess PCR's utility in patients with confirmed Lyme borreliosis via clinical examination and serologic tests.
Main Methods:
- Utilized polymerase chain reaction (PCR) alongside Western blot and enzyme-linked immunosorbent assay (ELISA) for diagnosis.
- Analyzed patient samples based on clinical signs and results from PCR, Western blot, and ELISA.
Main Results:
- Identified 18 true positive PCR results in patients with clinical signs, including those with negative serology.
- Observed 51 true negative results across all three diagnostic methods.
- Encountered 24 false positive results where clinical signs and serology were positive, but PCR was negative.
Conclusions:
- PCR demonstrates diagnostic value in Lyme borreliosis, particularly in cases with clinical symptoms but inconclusive serological results.
- The study highlights PCR's role in identifying infectious agents implicated in chronic articular diseases.
- Further research is warranted to fully elucidate PCR's sensitivity and specificity across diverse patient populations and disease stages.