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Recombinant or peptide antigens in the serology of Lyme arthritis in children
Tero Heikkilä1, Hans-Iko Huppertz, Ilkka Seppälä
1Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland.
Insights
This study evaluated recombinant antigens for diagnosing Lyme arthritis (LA) in children. While IR(6) shows diagnostic potential, antibody decline did not predict treatment response, suggesting combined antigens may improve Lyme borreliosis serology accuracy.
Area of Science:
- Immunology
- Microbiology
- Pediatrics
Background:
- Lyme borreliosis (LB) serodiagnosis requires accurate and reliable methods.
- Lyme arthritis (LA) is a common manifestation of LB in children.
- Recombinant antigens are increasingly used in serological assays for infectious diseases.
Purpose of the Study:
- To evaluate the performance of ELISAs using recombinant antigens (DbpA, DbpB, BBK32, and IR(6)) for serodiagnosis and follow-up of pediatric Lyme arthritis.
- To assess the utility of antibody decline to these antigens in predicting treatment response.
- To identify antigens with potential for universal use in Lyme borreliosis serology.
Main Methods:
- Serum samples from 52 children with confirmed Lyme arthritis were tested using IgG ELISAs.
- Performance evaluation of recombinant antigens: decorin-binding protein A (DbpA), DbpB, BBK32, and VlsE peptide antigen invariable region 6 (IR(6)).
- Analysis of antibody levels at diagnosis and during post-treatment follow-up.
Main Results:
- At diagnosis, high positivity rates were observed for BBK32 (50/52), DbpA (51/52), and IR(6) (51/52).
- Antibody decline after treatment did not correlate with treatment response or clinical course.
- IR(6) demonstrated significant potential for universal application in Lyme borreliosis diagnostics.
Conclusions:
- The VlsE peptide antigen IR(6) shows promise for widespread use in Lyme borreliosis serodiagnosis.
- Monitoring antibody decline to these specific antigens is not a reliable predictor of treatment outcomes in pediatric Lyme arthritis.
- Employing multiple specific Borrelial antigens in parallel assays may enhance the overall accuracy of Lyme borreliosis serology.
Abstract:
The performance of ELISAs with the recombinant antigens decorin-binding protein A (DbpA), DbpB, and BBK32 (from Borrelia afzelii, B. garinii, and B. burgdorferi sensu stricto) and VlsE peptide antigen invariable region 6 (IR(6)) were evaluated in the serodiagnosis and follow-up of children with Lyme arthritis (LA). Serum samples were obtained from 52 children with clinically typical and serologically confirmed LA. In IgG ELISAs, at diagnosis, 50 samples were positive for BBK32, 51 for DbpA, 40 for DbpB, and 51 for IR(6). In the posttreatment follow-up, the rate of decline of the antibodies to the recombinant protein antigens or to IR(6) did not appear useful in the prediction of the treatment response or the clinical course of LA. Yet, IR(6) seems to have the greatest potential to be used universally in the diagnostic serology of Lyme borreliosis (LB). Alternate to that, the use of several specific borrelial antigens, in parallel, might improve the accuracy of serology for LB.
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