MELISA-TESTI

[Bb]

Lähettäjä: Soijuv Lähetetty: 5.8.2006 19:21

Borrelioosin diagnosointiin kehitetyt testimenetelmät ovat osoittautuneet epäluotettaviksi. Artikkelin mukaan uusi Melisa-testi saattaa aiempia menetelmiä (vasta-aineet, PCR) paremmin kyetä osoittamaan aktiivisen borrelioosin olemassaolon.


Diagnostic Microbiology and Infectious Disease
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doi:10.1016/j.diagmicrobio.2006.06.008 How to Cite or Link Using DOI (Opens New Window)
Copyright © 2006 Published by Elsevier Inc.

A novel lymphocyte transformation test (LTT-MELISA®) for Lyme borreliosis

Preliminary accounts of this work were 1st presented at the 5th International Symposium on Molecular Diagnostics in Laboratory Medicine, Graz, Austria, 10?12 June 2004, and most recently at the 10th International Conference on Lyme Borreliosis and Other Tick-Borne Diseases, Vienna, Austria, 11?15 September 2005.

Elizabeth Valentine-Thona, Corresponding Author Contact Information, E-mail The Corresponding Author, Karsten Ilsemannb and Martin Sandkampc

aDepartment of Immunology, Laboratory Center Bremen, 28205 Bremen, Germany
bDepartment of Serology in Laboratory Center Bremen, 28205 Bremen, Germany
cLaboratory Center Bremen, 28205 Bremen, Germany

Received 18 April 2006; accepted 7 June 2006. Available online 28 July 2006.

Abstract

Diagnosis of active Lyme borreliosis (LB) remains a challenge in clinically ambiguous, serologically indeterminant, and polymerase chain reaction-negative patients. Lymphocyte transformation tests (LTTs) have been applied to detect specific cellular immune reactivity, but their clinical application has been severely hampered by the poorly defined Borrelia antigens and nonstandardized LTT formats used. In this study, we describe the development and clinical relevance of a novel LTT using a validated format (MELISA®) together with well-defined recombinant Borrelia-specific antigens. From an initial screening of 244 patients with suspected Borrelia infection or disease, 4 informative recombinant antigens were selected: OspC (Borrelia afzelii), p41-1 (Borrelia garinii), p41-2 (B. afzelii), and p100 (B. afzelii). Thereafter, 30 seronegative healthy controls were tested in LTT-MELISA® to determine specificity, 68 patients were tested in parallel to determine reproducibility, and 54 lymphocyte-reactive symptomatic patients were tested before and after antibiotic therapy to assess clinical relevance. Most (86.2%) of the 36.9% (90/244) LTT-MELISA® positive patients were seropositive and showed symptoms of active LB. Specificity was 96.7% and reproducibility 92.6%. After therapy, most patients (90.7%) showed negative or markedly reduced lymphocyte reactivity correlating with clinical improvement. This novel LTT-MELISA® assay appears to correlate with active LB and may have diagnostic relevance in confirming LB in clinically and serologically ambiguous cases.

Keywords: Lyme borreliosis; Lymphocyte transformation test; MELISA; Recombinant antigens