| Anti-Borrelia
burgdorferi-IgG, IgM-Immunoblot Here you see an anti-Borrelia burgdorferi sensu stricto-IgG-immunoblot, scanned with the AID BlotScanning System.
Borrelia burgdorferi Cut off: Standard setting:
Antigen (strain): Purified complete B31 antigen (lower passage) |
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The following
bands are characterized:
Specificity: |
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| 18 kD Specificity is not ensured, an isolated occurrence is not proof of a Borrelia infection. |
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| 21 kD Probably belongs to the OSP C complex and is therefore highly specific to B. burgdorferi. |
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| Early
marker. OSP C (25 kD) OSP C (Outer surface protein C) is highly specific to B. burgdorferi. IgM antibodies are frequently observed, therefore OSP C is an important marker of the acute phase. |
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| 28 kD,
OSP D (29 kD) und 30 kD Highly specific proteins with unknown function. |
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| OSP
A (31 kD) According to literature highly specific to B. burgdorferi, but this protein is strongly over-expressed in this immunoblot, so that inspecificities can be observed (this applies especially to IgM). It cannot therefore be interpreted as highly specific. |
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| OSP
B (34 kD) Highly specific to B. burgdorferi. |
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| 37 kD Specificity is not ensured, but it supports a positive result. |
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| 39 kD
(p39) Highly specific marker of B. burgdorferi. Marker of an infection at an early stage. |
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| 41 kD Flagellin protein. Not specific to B. burgdorferi. The 41 kD band occurs both in late and early stages. IgM antibodies against this protein are also frequently produced. Without the simultaneous occurrence of a highly specific band, these findings remain uncertain. |
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| 48 kD The specificity is disputed, it supports the findings when found together with a highly specific band. |
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| 60 kD Common antigen. Not specific to Borrelia infections. |
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| 62 -
72 kD Heat shock proteins. These proteins are not considered to be specific to Borrelia, because they also appear during many other bacterial infections. But in connection with the appearance of a highly specific band, especially the 93 kD band, they can be diagnostically important, because a broad spectrum of bands in this region points to chronic borreliosis. |
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| 93 kD
(p 100) Protein of the membranous vesicle on the surface of B. burgdorferi. Antibodies against this band are usually of the IgG type and only appear in the chronic stage of the infection. As this protein is highly specific to B. burgdorferi, it is generally considered to be a marker of stadium-III- Borreliosis. In several cases IgM antibodies against this protein can be observed (persistant IgM or indication of an imminent chronic course?). |
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| Comments:
Antibodies against B31 show a very strong cross-reaction to European Borrelia burgdorferi, afzelli and garinii. The cross-reaction between B. afzelli and B. garinii is weaker, therefore the burgdorferi strain appears to be the most suitable. |
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| Interpretation: The scanner software offers two possible means of interpretation. 1. Evaluation as recommended by the Center of Disease Control (Atlanta, USA), these criteria are taken from literature and are not valid for this test kit. Dressler IgM Borrelia-specific antibodies are serologically confirmed if two of the following bands are marked: 21, 25, 28, 37, 41, 48, 60, 93 kD. Borrelia infection (contact) is uncertain if less than two bands are marked. Dressler IgG Borrelia-specific antibodies are serologically confirmed if 5 of the following ten bands are marked: 21, 25, 28, 30, 39, 41, 48, 60, 62, 93 kD Borrelia infection (contact) is uncertain if less than two bands are marked. 2. Evaluation according to modified criteria. These criteria are validated by the manufacturer. IgG results uncertain: 2 highly specific bands and 0 - 1 additional characterised bands. Or 1 highly specific band and 2 - 3 additional characterised bands. Or no highly specific bands, but 5 characterised bands. IgG results positive: 2 highly specific bands and at least 2 additional characterised bands. Or 1 highly specific band and at least 4 additional characterised bands. IgM results uncertain: The 41 kD band only or one of the following specific bands: 28, 30, 34, 39, 93 kD . IgM results positive: The 41 kD band and at least one additional highly specific band. Or OSPC 21kD or 25 kD alone. Or at least 2 highly specific bands. Further assistance in interpretation: IgM antibodies are often only observed against the following bands: 18, 21, 25, 31, 34, 39, 41 kD. If the bands at 21 kD und 25 kD are marked, a Borrelia infection is very probable. If the band at 41 kD also appears, this supports the positive results. The isolated appearance of the 18, 31, 34, 39 or 41 kD band has little significance, unless in connection with positive IgG-blot results, the results of other testing methods and the case history. On the whole, the same applies to IgA antibodies as to IgM antibodies. The presence of IgA antibodies against specific B. burgdorferi antigens implies an early stage of infection. IgG antibodies are found against all described bands. Numerous bands in the highly molecular region (> 60 kD) indicate a chronic course of disease. An acute infection can only be diagnosed after taking IgM or IgA results and the clinical symptoms into consideration, because a blot result of 3 – 5 bands can indicate not only an early stage of infection but also a serum scar after the infection has subsided. |
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