IgM detection of Lyme borreliosis by immunoblotting

Borrelia burgdorferi infection can cause symptoms of damage to the skin, nervous system, eyes and internal organs.

The clinical expression of borreliosis is divided into three stages:

Stage I: A few days to weeks after the tick bite, the primary Lyme infection presents with erythema migrans (redness of the skin that spreads in a ring) and/or flu-like symptoms: fever, chills, headaches, and vomiting. Lyme disease can be present without an erythematous rash. The infection is usually manifested by neurological symptoms, muscle and joint pain, cardiovascular system disorders, regional lymph node enlargement, or a combination of all these forms of the disease. Serological methods detect IgM antibodies in 50-90% of patients with stage I disease. A negative IgM result cannot rule out a new infection, because after a second infection, only IgG class antibodies may be formed, and IgM antibodies may not be formed. The cause of false-positive IgM results is often unclear: they are often found in mononucleosis, herpes virus infections, or various autoimmune diseases. Since Anti-Borrelia EUROLINE-WB uses a combination of antigen extract (B.afzelii) and recombinant VisE (an early marker common to all species), this kit can detect atypical reactions and detect Borrelia-specific antibodies with a highly sensitive method. When diagnosing, it is always necessary to take into account not only the serological results, but also the patient's condition.

Stage II: After a tick bite, various symptoms develop over several weeks or months. The most important of them are neurological disorders: meningitis, asymmetric polyneuritis, cranial nerve paresis, etc. Peripheral facial nerve palsy is most common in children. Arthritis (usually multi-joint) and non-localized bone, joint and muscle pain are common. In the early phase of this stage, IgM antibodies are usually detected, and in the later phase only IgG antibodies are often detected. Additional determination of the immunoblot Anti-Borrelia EUROLINE-WB increases the diagnosis of the disease by 30%. Of all the antigens used to detect IgG class antibodies, VisE has the highest sensitivity.

Stage III: Without treatment, stage III develops for a long time (years, decades) from the beginning of the infection. This stage is characterized by chronic relapsing erosive arthritis, atrophic acrodermatitis (acrodermitis chronica atrophicans) and progressive encephalomyelitis, the course of which resembles multiple sclerosis. In stage III, IgG class antibodies are detected in the blood serum of 90-100% of patients, while IgM class antibodies are found very rarely.

According to the recommended standards, serological diagnosis of borreliosis should be carried out in two stages: during the first stage, ELISA tests should be performed, and POSITIVE results should be confirmed by immunoblot testing. Among all tested recombinant antigens, VisE has the highest sensitivity for detecting infections caused by Borrelia.