Lyme disease – treatment assessment based on anti-VIsE antibodies: a pilot study

Abstract

Abstract Introduction: Although the causative agent of Lyme disease (LD) has been known for a long time, and so far it has been possible to develop patterns useful in diagnosis and treatment, several factors continue to complicate the management of infection with Borrelia burgdorferi sensu lato. These include high species diversity of the spirochete causing LD and the lack of a treatment that could guarantee a complete and sustained eradication of infection in all patients. Therefore, the current study aimed to evaluate the effectiveness of treatment of patients with LD based on the measurement of LD-related antibodies generated in response to the highly immunogenic VlsE antigen evaluated using enzyme-linked immunosorbent assay (Lyme Trace ELISA). Materials and methods: The study group consisted of 10 healthy volunteers (control group) and 21 outpatients (experimental group) with LD, living in the West Pomeranian Province of Poland. The serum samples of the experimental and control groups were tested with the anti-Borrelia IgG plus VlsE ELISA, anti-Borrelia IgG immunoblot, and anti-VlsE IgG Lyme Trace ELISA. Results: Research showed that the mean value of anti-VIsE IgG antibody concentration decreased after treatment by 41.6%, 35.9%, and 31.7% in the serum dilutions 1:101, 1:1010, and 1:10100, respectively. A statistically significant difference was obtained in antibody concentration in the serum dilution 1:101 before (R) and after (R*) treatment. The R/R* ratio presented at least a 4-fold decrease in antibody concentration in 2 patients (9.5%), thereby suggesting the effectiveness of the therapy. In serum samples diluted at 1:101 and 1:1010, antibody levels showed an increase after treatment in 7 patients (33.3%), and at a dilution of 1:10100, this increase was found in 6 patients (28.6%). The R/R* ratio differed significantly between the subgroups, where the antibody concentration increased after treatment and then decreased. Conclusion: Summing up, it can be concluded that the Lyme Trace ELISA assay used in the study to assess the level of anti-VlsE IgG antibodies showed insufficient satisfactory results in the assessment of monitoring the effectiveness of treatment in patients with LD before and after the treatment. The assessment of the effectiveness of treatment should, as such, still be based on the evaluation of the clinical symptoms of the disease, treating the quantification of IgG antibodies with the use of recombinant VlsE antigens as an additional tool.