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Abstract：
Lyme disease is a tick-borne disease caused by spirochetes belonging to the Borrelia burgdorferi sensu lato complex. The disease is characterized by a varied course; therefore, the basis for diagnosis is laboratory methods. Currently, a two-tiered serological test is recommended, using an ELISA as a screening test and a Western blot as a confirmatory test. This approach was introduced due to the relatively high number of false-positive results obtained when using an ELISA alone. However, even this approach has not entirely solved the problem of false-positive results caused by cross-reactive antibodies. Many highly immunogenic B. burgdorferi s.l. proteins are recognized nonspecifically by antibodies directed against other pathogens. This also applies to antigens, such as OspC, BmpA, VlsE, and FlaB, i.e., those commonly used in serodiagnostic assays. Cross-reactions can be caused by both bacterial (relapsing fever Borrelia, Treponema pallidum) and viral (Epstein-Baar virus, Cytomegalovirus) infections. Additionally, a rheumatoid factor has also been shown to nonspecifically recognize B. burgdorferi s.l. proteins, resulting in false-positive results. Therefore, it is necessary to carefully interpret the results of serodiagnostic tests so as to avoid overdiagnosis of Lyme disease, which causes unnecessary implementations of strong antibiotic therapies and delays in the correct diagnosis.
摘要：
莱姆病是由螺旋体引起的蜱传疾病，属于伯氏疏螺旋体。这种疾病的特点是病程各异；因此，诊断的基础是实验室方法。目前,建议进行两级血清学测试，使用ELISA作为筛选测试和蛋白质印迹作为确认测试。这种方法是由于当单独使用ELISA时获得的假阳性结果的相对高数量而引入的。然而,即使这种方法也不能完全解决交叉反应抗体引起的假阳性结果问题.许多高度免疫原性的B.burgdorferi.l.蛋白被针对其他病原体的抗体非特异性识别。这也适用于抗原，比如OspC,BmpA,VlsE,还有Flab,即，那些通常用于血清诊断测定。交叉反应可由两种细菌引起（复发性发热疏螺旋体，梅毒螺旋体)和病毒(爱泼斯坦-巴尔病毒，巨细胞病毒）感染。此外,类风湿因子也已显示出非特异性识别B.burgdorferis.l.蛋白，导致假阳性结果。因此,有必要仔细解释血清诊断测试的结果，以避免莱姆病的过度诊断，这导致了强有力的抗生素治疗的不必要实施和正确诊断的延误。
