PDF(Pubmed)
Abstract：
(1) Background: Lyme borreliosis (LB) is a tick-borne disease known for its diagnostic challenges. Conventional two-tiered testing (CTTT) for antibodies is time-consuming, has low sensitivity in the early stages of disease, and sometimes generates false-positive IgM immunoblots. To tackle this issue, modified two-tiered testing (MTTT) was introduced, incorporating recombinant VlsE and C6 antigens to enhance diagnostic accuracy. (2) Methods: In this prospective study, we enrolled children exhibiting symptoms indicative of LB. We collected serum samples at various intervals and subjected them to analysis using standard enzyme immunoassays. We then compared these results with the outcomes from the VlsE and C6 assays. (3) Results: In our study, all 33 patients displaying erythema migrans (EM), a characteristic symptom of LB, exhibited positive responses to the C6 antigen. This finding underscores the potential utility of the C6 antigen as a reliable diagnostic tool for LB. Additionally, we observed a significant reduction in anti-VlsE antibody levels following antibiotic treatment in EM patients. (4) Conclusions: The utilization of recombinant VlsE and C6 antigens in LB diagnostics and monitoring has yielded promising results. Nonetheless, it is imperative for clinicians to exercise caution and interpret results in conjunction with clinical findings, considering the dynamic nature of medical guidelines. Even with recombinant antigen tests, some children with EM tested negative, highlighting the importance of clinical diagnosis for treatment decisions. Furthermore, clinicians should be mindful of the possibility of persistently positive VlsE/C6 test results during LB treatment monitoring.
摘要：
（1）背景：莱姆病（LB）是一种蜱传疾病，以其诊断挑战而闻名。传统的抗体两级测试（CTTT）是耗时的，在疾病的早期阶段敏感性较低，有时会产生假阳性IgM免疫印迹。为了解决这个问题，引入了改进的两级测试(MTTT)，掺入重组VlsE和C6抗原以提高诊断准确性。(2)方法：在本前瞻性研究中，我们招募了表现出LB症状的儿童。我们以不同的时间间隔收集血清样品，并使用标准酶免疫测定法对其进行分析。然后我们将这些结果与VlsE和C6测定的结果进行比较。（3）结果：在我们的研究中，所有33例患者均表现为偏头痛红斑(EM)，LB的特征性症状，对C6抗原表现出阳性反应。这一发现强调了C6抗原作为LB的可靠诊断工具的潜在用途。此外,我们观察到EM患者接受抗生素治疗后,抗VlsE抗体水平显著降低.（4）结论：重组VlsE和C6抗原在LB诊断和监测中的应用取得了有希望的结果。尽管如此，临床医生必须谨慎行事，并结合临床发现解释结果，考虑到医学指南的动态性。即使有重组抗原测试，一些患有EM的儿童测试呈阴性，强调临床诊断对治疗决策的重要性。此外，在LB治疗监测期间,临床医师应注意VlsE/C6检测结果持续阳性的可能性.
