目的:对人感染疏螺旋体属的诊断主要依赖于血清学检测,聚合酶链反应(PCR)或培养,但此类血清学测试已被报道具有异质敏感性,而伯氏螺旋体PCR和培养物被报道具有中等的诊断价值。有人建议,辅助使用淋巴细胞转化测试-记忆淋巴细胞免疫刺激测定(LTT-MELISA)可能在这方面有所帮助;然而,该方法的临床实用性受到质疑。疏螺旋体免疫优势41-kDa鞭毛蛋白几乎总是在感染后产生明显的人抗体反应。因此决定确定LTT-MELISA是否检测到对该抗原的人抗体应答。
方法:通过Western印迹法和LTT-MELISA法独立检测来自连续就诊的可能疏螺旋体病患者的血液样本。
结果:在省略了不确定的Westernblot结果和模棱两可的LTT-MELISA结果的病例后,多元线性回归模型表明,从两个LTT-MELISA变量可以预测41kDa鞭毛蛋白免疫球蛋白(Ig)M水平(F2,51=5.981,P=0.005)。同样,相应的41-kDaIgG模型还包含两个LTT-MELISA变量(F2,57=3.700,P=0.031).
结论:结论是LTT-MELISA似乎能够检测对该抗原的反应。
OBJECTIVE: Diagnosis of human infection by various species of the bacterial genus Borrelia is mainly reliant on serological testing, polymerase chain reaction (PCR) or culture but such serological tests have been reported to have heterogeneous sensitivities, while Borrelia PCR and culture have been reported as being of modest diagnostic value. It has been suggested that the adjunctive use of the lymphocyte transformation test-memory lymphocyte immunostimulation assay (LTT-
MELISA) may be helpful in this regard; however, the clinical usefulness of this assay has been questioned. The Borrelia immunodominant 41-kDa flagellin protein almost always gives rise to a marked human antibody response following infection. It was therefore decided to determine whether the LTT-
MELISA detects the human antibody response to this antigen.
METHODS: Blood samples from consecutive patients with possible borreliosis attending a clinic were independently tested by both Western blots and LTT-MELISA.
RESULTS: After omitting cases with indeterminate Western blot results and equivocal LTT-
MELISA results, multiple linear regression modelling demonstrated that the 41-kDa flagellin immunoglobulin (Ig) M level was predictable from two LTT-MELISA variables (F 2,51 = 5.981, P = 0.005). Similarly, the corresponding 41-kDa IgG model also contained two LTT-
MELISA variables (F 2,57 = 3.700, P = 0.031).
CONCLUSIONS: It is concluded that the LTT-
MELISA appears to be able to detect the response to this antigen.