Interpretation Criteria for Standardized Western Blot for the Predominant Species of Borrelia Burgdorferi Sensu Lato in China

/Home/Lyme Disease Diagnosis/Lyme Disease Western Blot Test

Yi JIANGa, Xue-Xia HOUa, Zhen GENGa, Qin HAOa and Kang-Lin WAN, a, [Author vitae]

a State Key Laboratory for Infectious Diseases Prevention and Control, National Institute of Communicable Disease Control & Prevention, Chinese Center of Disease Control & Prevention, Beijing 102206, China

Received 10 February 2010; accepted 15 August 2010. Available online 26 November 2010.

Objective
Western blotting (WB; immunoblotting) is a widely used tool for the serodiagnosis of Lyme borreliosis (LB), but so far, no generally accepted criteria for its performance and interpretation have been established in China. The present study was designed to determine the criteria for standardized Western blot for the predominant species of Borrelia burgdorferi sensu lato in China, in which WB was produced with strain PD91 as the representative strain attributed to predominant genospecies Borrelia garinii of Borrelia burgdorferi sensu lato.

Methods
Approximately 13 bands between 14 and 100 kD were differentiated for strain PD91 by using Gel-Pro analysis software. In a study with 631 serum samples (taken from 127 patients with Lyme borreliosis and 504 controls), all observed bands were documented. To establish criteria for a positive WB result for strain PD91, receiver operating characteristic (ROC) curves were used.

Results
The following interpretation criteria were recommended: for IgG, at least one band of P83/100, P58, P39, P30, OspC, P17, P66, and OspA; for IgM, at least one band of P83/100, P58, OspA, P30, OspC, P17 or P41. In addition, syphilis, leptospirosis and other related diseases should be excluded when the positive band is P41 in IgM. For IgG criteria, the sensitivity is 73.2%, the specificity is 99.4% and Youden index is 0.726; for IgM criteria, the sensitivity is 50.6%, the specificity is 93.1% and Youden index is 0.437.

Conclusion
Standardization of WB assays is necessary for comparison of results from different laboratories. Moreover, the criteria of other genospecies of Borrelia burgdorferi sensu lato should be determined in the future to complete the criteria of WB for the diagnosis of the Lyme disease in China.

Key words: Criteria; Western blot; Borrelia burgdorferi sensu lato

This research was supported by the “Tenth Five-Year Plan” project of research on the specific diagnosis method for the Lyme disease. 2001BA705B07.


Correspondence should be addressed to Kang-Lin WAN. Tel: 86-10-61739466. Fax: 86-10-61739466
Vitae
Biographical note of the first author: Yi JIANG, female, born in 1978, Assistant Research Fellow.


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Biomedical and Environmental Sciences
Volume 23, Issue 5, October 2010, Pages 341-349