DIAGNOSIS OF SPECIFIC ANTIBODIES TO THE COMPLEX B. BURGDORFERI S. L. IN PATIENTS WITH LYME-BORRELIOSIS COMBINED WITH EPSTEIN – BARR VIRUS INFECTION
DOI:
https://doi.org/10.11603/1811-2471.2024.v.i2.14731Keywords:
Lyme borreliosis, specific IgM, IgG, antigens, B. burgdorferi s. l. complex, B. burgdorferi s.s., B. afzelii, B. garinii and B. spielmanii, ELISA, immunoblot, EBV, multiplex indirect immunofluorescence, BIOCHIP technology, polymerase chain reactionAbstract
SUMMARY. The aim – to diagnose specific antibodies of class M and G to antigens of the B. burgdorferi s. l. complex in patients with Lyme borreliosis combined with Epstein – Barr virus infection.
Material and Methods. At the Center for the Study of Lyme Borreliosis and Other Tick-Transmitted Infections at the I. Horbachevsky Ternopil National Medical University of the Ministry of Health of Ukraine, 106 patients, residents of the Ternopil region, aged 30 to 72 years, with clinical manifestations of LB and EBV were examined. 33 (31.1 %) were men, 73 (68.9 %) were women. Among the patients, urban residents predominated over the countryside – 85 (80.2 %) vs. 21 (19.8 %) people.
Laboratory confirmation of LB was performed serologically using a two-stage diagnostic scheme (ELISA, immunoblot). The etiologic structure of LB was studied by immunoblot (line-blot). Specific IgM antibodies were detected against OspC of B. burgdorferi s. s., B. afzelii, B. garinii and B. spielmanii, VlsE, p41 and p39 – antigens of B. afzelii. Specific IgG antibodies were diagnosed to VlsE of B. afzelii, B. burgdorferi s. s. and B. garinii; cell membrane lipids of B. afzelii and B. burgdorferi s. s.; p83 to B. afzelii, p41, and p39 to B. garinii antigens; OspC (p25) to B. garinii, as well as to recombinant highly specific B. burgdorferi antigens: p18, p19, p20, p21, and p58.
Using the multiplex indirect immunofluorescence, BIOCHIP technology, specific antibodies of M and G classes to EBV antigens were detected in the sera of the examined patients. The phases of chronic EBV infection (active or latent) were diagnosed by real-time PCR, determining EBV DNA in blood and saliva (in both or one sample); detection range (103–107 copies/ml).
Results. LB was diagnosed serologically, using ELISA and immunoblot diagnostic methods, in 52.8 % of patients with clinical manifestations of Lyme borreliosis. The active phase of Epstein – Barr virus infection (EBV) was diagnosed in 44.6 % of patients with clinically and serologically confirmed LB. In patients with monoinfection of LB, serum anti-IgG to p83 B. afzelii and p39 B. garinii prevailed, p<0.05. In patients with a combination of LB and EBV infection, anti-IgM to p41 and p39 of B. afzelii and OspC of B. spelmanii prevailed.
Conclusions. Determination of specific serum IgM and IgG in patients with Lyme borreliosis combined with Epstein – Barr virus infection, residents of Ternopil region, was carried out for the first time and allowed to establish a significant difference in the content of specific antibodies of class M and G to different antigens to the B. burgdorferi s. l. complex in individuals with both LB and EBV separately.
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