Serologiczna diagnostyka boreliozy z Lyme w praktyce laboratoryjnej
1. Etiologia boreliozy. 2. Swoista, humoralna odpowiedź immunologiczna w przebiegu boreliozy. 3. Materiał i metody stosowane w diagnostyce boreliozy. 4. Testy serologiczne w diagnostyce boreliozy. 4.1. ELISA. 4.2. Western-blot czy Immunoblot 5. Interpretacja wyników. 5.1. Wyniki fałszywie ujemne. 5.2. Wyniki fałszywie dodatnie. 6. Podsumowanie
Abstract: Lyme disease (LD) is a tick-borne multisystem disease caused by B. burgdorferi sensu lato genospecies. The disease requires mandatory reporting and registration since 2014. The laboratory testing for LD is desirable because the diversity and non-specificity of symptoms can complicate the diagnosis. Laboratory data can support or cast doubt on a clinical suspicion of LD. A laboratory method of choice for LD diagnosis is two-tier serological testing recommended by European and Polish guidelines. The choice of target antigens for LD serodiagnostics is still a great challenge due to borrelial antigen heterogeneity in European countries. Commercial tests are still being modified to improve sensitivity and/or specificity of LD serodiagnostics by means of emerging technology advances. The use of species-specific borrelial antigens can be promising for determination of LD etiology, but does not eliminate the cross-reactivity completely. The uniform standardized interpretation criteria are still unrealistic because of different methodologies used in laboratory practice. The serodiagnostics of Lyme disease should be carried out in a laboratory by specialists who understand the limitations of commercial kits [1.13], and cooperate withclinicians regarding laboratory reporting and diagnostic doubts.
1. Etiology. 2. Specific humoral immunoresponse in the course of Lyme disease. 3. Material and methods used in Lyme disease diagnostics. 4. Serodiagnostics of Lyme disease. 4.1. ELISA. 4.2. Western-blot or Immunoblot 5. Criteria for interpretation. 5.1. False-negative results. 5.2. False-postive results. 6. Summary