Significancia biológica de la Ig M anti p41 en Lyme.(Click here)
We performed a prospective study to investigate the biological significance and diagnostic specificity of
anti-p41 immunoglobulin (Ig)M antibodies against Borrelia burgdorferi. During a 1-year interval 2403
patients were referred to our department for B. burgdorferi serology. Sixty-three patients had repetitive
positive tests for IgM anti-p41 antibodies and negative tests for anti-p41 IgG antibodies. Ten of the 63
patients recently had symptoms of erythema migrans. A confirmatory IgM Western blot gave a positive
reaction in 5 patients out of 53 patients with little or no clinical evidence of B. burgdorferi infection. The
remaining 48 patients were negative in this test and were considered as false-positives. Two whole cell
enzyme-linked immunosorbent assay (ELISAs), two immunofluorescence assays and Western blotting were
not useful as confirmatory tests. Sera from 330 blood donors and 72 cord sera were also screened for anti-p41 IgM. Five blood donor sera and five cord sera showed an IgM reactivity against p41. Based on our data we hypothesize that up to 1.5% of the population may have natural IgM antibodies against p41 in their sera. We observed that six out of nine sera with such antibodies could immobilize a B. afzelii reference strain in vitro. Whether anti-p41 IgM antibodies are capable of inactivating infective spirochetes and thereby prevent infection in vivo is, however, not yet clarified. The paradoxical conclusion that anti-p41 IgM antibodies may be a sign of resistance to infection rather than a sign of infection should.
We performed a prospective study to investigate the biological significance and diagnostic specificity of
anti-p41 immunoglobulin (Ig)M antibodies against Borrelia burgdorferi. During a 1-year interval 2403
patients were referred to our department for B. burgdorferi serology. Sixty-three patients had repetitive
positive tests for IgM anti-p41 antibodies and negative tests for anti-p41 IgG antibodies. Ten of the 63
patients recently had symptoms of erythema migrans. A confirmatory IgM Western blot gave a positive
reaction in 5 patients out of 53 patients with little or no clinical evidence of B. burgdorferi infection. The
remaining 48 patients were negative in this test and were considered as false-positives. Two whole cell
enzyme-linked immunosorbent assay (ELISAs), two immunofluorescence assays and Western blotting were
not useful as confirmatory tests. Sera from 330 blood donors and 72 cord sera were also screened for anti-p41 IgM. Five blood donor sera and five cord sera showed an IgM reactivity against p41. Based on our data we hypothesize that up to 1.5% of the population may have natural IgM antibodies against p41 in their sera. We observed that six out of nine sera with such antibodies could immobilize a B. afzelii reference strain in vitro. Whether anti-p41 IgM antibodies are capable of inactivating infective spirochetes and thereby prevent infection in vivo is, however, not yet clarified. The paradoxical conclusion that anti-p41 IgM antibodies may be a sign of resistance to infection rather than a sign of infection should.
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