XX. BORRELIA BURGDORFERI SEROLOGY

Borrelia burgdorferi

1. _______

2. Causes ____, also referred to as ____

Spirochete

Lyme disease ; Lyme borreliosis

Transmission

• The microorganism is transmitted to humans in the saliva of a ____.

• Because it take days to feed, if removed within _____, infection might be prevented.

• tick (Ixodes)

• 24–36 hours

Where a reddened area on the skin that occurs 2–32 days after being bitten by an infected tick

Early stage

The most common symptom of the this stage is arthritis affecting the knees, shoulders, and elbows.

Late stage

Early stage

• A reddened area on the skin that occurs _____ days after being bitten by an infected tick

• The reddened area can develop into the classic target or ____ rash, called _____.

• The rash is present in about ____ of the cases.

• 2–32

• “bull’s eye” ; erythema migrans

• 60%

Late stage

• The most common symptom of the late stage is ____ affecting the knees, shoulders, and elbows.

• Approximately ___ of patients exhibit aseptic meningitis, facial nerve palsy, encephalitis, cranial neuritis, and radiculoneuritis.

• Approximately _____ of patients exhibit carditis.

• ______ may present as a sclerotic or atrophic skin lesion or a lymphocytoma.

• arthritis

• 15%

• 8%

• Chronic disease

Antibody response

• The first antibody produced in Lyme disease is ____, which is primarily directed against the outer surface protein ____ subunits ____ and ___

• Subsequently, in the late stage ____ antibody specific to a number of B. burgdorferi antigens is produced.

• Antibodies often persist for _____.

• IgM ; OspC and flagellin ; p41 (FlaB) and p37 (FlaA).

• IgG

• several years

Serology tests

• Diagnosis can be made if a _____ increase in titer is detected between an acute serum specimen and a specimen taken ___ weeks later (convalescent).

• A more rapid method is to detect ____ antibodies to B. burgdorferi antigens

• fourfold ; 6–8

• IgM

Serology tests

• _____ and ____ are screening methods.

• Positive specimens should be confirmed by _____.

• Immunofluorescence ; ELISAs

• immunoblotting

Immunoblot (western blot)

1) Procedure

• ____ are electrophoretically separated on a ____ to form bands.

• The antigenic bands are transferred to an inert _____ (e.g., nitrocellulose) and then incubated with ____. 

• After incubation, the membrane is _____ and an _____ is added.

• _____ is added to detect antigen-antibody reactions.

• Antigens ; polyacrylamide gel

• membrane filter ; patient serum. 

• washed ; enzyme-labeled antihuman antibody

• Enzyme substrate