Author/Editor		Ružić-Sabljić, E; Strle, F; Cimperman, J; Kotnik, V
Title		Vrednotenje imunofluorescenčnega testa za dokazovanje lymske borelioze
Translated title		Immunofluorescence test evaluation for Lyme borreliosis confirmation
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 64, št. 2
Publication year		1995
Volume		str. 63-7
Language		slo
Abstract		Background. Lyme borreliosis (LB) is the most frequent tick-born disease in Slovenia. Wide clinical manifestations of LB often have to be confirmed by microbiological tests. The aim of this study was to determine the value of the immunofluorescence test without (BB-IFT) and with adsorption (BB-IFT-abs) routinely used to confirm LB. We also try to determine the influence of cross-reaction on the IgM and IgG antibodies levels. Methods. Patients with LB and suspected LB were tested as well as control group. Serum IgM and IgG antibodies were determined with BB-IFT and BB-IFT-abs. Patients were also tested for rheumatoid factor (RF) and Treponema pallidum. To detect reaction of serum IgG antibodies with T. pallidum TP-IFT, TP-IFT-abs, haemaglutination test, VDRL and Wassermann test were used. Results. We compared antibody titters of BB-IFT and BB-IFT-abs tests and found that 95 percent sera with titters = great. th. 1:256, 31 percent with titter 1:128 and 4 percent with titter less th. 1:128 tested with BB-IFT had titter 1:64 or higher tested with BB-IFT-abs. IgG antibodies present in sera influenced on the IgM titter levels; the influence of IgM antibodies on the titter levels of IgG antibodies was not found. On the IgM titter levels influenced RF resulting with false positive and false negative IgM titters. In the IgG class we found that 59 (29.5 percent) sera reacted with T. pallidum as antigen. Using other tests to confirm infection with T. pallidum we found only 9 (15.3 percent) sera reacted and only in one additional test. Conclusions. BB-IFT as well as BB-IFT-abs could be successfully used to confirm borrelial infection. We establish cutoff titter in BB-IFT as 1:256 and in BB-IFT-abs as 1:64. IgM and IgG titter 1:128 in BB-IFT have to be additionally evaluated with BB-IFTabs. Cross-reactions could be determined in both classes of antibodies. Adsorption tests could reduce the cross-reactivity.(trunc.)
Summary		Izhodišča. Lymska borelioza (LB) je v Sloveniji najbolj pogosta bolezen, ki jo prenašajo klopi. Klinična slika LB je zelo pestra in variabilna, tako da je za diagnozo pogosto potrebna mikrobiološka potrditev borelijske okužbe. Cilj naše raziskave je bil ovrednotiti imunofluorescenčni test (IFT) za serološko dokazovanje borelijske okužbe in ugotoviti, kakšen in kolikšen vpliv imajo navzkrižne reakcije na določanje IgM in IgG protiteles proti B. burgdorferi. Metode. Testirali smo serume bolnikov s klinično sliko LB ali s sumom nanjo in kontrolno skupino. Protitelesa proti B. burgdorferi razreda IgM in IgG smo dokazovali z IFT brez in z absorpcijo (BB-IFT in BB-IFT-abs). Vse bolnika smo testirali na prisotnost RF. Morebitno reakcijo bolnikovih IgG na Treponema pallidum kot antigen smo dokazovali s TP-IFT, TP-IFT-abs, hemaglutinacijskim testom (TPHA), VDROL in Wassermanovim testom. Rezultati. Primerjali smo titre IgM in IgG protiteles, ki smo jih dobili z BB-IFT in BB-IFT-abs. Ugotovili smo, da ima 95 odst. bolnikov s titri = večje kot 1:256, 31 odst. s titri 1:128 in 4 odst. s titri manjše kot 1:128 v BB-IFT v BB-IFT-abs titer = večje kot 1:64. Na višino titrov IgM protiteles je vplivala istočasna prisotnost IgG protiteles v serumu, medtem ko IgM protitelesa niso imela pomembnejšega vpliva na višino IgG titrov. Na višino titrov IgM protiteles je vplival v serumu prisoten revmatoidni faktor (RF); ugotovili smo tako lažno pozitivne kot lažno negativne titre. Pri 59 bolnikih (29,5 odst.) so protitelesa IgG razreda reagirala tudi s T. pallidum kot antigenom. Navzkrižno reakcijo s T. pallidum smo lahko potrdili le pri devetih (15,3 odst.) bolnikih, in sicer s še enim dodatnim testom. Zaključki. BB-IFT in BB-IFT-abs sta testa, s katerima lahko potrdimo borelijsko okužbo. Mejna titra IgM in IgG protiteles sta 1:256 za BB-IFT in 1:64 za BB-IFT-abs. Titre IgM in IgG protiteles 1:128 v BB-IFT je treba dodatno ovrednotiti z BB-IFTabs.(krajš.)
Descriptors		LYME DISEASE FLUORESCENT ANTIBODY TECHNIQUE BORRELIA BURGDORFERI SERODIAGNOSIS