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An antibody capture enzyme-linked immunosorbent assay was developed to measure directly intrathecal immunoglobulin(Ig)G,A,and M synthesis specific for Borrelia burgdorferi.Purified,biotin-avidin-peroxidase- labeled B.burgdorferi flagella was used as test antigen.Paired cerebrospinal fluid and serum specimens from 100 patients with clinically definite neuroborreliosis and 35 control subjects with neurological diseases were examined.Significant B.burgdorferi-specific intrathecal IgG, A,and M production was found in 89%,65%,and 67%of patients with neuroborreliosis.Local synthesis of specific IgA was only seen in patients with significant local IgG synthesis.Antibody production in cerebrospinal fluid began by 2 weeks after onset of neurological symptoms.At the end of the second week specific IgM,IgG,or both,was detected in 88%of the patients.Specific IgG synthesis was present in all patients by 6 weeks after onset.Specific local IgM synthesis usually disappeared by 3 to 6 months after therapy,whereas specific IgG synthesis persisted after recovery.Even in patients with a severely altered blood-brain barrier,the assay discriminated between intrathecal antibody synthesis and antibody leakage from serum.The assay makes diagnostic measurement of B. burgdorferi-specific intrathecal antibody synthesis reliable,rapid,and accessible as a routine serological test. |
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ELISA Lyme disease neurologic disease,diagnoses of serologic testing of cerebrospinal fluid spinal cord,compression,epidural abscess causing
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