Serodiagnosis of Lyme disease by kinetic enzyme-linked immunosorbent assay using recombinant VlsE1 or peptide antigens of Borrelia burgdorferi compared with 2-tiered testing using whole-cell lysates

J Infect Dis. 2003 Apr 15;187(8):1187-99. doi: 10.1086/374395. Epub 2003 Apr 2.


In a study of US patients with Lyme disease, immunoglobulin (Ig) G and IgM antibody responses to recombinant Borrelia burgdorferi antigen VlsE1 (rVlsE1), IgG responses to a synthetic peptide homologous to a conserved internal sequence of VlsE (C6), and IgM responses to a synthetic peptide comprising the C-terminal 10 amino acid residues of a B. burgdorferi outer-surface protein C (pepC10) were evaluated by kinetic enzyme-linked immunoassay. At 99% specificity, the overall sensitivities for detecting IgG antibody to rVlsE1 or C6 in samples from patients with diverse manifestations of Lyme disease were equivalent to that of 2-tiered testing. When data were considered in parallel, 2 combinations (IgG responses to either rVlsE1 or C6 in parallel with IgM responses to pepC10) maintained high specificity (98%) and were significantly more sensitive than 2-tiered analysis in detecting antibodies to B. burgdorferi in patients with acute erythema migrans. In later stages of Lyme disease, the sensitivities of the in parallel tests and 2-tiered testing were high and statistically equivalent.

Publication types

  • Comparative Study

MeSH terms

  • Antibodies, Bacterial / analysis
  • Antibodies, Bacterial / immunology
  • Antigens, Bacterial / immunology*
  • Bacterial Proteins / immunology*
  • Borrelia burgdorferi / cytology*
  • Borrelia burgdorferi / immunology*
  • Cell Extracts / immunology
  • Enzyme-Linked Immunosorbent Assay / methods*
  • Humans
  • Immunoglobulin G / immunology
  • Lipoproteins / immunology*
  • Lyme Disease / blood
  • Lyme Disease / diagnosis*
  • Lyme Disease / immunology*
  • Sensitivity and Specificity
  • Serologic Tests


  • Antibodies, Bacterial
  • Antigens, Bacterial
  • Bacterial Proteins
  • Cell Extracts
  • Immunoglobulin G
  • Lipoproteins
  • VlsE protein, Borrelia burgdorferi