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Multiplex Bead Based Immunoassays For The Serodiagnosis of Lyme Borreliosis

Rudolf Gruber

Laboratory diagnosis of Lyme borreliosis is based on the detection of specific IgG and IgM antibodies against relevant antigens of Borrelia burgdorferi. Serological diagnosis usually is performed by a two-step procedure. Where immunoassays for antibody screening exhibit high sensitivity, second-line tests, e.g. Western-blot or line-blot assays,show high specificity, and are used for confirmation of positive screening results. In addition to serology, in certain cases Borrelia spp. can be detected directly, for instance in synovial fluid from patients with Lyme arthritis by PCR or bacterial culture. With the development of multiplex technology, e.g. bead-based immunoassays, multiple antibodies to distinct bacterial antigens can be detected in a single run. Detection systems used in this context, e.g. analysers
based on flow cytometry, can be highly standardised and automated. Furthermore, these analysers can be connected bidirectionally to an order-entry based laboratory information system, with random access for high throughput analysis. Thus, multiplex bead assays may have the power to replace the current two-step procedure.