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CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ |
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Česky / Czech version | Čes. a slov. Neurol. Neurochir., 66/99, 2003, No. 2, p. 121–125. |
Comparison of Two
Methods – Evidence of Intrathecal Synthesis of Specific Antiborrelia Antibodies and the
Polymerase Chain Reaction – in the Diagnosis of Lyme Borreliosis Moravcová L.1, Pícha D.1, Lásiková Š.1, Žďárský E.2 1Univerzita Karlova, 2. lékařská fakulta, 1. infekční klinika, Praha 2Univerzita Karlova, 3. lékařská fakulta, Centrum biomedicínských oborů, oddělení buněčné a molekulární genetiky, Praha |
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Summary: In 25 patients with the diagnosis of Lyme neuroborreliosis the intrathecal secretion of specific
antiborrelia antibodies was assessed and compared with evidence of Borrelia DNA in cerebrospinal
fluid and plasma. Autochthonous production of antiborrelia antibodies was assessed by calculation
using the specific antibody index AIBb and for detection of the DNA of spirochete the authors used the
two-stage polymerase chain reaction („nested“ PCR) with three sets of primers: for the plasmid gene
coding OspC protein and for chromosomal genes coding 16S rDNA and flagellin. Specific antiborrelia
antibodies in serum were detected in 20 (80%) patients and intrathecal synthesis of specific IgG
antibodies was found in 22/(88%) of the examined subjects. DNA spirochetes were detected in cerebrospinal
fluid 12x (48%) and in plasma 6x (24%). At least onceDNA of borrelias in some examined biological
material was detected in 13 (52%) of the patients. In 3 patients DNA was detected and no specific
antibodies were found. By comparison of results of assessment of autochthonous production of antiborrelia
antibodies and PCR it was revealed that the method of calculation of the antibody index was
more sensitive (88%) as compared with „direct“ evidence of the spirochete in cerebrospinal fluid (48%)
and in plasma (24%) before antibiotic therapy. The assembled results showed that the PCR for detection
of borrelias can usefully supplement the diagnosis of neuroborreliosis but cannot replace „classical“
serology.
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