Clinical comparison of immunoblot and antibody index for detection of intrathecal synthesis of specific antibodies in Lyme neuroborreliosis
Abstract
The quality of current laboratory procedures for the diagnosis of Lyme borreliosis (LB) is unsatisfactory worldwide, primarily because widely applicable direct methods for the detection of Borrelia burgdorferi do not exist. Therefore, the diagnosis of LB often has to be based on clinical signs of disease, supplemented by antibody detection.
In cases of neuroborreliosis (NB), in particular, it is rarely possible to make the diagnosis based on clinical manifestations exclusively, so the detection of specific antibodies in cerebrospinal fluid (CSF) is essential. However, diagnosis by this method can be complicated by the relatively high seroprevalence of Borrelia-specific antibodies, especially in endemic areas.
These antibodies usually diffuse through the impaired blood-brain barrier during many neuroinfections of nonborrelial origin.