Significance of Detecting Serum Antibodies to Outer Surface Protein A of Lyme Disease Borreliae in PCR-Confirmed Blood Infections

Abstract

Background/Objectives: Lyme disease is caused by some species of tick-borne bacteria of the genus Borrelia, termed Lyme disease Borreliae (LDB). Borrelia burgdorferi is the LDB species principally responsible for Lyme disease in the US. The outer surface protein A (OspA) of LDB attaches the bacteria to the gut of Ixodes tick vectors. OspA expression is downregulated when B. burgdorferi is transmitted from ticks to mammalian hosts. Vaccination with OspA elicits antibody-mediated protective immunity in animals and humans against LDB infection. The possible presence of serum antibodies against OspA in persons with PCR-confirmed LDB infections in blood was investigated in this study. Methods: Ninety-one archived sera from patients with LDB infections in blood demonstrated by a sensitive PCR assay were tested for reactivity with OspA from multiple LDB species in line immunoblots. Results: In total, 14 of the 91 sera (15.4%) had either IgG or IgM antibodies to OspA from one or more LDB species. Conclusions: The results show for the first time that serum antibodies to OspA are formed when LDB are present in human blood. However, the factors that governed the expression of OspA by LDB in patients could not be ascertained. It will be useful to determine whether the observed levels of serum antibodies to OspA in infected persons can protect against subsequent tick-borne infection and whether OspA used in conjunction with other LDB antigens can improve the serological diagnosis of Lyme disease.