Deze wordt op dit moment als ik het goed begrijp bij/via o.a. Prohealth Weert en ELN Bunnik gebruikt:
https://www.ncbi.nlm.nih.gov/pubmed/16876371
http://www.melisa.org/pdf/MELISA-Lyme.pdf
Diagn Microbiol Infect Dis. 2007 Jan;57(1):27-34. Epub 2006 Jul 28.
A novel lymphocyte transformation test (LTT-MELISA) for Lyme borreliosis.
Valentine-Thon E1, Ilsemann K, Sandkamp M.
Abstract
Diagnosis of active Lyme borreliosis (LB) remains a challenge in clinically ambiguous, serologically indeterminant, and polymerase chain reaction-negative patients. Lymphocyte transformation tests (LTTs) have been applied to detect specific cellular immune reactivity, but their clinical application has been severely hampered by the poorly defined Borrelia antigens and nonstandardized LTT formats used. In this study, we describe the development and clinical relevance of a novel LTT using a validated format (MELISA) together with well-defined recombinant Borrelia-specific antigens. From an initial screening of 244 patients with suspected Borrelia infection or disease, 4 informative recombinant antigens were selected: OspC (Borrelia afzelii), p41-1 (Borrelia garinii), p41-2 (B. afzelii), and p100 (B. afzelii). Thereafter, 30 seronegative healthy controls were tested in LTT-MELISA(R) to determine specificity, 68 patients were tested in parallel to determine reproducibility, and 54 lymphocyte-reactive symptomatic patients were tested before and after antibiotic therapy to assess clinical relevance. Most (86.2%) of the 36.9% (90/244) LTT-MELISA positive patients were seropositive and showed symptoms of active LB. Specificity was 96.7% and reproducibility 92.6%. After therapy, most patients (90.7%) showed negative or markedly reduced lymphocyte reactivity correlating with clinical improvement. This novel LTT-MELISA assay appears to correlate with active LB and may have diagnostic relevance in confirming LB in clinically and serologically ambiguous cases.
In deze recente studie zijn de MELISA-LTT en Igenex Western Blot gebruikt:
https://www.ncbi.nlm.nih.gov/pubmed/25664127
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4307574/pdf/ijcem0007-5890.pdf
Int J Clin Exp Med. 2014; 7(12): 5890–5892. Published online 2014 Dec 15. PMCID: PMC4307574
Diagnostic use of the lymphocyte transformation test-memory lymphocyte immunostimulation assay in confirming active Lyme borreliosis in clinically and serologically ambiguous cases
Basant K Puri,1 Daniel RM Segal,2 and Jean A Monro2
Abstract
The aim of this study was to carry out an independent evaluation of the proposition that the lymphocyte transformation test-memory lymphocyte immunostimulation assay (LTT-MELISA) may be diagnostically useful in the confirmation of active Lyme borreliosis in clinically and serologically ambiguous cases. Blood samples from 54 patients consecutively presenting to a British center with clinical suspicion of Lyme borreliosis were tested for this disease by immunoglobulin M (IgM) and immunoglobulin G (IgG) Western blots and by LTT-MELISA. Forty-five of these patients had Western blot results which were negative for both IgM and IgG by the criteria of the Centers for Disease Control and Prevention (CDC); of these patients, 19 (42%) were LTT-MELISA-positive. Two of the patients who had IgM positive results by the CDC criteria were LTT-MELISA-negative. It is concluded that, for putative European-acquired Lyme borreliosis infections, it would be sensible to carry out both the LTT-MELISA and Western blot assay.
(...)The aim of the present study was to carry out the first independent evaluation of the value of the LTT-MELISA in serologically and clinically ambiguous cases of Lyme borreliosis in which Western blot IgG and IgM results were negative.
Deze Borrelia-LTT wordt bij het IMD Berlijn gebruikt en deze studie is ook door hen uitgevoerd:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3474945/
Open Neurol J. 2012; 6: 104–112. Published online 2012 Oct 5. doi: 10.2174/1874205X01206010104 PMCID: PMC3474945 Suppl 1
The Lymphocyte Transformation Test for Borrelia Detects Active Lyme Borreliosis and Verifies Effective Antibiotic Treatment
Volker von Baehr,1 Cornelia Doebis,1 Hans-Dieter Volk,2 and Rüdiger von Baehr1,*
Abstract
Borrelia-specific antibodies are not detectable until several weeks after infection and even if they are present, they are no proof of an active infection. Since the sensitivity of culture and PCR for the diagnosis or exclusion of borreliosis is too low, a method is required that detects an active Borrelia infection as early as possible. For this purpose, a lymphocyte transformation test (LTT) using lysate antigens of Borrelia burgdorferi sensu stricto, Borrelia afzelii and Borrelia garinii and recombinant OspC was developed and validated through investigations of seronegative and seropositive healthy individuals as well as of seropositive patients with clinically manifested borreliosis. The sensitivity of the LTT in clinical borreliosis before antibiotic treatment was determined as 89,4% while the specificity was 98,7%. In 1480 patients with clinically suspected borreliosis, results from serology and LTT were comparable in 79.8% of cases. 18% were serologically positive and LTT-negative. These were mainly patients with borreliosis after antibiotic therapy. 2.2% showed a negative serology and a positive LTT result. Half of them had an early erythema migrans. Following antibiotic treatment, the LTT became negative or borderline in patients with early manifestations of borreliosis, whereas in patients with late symptoms, it showed a regression while still remaining positive. Therefore, we propose the follow-up monitoring of dis-seminated Borrelia infections as the main indication for the Borrelia-LTT.
Josie