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Infection and Immunity, January 1999, p. 173-181, Vol. 67, No. 1
0019-9567/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

The Immunoglobulin (IgG) Antibody Response to OspA and OspB Correlates with Severe and Prolonged Lyme Arthritis and the IgG Response to P35 Correlates with Mild and Brief Arthritis

Evren Akin,1,* Gail L. McHugh,2 Richard A. Flavell,3 Erol Fikrig,4 and Allen C. Steere2

Divisions of Rheumatology/Immunology and Pediatric Rheumatology1 and Division of Rheumatology/Immunology,2 Tufts University School of Medicine, New England Medical Center, Tupper Research Institute, Boston, Massachusetts, and Howard Hughes Medical Institute3 and Division of Rheumatology,4 Yale University School of Medicine, New Haven, Connecticut

Received 17 July 1998/Accepted 23 September 1998

In an effort to implicate immune responses to specific Borrelia burgdorferi proteins that may have a role in chronic Lyme arthritis, we studied the natural history of the antibody response to B. burgdorferi in serial serum samples from 25 patients monitored throughout the course of Lyme disease. In these patients, the immunoglobulin G (IgM) and IgG antibody responses to 10 recombinant B. burgdorferi proteins, determined during early infection, early arthritis, and maximal arthritis, were correlated with the severity and duration of maximal arthritis. The earliest responses were usually to outer surface protein C (OspC), P35, P37, and P41; reactivity with OspE, OspF, P39, and P93 often developed weeks later; and months to years later, 64% of patients had responses to OspA and OspB. During early infection and early arthritis, the levels of IgG antibody to P35 correlated inversely with the subsequent severity or duration of maximal arthritis. In contrast, during periods of maximal arthritis, the levels of IgG antibody to OspA and OspB, especially to a C-terminal epitope of OspA, correlated directly with the severity and duration of arthritis. Thus, the higher the IgG antibody response to P35 earlier in the infection, the milder and briefer the subsequent arthritis, whereas during maximal arthritis, the higher the IgG response to OspA and OspB, the more severe and prolonged the arthritis.

* Corresponding author. Mailing address: Division of Rheumatology/Immunology, New England Medical Center, NEMC 406, 750 Washington St., Boston, MA 02111. Phone: (617) 636-5789. Fax: (617) 636-4252.

Infection and Immunity, January 1999, p. 173-181, Vol. 67, No. 1
0019-9567/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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Copyright © 1999 by the American Society for Microbiology. All rights reserved.