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• Nordberg, M
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Cells 2012, 1(2), 153-167; doi:10.3390/cells1020153

Article

Can ELISPOT Be Applied to A Clinical Setting as A Diagnostic Utility for Neuroborreliosis?

Marika Nordberg ^1,2,* , Pia Forsberg ^1,3 , Dag Nyman ² , Barbro H. Skogman ⁴ , Clara Nyberg ² , Jan Ernerudh ^5,6 , Ingvar Eliasson ⁷  and Christina Ekerfelt ⁵

¹ Department of Clinical and Experimental Medicine, Infectious Medicine Faculty of Health Sciences, Linköping University, 581 83 Linköping, Sweden ² The Åland Borrelia Group, Åland, 22100 Mariehamn, Åland, Finland ³ Department of Infectious Diseases, County Council of Östergötland, 581 85 Linköping, Sweden ⁴ Center for Clinical Research (CKF) Dalarna, 791 36 Falun, Sweden ⁵ Department of Clinical and Experimental Medicine, Clinical Immunology, Linköping University, S-581 83 Linköping, Sweden ⁶ Department of Clinical Immunology and Transfusion Medicine, County Council of Östergötland, 581 85 Linköping, Sweden ⁷ Department of Laboratory Medicine, NÄL, 461 85 Trollhättan, Sweden

* Author to whom correspondence should be addressed.

Received: 1 April 2012; in revised form: 7 May 2012 / Accepted: 8 May 2012 / Published: 8 June 2012

(This article belongs to the Special Issue ELISPOT Research)

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Abstract: The aim of this prospective study was to investigate the diagnostic performance of Borrelia (Bb)-induced interferon (IFN)-γ secretion detected by ELISPOT modified to be feasible for clinical laboratories as a supplementary test to the laboratory diagnosis of Lyme neuroborreliosis (LNB) in an endemic setting. Between 2002 and 2004, patients with symptoms of suspected clinical LNB were included in a study conducted on the Åland islands in the Finnish archipelago, which is a hyper-endemic area for Lyme borreliosis (LB). Fourteen patients with confirmed LNB and 103 patients with non-LNB were included, and the numbers of spontaneous and Bb-induced IFN-γ-secreting cells were assayed by the ELISPOT test. The ELISPOT assay showed a weak diagnostic performance with a sensitivity of 36% and a specificity of 82%. The findings in this study show that this ELISPOT-assay modified to be feasible in clinical routine laboratories is not useful as a supplementary diagnostic tool in the laboratory diagnosis of patients with clinically suspected LNB.

Keywords: Borrelia burgdorferi; neuroborreliosis; ELISPOT; cerebrospinal fluid; diagnostic test; sensitivity; specificity

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