Background: Laboratory support is needed to confirm the clinical diagnosis of Lyme neuroborreliosis (LNB). Antibodies to Borrelia-specific proteins have been used to improve serological diagnostics. The aims of this study were to assess the occurrence of antibodies to decorin-binding protein B (DbpB) in serum and cerebrospinal fluid (CSF) in children with LNB and to evaluate the performance of DbpB variants in the diagnosis of LNB in children.
Methods: Serum and CSF sample pairs were available from 57 children evaluated for LNB. Based on the presence of anti-flagella antibodies and pleocytosis in the CSF, patients were divided into three different groups: confirmed LNB (n=24), possible LNB (n=16), and non LNB (n=17). Recombinant DbpBs from three Borrelia burgdorferi sensu lato species - Borrelia burgdorferi sensu stricto, Borrelia garinii, and Borrelia afzelii - were used in an ELISA to detect IgG antibodies.
Results: The sensitivity of variant recombinant DbpBs in serum and CSF samples varied between 0% and 46% and between 0% and 42%, respectively. In CSF, the most sensitive antigen was the DbpB variant from B. garinii.
Conclusions: Serum or CSF antibodies to DbpB do not appear to be beneficial in the laboratory diagnosis of LNB in children.
Keywords: Borrelia burgdorferi sensu lato; CSF; Children; DbpB; Lyme neuroborreliosis.