March 23, 2015
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Metabolic biosignature aids in detection of early Lyme disease

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A metabolic biosignature may detect early Lyme disease before patients have a detectable antibody response to Borrelia burgdorferi, according to data published in Clinical Infectious Diseases.

“Current diagnostic tests for early Lyme disease have excellent specificity, but relatively poor sensitivity,” John T. Belisle, PhD, professor in the department of microbiology, immunology and pathology at Colorado State University, told Infectious Disease News. “Thus, we wanted to test whether a new technology — metabolomics — that allows for the detection and measurement of a large number of analytes in a single sample, could be used to improve Lyme disease diagnostics.”

Belisle and colleagues used liquid chromatography-mass spectrometry to analyze retrospective serum samples from patients with early Lyme disease, other diseases and healthy controls for small molecule metabolites. They selected a biosignature for early Lyme disease, which then was used as an experimental diagnostic tool for additional patient sera. The accuracy of the method was compared with the two-tier serology method.

The initial biosignature included 95 molecular features that were specific to early Lyme disease, but further statistical modeling narrowed the signature to 44 molecular features.

When the researchers tested the biosignature in additional sera that were not used to develop the biosignature, the average accuracy was 88% for identifying early Lyme disease and 95% for healthy controls. There were five independent liquid chromatography-mass spectrometry runs conducted on all these samples. For all the tests, the sensitivity ranged from 84% to 95%, and the specificity ranged from 90% to 100%. The researchers said that the sensitivity of two-tier testing for the same early Lyme disease samples ranged from 43% to 48%, and the metabolic profiling identified 77% to 95% of the early Lyme disease samples that were negative by two-tier testing.

“This proof-of-concept study demonstrates that technologies beyond antibody-based serological tests can be developed and applied for the early diagnosis of Lyme disease,” Belisle said. “However, in its current form, this test cannot yet be directly applied to clinical practice. With continued development, this technology does hold potential for improved diagnosis of early Lyme disease.”

Belisle said his team is currently evaluating the technology with other specimen types, such as urine. They are also mapping metabolic biosignatures for other stages of Lyme disease. – by Emily Shafer

Disclosure: The researchers report no relevant financial disclosures.