Infection with the spirochete Borrelia burgdorferi leads to Lyme disease (LD), the most prevalent tick-borne illness in the Northern Hemisphere. If left untreated, the infection spreads throughout the body, causing multisystem disease. The current standard for LD diagnosis is a two-tiered approach (ELISA followed by Western blot), which targets the immune response to bacterial proteins. This approach, however, lacks sensitivity and specificity, leading to misdiagnosis. We developed a protein microarray assay to detect antibodies against B. burgdorferi proteins with high sensitivity using grating-coupled surface plasmon resonance, combined with fluorescence imaging (Grating Coupled-Fluorescent Plasmonics, GC-FP). Here, we use GC-FP for rapid and multiplexed detection of antibodies from B. burgdorferi in human serum. We confirmed the fluorescence enhancement capability of GC-FP analysis and optimized reagent concentrations for detection of serum antibodies present in human LD. By conducting GC-FP analysis of patient serum samples, we were able to accurately diagnose LD in patients with disseminated and early-stage infection. Our results show that GC-FP can detect IgG antibodies in highly dilute human sera (up to 1:1250X serum dilution) and we are currently establishing whether or not our GC-FP platform can detect serum antibodies with greater sensitivity and specificity compared to the standard Western blot approach. Altogether, our work provides a potential path towards replacement of the cumbersome two-tiered testing algorithm, and thus a streamlined approach to LD diagnosis.
|