Antibodies to decorin-binding protein B (DbpB) in the diagnosis of Lyme neuroborreliosis in children

• Antibodies towards three decorin binding protein B (DbpB) variants were evaluated.
• DbpB variant from Borrelia garinii performed best both in CSF and serum samples.
• Sensitivity of the DbpB ELISA was lower in children than in adults tested earlier.
• DbpB test does not seem to improve laboratory diagnosis of LNB in children.

SummaryBackgroundLaboratory 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.MethodsSerum 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.ResultsThe 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.ConclusionsSerum or CSF antibodies to DbpB do not appear to be beneficial in the laboratory diagnosis of LNB in children.