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ELISA Test to Identify Autoantigen in Antibiotic-Refractory Lyme Arthritis

Massachusetts General Hospital
posted on 03/15/2012

Technology: A subgroup of patients with Lyme arthritis, a tick-borne spirochetal infection, have persistent synovitis for months or even several years after spirochetal eradication with antibiotic therapy, called antibiotic-refractory Lyme arthritis. This results from infection induced autoimmunity within affected joints. The inventors have identified an autoantigen, platelet derived endothelial cell growth factor (ECGF) in the synovial fluid of affected joints of these patients. An ELISA diagnostic assay has been developed to detect ECGF autoantigen-binding autoantibodies in serum and ECGF protein in synovial fluid, which allows the clinician to appropriately identify these patients and treat this disease. Currently a number of patients are being continuously treated with antibiotics for months and years, by using this diagnostic test they could be possibly switched to an appropriate anti-rheumatic/anti-inflammatory therapy. Applications: 1. A diagnostic assay to rapidly identify chronic lyme disease (CLD) patients with antibiotic refractory Lyme arthritis. 2. More effective treatment regimens can be developed for CLD patients who had prolonged illness and an associated lower quality of life. Advantages: 1. The assay is highly sensitive and specific. 2. Convenient, cost-effective, faster than available PCR Borrelia burgdorferi DNA tests in synovial fluids. 3. Improve treatment to patient; avoid costly and ineffective antibiotic therapy. 4. Tests can be offered by CLIA lab to clinicians. 5. Format of assay: ELISA, agglutination test, direct immunoflourescence assay, indirect immunofluorescence assay, western blot, and the immunoblot. Publications: - Seward RJ et al., Mol Cell Proteomics. 2011 Mar;10(3): M110.002477. Epub 2010 Nov 16. Peptides presented by HLA-DR molecules in synovia of patients with rheumatoid arthritis or antibiotic-refractory Lyme arthritis. - Li X, et al, Arthritis Rheum. 2011 Aug;63(8):2238-47. Burden and viability of Borrelia burgdorferi in skin and joints of patients with erythema migrans or lyme arthritis. - Shen S,et al. Arthritis Rheum. 2010 Jul;62(7):2127-37. Treg cell numbers and function in patients with antibiotic-refractory or antibiotic-responsive Lyme arthritis. - Strle K et al, Arthritis Rheum. 2012 Jan 13. Epub ahead of print. A Toll-like receptor 1 polymorphism is associated with heightened T-helper 1 inflammatory responses and antibiotic-refractory lyme arthritis.

Innovation Details

File Number: 20842 

Other Information: *Investigator(s)*
Allen C. Catherine E.; Steere Elise ; Costello Robert ; Drouin Seward

Rekha Paleyanda, (617) 954-9351

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February 11, 2009

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