Dynamics of borrelial antibodies in European Lyme borreliosis patients with erythema migrans

Bogovič, Petra (author), Jaklič, Martina (author), Ogrinc, Katarina (author), Maraspin-Čarman, Vera (author), Rojko, Tereza (author), Nahtigal Klevišar, Mirijam (author), Ružić-Sabljić, Eva (author), Wormser, Gary P. (author), Strle, Franc (author)

Background/Objectives: The diagnosis of typical erythema migrans (EM) is clinical, and serological testing for Borrelia-specific antibodies is not required. However, characterization of the immune response in patients with a reliable clinical diagnosis may improve the interpretation of serological findings in early Lyme borreliosis (LB) without characteristic skin lesions. Methods: Serum IgM and IgG antibodies to Borrelia burgdorferi sensu lato were evaluated in 1356 Slovenian adults with EM at baseline and at a follow-up visit approximately two months after treatment initiation, using a chemiluminescence immunoassay based on recombinant borrelial antigens. Results: At baseline, 41.5% of patients were IgMseropositive, 55.5% IgG-seropositive, and 70.1% positive for either IgM or IgG. Patients with multiple EM were significantly more often seropositive than those with solitary EM. In previously untreated patients, baseline IgG seropositivity showed a clearer positive association with longer lesion duration and larger lesion diameter, whereas the corresponding IgM patterns were less consistent. Multiple EM remained strongly associated with both IgM and IgG seropositivity in adjusted analyses. Seroconversion at follow-up was uncommon, occurring in 8.0% of initially IgM-negative and 8.2% of initially IgG-negative patients. Conclusions: The low frequency of newly detectable antibody responses indicates that repeat qualitative serologic testing approximately two months after treatment initiation provides limited additional diagnostic information in European adults with EM.

• Language: English
• Keywords: Lyme borreliosis, erythema migrans, Borrelia burgdorferi sensu lato, humoral immune response, IgM antibodies, IgG antibodies, Lyme serology
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2026
• Number of pages: 16 str.
• Numbering: Vol. 14, iss. 5, art. 563
• PID: 20.500.12556/RUL-187891
• UDC: 616.9
• ISSN on article: 2076-3271
• DOI: 10.3390/medsci14050563
• COBISS.SI-ID: 290967811
• Publication date in RUL: 01.10.2026

Record is a part of a journal

• Title: Medical sciences
• Shortened title: Med. sci.
• Publisher: MDPI
• ISSN: 2076-3271
• COBISS.SI-ID: 520260121

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

• Language: Slovenian
• Keywords: lymska borelioza, erythema migrans, Borrelia burgdorferi sensu lato, protitelesa IgM, protitelesa IgG

Projects

• Funder: ARIS - Slovenian Research and Innovation Agency
• Project number: P3-0296
• Name: Bolezni in povzročitelji, ki jih v Sloveniji prenašajo členonožci