CSF Enzyme-linked Immunosorbent Assay (ELISA) - IgG

Detection of IgG antibodies to recombinant antigens and whole antigen extracts of Borrelia burgdoreri sensu lato by immunoblot assay.

Fresh human serum and cerebrospinal fluid (CSF). 
Minimum volume of 0.25 mL of both serum and CSF is required.  

Hemolytic, lipemic or icteric sera may yield erroneous results

In order to perform interpretive calculations for this test, absolute values for total albumin and total IgG concentrations of both the serum and CSF must be provided.

The CSF ELISA will only be performed if an approved screening ELISA is positive or equivocal. These results must be provided on the requisition.

Collect blood in serum separator tubes. Collect CSF into a sterile tube without preservatives. The serum and CSF specimens should be collected from the patient within a one hour interval of each other, up to a maximum of 24 hours. If this timeframe is exceeded, the samples will not be tested.

Transfer an aliquot of serum and CSF to 1.5 ml screw-top vials with O-ring (Sarstedt Vial). Store samples refrigerated up to 5 days or store frozen until shipped for testing.  Ship frozen on dry ice or with freezer packs.

Shipping of specimens shall be done by a TDG certified individual in accordance with TDG regulations. For additional information regarding classification of specimens for the purposes of shipping, consult either Part 2 Appendix 3 of the TDG Regulations or section 3.6.2 of the IATA Dangerous Goods Regulations as applicable.

Appropriate clinical symptoms with potential exposure to Ixodes species ticks.  Typical symptoms include lymph and nervous system inflammation, cognitive decline, and polyneuropathy/polyneuritis.

Completed Requisition for Serological Testing for Selected Zoonotic Agents. If possible, include the clinical history and lab results performed at local or provincial laboratories.

Specimens may be subject to rejection if they are not the appropriate sample type, have insufficient volume, do not have the required documentation (total IgG and albumin concentrations and screening ELISA result), are not collected within a 24 hour time interval, or are not accompanied by relevant patient information.

Testing is performed using a test which has not been fully validated/verified for this particular sample type.    

Commercial microplate ELISA kit. This is a quantitative test for the detection of IgG antibodies produced in the CNS to B. burgdorferi sensu lato. 

Initiation of antibiotic treatment prior to testing may result in decreased antibody production which will affect the outcome of serological testing.

21 calendar days.

1. Reiber, H. 1994. The hyperbolic function: a mathematical solution of the protein flux/CSF flow model for the blood-CSF barrier function. J Neurol Sci 126:243-245.