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Clinical and Diagnostic Laboratory Immunology, May 2004, p. 458-462, Vol. 11, No. 3
1071-412X/04/$08.00+0 DOI: 10.1128/CDLI.11.3.458-462.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
Department of Research and Development, IDEXX Laboratories, Inc., Westbrook, Maine 04092,1 Division of Bacteriology and Parasitology, Tulane National Primate Research Center, Tulane University Health Sciences Center, Covington, Louisiana 704332
Received 16 September 2003/ Returned for modification 14 November 2003/ Accepted 16 February 2004
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Recently, a short segment of a B. burgdorferi surface protein named VlsE (Vmp-like sequence, expressed) has been used (9-16), in addition to the full-length protein (7), to construct antibody detection assays that have excellent sensitivity and virtually eliminate false-positive results. This peptide, named C6, is 25 amino acids in length and reproduces the sequence of an immunodominant and conserved region (IR6) of VlsE (12). A distinguishing feature of assays constructed with this peptide is the ability to obtain meaningful results with sera from vaccinated animals. The C6 peptide-based ELISA has been reported to be nonreactive with serum samples from animals vaccinated with either the OspA or the whole-cell (bacterin) Lyme disease vaccines (14, 15).
The purpose of this study was to conduct a controlled vaccination and testing trial, using experimental animals that were known to be uninfected, to unequivocally determine if serological assays using the C6 peptide developed by IDEXX Laboratories, Inc. (Westbrook, Maine), for B. burgdorferi antibody reacted with antibody resulting from vaccination. It was necessary to conduct such a vaccination study because of the ambiguity associated with reading WB results obtained from field populations of vaccinated dogs. We were not able to reliably distinguish populations of exposed and nonexposed vaccinated animals using the results of the WB assay as the sole criterion. Sera from vaccinated dogs known to be uninfected were needed to conclusively demonstrate the absence or presence of a reaction of C6 with vaccine-induced antibody.
Nine specific-pathogen-free dogs were vaccinated five times over a period of 39 weeks with three commonly used commercial Lyme disease vaccines. This frequency of vaccine administration was greater than that recommended by the vaccine manufacturers. The purpose of this experimental design was to induce high titers of antibody to each vaccine. Serum samples were obtained several times and tested by the IFA and WB assay to verify that the animals had received vaccine and that a vaccine-mediated response had been induced. The same samples were tested with a microtiter plate format C6-peptide ELISA and by a commercial lateral-flow B. burgdorferi antibody immunoassay (SNAP 3Dx test; IDEXX Laboratories, Inc.) constructed using the C6 peptide (8). Here we report the results of these studies.
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IFA and WB assay. An indirect IFA was performed using whole-cell B. burgdorferi antigen-coated IFA slides (Bion Enterprises, Des Plaines, Ill.) and fluorescein isothiocyanate-labeled goat anti-canine immunoglobulin G (IgG) (Jackson Immunodiagnostics, West Grove, Pa.). The IFA slides were made with a low-passage-number B-31 strain of B. burgdorferi. The conjugate stock was diluted 1:50 in 50 mM carbonate buffer (pH 9.5) containing 150 mM NaCl. Dilutions of test samples were made in phosphate-buffered saline (pH 7.2) and incubated with the antigen-coated IFA slides. The slides were washed, incubated with fluorescein isothiocyanate-labeled conjugate, and viewed by UV light microscopy. Samples with IFA titers greater than or equal to 100 were positive. WBs for B. burgdorferi antibody were run with the QualiCode canine Lyme disease kit (Immunetics, Inc., Cambridge, Mass.) by using directions supplied with the kit. The WB strips were prepared with antigen obtained from a low-passage-number B-31 strain of B. burgdorferi. Specific bands were identified by comparison of the results obtained with the kit positive control to a template supplied with the kit.
Synthesis of the C6 peptide. The amino acid sequence of the B. burgdorferi sensu lato synthetic C6 peptide is Met-Lys-Lys-Asp-Asp-Gln-Ile-Ala-Ala-Ala-Met-Val-Leu-Arg-Gly-Met-Ala-Lys-Asp-Gly-Gln-Phe-Ala-Leu-Lys. These are the same 25 amino acids in the published sequence of IR6 found within the variable surface antigen (VlsE) of B. burgdorferi sensu lato (15). An amino-terminal Cys residue was added to the peptide to facilitate chemical coupling. The linear peptide raw material was synthesized at IDEXX on a Perkins-Elmer (Applied Biosystems Division, Foster City, Calif.) model 433A peptide synthesizer by using standard 9-fluorenylmethoxycarbonyl chemistry methods (1). The amino terminus of the peptide was esterified with acetic anhydride. The peptide was deprotected and cleaved from the resin in trifluoroacetic acid with scavengers by using standard methods for 9-fluorenylmethoxycarbonyl chemistry. The cleaved peptide product was precipitated, washed, lyophilized, and stored at 2 to 7°C or frozen for long-term storage in sealed bags with desiccant. The identity of the peptide was verified by mass spectral analysis. The C6 multiple antigenic peptide (C6-MAP) was synthesized with a four-branch lysine core (Applied Biosystems). The synthesis, cleavage, processing, and storage of C6-MAP were identical to those of the linear peptide.
Immunoassays for antibody to the C6 peptide. The immunoassays for antibody to the C6 peptide were performed using the SNAP 3Dx test and a microtiter plate format ELISA (IDEXX Laboratories, Inc.). The SNAP 3Dx test is an immunoassay for simultaneous detection of canine heartworm antigen, antibodies to Ehrlichia canis, and antibodies to B. burgdorferi in canine serum, plasma, or whole blood. The SNAP assay format utilizes IDEXX's proprietary assay device, which provides reversible chromatographic flow of sample, and automatic, sequential flow of wash and enzyme substrate. The linear C6 synthetic peptide was conjugated to bovine serum albumin (BSA) and to horseradish peroxidase (HRP) by standard methods (5). The BSA-peptide conjugate was deposited onto a flow matrix. The HRP-peptide conjugate was added to a conjugate diluent containing nonspecific proteins and detergent. Two drops of test sample were mixed with 5 drops of conjugate and applied to the flow matrix as described in the kit package insert. The B. burgdorferi antibody, if present in the sample, would bind to the synthetic-peptide-HRP conjugate and to the synthetic-peptide-BSA conjugate. The deposited peptide-BSA conjugate is then exposed to wash and substrate reagents in the course of the assay. Color development in the area of deposition of the BSA-peptide conjugate would signify a positive result. The sensitivity and specificity of the SNAP 3Dx assay for B. burgdorferi antibody were determined by testing B. burgdorferi IFA-positive and -negative canine samples on SNAP 3Dx. The WB assay confirmed discrepant results. The SNAP 3Dx test was positive for 238 of 252 B. burgdorferi antibody-positive samples. The positive samples were from submissions to the IDEXX reference laboratory in Grafton, Mass. There were 18 IFA-reactive, SNAP 3Dx-negative samples that were tested by the WB assay and were shown to be from vaccinated animals with no evidence of natural infection (6.7% of IFA-positive samples). These samples were not considered to be part of the positive group. The sensitivity of the SNAP 3Dx test was 94.4% (238 of 252 samples).
Each of 203 B. burgdorferi antibody-negative samples tested on SNAP 3Dx was negative. The specificity of the SNAP 3Dx test in this population was 100% (203 of 203 samples).
The microtiter plate format ELISA was performed using C6-MAP-coated microtiter plates and a rabbit anti-canine IgG-HRP conjugate (Jackson Immunodiagnostics). The ELISA was optimized by testing dilutions of samples known to be positive and negative on microtiter plates (Immulon I; Dynatech Laboratories, Chantilly, Va.) coated with different levels of the C6-MAP in a checkerboard fashion with different concentrations of the anti-canine IgG-HRP conjugate. Optimized microtiter plates were coated with 1 µg of the C6-MAP per ml in 0.2 M phosphate buffer (pH 7.5) for 12 to 16 h at 3°C. Plates were washed three times with phosphate-buffered saline solution containing 0.05% Tween 20 (PBS-T), incubated with fish gelatin and sucrose solutions, and dried. Test samples were diluted 1:50 in PBS-T containing BSA, fish gelatin, and calf serum. A volume of 100 µl was added to individual microtiter wells and incubated for 30 min at room temperature. The contents of the microtiter wells were aspirated, washed three times with PBS-T, and incubated (at room temperature for 30 min) with rabbit anti-canine IgG-HRP conjugate diluted 1:3,000 in a conjugate diluent containing nonspecific proteins and detergent.
The microtiter plate wells were aspirated, washed three times as described above, and incubated with substrate solution containing 3,3',5,5'-tetramethylbenzidine at room temperature. Optical density (OD) values were determined spectrophotometrically at 650 nm. The microtiter plate assay was qualified by testing field samples that were known to be positive and presumed to be negative. One hundred twenty-one samples reactive in the whole-cell B. burgdorferi IFA were obtained from the IDEXX reference laboratory in Grafton, Mass., and tested with the C6 microtiter plate test. One hundred four of these samples were positive. The 17 negative samples were tested by WB assay and found to be from either vaccinated animals with no evidence of natural infection (n = 16) or a nonexposed animal (n = 1). The sensitivity of the microtiter plate test in this population was 100%. Microtiter plate test specificity was evaluated by testing 39 canine samples from a region of Europe (England) in which Lyme disease is not endemic. The specificity of the microtiter plate test in this population was 97.4% (38 of 39). The mean OD of the 39 canine samples was 0.051 (standard deviation, 0.013), and the assay cutoff was an OD of 0.096. Several very weak SNAP 3Dx-positive canine field samples were used as positive controls for the microtiter plate test.
This study was conducted in accordance with applicable Covance Research Products, Inc., standard operating procedures. All procedures are in compliance with U.S. Animal Welfare Act regulations (9 Code of Federal Regulations 3).
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IFA. Sera from all of the vaccinated animals had elevated IFA titers ranging from 800 to 1,600 at week 5 following the initial vaccination. These values declined 4- to 16-fold (titer range, 100 to 400) by week 33 but increased markedly following administration of additional doses of vaccine at weeks 33, 36, and 39. The IFA titers reached their highest levels (titer range, 1,600 to 6,400) 1 week following the fifth vaccination (week 40). The mean IFA titer for each vaccine group throughout the course of the study is shown in Fig. 1. Assay results for key time points are given in Table 1.
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FIG. 1. Mean reciprocal IFA titer results for serum samples from experimentally vaccinated animals. IFA results are shown for serum specimens collected throughout the study. Reciprocal IFA titers are given for the mean obtained from three dogs in each vaccine group. The IFA titer was <100 for serum samples from the single unvaccinated control dog at all time points. Dogs were vaccinated at weeks 0, 2, 33, 36, and 39 as described in Materials and Methods. Serum samples were obtained prior to vaccination at weeks 0 and 33. Vaccine manufacturers were Fort Dodge, Schering-Plough, and Merial.
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TABLE 1. Assay results for experimentally vaccinated dogsa
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FIG. 2. Western blot results for serum samples obtained from experimentally vaccinated dogs prior to and at various times (weeks) following initial vaccination. Vaccine was administered to dogs at weeks 0, 2, 33, 36, and 39; WB results are shown for sera collected at weeks 0, 5, 33, 34, and 40. Serum samples were obtained prior to vaccination at weeks 0 and 33. (A) Fort Dodge LymeVax vaccine, administered to dogs FD1, FD2, and FD3; (B) Schering-Plough Galaxy Lyme vaccine, administered to dogs SP1, SP2, and SP3; (C) Merial RECOMBITEK Lyme vaccine, administered to dogs M1, M2, and M3; (D) positive control. Sera from the unvaccinated control dog failed to produce clearly visible bands in the WB assay at any time. WBs were run with the QualiCode canine Lyme disease kit (Immunetics, Inc.) as described in Materials and Methods.
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The results obtained with the WB assay further illustrate the extent to which the absence of cross-reactivity of the C6 tests is reliable. Serum samples from dogs that had been vaccinated with the whole-bacterin vaccines reacted initially with OspA (31 kDa) and OspB (34 kDa), while samples from animals that had received the recombinant OspA vaccine reacted primarily, as expected, with the OspA protein. However, after additional vaccine doses were administered, serum from animals that had received bacterin-type vaccines displayed multiple WB bands, and even the OspA-vaccinated animals showed serum antibody specificities other than just OspA. As antibody affinity matures, following repeated administration of antigen, high-affinity antibodies tend to react more broadly, as shown in these WBs. Despite this broadening of antigenic specificity of the vaccine-induced antibodies, reactivity with the C6 peptide remained undetectable. The WB results also illustrate the inherent difficulty of using WB assays to detect B. burgdorferi infection or exposure in a vaccinated dog, as bands reflecting infection or exposure would have to be discerned from the potentially numerous vaccine-derived bands.
In closing, we put forward what we believe is a likely explanation for the absence of anti-C6 antibody in vaccinated dog serum. Serodiagnosis with the C6 peptide has been found to be highly specific (11, 14, 15). Except for sequences present in the vlsE gene and vls loci of B. burgdorferi, no other sequences homologous to C6 could be identified by the BLAST search algorithm in the National Center for Biotechnology Information protein sequence database (15). The uniqueness of the C6 sequence readily explains the absence of cross-reactivity between antibodies elicited by the OspA vaccine and C6. The failure of the bacterin-type vaccines to elicit anti-C6 antibody is probably due to the loss of the lp 28-1 plasmid, which contains the vlsE gene, by the spirochete stocks used to generate such vaccines. As few as five culture passages are sufficient to generate B. burgdorferi clones that lack the lp 28-1 plasmid (17), and it is likely that the spirochetal isolates used to produce bacterin vaccines have undergone many more such passages and have therefore lost the ability to express VlsE.
The C6 peptide technology offers a more reliable single-test alternative to the standard two-tier method (18) of Lyme disease diagnosis in dogs. Diagnostic assays utilizing the C6 peptide provide a unique capability that is particularly needed in areas of the country where Lyme disease vaccines are frequently administered and where the disease is endemic. At issue is the problem of distinguishing between animals that are naturally infected and those that are vaccinated. In these populations, C6 peptide-based assays for Lyme disease antibody circumvent problems related to vaccine-induced antibody and provide an effective procedure for routine testing.
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