Rapid single-tier serodiagnosis of Lyme disease

Rajesh Ghosh, Hyou-Arm Joung, Artem Goncharov, Barath Palanisamy, Kevin Ngo, Katarina Pejcinovic, Nicole Krockenberger, Elizabeth J. Horn, Omai B. Garner, Ezdehar Ghazal, Andrew O’Kula, Paul M. Arnaboldi, Raymond J. Dattwyler, Aydogan Ozcan () and Dino Di Carlo ()
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Rajesh Ghosh: University of California
Hyou-Arm Joung: University of California
Artem Goncharov: University of California
Barath Palanisamy: University of California
Kevin Ngo: University of California
Katarina Pejcinovic: University of California
Nicole Krockenberger: University of California
Elizabeth J. Horn: Portland
Omai B. Garner: University of California
Ezdehar Ghazal: New York Medical College
Andrew O’Kula: New York Medical College
Paul M. Arnaboldi: New York Medical College
Raymond J. Dattwyler: New York Medical College
Aydogan Ozcan: University of California
Dino Di Carlo: University of California

Nature Communications, 2024, vol. 15, issue 1, 1-13

Abstract: Abstract Point-of-care serological and direct antigen testing offers actionable insights for diagnosing challenging illnesses, empowering distributed health systems. Here, we report a POC-compatible serologic test for Lyme disease (LD), leveraging synthetic peptides specific to LD antibodies and a paper-based platform for rapid, and cost-effective diagnosis. Antigenic epitopes conserved across Borrelia burgdorferi genospecies, targeted by IgG and IgM antibodies, are selected to develop a multiplexed panel for detection of LD antibodies from patient sera. Multiple peptide epitopes, when combined synergistically with a machine learning-based diagnostic model achieve high sensitivity without sacrificing specificity. Blinded validation with 15 LD-positive and 15 negative samples shows 95.5% sensitivity and 100% specificity. Blind testing with the CDC’s LD repository samples confirms the test accuracy, matching lab-based two-tier results, correctly differentiating between LD and look-alike diseases. This LD diagnostic test could potentially replace the cumbersome two-tier testing, improving diagnosis and enabling earlier treatment while facilitating immune monitoring and surveillance.

Date: 2024
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DOI: 10.1038/s41467-024-51067-5

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