Detection of Borrelia burgdorferi sensu lato by proteomics: a complementary diagnosis tool on erythema migrans biopsies.

We have developed targeted proteomics in the context of Lyme borreliosis as a new direct diagnostic tool for detecting Borrelia proteins in the skin of patients with erythema migrans. If satisfactory, this proteomic technique could be used in addition to culture and/or PCR for disseminated infections, where Borrelia detection is essential to demonstrate active infection. In these infections, diagnosis is indirect and relies mainly on serology. We recruited 46 patients with Lyme borreliosis and 11 controls and collected two skin biopsies from each patient. One biopsy was used for B. burgdorferi sensu lato PCR and culture and the other one was for targeted mass-spectrometry based proteomics. Six markers of infection were selected for proteomics: OspC, flagellin, enolase, lipoprotein gi|365823350, DpbA, and GAPDH. Culturing Borrelia from the biopsies increased the sensitivity of the methods. Among the patients included for analysis, 61% (28 patients), 61% (28), and 46% (21) were detected as positive, by proteomics, PCR, and culture respectively. PCR and proteomics were complementary. OspC and flagellin were the most frequently detected protein markers of infection by proteomics, which in some patients, detected up to 9 peptides for the flagellin. It is possible to identify bacterial makers from the skin by proteomics. Our approach can be used to diagnose tick-borne diseases such as Lyme borreliosis. ClinicalTrials.gov Identifier: NCT02414789.

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Potential conflicts of interest All authors: No reported conflicts linked to this study.