This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. C6, a peptide derived from Borrelia burgdorferi sensu lato, is used as antigen in the C6-Lyme diagnostic test. We assessed in a retrospective manner whether a 4-fold decrease or a decrease to a negative value in anti-C6 antibody titer is positively correlated with a positive response to antibiotic treatment in a group of culture-confirmed Lyme disease patients with either early localized (erythema migrans [EM], n = 93) or with early-disseminated disease (multiple EM, n = 27). All of these patients had been treated with antibiotics and were free of disease within 6-to-12-months of follow up. Results show that a serum specimen taken at this time was either C6-negative or had decreased by at least 4-fold in C6 antibody titer with respect to a specimen taken at baseline (or during the early convalescent period if the baseline specimen was C6-negative) in all of the multiple-EM patients (p 0.0001) and in 89% of the single-EM patients (p 0.0001). These results indicate that decline in anti-C6 antibody titer coincides with effective antimicrobial therapy in patients with early localized or early-disseminated Lyme borreliosis. Patients who had a decline of less than 4-fold in C6 antibody titer were more likely to have a previous history of Lyme disease than the other individuals in the study (p = 0.001). Therefore, previous exposure to the pathogen may have increased C6-immunological memory in a manner that affected C6 antibody titer decline. However, in patients with early localized or disseminated Lyme disease involving the skin, our data convincingly show that a decline (by 4-fold or to negative values) in C6 antibody titer significantly correlates with a successful treatment outc
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