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Antibodies to Borrelia burgdorferi and Bartonella species in serum and synovial fluid from people with rheumatic diseases

Kim, Lisa1; Lashnits, Erin1; Breitschwerdt, Edward2; Elam, Amanda3; Grade, Neenah3; Miller, Jennifer3; Shikhman, Alexander4

Published Mar 14, 2024 on Dryad. https://doi.org/10.5061/dryad.xwdbrv1mg

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Mar 14, 2024 version files 33.14 KB

Abstract

Vector-borne infections may underlie some rheumatic diseases, particularly in people with joint effusions. The aim of this study was to compare serum and synovial fluid antibodies to B. burgdorferi and Bartonella spp. in patients with rheumatic diseases.

This observational, cross-sectional study examined paired synovial fluid and serum specimens collected from 110 patients with joint effusion between October 2017 and January 2022. Testing for antibodies to B. burgdorferi (using CDC criteria) and Bartonella spp. via two Indirect Fluorescent Antibody [IFA] assays, was performed as part of routine patient care.

There were 30 participants (27%) with positive two-tier B. burgdorferi serology, and 26 participants (24%) with IFA seroreactivity (≥1:256) to B. henselae and/or B. quintana. Both B. burgdorferi IgM and IgG were detected more frequently in synovial fluid than serum: 27% of patients were either IgM or IgG positive in synovial fluid, compared to 15.5% in serum (p = 0.048). Conversely, B. henselae and B. quintana antibodies were detected more frequently in serum than synovial fluid; overall only 2% of patients had positive IFA titers in synovial fluid, compared to 24% who had positive IFA titers in serum (p <0.001). There were no significant associations between B. burgdorferi or Bartonella spp. seroreactivity with any of the clinical rheumatological diagnoses.

This study provides preliminary support for the importance of synovial fluid antibody testing for documenting exposure to B. burgdorferi, but not for documenting exposure to Bartonella spp.