The Tick-Borne Relapsing Fever (TBRF) ImmunoBlot is a qualitative immunoassay in which antibodies specific to the TBRF Borrelia antigens on a membrane strip are visualized. It is a qualitative test and is more sensitive and specific than the IFA and traditional Western Blot tests. In early or late stage of the disease when antibody levels are very low, ImmunoBlot can be positive whereas IFA tests can be negative.

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Principle

The TBRF ImmunoBlot assay is based upon an antigen-antibody complex formation in the following steps:

  1. Binding of anti-TBRF Borreliaspecific antibodies in human serum to the ImmunoBlot strip.  ImmunoBlot strip is a membrane strip with fixed TBRF Borrelia recombinant antigens on it.
  2. Binding of enzyme labeled anti-humanIgG or IgM antibodies to the human antiTBRF Borrelia antibodies bound to fixed TBRF Borrelia antigens on the membrane.
  3. Reaction with BCIP/NBT, a chromogenic substratewith bound antibodies on the strip.  A dark purple colored precipitate (band) develops on the antigen-antibody complexes.

TBRF ImmunoBlot IgM

The TBRF ImmunoBlot IgM is a very sensitive indicator of exposure to TBRF Borrelia.  It may be positive as early as 2 weeks after a tick bite. This test will usually remain positive for six to eight weeks after initial exposure and in some patients will remain positive for a very long time.  Re-exposure will also cause this test to be positive for a brief period of time.  For the testing to be complete, it is preferable that the IgM ImmunoBlot be run along with the IgG ImmunoBlot.


TBRF ImmunoBlot IgG

The IgG ImmunoBlot is an immunoassay and qualitative test in which antibodies are visualized.  The IgG antibody can be present as early as 6 to 8 weeks after infection.


TBRF ImmunoBlot IgM

Reference Range

Negative <2 bands present on the blot


TBFR ImmunoBlot IgG

Reference Range

Negative <2 bands present on the blot

TBRF ImmunoBlot IgM

Clinical Significance

The TBRF ImmunoBlot IgM is a sensitive indicator of exposure to TBRF Borrelia. It may be positive as early as 2 weeks after a tick bite. This test will usually remain positive for six to eight weeks after initial exposure. Re-exposure will also cause this test to be positive for a brief period of time. In some patients this test can be positive for a very long time.   For the testing to be complete, it is preferable that the IgM ImmunoBlot be run along with the IgG ImmunoBlot.


TBRF ImmunoBlot IgG

Clinical Significance

The TBRF ImmunoBlot IgG is a sensitive indicator of an exposure to B. burgdorferi.  The IgG antibody can be present as early as 6 to 8 weeks after infection.

TBRF ImmunoBlot IgM and IgG

Limitations

TBRF ImmunoBlot can be false negative early in the disease.

  1. A negative TBRF ImmunoBlot does not exclude the possibility of infection with TBRF Borrelia.
  2. IGeneX interpretation is based on internal validation studies.
  3. The results of this test must be interpreted in relation to patient’s clinical history, epidemiological data, stages of disease, clinical symptoms or other laboratory results.
  4. Indeterminate result may have clinical significance. Therefore, we recommend testing with another method and/or retesting in 4-6 weeks.

Result Interpretation

TBRF ImmunoBlot IgM and IgG

Ordering Information

TBRF ImmunoBlot

Test Offered

Test# 345

TBRF ImmunoBlot IgM

CPT Code 86619

Test# 355

TBRF ImmunoBlot IgM        

CPT Code 86619

TBRF ImmunoBlot IgG & IgM are part of the following Test Panels

Test Panel TBRF1

TBRF Panel 1**

Test Panel TBRF2

TBRF Panel 2**

Test Panel TBD1

Tick-Borne Disease Panel 1**

**Test/Panels are not yet available for New York Residents