{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"bioRxiv"}],"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T19:18:35Z","timestamp":1768504715290,"version":"3.49.0"},"posted":{"date-parts":[[2023,6,14]]},"group-title":"Bioengineering","reference-count":30,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2023,6,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:p>\n                  Point-of-care (POC) serological testing provides actionable information for several difficult to diagnose illnesses, empowering distributed health systems. Accessible and adaptable diagnostic platforms that can assay the repertoire of antibodies formed against pathogens are essential to drive early detection and improve patient outcomes. Here, we report a POC serologic test for Lyme disease (LD), leveraging synthetic peptides tuned to be highly specific to the LD antibody repertoire across patients and compatible with a paper-based platform for rapid, reliable, and cost-effective diagnosis. A subset of antigenic epitopes conserved across\n                  <jats:italic>Borrelia burgdorferi<\/jats:italic>\n                  genospecies and targeted by IgG and IgM antibodies, were selected based on their seroreactivity to develop a multiplexed panel for a single-step measurement of combined IgM and IgG antibodies from LD patient sera. Multiple peptide epitopes, when combined synergistically using a machine learning-based diagnostic model, yielded a high sensitivity without any loss in specificity. We blindly tested the platform with samples from the U.S. Centers for Disease Control &amp; Prevention (CDC) LD repository and achieved a sensitivity and specificity matching the lab-based two-tier results with a single POC test, correctly discriminating cross-reactive look-alike diseases. This computational LD diagnostic test can potentially replace the cumbersome two-tier testing paradigm, improving diagnosis and enabling earlier effective treatment of LD patients while also facilitating immune monitoring and surveillance of the disease in the community.\n                <\/jats:p>","DOI":"10.1101\/2023.06.14.544508","type":"posted-content","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T00:20:18Z","timestamp":1686788418000},"source":"Crossref","is-referenced-by-count":3,"title":["Single-tier point-of-care serodiagnosis of Lyme disease"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7408-8944","authenticated-orcid":false,"given":"Rajesh","family":"Ghosh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyou-Arm","family":"Joung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Artem","family":"Goncharov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barath","family":"Palanisamy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Ngo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katarina","family":"Pejcinovic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Krockenberger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth J.","family":"Horn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7366-2692","authenticated-orcid":false,"given":"Omai B.","family":"Garner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ezdehar","family":"Ghazal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"O\u2019Kula","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul M.","family":"Arnaboldi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond J.","family":"Dattwyler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0717-683X","authenticated-orcid":false,"given":"Aydogan","family":"Ozcan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3942-4284","authenticated-orcid":false,"given":"Dino","family":"Di Carlo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2023061704350535000_2023.06.14.544508v1.1","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.cca.2019.03.008","article-title":"Point of Care Testing for Infectious Diseases","volume":"493","year":"2019","journal-title":"Clin. Chim. Acta"},{"issue":"7","key":"2023061704350535000_2023.06.14.544508v1.2","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1038\/s41576-021-00360-w","article-title":"Testing at Scale during the COVID-19 Pandemic","volume":"22","year":"2021","journal-title":"Nat. Rev. Genet"},{"key":"2023061704350535000_2023.06.14.544508v1.3","doi-asserted-by":"publisher","DOI":"10.1021\/acsnano.1c02981"},{"issue":"9","key":"2023061704350535000_2023.06.14.544508v1.4","doi-asserted-by":"crossref","first-page":"1634","DOI":"10.1039\/D0LC01156H","article-title":"Point-of-Care Testing Detection Methods for COVID-19","volume":"21","year":"2021","journal-title":"Lab. 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Small n\/a (n\/a), 2300617. https:\/\/doi.org\/10.1002\/smll.202300617.","DOI":"10.1002\/smll.202300617"},{"issue":"8","key":"2023061704350535000_2023.06.14.544508v1.22","doi-asserted-by":"crossref","first-page":"944","DOI":"10.3390\/pathogens11080944","article-title":"Linear Peptide Epitopes Derived from ErpP, P35, and FlaB in the Serodiagnosis of Lyme Disease","volume":"11","year":"2022","journal-title":"Pathogens"},{"key":"2023061704350535000_2023.06.14.544508v1.23","doi-asserted-by":"publisher","DOI":"10.1128\/CVI.00608-12"},{"key":"2023061704350535000_2023.06.14.544508v1.24","doi-asserted-by":"publisher","DOI":"10.1128\/CVI.00383-14"},{"key":"2023061704350535000_2023.06.14.544508v1.25","doi-asserted-by":"publisher","DOI":"10.1128\/CVI.00792-13"},{"issue":"3","key":"2023061704350535000_2023.06.14.544508v1.26","first-page":"e00111","article-title":"Linear B Cell Epitopes Derived from the Multifunctional Surface Lipoprotein BBK32 as Targets for the Serodiagnosis of Lyme Disease","volume":"4","year":"2019","journal-title":"mSphere"},{"key":"2023061704350535000_2023.06.14.544508v1.27","doi-asserted-by":"publisher","DOI":"10.1021\/acsnano.9b08151"},{"issue":"6","key":"2023061704350535000_2023.06.14.544508v1.28","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1039\/C9LC00011A","article-title":"Paper-Based Multiplexed Vertical Flow Assay for Point-of-Care Testing","volume":"19","year":"2019","journal-title":"Lab. 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