Is it possible to see in tests if it is a late infection?

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X-member
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Is it possible to see in tests if it is a late infection?

Post by X-member » Sat 8 Feb 2014 18:55

This question was asked in another topic.

Well, it might be possible with a Western blot. Some "band or bands" come later in the disease.

But, as I already have said a couple of times, it is for how long you have had the infection that tells if it is an early/acute or a late/chronic borrelia infection.

RitaA
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Re: Is it possible to see in tests if it is a late infection

Post by RitaA » Sat 8 Feb 2014 21:21

Hi Carina,

I recently came across the abstract for an article published in 1993 and wondered if there is more recent information available regarding specific bands that are associated with late-stage infection -- at least in Europe.

http://www.ncbi.nlm.nih.gov/pubmed/8223404
Electrophoresis. 1993 Sep;14(9):937-44.

Western blot as a tool in the diagnosis of Lyme borreliosis.

Zöller L, Cremer J, Faulde M.

Author information

Department of Medical Microbiology, Ernst-Rodenwaldt-Institute, Koblenz, Germany.

Abstract

Borrelia burgdorferi is the causative agent of Lyme borreliosis, a multisystem disorder, which can mimic numerous immune disorders and inflammatory diseases. Laboratory diagnosis of Borrelia infection relies on immunodiagnostic assays, which, however, are hampered by unsatisfactory specificity. The Western blot technique has been employed to analyze the humoral immune response in Lyme borreliosis and is used as a serodiagnostic confirmation test. The most important immunodominant proteins of Borrelia burgdorferi are the 94 kDa, 60 kDa, 41 kDa (flagellin), 34 kDa (Osp B), 31 kDa (Osp A), 30 kDa, 21 kDa (Osp C), and 17/18 kDa proteins. Whereas the 60 kDa, 41 kDa, and 34 kDa constituents reveal a marked cross-antigenicity with other spirochetes and even more distantly related bacteria, antibodies against the 94 kDa, 31 kDa and 21 kDa proteins are largely species-specific. The early immune response in Lyme borreliosis is triggered mainly by the flagellin. In the later stage a wide range of immunogenic proteins is involved, with the 94 kDa antigen being the best marker for late immune response. If the Western blot is used for diagnostic purposes the differences between early and late-stage immunogenicity of Borrelia proteins must be taken into account. Interpretation criteria for blot positivity in early-stage borreliosis are primarily based on the presence of the 21 kDa band and the semiquantitatively recorded intensity of the 41 kDa band. In the diagnosis of late-stage infection, blot positivity relies on the presence of the 94 kDa, 39 kDa, 31 kDa, 30 kDa and 21 kDa bands.

PMID:
8223404
[PubMed - indexed for MEDLINE]
Noteworthy is that bands 31 and 34 (now excluded in most North American Lyme disease WB testing) were included in the "most important" group by the German authors in 1993.

As we've discussed before, individuals possess varying degrees of immune system efficiency/deficiency and therefore respond differently to any given infection. Individuals may even respond differently (i.e. with different bands at varying intensities) over time to the very same borrelia infection as a few members have already posted about in another thread.

duncan
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Re: Is it possible to see in tests if it is a late infection

Post by duncan » Sat 8 Feb 2014 21:38

You know, it has occurred to me (and to others I am sure), that the ability to clarify a Bb infection as late, to absolutely distinguish it from acute...Well, it could lead to potential difficulties for some.

If you postulate the number of individuals that possibly received false negative results early on and were told they did not have Lyme...if then in subsequent testing a year or more down the line, it could be demonstrated the infection is a late stage infection...If the strain were the same...

And if enough of these late stage cases emerged from people who had been told they had no infection...

Yes, it could get interesting. ;)

Rita, kinda cool that that paper you've posted here came out right before Dearborn Michigan thing. Probably meaningless in terms of the timing, but who knows? And cool regardless.

Claudia
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Re: Is it possible to see in tests if it is a late infection

Post by Claudia » Sun 9 Feb 2014 13:47

Henry had posted this information on the thread "Retreatment of LD Patients - Biostat Review:"
Henry wrote:
Look at the date-- 1991. Things have improved since then, especially with regard to Western blots. Current data from the CDC indicates that the 45 kDa, 58 kDa, 66 kDa and 93 kDa are characteristic of late Lyme disease. So, some or all of these bands should be present if one truly has a long-standing active infection. Although Tosho did not mention these bands specifically, it doesn't make sense that they are not present.

http://www.lymeneteurope.org/forum/view ... 3&start=50

duncan
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Re: Is it possible to see in tests if it is a late infection

Post by duncan » Sun 9 Feb 2014 17:28

Claudia, would you know Henry's source for that? I couldn't see it in the thread. I would love to read it.

If studies have emerged over the years that suggest a border of sorts between late/chronic and acute, particularly in bands presenting, I cannot find evidence in the U.S. that the NIH or CDC or IDSA are openly employing them in diagnostic settings. If some one can point me to any indication otherwise, I would eagerly greet it.

The problem with these WB studies is that today's diagnostic/treatment protocol, in my opinion, renders them moot after treatment in most cases. If you've received standard recommended treatment, and you sport eight or nine or even ten of ten IgG bands, the physician/researcher handling that case can - and most likely would - simply declare it a false positive, a serological scar, regardless of the bands manifesting. This is a terrible quandry facing Lyme patients that we all know.

Still, I wonder if enough data already exists that could sway official stance. That's why I believe threads such as this are so important.

Claudia
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Re: Is it possible to see in tests if it is a late infection

Post by Claudia » Mon 10 Feb 2014 16:33

Hi duncan,

No, I don't have any other sourcing and would love to read them too, but Henry's posts were and are always of high interest to me, and in particular this one about the bands. You may remember this old thread, "Maintaining IgM Antibodies for Years, Poor Prognosis in LD" http://www.lymeneteurope.org/forum/view ... f=6&t=3345.

The controversial nature, and often conflicting information on the lab tests and meaning (or lack of meaning) of the bands and IgM/IgG from the mainstream experts across the years and from study to study, is something that I keep trying to sift through and make some sense of. I keep hoping to personally find answers and meaning, some tangible validation or proof amongst all the LymeLand madness, for what we, meaning my family and son, have gone through.

duncan
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Re: Is it possible to see in tests if it is a late infection

Post by duncan » Mon 10 Feb 2014 18:34

Thank you, Claudia. I am immersed in that thread, but wanted to come up for air long enough to thank you properly.

Personally, I think part of the problem rests in perspective, in the particular vantage from which different interests approach Bb and diagnostic criteria. It seems to me, certainly from my own experience, that many clinicians and researchers are focused with laser intensity on proving that possible Lyme cases are NOT active late stage (this is my personal experience) as opposed to investigating that a patient or subject actually has it. I fear that attitude has been fostered and accepted as SOP across much of the medical landscape.

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