Why is the CDC Trying to Block an Accurate Lyme Disease Test

Medical topics with questions, information and discussion related to Lyme disease and other tick-borne diseases.
duncan
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Re: Why is the CDC Trying to Block an Accurate Lyme Disease

Post by duncan » Thu 20 Nov 2014 14:38

Sigh.

Henry, no one is asking you to buy anything. This is basic stuff. You can't argue the threat posed to any established technology by innovation. Innovation can change everything. Any business major can attest to that. It has re-written the rules and histories of many industries. When it occurs, it can be subtle and just fold into the existing terrain and adopted by current players, or it can be cataclysmic, as it was for the Payphone industry. Competitive pressures come in all shapes and sizes, Henry.

Come on, you've got to know this. Let me guess: You've never run your own business? Just as you probably never crafted your own survey? Nothing wrong with that! Just, well, my advice is to stick with what you know best.

Now, if you want to talk conspiracies, that's easy: I suspect there are some that would prefer not to see a diagnostic that could prove, unequivocally, once and for all that Bb persists after treatment. Quite a few, actually. I would imagine proof like that might even add fuel to the flames of that proposed investigation into the IDSA, CDC, and ALDF. But let's stick to dollars and cents because, as you've stated, you prefer numbers. When it's your income on the line, even the small competitive threats matter. If you doubt that, why don't you give one of those companies I mentioned above a call and ask them? That can be your homework for the day. ;)

Henry
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Re: Why is the CDC Trying to Block an Accurate Lyme Disease

Post by Henry » Thu 20 Nov 2014 14:41

You've just confirmed my assertion.

Lorima
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Re: Why is the CDC Trying to Block an Accurate Lyme Disease

Post by Lorima » Thu 20 Nov 2014 23:10

1) Which assertion?

2) ELISAs are typically quantitative. Unless some shortcuts are being taken on the Bb ones (that is, shortcuts in addition to the interpretation being placed on them).
"I have to understand the world, you see."
Richard Feynman

Henry
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Re: Why is the CDC Trying to Block an Accurate Lyme Disease

Post by Henry » Fri 21 Nov 2014 14:06

How is it possible to quantitate the results of an ELISA in which a bacterial cell lysate is used as a ligand to detect several types of antibodies being produced during infection -- using a titer as an endpoint no less? What specific antibody responses are going up during an infection -- and down in response to antibiotics? The C6 ELISA is a step in the right direction. However, it is still being used to provide a titer. There are plenty of ELISA plate readers on the market that enable one to really do quantitative ELISA -- in the way they should be done to get a precise numerical value of the magnitude of the antibody response. Surely, there are antibody standards that can be used to calibrate such a test.

duncan
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Re: Why is the CDC Trying to Block an Accurate Lyme Disease

Post by duncan » Fri 21 Nov 2014 14:28

I suspected Henry was a C6 man, Lorima. Anybody that is anybody is... ;)

As to which assertion Henry was referencing, I basically just figured it wasn't worth asking; I knew the conversation had nosed-dived into the illogical when he actually blurted, "You've just confirmed my assertion."

Sometimes you just have to walk away.

Henry
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Re: Why is the CDC Trying to Block an Accurate Lyme Disease

Post by Henry » Fri 21 Nov 2014 15:12

Duncan: It is interesting to note that results obtained using the C6 ELISA -- an immunoassay that detect antibodies against a well-defined ligand that is produced during the EARLY stages of Lyme disease-- are in complete accord with those obtained using two tier testing. That's a good sign, don't you agree Duncan? Although the FDA may decide to replace two tier testing with the C6 ELISA, they want to have more data before making such a decision.

Other ELISAs are now being developed (by Dattwyler among others) using still different well defined peptides as ligands; these are specific for segments of Borrelia antigens that play a role in early infection and/or pathogenesis. The published results using these well-defined peptides once again are in complete accord with those obtained using two tier testing and/or the C6 ELISA. Do you see the pattern Duncan? Two tier testing really may not be all that bad.

I find all this to be most reassuring, and a short step away from having a truly quantitative ELISA with an end point that means something, e.g., nanograms of antibody per ml blood vs C6 or some other defined ligand. Then, one can precisely monitor the effect of antibiotic therapy with time. As I said before, relatively inexpensive ELISA plate readers have been available for years to permit this to be done in most laboratories by the average laboratory technician.

duncan
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Re: Why is the CDC Trying to Block an Accurate Lyme Disease

Post by duncan » Fri 21 Nov 2014 15:19

But only in early stage, Henry, only in early stage. One of the reasons the C6 is currently being considered as a replacement only for the ELISA, and NOT the WB is that promoters can't seem to explain away some results brought in from the C6 in late stage. For instance, the manufacturer, when I asked a representative to explain why my C6 levels were six time normal levels, said that I must have active Lyme. But a govt official dismissed that and said no one really knows how applicable the C6 is in late stage. Accordingly, the demand for the WB will continue.

Henry
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Re: Why is the CDC Trying to Block an Accurate Lyme Disease

Post by Henry » Fri 21 Nov 2014 16:01

Early stage most likely involves active infection and the likelihood of a response to antibiotics. However, individuals may be seropositive for long periods of time after treatment in the absence of active infection; here, further antibiotic treatment would be of no value and the results of serological testing are unclear. The C6 ELISA assay apparently distinguishes between these two situations. That's why it is useful for early diagnosis.

Although research now being done with other well defined peptides may be of more value, it is based on the same assumptions, i.e., the detection of antibodies against a well-defined peptide that is associated with pathogenesis and/or active infection. The establishment of a reference depository by the CDC will accelerate such research and enable one to make appropriate comparisons re: results obtained with other assays. You must admit that's progress.

velvetmagnetta
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Re: Why is the CDC Trying to Block an Accurate Lyme Disease

Post by velvetmagnetta » Fri 21 Nov 2014 16:04

So, this brings us back to the original question of the thread:

Why is the CDC trying to block an accurate Lyme disease test?

duncan
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Re: Why is the CDC Trying to Block an Accurate Lyme Disease

Post by duncan » Fri 21 Nov 2014 16:14

No, Henry, I admit no such progress. How can I when even you fail to address the elephant in the room: All the cases of unresolved Late Stage Lyme. Where is the research into Late Stage Lyme? Research into Late Stage diagnostics? Research into treatment targeting Late Stage? Even Steere acknowledged close to 50% of patients with late manifestations of Lyme remained symptomatic following treatment - and that was 30 years ago. How is that progress??

Henry, you generously observe early stage "most likely involves active infection..." Which stage of Lyme does NOT involve active infection?

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