Interpretation of results medical, Lyme disease?

Medical topics with questions, information and discussion related to Lyme disease and other tick-borne diseases.
Lorima
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Re: Interpretation of results medical, Lyme disease?

Post by Lorima » Wed 28 Jan 2015 16:40

LHCTom wrote:
I wish somebody in the US would provide a printout like this with a scale built in and report all bands. They are too afraid to give doctors all the data and make a better judgement.
This lab is on the US east coast, so maybe not of much use to Californians or Europeans (I didn't check to see what their reference strain(s) are.) But they provide a photo of the blot, and of the negative control:

http://www.clongen.com/clinical-diagnos ... formation/

I haven't used this lab, but I think that is a great way to do it. Then you can check quality, as well as observe all the bands.
"I have to understand the world, you see."
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LHCTom
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Re: Interpretation of results medical, Lyme disease?

Post by LHCTom » Wed 28 Jan 2015 20:35

This lab is on the US east coast, so maybe not of much use to Californians or Europeans (I didn't check to see what their reference strain(s) are.) But they provide a photo of the blot, and of the negative control:

http://www.clongen.com/clinical-diagnos ... formation/

I haven't used this lab, but I think that is a great way to do it. Then you can check quality, as well as observe all the bands.
The tricky part is the use of a single B31 strain and some recombinant proteins based on B31. Its still better than not seeing anything at all but if the antibodies in my blood don't bind to the antigens used in the Western Blot, it won't show bands even if an important antibody is present.

The Euroimmune uses multiple species ( Bb, Bg and Ba recombinant Vlse, 18, 19, 20, 21 and 58) making it the most likley to show most of the antibodies that were created for Borrelia proteins. I have tested 3 times positive at 3 labs for C6 so a WB with recombinant Vlse interests me. I've had 0, 1, 2, 3,4 and 5 IgG bands on 3 different labs also so I'm guessing my antibody levels are very low and fluctuate but C6 has been fairly steady around 1.75-2.0. They might show up as "bumps" as I call them on the Clongen test but the Euroimmun looks by far the most thorough at both picking up antibodies and showing the actual blot optical reader output curve.

I wrote to a German Lab and they said they would only run the Euroimmun if the ELISA was positive. I'm guessing but a very old Bb infection would probably fail the European ELISA.

Based on discussions with a professor of immunology and microbiology who has designed Western Blots for another disease, the combination of a very old or low level infection, the bodys odd characteristic of not creating antibodies to all pathogen proteins, the bodys characterisitic of not producing large ammounts of some protein antibodies, the choice of Western Blot proteins, strain/species amino acid sequence differences, the recombinant protein design, the up (Vlse) and down regulation of some proteins during an infection temporally, the short half life of IgG antibodies and a whole host of other variables, lab variations, kit variations etc.. its not surprising to see the varied results.

Since the Euroimmune uses Bb, Bg, Ba, plus recombinant Vlse from each plus the other recombinant proteins and its showing the actual opitcal scanner output curve and kDa markers, its far more likely one will be able to have the best WB protein <-> antibody binding match plus the ability to read the kDa positions manually, make it by far the best antibody test out there.

There must be a European lab willing to run a US sample.

I wonder what it would cost to set up a small lab here in the US and import the Euroimmune and offer testing. Its not FDA approved but as long as it stays under the radar, its by far a better alkternative to the FDA controlled B31 based tests that don't show anything.

That being said, maybe I will try Clongen just to see.

Why has nobody imported the test? Seems odd.

Why has nobody done a study of the Euroimmun Anti-Borrelia EUROLINE-RN-AT here in the US. I know Euroimmun has gotten some of its tests FDA approved, but not Lyme.

http://www.euroimmun.us/
Attachments
Euroimmun system.JPG
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Euroimmun 2.JPG
Euroimmun 2.JPG (48.69 KiB) Viewed 1812 times
Euroimmun IgG.JPG
Euroimmun IgG.JPG (37.27 KiB) Viewed 1812 times
The greater the ignorance, the greater the dogmatism.

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ChronicLyme19
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Re: Interpretation of results medical, Lyme disease?

Post by ChronicLyme19 » Thu 29 Jan 2015 18:48

LHCTom wrote: Why has nobody imported the test? Seems odd.

Why has nobody done a study of the Euroimmun Anti-Borrelia EUROLINE-RN-AT here in the US. I know Euroimmun has gotten some of its tests FDA approved, but not Lyme.

http://www.euroimmun.us/
My guess is that it's hard to get it approved, too much red tape/politics. And if it isn't then we should get a kickstarter going with the right team of people. I'd be all in for doing a startup and pitch in my materials eng background. We'd have to be very careful, or we'll get taken down like Prof Morten Laane was with his research.

So stupid question on the Euroimmun output, those bumps aren't reported as positive because the resolution of the optics is too low and they fall in the noise range of the tool?
Half of what you are taught is incorrect, but which half? What if there's another half missing?

Userr0
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Re: Interpretation of results medical, Lyme disease?

Post by Userr0 » Fri 30 Jan 2015 1:37

ChronicLyme19, LHCTom, Lorima, thank you very much for your reply and your interest in my topic.
So if you look at your results, not only are you positive for the 2, you have some "bumps" at other key antigens. Based on the aggregate of your line blot, Lyme is very likely but it would be wise to rule out other possibilities. You might check your CK which is a blood test for muscle enzymes. Sometimes this is one of the other normal blood tests that is elevated if the spirochetes have disseminated to muscle tissue. This can also sometimes cause elevated Kidney creatinine which at your age should be low.
"CK" - That is to say Creatine kinase (CK), also known as creatine phosphokinase (CPK)?
Could you tell me of a lab in Poland or elsewhere that I might beable to get the Euroimmun test for the US if I write them? Its possible to use Fedex to get 2 day delivery from the US and the blood can be packed in ice.

Since I'm C6 positive, I would very much like to see if I have the same Vlse protein you have. I'd also like to use the blot curve at the top to compare against past blots from US labs.
If you can get me a lead to a lab or two, I would appreciate it.
http://www.euroimmun.ch/fileadmin/user_ ... UK_A02.pdf
I do not know whether I understood (because all translators via Google Translate).
You ask for information or lablolatorium in Poland can make you test Euroimmun Western blot (such as I had done).
Do you want your blood to send a courier Fedex Polish to the lab?

If I understand everything, yes, I can ask and learn.
How to ask for anything, I'll write you here an forum.
I would very much like to get the

Anti-Borrelia EUROLINE-RN-AT (IgG)[
I do not understand, you would like to do this test in poland what I had done Euroimmun Western blot

or this one?

Anti-Borrelia EUROLINE-RN-AT (IgG)

??
In addition to the justified suspicion for Bb infection, the low body temperature and other symptoms suggest possible hypothyroidism.
Your TSH is a little high. I would have it rechecked to see if it is increasing, and have your other thyroid numbers checked ("Free T4" and "Free T3") . Hypothyroidism can cause those symptoms and is usually easy to treat.
Also, take your temperature every morning just after you wake up and before you get out of bed. Write it down every day and see if it is consistently, significantly below normal. That's not completely specific for hypothyroidism, but it's a good indicator that something is slowing your metabolism. My family patient checks morning temperatures periodically, as a check on whether his levothyroxine dose is about right.

You could still have LD; one of my family LD patients had both hypothyroidism and late stage LD. If so, treat both.
Also wonder about the disease hypothyroidism. A high rate of TSH and a lot of matching symptoms.

Yesterday I got a referral from your family doctor for research:
TSH (Thyroid-stimulating hormone)
FT3 (free triiodothyronine)
FT4 (free thyroxine)
Anti-TPO (thyroid peroxidase antibodies against)
ANTI-TG (this Thyroglobulin antibodies)



Yesterday I was also on a visit to the doctor of infectious diseases and tropical disease (borreliosis).
The doctor said based on my research and symptoms of snares that according to him, I do not have Lyme disease and the cause of all my symptoms are something else.

Despite this statement I got a referral for another repeat ELISA test and Western blot this time not in a private laboratory, and hospital microbiology laboratory.

After completing these repeated tests only assess my situation and make a diagnosis.

Generally I do not know what to think. In Poland, treatment and medical knowledge about Lyme disease is very poor

In order to get an appointment to see a doctor and tropical diseases (Lyme disease) is waiting for a visit and a 1.5 years (18 months) !!!
I managed to go for a visit before (1,5 months) because I got a friend of the doctor.

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LHCTom
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Re: Interpretation of results medical, Lyme disease?

Post by LHCTom » Fri 30 Jan 2015 20:13

My guess is that it's hard to get it approved, too much red tape/politics. And if it isn't then we should get a kickstarter going with the right team of people. I'd be all in for doing a startup and pitch in my materials eng background. We'd have to be very careful, or we'll get taken down like Prof Morten Laane was with his research.
You don't need FDA approval for in-house developed tests but I bet Euroimmun would be restricted from selling it to a lab that plans on using it commercially. But there is no reason a lab here or doctor couldn't set up an agreement with a European lab to have samples sent for testing. Its unreasonable because people do occasionally travel and could catch a European strain and when they get tested here in the US, it fails. So the best thin would be to find a doctor willing to set up an agreement with a European lab. I'd be willing to bet that the more advanced Euroimmun Blot would outperform the US test in many cases.
So stupid question on the Euroimmun output, those bumps aren't reported as positive because the resolution of the optics is too low and they fall in the noise range of the tool?
No that's not completely true. Some yes, some no. Each kit supplier chooses a set of antigens to look for and a ratio that determines negative or positive. In the US, we have chosen 10 antigens for the IgG test and require 5 to be positive. The optical scanner only checks the optical output at those pre-decided antigens. But the Borrelia spirochete has more than 2 dozen potential proteins the human body could produce antibodies for. If the test kit uses sonicated spirochetes for some of the antigens then all the proteins in the spirochete are potential antibody targets.

Some of the proteins are recombinant so are very specific but not the sonicated spirochete proteins. They are just spirochetes run through a sonic blender. So if the Western Blot uses sonicated spirochetes in addition to recombinant proteins, any antibody in the test blood could bind to its target protein.

That would mean any optical output could be valid if located at a known protein kDa weight. If you look at the positives on the line blot, their output level is not greater than some of the ones I pointed out. So they are not just noise. The ones that are very low in output may be noise or may be very low levels of a protein that a very low level of antibodies bound to.

Its useful to use recombinant antigens/proteins for ones like Vlse which are down regulated and may not appear in sufficient volume in the sonicated spirochete blend. But if one just breaks a spirochete up into its component proteins by sonication, it will include not only the "chosen" set but all the proteins in the spirochete in the ratio they exist when it was sonicated. So showing every known protein would be wise rather than always choosing a set. If you look at the curve and compare the levels of positives to the levels of the ones not in the Euroimmun set but are known proteins, you will see some important ones.
The greater the ignorance, the greater the dogmatism.

Attributed to William Osler, 1902

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ChronicLyme19
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Re: Interpretation of results medical, Lyme disease?

Post by ChronicLyme19 » Wed 4 Feb 2015 19:42

Ok, yeh that makes sense. It would also be helpful to find some way to amplify the weak signal from certain antibodies that are underproduced as well. Use every signal you can get and amplify them somehow.
Half of what you are taught is incorrect, but which half? What if there's another half missing?

Userr0
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Joined: Mon 26 Jan 2015 13:00

Re: Interpretation of results medical, Lyme disease?

Post by Userr0 » Sun 1 Mar 2015 14:45

Hello again.
Thank you for all the answers and advice.

Overall, my condition has improved a little, I have no dizziness and headaches.
With symptoms that continue to maintain it looks like this:
My symptoms:

- Continuous fatigue
- Lack of concentration
- Lack of memory (fresh)
- Terrible sleepiness (even after having a good - with a different number of hours)
- Continuous feeling cold (even in the room when temp.25C and covering with two duvets and blankets)
- Rapid fatigue
- Lack of power
- Occasionally, myalgia (such as with a cold)
- Lack of energy
- Shaking hands
These symptoms do not always occur, as there is with different intensity.
Recently I had done another test for Lyme disease: ELISA IgG and IgM and IgG Western blot and IgM - all these tests came out negative.
I also visited the clinic of infectious diseases and a doctor there said that I do not have Lyme disease.
Symptoms that persist on and no doctor does not know where they come from.
Has the following tests for Lyme can be ruled out?
In these tests, although negative is something that does not work out and indicators have been exceeded.
Below links to scans of these studies:
1. -> http://images66.fotosik.pl/660/c2664b836d6d0765.jpg
2. -> http://images70.fotosik.pl/660/a8a38aee81925e9e.jpg
3. -> http://images70.fotosik.pl/660/42daaadfb8d95058.jpg

I also did recently following tests:
TSH (Thyroid-stimulating hormone) : 4.37 (Norm: 0,27-4,2)
FT3 (free triiodothyronine): 3.9 (Norm: 2,0-4,4)
FT4 (free thyroxine): 1.31 (Norm: 0,90-1,80)
Anti-TPO (thyroid peroxidase antibodies against): <5.0 (Norm: <34)
ANTI-TG (this Thyroglobulin antibodies): 13.5 (Norm: <115)
Glucose in plasma: 96
Iron: 190 (Norm: 33-193)
Total cholesterol: 184 (Norm: <190)
Reported the doctor that I have a white coating on the tongue and I also made a swab of the language and the result is: Candida sp. (Positive) +
So it looks like at the moment.

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