Anyone know the latest on the Ceres Nanotrap

Medical topics with questions, information and discussion related to Lyme disease and other tick-borne diseases.
nnecker
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Joined: Wed 19 Dec 2012 22:57

Re: Anyone know the latest on the Ceres Nanotrap

Post by nnecker » Sun 6 Nov 2016 16:55

IMUGEN utilizes IgG WB testing as part of the Lyme Antibody Analysis. Although IgM WB can be performed, the inherent test sensitivity and specificity are less well established than IgG WB.
B. burgdorferi spirochetes are derived from cell culture. IMUGEN typically employs two different strains – G39/40 is a “native” or wild strain originally isolated from a patient in CT; strain 49736 is a tick isolate from the upper Midwest which lacks the gene for OspA (the Lyme vaccine, no longer on the market, contained purified recombinant OspA). Employing these two distinct strains potentially improves test sensitivity. Furthermore, comparing WB’s with these two strains distinguishes patients who have received Lyme vaccine in the past from those with real exposure to B. burgdorferi, avoiding potentially false positive test results in those who have received Lyme vaccine.

Henry
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Joined: Thu 10 Nov 2011 18:49

Re: Anyone know the latest on the Ceres Nanotrap

Post by Henry » Sun 6 Nov 2016 17:18

Duncan: Well, it all depends on what you mean by " some evidence of Lyme infection". If the patient is culture positive, then there is clear evidence of active infection and you treat with antibiotics. However, if you are referring to seropositivity, then I've already discussed that issue.

There is clear evidence that antibiotics have significant pharmacological properties and do other things besides just kill bacteria. If the beneficial effects are due to such properties, one would expect them to dissipate when one stops taking the antibiotic and to relieve symptoms once the antibiotic regimen is re-started. It's a lot like when one take Aleve to relieve the pain of arthritis. The pain goes away as long as you are on Aleve. However, once you stop taking it, the pain comes back because the arthritis is still presence. So, you go back on Aleve.

Also, there is no clinical evidence for the development of antibiotic resistant mutant strains of Borrelia, e.g., as is the case for Staph infections. None. The occurrence of such mutants depend a great deal on the frequency of natural mutations from one generation of Borrelia to another. Since Borrelia multiply at a vet slow rate (once every 12-16 hours in comparison to E. coli or Staph that has a replication rate of one every 20 minutes), the mutation rate is extremely low. The low drug mutation rate has hampered genetic studies because of the difficulty in creating drug resistant mutants under defined conditions in the laboratory. That is not easy to do.

I think I have discussed the issue of a persistent infection in great detail in previous postings.

I could go into another discussion of cysts forms, another unfounded reason to justify the need for extended antibiotic therapy. But, I have gone over that in great detail in previous postings as well.

duncan
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Re: Anyone know the latest on the Ceres Nanotrap

Post by duncan » Sun 6 Nov 2016 18:33

Culture positive. Really? :)

So your answer is yes, you would treat a symptomatic patient with abx if the treatment helped with symptoms, regardless of whether or not you thought she was still infected with Lyme? Good.

It would appear a direct antigen test is also preferred by you. We agree about that, too, then.

So...What was your issue with the Ceres Nanotrap test other than you didn't think OspA was the best choice? That aside, if I understand correctly, you believe on paper a direct metric would benefit everyone (since you fall back on culture-positive results vs seropositivity).

We have some things in common, then.

Henry
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Joined: Thu 10 Nov 2011 18:49

Re: Anyone know the latest on the Ceres Nanotrap

Post by Henry » Sun 6 Nov 2016 20:44

No, you're playing with words. That is not quite what I said. But, you can go back an re-read my old posts. I did mention some qualifiers.

You still didn't answer my question about what you meant when you said you had "some evidence of Lyme infection" . What does that mean? What was the evidence?

duncan
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Joined: Wed 5 Sep 2012 18:48

Re: Anyone know the latest on the Ceres Nanotrap

Post by duncan » Sun 6 Nov 2016 20:47

It was hypothetical. Are you qualifying your response? We both know the culture-positive thing is silliness. Henry, out of 340,000 US Lyme cases in the last 12 months, how many do you suppose were determined by being culture positive?lol

In answer to your question, say ELISA positive but only 2 bands IgG on the WB, but they are Bb specific.

Henry
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Joined: Thu 10 Nov 2011 18:49

Re: Anyone know the latest on the Ceres Nanotrap

Post by Henry » Sun 6 Nov 2016 21:03

But you said you had evidence of Lyme infection. Once again, what does that mean? Being seropositive is to be expected in patients correctly diagnosed and treated for reasons that I mentioned. That just indicates past exposure. But, I take it the evidence you were referring to was something different? Please explain.

Sorry, being ELISA positive and having only 2 bands on an IgG Western blot does not make for a positive diagnosis. You know that!

duncan
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Joined: Wed 5 Sep 2012 18:48

Re: Anyone know the latest on the Ceres Nanotrap

Post by duncan » Sun 6 Nov 2016 21:12

Pshaw. It does in China. Being sero-positive could simply be a false positive, but it is still evidence. We are speaking degrees of evidence, and the perspective of what constitutes meaningful evidence depends in great measure on politics and geography.

For goodness sake, in the absence of an EM, how do you usually diagnose a case of late stage Lyme, Henry? It certainly isn't via a culture. It seems like you are tip-toeing, and you shouldn't need to. Remember my concern about equivocating?

If there is EVIDENCE of infection - not proof, as that is very, very rare outside of acute cases when the EM can be biopsied - would you treat? I seemed to get the sense you would treat regardless as long as the regimen seemed to be mitigating your patients' symptom cluster, but perhaps I misread you.

Henry
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Joined: Thu 10 Nov 2011 18:49

Re: Anyone know the latest on the Ceres Nanotrap

Post by Henry » Sun 6 Nov 2016 21:59

Read the IDSA guidelines. In the U.S., late stage Lyme disease is usually manifested by arthritic symptoms. Neurological symptoms are more common in Europe where their strains of Borrelia are more neurotropic. Even then, they treat with 28 days of oral doxycycline which was shown to be as effective as i.v. ceftriaxone. But, the IDSA guidelines deal with this and other issues. You can check them out.

duncan
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Joined: Wed 5 Sep 2012 18:48

Re: Anyone know the latest on the Ceres Nanotrap

Post by duncan » Sun 6 Nov 2016 22:57

I thought as much. So much for moving the discussion forward. 8-)

Preserving the status quo may benefit some, but I fear far too many patients won't be among those.

Henry
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Joined: Thu 10 Nov 2011 18:49

Re: Anyone know the latest on the Ceres Nanotrap

Post by Henry » Mon 7 Nov 2016 4:37

There's a section in the IDSA guidelines specifically devoted to late stage Lyme disease. It contains many references to published peer-reviewed clinical data to support the recommendations made. You should read it and read it carefully since it deals with many of the questions you've asked.

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