Pre-treatment and post-treatment assessment of the C(6) test in patients with persistent symptoms and a history of Lyme borreliosis.
Fleming RV, Marques AR, Klempner MS, Schmid CH, Dally LG, Martin DS, Philipp MT.
Department of Medicine, Boston University Medical Center, 650 Albany Street, Room 620, 02118, Boston, MA, USA.
It was recently reported that antibody to C(6), a peptide that reproduces an invariable region of the VlsE lipoprotein of Borrelia burgdorferi, declined in titer by a factor of four or more in a significant proportion of patients after successful antibiotic treatment of acute localized or disseminated Lyme borreliosis. The present study evaluated the C(6) test as a predictor of therapy outcome in a population of patients with post-treatment Lyme disease syndrome. The serum specimens tested were from patients with well-documented, previously treated Lyme borreliosis who had persistent musculoskeletal or neurocognitive symptoms. All of the patients had participated in a recent double-blind, placebo-controlled antibiotic trial in which serum samples were collected at baseline and 6 months thereafter, i.show $132#e. 3 months following treatment termination. In this patient population no correlation was found between a decline of C(6) antibody titer of any magnitude and treatment or clinical outcome. Antibodies to C(6) persisted in these patients with post-treatment Lyme disease syndrome following treatment, albeit at a markedly lower prevalence and titer than in untreated patients with acute disseminated Lyme disease. The results indicate that C(6) antibody cannot be used to assess treatment outcome or the presence of active infection in this population.
PMID: 15243815 [PubMed - as supplied by publisher]
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Antibodies to C(6) persisted in these patients with post-treatment Lyme disease syndrome following treatment, albeit at a markedly lower prevalence and titer than in untreated patients with acute disseminated Lyme disease. in english I read that the patients who who still had a titer to lyme....
I wonder what post treatment patients who DO NOT HAVE SYMPTOMS titers are???
I guess...if its looks like duckweed, it will feed the ducks..and this study is another DUCKWEED study!
The interesting thing is that previously, at least one of these authors (Marques, at the NIH intramural study) published that the C-6 test WAS a good measure of treatment effectiveness. Now they say it isn't.
When it comes to duck studies, you always have to wonder what they are up to.
If people with "post-treatment" Lyme still had an elevated titer, then these researchers would either have to admit they still had Lyme disease, or say that they were wrong before.
Note also that these are the people in Klempner's study, the infamous study that concluded chronic Lyme did not respond to 3 months of treatment, and therefore long-term treatment was not useful and was not continuing infection.
First they tell us it is a good test, then it isn't when it gives the wrong results, results that don't fit the party line.
Here's what they said before (the complete opposite):
J Clin Microbiol. 2003 Nov;41(11):4955-60. Related Articles, Links
C6 test as an indicator of therapy outcome for patients with localized or disseminated lyme borreliosis.
Philipp MT, Marques AR, Fawcett PT, Dally LG, Martin DS.
Division of Bacteriology and Parasitology, Tulane National Primate Research Center, Tulane University Health Sciences Center, Covington, Louisiana 70433, USA. [email protected]
Management of Lyme disease would benefit from a test to assess therapy outcome. Such a test could be employed to ascertain if treatment of early Lyme disease was successful and would be helpful to clinicians assessing patients with lingering posttreatment symptoms. We reported recently that levels of the antibody to C(6), a Borrelia burgdorferi-derived peptide that is used as an antigen in the C(6)-Lyme diagnostic test, declined after successful antibiotic treatment of Lyme borreliosis patients. We assessed retrospectively the change in anti-C(6) antibody titers in 131 patients with either early localized disease (erythema migrans) or disseminated disease. All of these patients were treated with antibiotics and were free of the clinical signs shown at presentation within 12 weeks after the initiation of treatment. Decreases in reciprocal geometric mean titers (rGMT) of the anti-C(6) antibody were quantified for the subpopulation of 45 patients whose baseline rGMT were >/=80 and whose second serum specimens were obtained at least 6 months after the baseline specimen. Eighty percent of this patient group (36 of 45) experienced a >/=4-fold decrease in their rGMT (P < 0.0003). These results suggest that a change in the anti-C(6) antibody titer may serve as an indicator of therapy outcome for patients with localized or disseminated Lyme borreliosis.
PMID: 14605123 [PubMed - indexed for MEDLINE]
[This message has been edited by lou (edited 29 July 2004).]
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quote:Originally posted by lou: Eur J Clin Microbiol Infect Dis. 2004 Jul 8 [Epub ahead of print] Antibodies to C(6) persisted in these patients with post-treatment Lyme disease syndrome following treatment, albeit at a markedly lower prevalence and titer than in untreated patients with acute disseminated Lyme disease. The results indicate that C(6) antibody cannot be used to assess treatment outcome or the presence of active infection in this population.
PMID: 15243815 [PubMed - as supplied by publisher] [/B]
I'm confused to exactly what they are saying. If C(6) was lower after abx treatment, why does that not indicate that more of the Bb was present before the trial than after?
In other words, that there was still active Lyme in these "post Lyme" patients to begin with and that the abx did kill off some of it?
I don't know anything about C(6). But if they were saying having C(6) meant you still had Lyme (and not having it meant you didn't have Lyme) doesn't their own trial tell them that the reduction in C(6) is evident that "post Lyme" is really "active" Lyme?
Can someone explain the C(6) theory to me, Please
[This message has been edited by tabbytamer (edited 29 July 2004).]