"Ceftriaxone Has No Effect on Antibody Profile in Lyme Encephalopathy: Presented at ANA"
By Fred Gebhart
SAN FRANCISCO -- September 17, 2010 --
Ceftriaxone generally does not affect antibodies in patients with post-treatment Lyme encephalopathy (PTLE), according to a study presented here at the 135th Annual Meeting of the American Neurological Association (ANA).
Only 1 patient of 19 in a recent longitudinal study of PTLE showed a positive response to the beta-lactam antibiotic.
"These PTLE patients are somehow different from people who recover from Lyme disease at the molecular level," said Armin Alaedini, PhD, Weill Cornell Medical College, Cornell University, New York, New York, on September 14. "They show a variety of antibodies, which is suggestive of immunologic abnormalities."
An earlier clinical trial of intravenous ceftriaxone therapy reported short-term cognitive improvement in patients with PTLE.
Researchers conducted a longitudinal study to assess the effect of this beta-lactam agent on B-cell activity and antibody response in patients with a history of Lyme borreliosis and persistent symptoms. The study examined the levels and specificity of serum antineural and antiborrelia antibodies using serum specimens from 19 PTLE patients.
All of the patients had been treated for 10 weeks with either ceftriaxone or placebo. Control specimens include healthy post-Lyme disease patients, patients with systemic lupus erythematosus, and normal healthy individuals.
Antineural, antiborrelia, and C6 antibodies were assessed by immunoblot, immunohistochemistry, and enzyme-linked immunosorbent assay before and up to 38 weeks after treatment.
Analysis found that patients with PTLE had higher antineurol antibody reactivity compared with healthy individuals ([P < .05), but antibody levels did not decrease significantly in response to ceftriaxone treatment. Antiborrelia and C6 antibodies also failed to show a significant change after ceftriaxone, except in 1 patient. Decreasing antibody levels in this single patient were correlated with clinical improvement, Dr. Alaedini said.
"Because this patient recovered, we think he actually had an ongoing Borrelia infection," he said. "Other patients in the group showed no sign of an ongoing infection."
One of the clinical complications of PTLE is the complete lack of accepted diagnostic markers, Dr. Alaedini continued, which makes it particularly difficult to distinguish patients with PTLE from those who are symptom-free after having had Lyme disease..
He indicated that the next step is to try immunomodulating agents to attempt to reduce antibody levels.
[Presentation title: Effect of IV Antibiotic Therapy on Antibody Profile in Patients With Post-Treatment Lyme Encephalopathy. Abstract T-91]
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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Actually the study may be somewhat useful, but some of the statements made are totally ridiculous.
And of course the study overlooks patients like hubby who have no antiborrelia antibodies to begin with. Or at least not the ones measured by standard Western Blot testing.
But hubby did have plenty of antibodies to both the central and peripheral nervous system the 3 or 4 times that was tested back in 2002 and 2003 -- both of the labs used have since gone out of business and I don't know any labs which do this testing anymore.
Any LLMD could have predicted the outcome of this study -- the level of antibodies does not predict whether or not a patient will improve on any one particular med.
I am not convinced that reducing antibody levels will "cure" anyone. Actually someone in the know once told me that it would be a positive sign if hubby ever started producing measurable antibodies.
Bea Seibert
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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posted
Yes, if we have a large number of seronegative chronic lyme cases, antibody levels are not going to decrease. In fact, it is sometimes the situation that seronegative people start showing antibody levels when they are being successfully treated. So, this is backwards from what the study looks for!
These are people who do not understand the disease, so the chances of them finding and understanding anything new are poor.
And there are probably anti-neural and other autoimmune markers in chronic cases, but these are infection driven and go away with successful treatment.
Posts: 8430 | From Not available | Registered: Oct 2000
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Rumigirl
Frequent Contributor (1K+ posts)
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posted
And if this study was done at Cornell NY Medical College---well that is home to Wormser and all the rest. What would you expect? They only believe in "Post Lyme" after 2-4 weeks of abx. In spite of the fact that all of their prior research show the opposite, which they are conveniently ignoring.
[ 09-22-2010, 04:51 PM: Message edited by: Rumigirl ]
Posts: 3771 | From around | Registered: Mar 2008
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