With most infections, your immune system first forms IgM antibodies, then in about 2 to 4 weeks, you see IgG antibodies. In some infections, IgG antibodies may be detectable for years.
Because Borrelia burgdorferi is a chronic persistent infection that may last for decades, you would think patients with chronic symptoms would have positive IgG Western blots.
But actually, more IgM blots are positive in chronic borreliosis than IgG. Every time Borrelia burgdorferi reproduces itself, it may stimulate the immune system to form new IgM antibodies.
Some patients have both IgG and IgM blots positive. But if either the IgG or IgM blot is positive, overall it is a positive result.
Response to antibiotics is the same if either is positive, or both. Some antibodies against the borrelia are given more significance if they are IgG versus IgM, or vice versa.
Since this is a chronic persistent infection, this does not make a lot of sense to me. A newly formed Borrelia burgdorferi should have the same antigen parts as the previous bacteria that produced it.
But anyway, from my clinical experience, these borrelia associated bands usually predict a clinical change in symptoms with antibiotics, regardless of whether they are IgG or IgM. In regard to the outer surface proteins, think of it like the skin of a human.
On the outer surface of the Lyme bacteria are various proteins. As they have been discovered, they have been assigned letters, such as outer surface proteins A, B, and C.
The following is a brief explanation of the test results. Again, each band is an antigen complexed (bound together) with an antibody made by the immune system, specifically for that antigen (part) of Borrelia burgdorferi.
18: An outer surface protein.
22: Possibly a variant of outer surface protein C.
23-25: Outer surface protein C (osp C).
28: An outer surface protein.
30: Possibly a variant of outer surface protein A.
31: Outer surface protein A (osp A). 34: Outer surface protein B (osp B).
37: Unknown, but it is in the medical literature that it is a borrelia-associated antibody. Other labs consider it significant.
39: Unknown what this antigen is, but based on research at the National Institute of Health (NIH), other Borrelia (such as Borrelia recurrentis that causes relapsing fever), do not even have the genetics to code for the 39 kDa antigen, much less produce it. It is the most specific antibody for borreliosis of all.
41: Flagella or tail. This is how Borrelia burgdorferi moves around, by moving the flagella. Many bacteria have flagella. This is the most common borreliosis antibody.
45: Heat shock protein. This helps the bacteria survive fever. The only bacteria in the world that does not have heat shock proteins is Treponema pallidum, the cause of syphilis.
58: Heat shock protein.
66: Heat shock protein. This is the second most common borrelia antibody.
73: Heat shock protein.
83: This is the DNA or genetic material of Borrelia burgdorferi. It is the same thing as the 93, based upon the medical literature. But laboratories vary in assigning significance to the 83 versus the 93.
93: The DNA or genetic material of Borrelia burgdorferi.
In my clinical experience, if a patient has symptoms suspicious for borreliosis, and has one or more of the following bands, there is a very high probability the patient has borreliosis.
These bands are 18, 22, 23-25, 28, 30, 31, 34, 37, 39, 41, 83, and 93.
[---- from DR C's update from 2005 --- ----The significant antibodies, in my opinion, are the 18, 23-25, 28, 30, 31, 34, 39, 58, 66 and 93.----]
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96222 | From Texas | Registered: Feb 2001
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posted
The first time was 23 and 39 Igm bands. Igg negative. 2 months later same test, same lab, negative to everything. Go figure. AND, I'm still symptomatic.
-------------------- kristi in Palm Coast Posts: 24 | From palm coast, fl | Registered: Apr 2011
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-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96222 | From Texas | Registered: Feb 2001
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map1131
Frequent Contributor (5K+ posts)
Member # 2022
posted
Labcorp IMO and experience wouldn't know borrellia bacteria if it bite them in the arse.
It's weird when they go pass the first test which is ELISA. Full Western Blot is only done with positive ELISA.
They don't know but a few bands. Useless for lyme & co infection testing based on my testing.
They were given 3 times early into and then given another shot at being educated and knowledgable another chance after highly positive IgM from Igenex and they failed again.
I was told by the director....if we knew in advance you were a lyme positive, chronic patient we would have completed the Western Blot and not stopped with the ELISA. Hello, anybody home?
The docs orders were Western Blot, not ELISA. Unbelievable!!!!!!!!!!!!!!!!
Pam
-------------------- "Never, never, never, never, never give up" Winston Churchill Posts: 6478 | From Louisville, Ky | Registered: Jan 2002
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philly78
Frequent Contributor (1K+ posts)
Member # 31069
posted
Yeppers Lymetoo! Lyme is weird...VERY weird!
There are several reasons why this may have happened.
1.) You're immune system is not functioning as it should and you are not making the antibodies.
2.) You may not have enough bacteria floating around in your blood. It could be the lyme is living in your tissues and the antibodies that you are making are busy trying to get rid of the infection...and thus are in your tissue as well.
I've already read that the antibodies can be attached to the bacteria trying to fight it off. If that is the case, then they will not be floating around in your blood.
3.) There are many different strains of Bb and not all are tested in the lab. Maybe you have one the strains that aren't being tested for?
4.) the lab sucks.
Here is what I found to be an interesting link with some good info.
-------------------- When faced with pain you have two choices....either quit and accept the circumstances, OR make the decision to fight with all the resources you have at your disposal. Posts: 1000 | From PA | Registered: Mar 2011
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t9im
Frequent Contributor (1K+ posts)
Member # 25489
posted
Don't just blame labcorp. I've seen something similar with my daughters Igenex.
Last test she was down to only 41 being positive on IgG (with a couple of IND). Last September she had 3 positives.
Just because the test doesn't show an antibody response doesn't mean one doesn't have a TBD.
-------------------- Tim Posts: 1111 | From Glastonbury, CT | Registered: Apr 2010
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map1131
Frequent Contributor (5K+ posts)
Member # 2022
posted
Oh, I'm not just blaming Labcorp. I know I've seen actual posts from some people on this site get a positive. Very few and far between.
T9, that was my experience with them. Now they can find myco pn, HHV-6, EBV, CMV, sed rate, c-reactive protein, just to name a few.
I have the same opinion on most the labs across this nation that are doing lyme anti-bodies based off CDC, NIH, other gov org and complete ignorance to lyme & all the other little simple bacteria like bart, babs, RMSF, to name a few.
All of this intelligence go hand in hand. Igenex completely screwed up my IgG side of my Western Blot. It wasn't important enough to correct.
Pam
-------------------- "Never, never, never, never, never give up" Winston Churchill Posts: 6478 | From Louisville, Ky | Registered: Jan 2002
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TerryK
Frequent Contributor (5K+ posts)
Member # 8552
posted
Antigenic variablility is another reason this can happen.
Borrelia changes it's outer surface protien in order to evade the immune system. I've had several Western Blots from the same lab, none of them identical. When I asked why, I was told antigenic variability.
In addition, an individual blood sample will not necessarily have all the antibodies that you are making in it. It is the luck of the draw.
Terry I'm not a doctor
Posts: 6286 | From Oregon | Registered: Jan 2006
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