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Charles Ray Jones, M.D.

Addendum Regarding Lyme Serology


There are nine known [Lyme] Borrelia burgdorferi Genus species specific
KDA Western Blot antibodies (bands): 18, 23, 31, 34, 37, 39, 83 and 93.

Only one of these Borrelia burgdorferi genus specific bands is needed to
confirm that there is serological evidence of exposure to the Borrelia
burgdorferi spirochete and can confirm a clinical diagnosis of Lyme Disease.

CDC Western Blot IgM surveillance criteria includes only two burgdorferi
genus species specific antibodies for IgM 23 and 39 and excludes the
other seven Borrelia burgdorferi antibodies.

CDC Western Blot IgG surveillance criteria includes 18, 23, 30, 37, 39
and 93 and excludes bands 31, 34 and 83.

It does not make sense to exclude any Borrelia burgdorferi genus
species-specific antibodies in a Lyme Western Blot, and to include only
two of these antibodies in IgM because all the antibodies in IgG were
once IgM.

IgM converts to IgG in about two months unless there is a persisting
infection driving a persisting IgM reaction. This is the case with any
infection including a Borrelia burgdorferi induced Lyme disease.

The CDC wrongfully includes five non-specific cross-reacting antibodies
in its Western Blot surveillance criteria: 28, 41, 45, 58 and 66. This
leads to the possibility of false positive Lyme Western Blots. There can
be no false positives if only Borrelia burgdorferi genus
species-specific antibodies are considered. One can have a CDC
surveillance positive IgG Lyme Western Blot with the five non-specific
antibodies without having any Borrelia burgdorferi genus species
specific antibodies.

This does not make sense.

The CDC recommends that the Lyme Western Blot be performed only if there
is a positive or equivocal Lyme ELISA. In my practice of over 6000
children with Lyme disease, 30% with a CDC positive Lyme Western Blot
have negative ELISA's. The Lyme ELISA is a poor screening test. An
adequate screening test should have false positives, not false negatives.

Rev. 2/25/04

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Reasons Why a Seronegative Lyme Western Blot Test Result Might Occur

1) You may have a recent infection before antibody production begins. It takes two to six weeks to begin antibody production in a new infection.

2) The spirochete bacteria may be in a dormancy, or cyst phase, and not presenting antigens, so the body will not be stimulated to produce antibodies.

3) The spirochete is encapsulated by host tissue (i.e. lymphocytic cell walls). In this case, the body will not recognize the bacteria and produce antibodies.

4) The bacteria may be protected in parts of the body where the immune system will not easily find it or recognize it, such as tendons, cartilage, and other areas that have poor blood supply.

5) Tests based on a few strains of the bacteria are not sensitive to other strains. There are over 300 strains in the US, with tests for only a very few.

6) The spirochete is capable of changing its surface antigen proteins, continually hiding from the immune system and preventing formation of antibodies.

7) Recent antibiotic treatment may reduce immune system response.

8) Recent anti-inflammatory treatment may reduce immune system response.

9) If you have an infection with another tick-borne infection like Babesia or Anaplasma (Ehrlichia), in addition to Lyme disease, your immune system may be suppressed and you will not be able to make enough antibodies for the test to show positive.

10) There are other cause of immune suppression that may have a similiar result, such as certain viral infections, very young or old age, stress, steroid use, genetic immune issues, etc.

11) Not all Lyme lab tests are equally sensitive and accurate. A person can be negative at one lab and positive at another.

12) Lab tests are not standardized for late stage disease. Certain tests are more sensitive to late stage Lyme, others to early stage.

13) Most labs only report positive or negative results based on strict criteria from the Center for Disease Control and Prevention. This criteria was intended to be used for surveillance purposes, and may exclude some people with Lyme infection. Labs that report all bands on the Western Blot will give information beyond the more strict parameters given for surveillance. A test may be negative according to the CDC criteria, but still show significant antibody activity in reaction to Lyme disease, indicating a possible infection.

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Posts: 2142 | From California | Registered: Nov 2003  |  IP: Logged | 

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Originally posted by concerned mother:
Before we were diagnosed with Lymes my son saw a neurologist. He called me today to say that he had the infectious disease doctor look at the Igenex results. He said the infectious disease doctor said the results are not always accurate. My son is now on 200 mg of Doxy a day and has been herxing. Would a person without lymes herx like that? He was positive in both tests for lyme. Why do the question it so?

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Hi Concerned Mom.

Ya wanna lose that "s" at the end of Lyme?

There. Now, that's better!!!

It won't take you long in the frustration department to see why Lyme patients get disgusted with these doctors.

If you want a good laugh, use the search function for a great thread called "Are all neurologists goofy?"

They are typically very unimpressed with tests which prove something that they themselves did not come up with. I.E., since they don't know anything about Lyme or accurate testing for Lyme, they are not now going to start exclaiming, "Oh gee, sorry, turns out you knew more than WE did -- you do have Lyme after all --OOPS!"

NOT.

I think that's it in a nutshell.

The secretaries at my own neuro's office told me in hushed whispers, "He will NEVER admit he is wrong!" (When I faxed over my CDC positive IGeneX results, after his stoopid MS diagnosis).

IGeneX is one of the most respected tickborne disease labs in the world. I would simply tell my neurologist he obviously doesn't know much about Lyme disease if he doesn't know THAT.

Michelle

[ 21. December 2005, 07:55 AM: Message edited by: Michelle M ]

Posts: 3193 | From Northern California | Registered: Apr 2005  |  IP: Logged |