posted
Can anyone recommend a resource to help explain what each band means?
I want to understand my negative Igenex IgG and IgM tests...IgG had 1 positive band, and one indeterminate and the IgM had 1 positive. I understand you need 2 or more positive bands to get an overall positive.
Posts: 55 | From North Carolina | Registered: Dec 2007
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posted
This can be a very frustrating process trying to understand the meaning of test results when they aren't CDC positive.
Dr. C's explanation is a good place to start. Keep in mind, however, that there are MANY factors as to why the testing can be unreliable. Negative results do not necessarily mean you do not have Lyme and 1 positive antibody also does not prove you have Lyme (false positives are definitely possible).
If you want to share your test results, I'd be happy to give you my thoughts. I'm not a doctor by any means...just a former microbiologist with Lyme disease that has done a great deal of research.
Kristin
Posts: 561 | From mass | Registered: Jul 2007
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posted
KS- YES YES!!!! Share your thoughts. IgG: 30 + 31 IND or weak (<1) 41 ++
IgM: 41 +
I did read Dr C's explanation. I'm thinking the risks of taking antibiotics are minimal...so maybe that's the path I should follow.
Posts: 55 | From North Carolina | Registered: Dec 2007
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posted
Simply stated, IgM response suggests recent or active infection. IgG response supports exposure at some point in your life. However, note that with chronic Lyme infection, it may not always be this simple.
As you probably already know, band 41 is associated with bacteria's flagella, but is not necessarily specific to Lyme Bb. It is not uncommon for healthy individuals to have an antibody response to band 41, particularly an IgG response. However, IgM positive band 41 supports that your body is actively recognizing an intruder with a flagella.
Regarding band 30, I honestly haven't seen too much scientific literature to support the specificity of this band to Lyme. I just don't know much about this one.
I find your IND response to band 31 to be an important piece here. Band 31 (OspA) is associated with the Vaccine that was available (I'm assuming you were not vaccinated here) and is an antibody response that is usually detected in late infection.
I'm thinking it is quite possible that you could start treatment, retest a few months from now, and find yourself with a lot more positive bands.
Please know that my thoughts here nor your test results should replace the opinion of a LLMD. Obviously I have no idea what your symptoms are or what your medical history is. For most of us dealing with Lyme, the risk of NOT treating far outweighs the risks of treating.
Another thought, if you are like most of us and want concrete evidence that you have Lyme, have a Lyme PCR test performed. Although it is like finding a needle in a haystack (negative result truly means nothing) a positive result is very accurate since it actually detects the Bb DNA.
Let me know if you have anymore questions. It is so difficult navigating through all of this and unfortunately, there is too much still that is unknown.
Kristin
Posts: 561 | From mass | Registered: Jul 2007
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sixgoofykids
Honored Contributor (10K+ posts)
Member # 11141
posted
We put my daughter on a trial run of abx based on a weaker test than yours (she had 41 + and 34 IND). She responded well to abx, ended up being treated for 8 months and now is completely better.
In my opinion, a trial run of abx has less risk than not treating a possible Lyme infection .... that is why we decided to treat her. She was diagnosed clinically based on symptoms, exposure, and a weak test.
-------------------- sixgoofykids.blogspot.com Posts: 13449 | From Ohio | Registered: Feb 2007
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posted
This is on IGENEX WEB on a confimration test. Note the last section. As people have stated I'm no doctor but this may help.
30-31kDA Epitope Confirmation Test (Sensitivity > 97% in Late Lyme; Specificity > 98%) The Lyme IgG or IgM 30-31kDA confirmation test is a qualitative immunoblot assay that determines whether 30 and/or 31kDA bands present on a Lyme IgG or IgM western blot are due to B. burgdorferi specific antibodies or not. B. burgdorferi specific epitope(s) - 30 and/or 31kDA, are denatured and separated by SDS polyacrylamide gel electrophoresis, blotted onto nitrocellulose membranes and cut into strips for the use of Lyme 30-31kDA Western Blot Confirmation Test. It is known that Western blots, especially IgM, can give false positive results with some viruses. This test would be very useful to rule out false positives when 30 and/or 31kDa bands are present on the Western blots.
Principle: Patient serum is incubated with 30-31kDA recombinant epitope on Western Blot strips. If the 30 and/or 31kDa specific antibodies to B. burgdorferi antigens are present, they will bind to the corresponding epitope bands. After washing the unbound serum off the strip, the bound B. burgdorferi specific antibody reacts with alkaline phosphatase conjugated goat anti-human antibody (IgG or IgM). After washing the unbound conjugated antibody, the strip reacts with BCIP/NBT, a chromogenic substrate. A dark purple colored precipitate will develop on the antigen-antibody complexes. Bands are visualized, scored for intensity relative to the positive and negative controls.
Specificity and Sensitivity The IGeneX Lyme Western blots determine whether a patient was exposed to B. burgdorferi or not. The IgG or IgM Western blot has an overall specificity of >96%; and the combined IgG and IgM Western Blots have a sensitivity of 92%. This is based on a study performed on 142 well characterized serum samples. The Lyme Western blot strips have bound B. burgdorferi proteins that are separated by molecular weight. Therefore, non-specific proteins present in the B. burgdorferi lysate co-migrate with B. burgdorferi specific proteins. The non-specific co-migrating proteins can give false positive results as has been demonstrated by us and others. When we tested Lyme Western blots against a panel of 94 sera from patients with viral infections (confirmed by presence of antibodies to viruses), the assay specificity for Lyme Western blot IgG dropped to 90% and IgM to 81%. The Lyme IgG Western blot bands 30-31kDa confirmation test improved the specificity for IgG to >97% and for IgM >98% (See table below). In addition when a panel of very well characterized 30 sera from patients with neuroborreliosis, that were part of an NIH study, (provided by Dr. Fallon, Columbia University) were tested, the assay sensitivity was >97% (29/30 were positive). Based on this data, we recommend that further testing is not necessary if in addition to 30 and/or 31kDa bands, two of the following bands (23-25, 34, 39,41 and 83-93 kDa), are present on the Western blot. Otherwise, the 30-31kDA confirmation test should be used to confirm whether 30-31kDa bands present on the Lyme Western blots are due to B. burgdorferi specific antibodies or not. If the 30-31kDa confirmation test is negative, we recommend that patient's sera be tested for viral antibodies.
-------------------- Raymond Leave the gun, take the cannolis Posts: 214 | From Rhode Island | Registered: Nov 2007
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