Just trying to understand how the IGM/IGG tests work. I was tested back August of 2008 through a normal Quest Diagnostics WB for IGG and IGM. The IGG results came back nonreactive on all bands. For IGM, there were only 3 bands it shows as being tested, 23 KD, 39 KD and 41 KD, 23 KD came back REACTIVE, the others didn't.
At that time I was told not to worry about it.
Was retested this past March via Igenix and on the IGM I had 31 show up as POS, 34,39 as IND and 41 as POS (Plus on the IGG 39 IND and 41 POS). BUT NO BAND 23 REACTIVITY?
My LLMD told me if he had seen the WB I had done back in 2008 he would have treated me based on the IGM 23 BAND reactivity alone.
Just curious why it would show up reactive on one test and then not 18 months later?
I am sure there is a very simple explanation...just curious if someone can enlighten me.
Currently on zithromax, cefdinir, probenicid, Plaquenil, and nystatin.
Thanks!
Posts: 55 | From NY | Registered: Apr 2010
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TerryK
Frequent Contributor (5K+ posts)
Member # 8552
posted
Antigenic variability. Borrelia changes it's surface proteins to survive the immune response.
posted
The western blot results vary all the time..it is a combination of the Borrelia antigens as well as your immune response.
I have gone from two IGG bands to 6 bands IGG and IGM in a few months.
It is my understanding that the IGG bands are more indicative of a chronic or past infection (you might always have some...i think); and the IGM are more indicative an immune systme reactivation or recent infection. Somebody please correct me if I am mistaken...
Posts: 172 | From ohio | Registered: Feb 2010
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TerryK
Frequent Contributor (5K+ posts)
Member # 8552
posted
Hi dali!
I do not believe that the same rules apply to lyme regarding IgG and IgM that apply to other infections.
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.
Posts: 6286 | From Oregon | Registered: Jan 2006
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