"New"/better testing? hopefully!

Discussion in 'Lyme Disease Archives' started by victoria, Dec 4, 2009.

  1. victoria

    victoria New Member

    2-Tiered Antibody Testing for Early and Late Lyme Disease Using Only an Immunoglobulin G Blot with the Addition of a VlsE Band as the Second-Tier Test John A. Branda, Maria E. Aguero-Rosenfeld, Mary Jane Ferraro, Barbara J. B. Johnson, Gary P. Wormser, and Allen C. Steere Clinical Infectious Diseases, electronically published 30 November 2009. http://dx.doi.org/10.1086/648674

    MAJOR ARTICLE

    • Background Standard 2-tiered immunoglobulin G (IgG) testing has performed well in late Lyme disease (LD), but IgM testing early in the illness has been problematic. IgG VlsE antibody testing, by itself, improves early sensitivity, but may lower specificity. We studied whether elements of the 2 approaches could be combined to produce a second-tier IgG blot that performs well throughout the infection.

    • Methods Separate serum sets from LD patients and control subjects were tested independently at 2 medical centers using whole-cell enzyme immunoassays and IgM and IgG immunoblots, with recombinant VlsE added to the IgG blots. The results from both centers were combined, and a new second-tier IgG algorithm was developed.

    • Results With standard 2-tiered IgM and IgG testing, 31% of patients with active erythema migrans (stage 1), 63% of those with acute neuroborreliosis or carditis (stage 2), and 100% of those with arthritis or late neurologic involvement (stage 3) had positive results. Using new IgG criteria, in which only the VlsE band was scored as a second-tier test among patients with early LD (stage 1 or 2) and 5 of 11 IgG bands were required in those with stage 3 LD, 34% of patients with stage 1, 96% of those with stage 2, and 100% of those with stage 3 infection had positive responses. Both new and standard testing achieved 100% specificity.

    • Conclusions Compared with standard IgM and IgG testing, the new IgG algorithm (with VlsE band) eliminates the need for IgM testing; it provides comparable or better sensitivity, and it maintains high specificity.

    http://dx.doi.org/10.1086/648674

  2. victoria

    victoria New Member

    maybe not. It was pointed out that 2 of the authors are Wormser & Steere.

  3. victoria

    victoria New Member

    a good explanation of testing is at:

    http://www.canlyme.com/labtests.html
  4. munch1958

    munch1958 Member

    at it's best!

    I wish the IDSA would release something ALREADY! Maybe it's a good sign that they are taking so long. Can it be they are actually reviewing the evidence?

    I do know that PJ Langhoff mailed the entire panel 10 copies of her newest book and this terrific letter which can be found here:

    http://www.chicagolyme.com/idsa-guidelines-review-panel-info.html
  5. fight4acure

    fight4acure Member

    We need something! I'm getting tired of waiting for tests and cures.

    Hugs
    Fight!