Igenex, lyme/TBD testing, different interpretations...

[Paul M]

Well they started me on Biaxin and Plaquenil, so that may be the antibiotic you are thinking of (Biaxin) - well hopefully haha

 

[LaurieL]

http://flash.lymenet.org/ubb/ultimatebb.php?ubb=get_topic;f=1;t=042077#000000

This is one of the best explanations of the bands, although I realize that I am a bit late in posting this.

 

[globalpilot]

Anyone have any thoughts on the meaning of my results?

IgM : positive for 34,39,41
IgG: all negative

 

[Ema]

Anyone have any thoughts on the meaning of my results?

IgM : positive for 34,39,41
IgG: all negative

I think Lyme is highly likely but the diagnosis should be made by an LLMD who can evaluate your symptoms along with the testing.

Here is an excerpt from a blog post by LymeMD that explains IgM positive without IgG antibodies:

Why IgM? There are no studies which acknowledge this anomaly, let alone have studied it. I can postulate. IgM and IgG antibodies are produced by the same cells: B lymphocytes. These lymphocytes may become plasma cells. The switching from IgM to IgG antibodies occurs by amolecular switching. This class switching--IgM to IgG-- frequently fails to occur. Is it because Borrelia hide from the immune system--change the reactive antigens? I don't know. Normally af IgG antibodies are used as a metric for immunity from a particular germ. Memory cells persist. These memory cells produce IgG antibodies which block re-infection. Perhaps memory cells are not produced in chronic infection with Borrelia burgdorferi infection. The question remain unanswered.

What do we know: Lyme is associated with more IgM than IgG antibodies. Certain antibodies, for example: 18, 23, 31, 34, 39 41?, 93 are HIGHLY specific for exposure to Lyme bacteria.

http://lymemd.blogspot.com/2009/12/igm-question-is-it-chronic-lyme-disease.html

Ema

 

[LaurieL]

I would say you need to make an appointment with a Lyme literate doc. More on your bands...

The CDC recommendations do not include the 31 and 34 Kda bands of the blot test. These two bands correspond to outer surface proteins A and B respectively (ospA and ospB).

In the world of borreliosis, these are two of the classic hallmark Lyme antibodies. But the CDC does not even have them in their recommendations.

There is a reason why the 31 and 34 bands are not included in the CDC's criteria, and that stems back to the Lyme vaccine.

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.

Again, my opinion, but I think Borrelia prevent the class switching, and lets not forget the different forms of the bacteria as well. The pleomorphism, again, IMO, in its different forms, could very well lead to more IgM. The lack of IgG, again IMO, is most likely due to the disruption of the Th1 and Th2 dependent reactions and then resulting in effects on the class switching of the B cells. This makes me think of Lyme in the T and/or B cells, disrupting differentiation, and preventing apoptosis. Resulting in continual immune dysfunction and lack of memory cells.

Laurie

 

[LaurieL]

Ahhh....here is something from lymeneteurope.

Another interesting observation about this bacteria is how it interacts with our body's immune system; Dr. David Dorward of Rocky Mountain Labs made a video tape of how Borrelia burgdorferi acts when surrounded by B-cells. (The type of white blood cell that makes antibody.) The spirochete attached tip first, entered the B lymphocyte, multiplied and ruptured the cell. It repeated this process for three days until the B-cells were able to come to an equilibrium. A matter of concern was that some of the spirochetes were able to strip away part of the B-cell's membrane, and wear it like a cloak. (Dorward, Hulinska 1994 LDF Conference Vancouver BC)

So, with this happening, its easier to remember why there is more IgM positive blots, versus IgG blots.

 

[roxie60]

This band is an outer surface protein and can cross react with viruses such as EBV. Igenex offers a test that can separate out whether or not this is a cross reaction or not. It is called the 31 kda epitope test.

FYI, as of 10/15/13 each additional epitope test costs $100.00.