Revised Elispot (Lymespot Revised)

[msf]

I just had a look at the Infectolab website and found this: http://www.infectolab.de/wp-content/uploads/2015/05/LymeSpot_PDF_english_print.pdf

I noticed that Armin Swarzebach does not offer this test - is this what his and Infectolab's difference of opinion was about?

It has only been available for a month or so, so I doubt anyone on here has had it done yet, but it will be interesting to see whether doctors start using this instead of the Elispot.

 

[msf]

And here's a fun video about it:

 

[msf]

Oh, and the website mentions links to this paper in which the same method was used in Q fever: http://www.infectolab.de/wp-content/uploads/2015/04/Chronic_Q-Fever_2_colours.pdf

 

[msf]

I've mentioned it before, but I just love the way the CDC has no problem at all with 18 months of Doxycycline for Q fever, but suggests no more than 1 month for Lyme.

 

[msf]

This bit in the discussion section of the Q fever paper seems to be relevant to the use of this method in other infections too:

Moreover, the method we used, in vitro measurement of IFN-γ and IL-2 production, does not clearly differentiate whether these cytokines are produced by effector T-cells (producing only IFN-γ) or effector memory T-cells (producing IFN-γ and IL-2) or central memory T-cells (producing predominantly IL-2). The ratio IFN- γ/IL-2 merely reflects the overall result and might be influenced by the total number of circulating T-cells and their viability in vitro. To increase our insight in the matter, detection of cytokine production on single-cell level, e.g., by flow cytometry with intracellular cytokine staining (Harari et al., 2005), would be a valuable addition in future research.

http://www.infectolab.de/wp-content/uploads/2015/04/Chronic_Q-Fever_2_colours.pdf

 

[msf]

Also this:

.Our study shows a promising role for the IFN-γ/IL-2 production profile, although the large variation in IFN-γ/IL-2 ratio between patients in this study makes it difficult to formulate general recommendations for the application of these biomarkers at the current time

http://www.infectolab.de/wp-content/uploads/2015/04/Chronic_Q-Fever_2_colours.pdf

 

[msf]

And finally this:

The patient that still showed signs of infection after more than 2 years of antibiotic treatment (patient 3), had markedly high IL-2 secretion and a low IFN-γ/IL-2 ratio from the start, which fluctuated in the follow-up but did not decrease. This might suggest bacterial persistence with low antigen concentrations; an assumption that is supported by the notion that C. burnetii DNA was not detectable in blood, even before start of antimicrobial therapy. The results of the total group of patients with unsuccessful treatment show the same pattern: overall lower IFN-γ/IL-2 ratio from the start of follow-up in this study, with no C. burnetii DNA detectable in blood.

http://www.infectolab.de/wp-content/uploads/2015/04/Chronic_Q-Fever_2_colours.pdf


From what I can make out, this patient seems to have been positive by PCR in tissue, although this was possibly at the start of his treatment.