Reading the study I find it pretty much about ME as well as lyme. There's no proof that the patients in the study were suffering from a active borrelia infection. Rather, it seems to me that the lyme (after the acute infection is gone) kick starts ME symptoms, just like giardiasis and mononucleosis can do. The patients get better with treatment, and they didn't have to have a positive lyme test to begin with. I think it's immune modulation via some pathway (e.g. via effects on the endothelium or the gut flora) which brings about the symptom alleviation when given the biaxin/plaquenil. A clue as for what's causing the symptom improvement, is that most patients relapse when they are off the antibiotics... RA patients also often times get better from plaquenil.