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New doctor wants to treat empirically for Lyme, good idea?

kungfudao

Senior Member
Messages
137
Location
Los Angeles
If you're talking about the paper which looked at IgeneX testing, I had said that I'd only cited that paper as it was the only blinded assessment of alternative testing available.

So you showed your sample of research of Alternative testing and I have shown my sample of research on mainstream testing. Well it would appear that your going after the wrong people,
This is the one I posted: It highlights the massive inadequacies of two tear (mainstream testing)
https://www.lymedisease.org/lymepolicywonk-new-study-shows-lyme-persists-in-monkeys/
 
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Esther12

Senior Member
Messages
13,774
So you showed your sample of research of Alternative testing and I have shown my sample of research on mainstream testing. Well it would appear that your going after the wrong people,
This is the one I posted: It highlights the massive inadequacies of two tear (mainstream testing)
https://www.lymedisease.org/lymepolicywonk-new-study-shows-lyme-persists-in-monkeys/

The paper I posted is the only blinded assessment of alternative testing, and there is no other good evidence that it is of any value. The paper you posted assessed lyme testing under unusual circumstance and on monkeys and found that it was unable to detect infection. There are other papers which provide good evidence that mainstream testing is of some value to patients. The monkey paper is of some interest for discussion around PTLD (or whatever you want to call it), but does nothing to challenge any of the points I have been making about mainstream and alternative testing.
 
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GcMAF Australia

Senior Member
Messages
1,027
from
http://www.bayarealyme.org/our-research/diagnostics/

Current methods used to detect Lyme disease aren’t good enough. That’s why we’re working to find better tests that can be used to catch the disease in its various stages and ultimately enable better outcomes.

Lyme Disease is Difficult to Diagnose
Ticks and tick bites are tiny and often go unnoticed. Most people never know they were bitten. The distinctive bullseye skin rash is an atypical presentation (many patients never have any rash) and other symptoms like fatigue, joint pain, and fever, mimic many other illnesses.

Indirect diagnostics
The widely used diagnostic testing regime for Lyme disease is the two-tier serological ELISA/Western Blot process, which indirectly detects Lyme disease by measuring the presence of antibodies that form against the pathogen. Because it can take 2-4 weeks for the body to generate antibodies, these tests have been shown to miss up to 60% of acute Lyme cases. They also do not detect other related Borrelia species (e.g., the Lyme-like Borrelia miyamotoi), have high inter-and intra-laboratory variability, and cannot be used to assess treatment response following antibiotics.

Direct testing
Unfortunately, direct detection of the infection has proven challenging due to low bacterial counts that disperse quickly throughout the human body and the insufficient sensitivity of current detection methods. Newer, more accurate detection approaches are being developed, but many of these tests have not yet been through formal controlled clinical trials.

The Problems with the Current Two-Tier Test*

  • Misses up to 60% of acute cases (Rosenfeld , Wang, Schwartz, Wormser, 2005)
  • Can not differentiate between active infection and previous exposure
  • Does not detect other Borrelia species including B. miyamotoi, which causes Lyme-like symptoms
  • Requires subjective interpretation of results, leading to significant variability across and even within laboratories
*Two-tiered ELISA / Western Blot blood test.
 

GcMAF Australia

Senior Member
Messages
1,027
Stanford University Report, August 19, 2015
http://news.stanford.edu/news/2015/august/ticks-lyme-risk-081815.html

The San Francisco Bay Area's broad swaths of trail-lined open space hold higher risks of tick-borne disease than previously thought, according to a new study by Stanford researchers.
Stanford researchers find surprising level of tick-borne disease risk on local trails

The assay utilizes primer pairs that can detect any member of the Borrelia genus and then combines species-specific hybridization probes to distinguish between Lyme group and TBRF group samples.

There were up to 10-30% of ticks testing positive for Borrelia
 

GcMAF Australia

Senior Member
Messages
1,027
http://www.dnalymetest.com/lymediseasediagnostics.html


Lyme Disease Diagnostics

Diagnostics Concerning the Identification of Tick-borne Diseases

Diseases caused by tick-borne pathogens in the United States include Lyme disease (more precisely Borrelia burgdorferi infection) and Lyme disease-like borrelioses ( such as Borrelia miyamotoi infection, Southern Tick-Associated Rash Illness and Borrelia hermsii infection), Babesiosis, Ehrlichiosis, Anaplasmosis, Rocky Mountain Spotted Fever, Tularemia, Colorado tick fever, Powassan encephalitis and Q fever. Some of these diseases, for example Babesiosis, Ehrlichiosis and Anaplasmosis, can be easily diagnosed by microscopic examination of a Wright-stained blood smear of the patient. A firm diagnosis of the others, especially for Lyme disease and Lyme disease-like borrelioses, the most common tick-borne disease group, may be difficult due to a lack of reliable laboratory tests.


The most effective means to control Lyme disease and Lyme disease-like borrelioses is the practice of personal protective measures against tick exposure. People living in or visiting a disease-endemic area are generally aware of the danger of tick bites. However, many individuals still contract Lyme disease or Lyme disease-like borrelioses in spite of taking all the personal protective measures.


Heightened awareness about tick-borne diseases by health care providers and the public has been achieved largely through intensified public health and Lyme disease specific educational programs, particularly in states with high rates of incidences. However, more often than not, the diagnosis of “Lyme disease," typical or atypical, rightly or wrongly, is patient-initiated. The medical practitioners in the health care front line know that if diagnosed early and reliably, the treatment with a proper course of antibiotics can “cure” the infection and effectively eliminate the “chronic phase” of the disease and avoid tissue damages.


However, the physicians have never had a reliable laboratory test for a conclusive diagnosis. This has left physicians unable to prescribe the proper treatment for the “cure” for many Lyme patients at the earliest, most advantageous time. This problem has become more complicated because it is now evident that there are Lyme disease-like borrelioses which do not have a set of typical diagnostic clinical manifestations and are antibody-negative when the patients are tested by the two-tier serology assays, the tests currently in use.


In the past 5 years, Dr. Sin Hang Lee and his associates have developed a nested PCR/DNA sequencing-based test for the infectious agents of Lyme disease and Lyme disease-like borrelioses, based on the technology published in 2010. The test offers a highly sensitive and reliable molecular diagnosis independent of clinical manifestations and serology test results. Before performing PCR amplification, the borrelial bacteria are concentrated by differential centrifugation from the blood and body fluids for DNA extraction to further increase the sensitivity of the detection method.
 

GcMAF Australia

Senior Member
Messages
1,027
http://www.dnalymetest.com/lymediseasediagnostics.html
Lyme Disease DNA Testing


Milford Molecular Diagnostics is the first, and at present, the only licensed clinical laboratory in the United States to offer a combined DNA Sequencing-based diagnostic test for Borrelia burgdorferi, the infectious agent for Lyme disease and Borrelia miyamotoi, the infectious agent of a similar Lyme disease-like illness found recently in the United States.


Milford Molecular Diagnostics can produce a diagnosis within five days of a sample's receipt, ensuring the fastest, most conclusive test for Lyme disease available anywhere. The diagnosis fee is $150.00 per sample.

All tested samples are issued an official laboratory report as well as an accompanying DNA sequencing electropherogram and GenBank BLAST alignment analysis if the result is positive.
637_B.burgdorferi_website_.jpg
 

GcMAF Australia

Senior Member
Messages
1,027
Here attached is the latest paper on Lyme tests
It shows how difficult it is.
also the tests are continuously being updated and/or replaced.
They dont even bother using the US tests. The rest of the world has moved on.
 

Attachments

  • Ang et al 2015 Diagnostic Microbiology and Infectious Diseases Borrelia antibody evaluation.pdf
    138.4 KB · Views: 35

voner

Senior Member
Messages
592
Here attached is the latest paper on Lyme tests
It shows how difficult it is.
also the tests are continuously being updated and/or replaced.
They dont even bother using the US tests. The rest of the world has moved on.

thanks for posting that paper. here is a quote from the conclusion..

The specificity of the assays varies considerably. This problem is most prominent in patients with potential aspecific or cross-reacting anti-bodies. This phenomenon may also be of importance in patients in whom chronic Lyme disease is suspected. In this patient group, sero-logical diagnosis is very troublesome and not well studied because of the difficult definition of this patient group. The large number of available and used tests with different test characteristics hampers interpretation of results from serological testing for anti–B. burgdorferi antibody testing.
 

Esther12

Senior Member
Messages
13,774
Here attached is the latest paper on Lyme tests
It shows how difficult it is.
also the tests are continuously being updated and/or replaced.
They dont even bother using the US tests. The rest of the world has moved on.

I didn't see them say that mainstream US testing is something that they've moved on from. It could just be that they used the tests from their area.

It looks like they support what I was saying about a lot of the difficulties with testing relating to those recently infected:

For manifestations of B. burgdorferi infection with short disease duration, the positivity
rate of the assays varied significantly. In patients with long disease duration, the positivity rate differed only
marginally.
 

voner

Senior Member
Messages
592
thanks for posting that paper. here is a quote from the conclusion..

The specificity of the assays varies considerably. This problem is most prominent in patients with potential aspecific or cross-reacting anti-bodies. This phenomenon may also be of importance in patients in whom chronic Lyme disease is suspected. In this patient group, sero-logical diagnosis is very troublesome and not well studied because of the difficult definition of this patient group. The large number of available and used tests with different test characteristics hampers interpretation of results from serological testing for anti–B. burgdorferi antibody testing.

@Jonathan Edwards, do you have any comments on this?
 
Messages
20
https://m.medicalxpress.com/news/2019-04-three-antibiotic-cocktail-persister-lyme-bacteria.html

the scientists isolated slow-growth forms of the Lyme bacterium, Borrelia burgdorferi. They found that, compared to normal fast-growth forms, the slow-growing forms caused more severe arthritis-like symptoms and resisted standard antibiotic treatment in test tube as well as in a mouse model. The scientists found that a combination of three antibiotics—daptomycin, doxycycline and ceftriaxone—cleared the Lyme infection in the study mice. The scientists now hope to test the combination in people with persistent Lyme disease.