chronic Lyme cannot be excluded by absence of antibodies against Bb

[Guest guest]

Anyone know of further immunology or politics related to this

ancient document?

" We conclude that the presence of chronic Lyme disease cannot be

excluded by the absence of antibodies against B. burgdorferi and

that a specific T-cell blastogenic response to B. burgdorferi is

evidence of infection in seronegative patients with clinical

indications of chronic Lyme disease. "

======================================================

N Engl J Med. 1988 Dec 1;319(22):1441-6. Related Articles, Links

Comment in:

N Engl J Med. 1989 May 11;320(19):1279-80.

Seronegative Lyme disease. Dissociation of specific T- and B-

lymphocyte responses to Borrelia burgdorferi.

Dattwyler RJ, Volkman DJ, Luft BJ, Halperin JJ, J, Golightly

MG.

Department of Medicine, State University of New York, School of

Medicine, Stony Brook 11794-8161.

The diagnosis of Lyme disease often depends on the measurement of

serum antibodies to Borrelia burgdorferi, the spirochete that causes

this disorder. Although prompt treatment with antibiotics may

abrogate the antibody response to the infection, symptoms persist in

some patients. We studied 17 patients who had presented with acute

Lyme disease and received prompt treatment with oral antibiotics,

but in whom chronic Lyme disease subsequently developed. Although

these patients had clinically active disease, none had diagnostic

levels of antibodies to B. burgdorferi on either a standard enzyme-

linked immunosorbent assay or immunofluorescence assay. On Western

blot analysis, the level of immunoglobulin reactivity against B.

burgdorferi in serum from these patients was no greater than that in

serum from normal controls. The patients had a vigorous T-cell

proliferative response to whole B. burgdorferi, with a mean ( +/-

SEM) stimulation index of 17.8 +/- 3.3, similar to that (15.8 +/-

3.2) in 18 patients with chronic Lyme disease who had detectable

antibodies. The T-cell response of both groups was greater than that

of a control group of healthy subjects (3.1 +/- 0.5; P less than

0.001). We conclude that the presence of chronic Lyme disease cannot

be excluded by the absence of antibodies against B. burgdorferi and

that a specific T-cell blastogenic response to B. burgdorferi is

evidence of infection in seronegative patients with clinical

indications of chronic Lyme disease.

PMID: 3054554 [PubMed - indexed for MEDLINE]

[Guest guest]

Wow, even Steere says, in 1991:

" CONCLUSION: The T-cell proliferative assay may be a helpful

diagnostic test in the small subset of patients with late Lyme disease

who have negative or indeterminant antibody responses by ELISA. "

[Guest guest]

In patients with Lyme borreliosis, including seronegative patients,

there was a strikingly elevated [T cell] proliferation in response to

whole B burgdorferi bacteria (mean 64,750 dpm) compared with that of

normal donors (mean 19,700 dpm; P less than 0.0001) and especially

that of non-Lyme arthritis patients (mean 11,600 dpm; P less than

0.0001). Levels of proliferation declined significantly in patients

with Lyme borreliosis after successful antibiotic treatment.

[******] There was no correlation between disease stages and

proliferation values.

PMID: 2012626