CD 57 NK Cells

[Guest guest]

is letting me post this. It not only gives info., it tells how

to find and use the labs for it. The last time I tried to get this

count done on a family member, the doctor's office messed up the

whole thing, saying they could not find the code, could not find a

lab to do it, etc. Thus, keep the lab info. handy that is mentioned

in this report.

Love and prayers,

Heidi N

You can post it.

Rosner

BioMed Publishing Group

Phone:

Fax:

theskyking@...

http://www.biomedpublishers.com

Mailing Address:

BioMed Publishing Group

1157 Early Dawn Trail

South Lake Tahoe, CA 96150

Don't miss Rosner's new video blog!

http://www.lymevideoblog.com

In a message dated 12/7/2008 6:55:39 A.M. Pacific Standard Time,

Ambitionn01 writes:

:

Can you post this on our BorreliaMultipleInfectionsAndAutism forum or

just give me permission to post it there?

Thanks,

Heidi N

To: Lyme-and-rife@...: TheSkyKing@...: Sat, 6

Dec 2008 01:05:58 +0000Subject: OT:Re: [Lyme-and-rife] CD-57

EVERYTHING YOU ALWAYS WANTED TO KNOW ABOUT THE CD57 TEST By: GINGER

SAVELY, RN, FNP-CFrom coast to coast, frustrations abound among

patients and clinicians regarding the diagnosis of chronic Lyme

disease. Misinformed health care providers in Texas and surrounding

states consider the infection rare and non-endemic. They are inclined

to rule out Lyme disease based on the negative result of a laboratory

test that, unbeknownst to them, is highly insensitive. In the absence

of a reliable laboratory test or adequate experience in the

recognition of the varied and complex presentations of the illness,

most clinicians are ill-equipped to diagnose chronic Lyme disease.

Many patients suffer needlessly for years, hopelessly lost in the

maze of the health care system, looking for answers and enduring the

skepticism of practitioners inexperienced with the disease's signs

and symptoms.What is needed is a better Lyme test or some other

objective measure to persuade the practitioner to consider the

diagnosis of chronic Lyme disease. Enter the CD57 test! You may have

heard the term " CD57 " tossed around on chat groups, or your Lyme-

literate health care provider may have even explained the test to you

in one of your moments of brain-fogged stupor. What is this number

that sounds more like a type of Heinz steak sauce than a lab test,

and what in the world does it have to do with Lyme disease? Let's

start by going back to basic high school biology. You may remember

that white blood cells (a.k.a. leukocytes) are the components of

blood that help the body fight infections and other diseases. White

blood cells can be categorized as either granulocytes or mononuclear

leukocytes. Mononuclear leukocytes are further sub-grouped into

monocytes and lymphocytes.Lymphocytes, found in the blood, tissues

and lymphoid organs, attack antigens (foreign proteins) in different

ways. The main lymphocyte sub-types are B-cells, T-cells and natural

killer (NK) cells. B-cells make antibodies that are stimulated by

infection or vaccination. T-cells and NK cells, on the other hand,

are the cellular aggressors in the immune system and are our main

focus in the discussion that follows. Let's pause a moment and

introduce something you probably never learned about in high school

biology class: CD markers. CD, which stands for " cluster

designation " , is a glycoprotein molecule on the cell surface that

acts as an identifying marker. Think of comparing cells as comparing

people. Humans are made up of innumerable superficial identifying

characteristics (such as hair color, eye color, etc.) and so are

cells. Cells probably have thousands of different identifying

markers, or CDs, expressed on their surfaces, but 200 or so have been

recognized and named so far.Each different marker (or CD) on a cell

is named with a number, which signifies nothing more than the order

in which the CD was discovered. On any given cell there are many

different cluster designation markers (CDs), giving each cell its

unique appearance and function but also linking certain cells by

their similarities (like grouping all people with brown hair or all

people with blue eyes). Cells that have a certain kind of CD present

on their surface are denoted as + for that CD type (e.g., a cell with

CD57 markers on its surface is CD57+).NK cells have their own

specific surface markers. The predominant marker is CD56. The

percentage of CD56+ NK cells is often measured in patients with

chronic diseases as a marker of immune status: the lower the CD56

level, the weaker the immune system. You may have heard Chronic

Fatigue Syndrome patients talk about their CD56 counts. A smaller

population of NK cells are CD57+. A below-normal count has been

associated with chronic Lyme disease by the work of Drs. Raphael

Stricker and Winger. No one knows for sure why CD57+ NK cells

are low in Lyme disease patients, but it is important to note that

many disease states that are often confused with chronic Lyme (MS,

systemic lupus, rheumatoid arthritis) are not associated with low

CD57+ NK counts. The good news is that for most Lyme patients the

CD57+ NK level increases as treatment progresses and health is

regained.CD57 markers can also be expressed on other kinds of cells,

including T-cells, so it is important to distinguish between CD57+ T-

cells and CD57+ NK cells. Clinicians need to be aware that many

testing laboratories claiming to perform the CD57 test are actually

looking at CD57+ T-cells rather than CD57+ NK cells, which are the

cells of interest in chronic Lyme disease.In order for a testing

laboratory to measure the CD57+ NK level, it first measures the

percentage of lymphocytes that are CD57+ NK cells. Then an absolute

count is calculated by multiplying that percentage by the patient's

total lymphocyte count. The standard normal range for the absolute

CD57 NK count is 60 to 360 cells per microliter of blood. This wide

range was established based upon test results of hundreds of healthy

patients. By these laboratory standards, a test result below 60 cells

per microliter would be considered below normal and therefore

associated with chronic Lyme disease. However, a recent study of my

Austin patients has led me to believe that 100 cells per microliter

is a more reliable threshold separating Lyme patients and healthy

controls. When Drs Stricker and Winger discovered that CD57+ NK cells

are low in chronic Lyme patients and tend to increase with patients'

clinical improvement, an opportunity arose for Lyme-literate

practitioners to utilize a handy tool to aid in the diagnosis of

chronic Lyme disease, to follow treatment progress, and to determine

treatment endpoint. Just as AIDS patients have always held great

store in their CD4 T-cell count, Lyme patients now have a fairly

reliable marker of the status of their illness.It is important to

remember that the CD57 result is just a number; far more important is

the patient's clinical status. An old professor of mine used to

say, " treat the patient, not the lab test! " There is still much we do

not know about the CD57 marker and what other factors may lower or

raise it. However, overall, the CD57+ NK count is a useful tool in

diagnosing and treating chronic Lyme disease in most patients. As a

measure of immune status, it provides an indirect measure of

bacterial load and severity of illness. Furthermore, in a patient who

has a negative or indeterminate Lyme test but is highly suspect for

the disease, the clinician may utilize the CD57+ NK count as one more

piece in the complex puzzle of a Lyme disease diagnosis. Postscript:

If you would like your health care provider to order the CD57 NK test

for you, your blood sample needs to be drawn into an EDTA tube

(lavender top) on Monday through Thursday and sent immediately to

either LabCorp in Burlington, NC, or Clinical Pathology Laboratories

(CPL) in Austin, TX. LabCorp and CPL are the only two labs that

perform this test properly. Quest does NOT. The LabCorp test code is

#505026 and is named HNK1 (CD57) Panel. The CPL test code is #4886,

CD57 for Lyme disease. The test is time-sensitive and must be

performed within 12 hours of collection, so blood should not be drawn

on a Friday or results may be inaccurate.