Re: Test Results confusing????

[Guest guest]

Hello All,

Just wondering if anyone can clarify the results of my wifes latest bout of

medical tests.

We live in Buffalo, NY and went to NYC to have a brain spect, LB puncture and

western blot. The following is what the labs and and Colombia hospital

relayed to us (couldn't wait for the Doc)

Brain Spect shows moderate hypoperfusion, but the hospital wouldn't say where.

The Spinal Tap yielded zilch

The Western Blot was as follows...Igm reactive on bands 41, 18, 35, 93, 31

and 34.

My wife has been to literally 20plus docs, and in Buffalo they really don't

know anything about lyme. Hopefully the doc in NYC has answers and treatment

to help with the memory loss, muscle/joint pain, burning feet and shins etc.

Just looking for some for some solice and a sympathetic ear.

Darren

[Guest guest]

" The Western Blot was as follows...Igm reactive on bands 41, 18, 35, 93, 31

and 34. "

Band 18 - Unknown

Band 41 - Flagllin protein of all spirochetes, one of the first to appear;

Bb specific

Band 35 - Specific Bb

Band 93 - Unknown, but probably the same as 83, just measured incorrectly

(83-specific for Lyme bacterium, probably a

cytoplamic membrane

Band 31 - OspA - Specific for Bb

I printed a list of the band interpretations from this list on Friday,

December 1. Not a doc...just passing along info.

Tamara Bolthouse

[Guest guest]

The data looks " Not inconsistent with " Lyme Disease. It is after all a

" clinical " diagnosis, meaning that a

savvy physician should put together the story with supportive lab evidence.

Hypoperfusion on a SPECT scan

is consistent with Lyme but can appear in other diseases as well. The Western

Blot data will not meet the

CDC's criteria, however the bands that are present are very supportive of the

diagnosis. 31kD is outer

surface protein A, 34kD is outer surface protein B, and 41kD is the flagellar

protein. The other bands are

also Bb proteins. If your wife has not received the Lyme vaccine, there would be

no reason for ospA or B to

be present. Labs can also tell if these are vaccine proteins, but you may need

to ask them to do it. The

real key here is to be with a physician who will stick with you regardless of

the diagnosis, and see you

through whatever it is you have.

Good luck to you.

B

[Guest guest]

Your wife's Western Blot is positive for Lyme disease by anyone's standards. Particularly bands 31 and 34, along with other highly probable Lyme bands, and some cross-reactive bands. Although this is enough evidence for almost any MD to treat Lyme, a person with neurologic Lyme is best treated by a specialist recognized by the Lyme patient community. Advanced Lyme needs to be treated longer and at higher doses than the average MD would be educated about. There are some " anti-Lyme " doctors who would not treat, saying that the WB reflects a past infection. However, If you've still got the symptoms, you still have the disease - assuming lupus,syphilis,MS, B12 deficiency, and thyroid problems have been ruled out. And she could have more than one of these conditions. MS is often confused with Lyme. But it sounds like it is Lyme, and you're on the right track. Could you identify the doctor using only the initial of his/hers last name?

[Guest guest]

OspA will show up in some Lymies even without being vaccinated. That is the

reason the Western Blot looks for OspA in the band 31kD. I know many Lymies

with this positive band, even before the vaccine was approved and used in

the public. MOST of the time, but certainly not ALL of the time, the

spirochete will start expressing OspC when in a human host instead of the

OspA which is more predominant in the tick gut.

This has to do with mice not humans, so who knows what really happens in us?

All emphases are mine. - Robynn

Temporal Changes in Outer Surface Proteins A and C of the Lyme

Disease-Associated Spirochete, Borrelia burgdorferi, during the Chain of

Infection in Ticks and Mice.

J Clin Microbiol 2000 Jan;38(1):382-388

Schwan TG, Piesman J

Laboratory of Human Bacterial Pathogenesis, Rocky Mountain Laboratories,

National Institute of Allergy and Infectious Diseases, National Institutes

of Health, Hamilton, Montana 59840.

The Lyme disease-associated spirochete, Borrelia burgdorferi, is maintained

in enzootic cycles involving Ixodes ticks and small mammals. Previous

studies demonstrated that B. burgdorferi expresses outer surface protein A

(OspA) but not OspC when residing in the midgut of unfed ticks. However,

after ticks feed on blood, SOME spirochetes stop making OspA and express

OspC. Our current work examined the timing and frequency of OspA and OspC

expression by B. burgdorferi in infected Ixodes scapularis nymphs as they

fed on uninfected mice and in uninfected I. scapularis larvae and nymphs as

they first acquired spirochetes from infected mice. Smears of midguts from

previously infected ticks were prepared at 12- or 24-h intervals following

attachment through repletion at 96 h, and spirochetes were stained for

immunofluorescence for detection of antibodies to OspA and OspC. As shown

previously, prior to feeding spirochetes in nymphs expressed OspA but not

OspC. During nymphal feeding, however, the proportion of spirochetes

expressing OspA DECREASED, while spirochetes expressing OspC became

detectable. In fact, spirochetes rapidly began to express OspC, with the

greatest proportion of spirochetes having this protein at 48 h of attachment

and then with the proportion decreasing significantly by the time that the

ticks had completed feeding. In vitro cultivation of the spirochete at

different temperatures showed OspC to be most abundant when the spirochetes

were grown at 37 degrees C. Yet, the synthesis of this protein waned with

continuous passage at this temperature. Immunofluorescence staining of

spirochetes in smears of midguts from larvae and nymphs still attached or

having completed feeding on infected mice

demonstrated that OspA but not OspC was produced by these spirochetes

recently acquired FROM mice. Therefore, the temporal synthesis of OspC by

spirochetes only in feeding ticks that were infected prior to the blood meal

suggests that this surface protein is involved in transmission from tick to

mammal but not from mammal to tick.

Re: [ ] Test Results confusing????

The data looks " Not inconsistent with " Lyme Disease. It is after all a

" clinical " diagnosis, meaning that a

savvy physician should put together the story with supportive lab evidence.

Hypoperfusion on a SPECT scan

is consistent with Lyme but can appear in other diseases as well. The

Western Blot data will not meet the

CDC's criteria, however the bands that are present are very supportive of

the diagnosis. 31kD is outer

surface protein A, 34kD is outer surface protein B, and 41kD is the

flagellar protein. The other bands are

also Bb proteins. If your wife has not received the Lyme vaccine, there

would be no reason for ospA or B to

be present. Labs can also tell if these are vaccine proteins, but you may

need to ask them to do it. The

real key here is to be with a physician who will stick with you regardless

of the diagnosis, and see you

through whatever it is you have.

Good luck to you.

B

[Guest guest]

Sorry, What I meant was, in the absence of prior vaccination against Bb, there

is no reason for the

proteins (OspA, OspB) to be present BESIDES Lyme Disease itself. I was just

anticipating the only important

other reason to see Osp A and/or B. Since they have been left out of the ASTPHLD

criteria, it is common for

physicians to be unaware of their importance, and in the absence of vaccination

against Bb, their presence

in the blot is VERY supportive of Lyme as a diagnosis. I know many want to say

that with those bands

present there is no doubt that this person has Lyme. But I caution : the tests

do not make the diagnosis.

It is the total picture, which must be carefully evaluated. Neither does the

lack of laboratory

confirmation prove that the disease is not there. Overreliance on the tests does

not necessarily further

the cause of physician and patient education.

Thanks for clarifying my goof for me.

Bea

and/or Robynn wrote:

> OspA will show up in some Lymies even without being vaccinated. That is the

> reason the Western Blot looks for OspA in the band 31kD. I know many Lymies

> with this positive band, even before the vaccine was approved and used in

> the public. MOST of the time, but certainly not ALL of the time, the

> spirochete will start expressing OspC when in a human host instead of the

> OspA which is more predominant in the tick gut.

>

> This has to do with mice not humans, so who knows what really happens in us?

>

> All emphases are mine. - Robynn

>

> Temporal Changes in Outer Surface Proteins A and C of the Lyme

> Disease-Associated Spirochete, Borrelia burgdorferi, during the Chain of

> Infection in Ticks and Mice.

> J Clin Microbiol 2000 Jan;38(1):382-388

>

> Schwan TG, Piesman J

> Laboratory of Human Bacterial Pathogenesis, Rocky Mountain Laboratories,

> National Institute of Allergy and Infectious Diseases, National Institutes

> of Health, Hamilton, Montana 59840.

>

> The Lyme disease-associated spirochete, Borrelia burgdorferi, is maintained

> in enzootic cycles involving Ixodes ticks and small mammals. Previous

> studies demonstrated that B. burgdorferi expresses outer surface protein A

> (OspA) but not OspC when residing in the midgut of unfed ticks. However,

> after ticks feed on blood, SOME spirochetes stop making OspA and express

> OspC. Our current work examined the timing and frequency of OspA and OspC

> expression by B. burgdorferi in infected Ixodes scapularis nymphs as they

> fed on uninfected mice and in uninfected I. scapularis larvae and nymphs as

> they first acquired spirochetes from infected mice. Smears of midguts from

> previously infected ticks were prepared at 12- or 24-h intervals following

> attachment through repletion at 96 h, and spirochetes were stained for

> immunofluorescence for detection of antibodies to OspA and OspC. As shown

> previously, prior to feeding spirochetes in nymphs expressed OspA but not

> OspC. During nymphal feeding, however, the proportion of spirochetes

> expressing OspA DECREASED, while spirochetes expressing OspC became

> detectable. In fact, spirochetes rapidly began to express OspC, with the

> greatest proportion of spirochetes having this protein at 48 h of attachment

> and then with the proportion decreasing significantly by the time that the

> ticks had completed feeding. In vitro cultivation of the spirochete at

> different temperatures showed OspC to be most abundant when the spirochetes

> were grown at 37 degrees C. Yet, the synthesis of this protein waned with

> continuous passage at this temperature. Immunofluorescence staining of

> spirochetes in smears of midguts from larvae and nymphs still attached or

> having completed feeding on infected mice

> demonstrated that OspA but not OspC was produced by these spirochetes

> recently acquired FROM mice. Therefore, the temporal synthesis of OspC by

> spirochetes only in feeding ticks that were infected prior to the blood meal

> suggests that this surface protein is involved in transmission from tick to

> mammal but not from mammal to tick.

>

> Re: [ ] Test Results confusing????

>

> The data looks " Not inconsistent with " Lyme Disease. It is after all a

> " clinical " diagnosis, meaning that a

> savvy physician should put together the story with supportive lab evidence.

> Hypoperfusion on a SPECT scan

> is consistent with Lyme but can appear in other diseases as well. The

> Western Blot data will not meet the

> CDC's criteria, however the bands that are present are very supportive of

> the diagnosis. 31kD is outer

> surface protein A, 34kD is outer surface protein B, and 41kD is the

> flagellar protein. The other bands are

> also Bb proteins. If your wife has not received the Lyme vaccine, there

> would be no reason for ospA or B to

> be present. Labs can also tell if these are vaccine proteins, but you may

> need to ask them to do it. The

> real key here is to be with a physician who will stick with you regardless

> of the diagnosis, and see you

> through whatever it is you have.

> Good luck to you.

> B

>

>

> HAPPY HOLIDAYS!!!

>

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