Bands 31 and 34 ARE NOT Lyme specific!! http://flash.lymenet.org/ubb/ultimatebb.php/topic/1/100975
little_olive
LymeNet Contributor
Member # 28063
posted 11-19-2010 08:26 AM
I don't know if this has just been passed on through repetition so much that no one thought to find out if it's true, but...
IGeneX themselves says that bands 31 and 34 can cross-react with Epstein Barr Virus, Herpes Simplex Virus, and Hepatitis C Virus.
So I really, really wish people would stop perpetuating the false information that these bands are "Lyme specific" when they ARE NOT.
There are additonal tests you can do to find out if these bands (at least band 31) is caused by Lyme or other pathogens, but just having these bands does not automatically mean it's Lyme disease:
Cross reaction does occur, and nearly everyone has at least one of those three viruses.
Research found that bands 31 and 34 were most likely to turn up in the late stages of Lyme disease rather than the early stages...
Which begs the question, are those bands showing up because of the Lyme bacteria itself, OR because chronic Lyme suppresses the immune system and causes other infections that most people have, like EBV and HSV, to be (often chronically) activated (which would thus cause a positive, cross-reactive 31 or 34 band).
Either way, just having these bands does not indicate Lyme disease. Does it suggest it? Yes.
But they're not "Lyme specific" like everyone claims, and not near as indicative of Lyme as bands 39, and 83-93.
I just wanted to get that out there in case people were not aware that IGeneX states this on their newer test results, regardless of what information we thought we knew in the past.
little olive
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timaca
Frequent Contributor (1K+ posts)
Member # 6911
posted 11-19-2010 09:09 AM
Little Olive~
You make a good point. In discussing with my ID doctor (who is very open minded about what the heck we are sick with):
he says the more bands positive on a WB the more likely one has lyme and not some other pathogen. So he needs a lot of positive bands to convince him he is dealing with Bb and not some other pathogen.
He has recently found that some of his patients are not sick with Bb but with Borrelia hermsii.
Which is why he tests for all kinds of pathogens and treats what looks to be most obviously wrong.
A few bands on a WB, even if they are "Lyme specific" bands vs sky high antibody titers to another pathogen means I'm getting treated for the other pathogen. And that makes sense. And it has helped me.
You also cannot go by a "clinical diagnosis" for Lyme disease. Viruses can give you the same symptoms.
Best, Timaca
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lou
Frequent Contributor (5K+ posts)
Member # 81
posted 11-19-2010 09:24 AM
Then there are those with late stage lyme with no bands, also known as seronegative.
We did have some IgG bands earlier, but contrary to the IDSA, they did not remain for a long time. So, testing is not going to be the end all in this disease.
Some effort is being made to find ways other than antibodies to use in testing, per remarks made in IOM session, with the statement made that negative testing only shows the inability of current testing to provide evidence with lyme patients whose immune system is dysfunctional.
Chronic diseases exist because the immune system has failed to eliminate them.
We all have viruses, latent and opportunistic, in chronic diseases. I had an outbreak of the shingles because of this.
So, I think it might be a bit misleading to say that we could have viruses instead of lyme, when the situation might be lyme + viruses.
I know I was bitten in an endemic area and got a blood smear confirmed babesia case too. There really is no doubt that I have both viruses and tickborne diseases.
We also do not know if any viruses are transmitted by ticks.
And we might need treatment for viruses too. But for those people who successfully clear lyme, their immune systems may then hold down the viruses.
It is the chronic cases of lyme that might need help with these other coinfections with viruses. Or people who only have uncontrolled viruses.
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little_olive
posted 11-19-2010 09:41 AM
It wasn't my intention to say ANYTHING other than, bands 31 and 34 are not specific to the Lyme disease bacteria, so people shouldn't keep saying that they are. It's misleading.
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randibear
Frequent Contributor (5K+ posts)
Member # 11290
posted 11-19-2010 09:51 AM
well when you have so many positive and then those bands, pretty sure you have lyme....
plus my doc said to go by physical symptoms not so much testing.
but anytime you have positive bands, i'm sorry, you should be alarmed.
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the3030club
LymeNet Contributor
Member # 21898
posted 11-19-2010 10:06 AM
That's why they should not include bands that potentially cross react with the 2 of the most common viruses on earth.
The funny thing is with igenex you only need two positive bands to have an overall positive.
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carly
LymeNet Contributor
Member # 14810
posted 11-19-2010 10:51 AM
Facts. They are such curious things.
While some consider them to be necessary pieces of the puzzle, they can be manipulated by the uninformed, underinformed, ill-intended and just plain lazy.
Thanks all, for lifting my spirits today .
~the above are refences to different types of drs using pieces of info [test reults] to treat [or not] patients~
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lou
posted 11-19-2010 11:02 AM
Thanks for the info, little olive. I was just putting it in the broader context.
Doctors should be treating the patient not the test results. Until testing is infallible, doctors will only use it as one piece of the puzzle.
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Dekrator48
Frequent Contributor (1K+ posts)
Member # 18239
posted 11-19-2010 12:56 PM
Hi little olive,
Can you please help me find that info on the Igenex site? Which page is it on?
I was thinking that band 34 was used in the vaccine, and that bands 30-31 can cross react with viruses.I would like to reread it so I don't mislead anyone.
Thanks alot.
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little_olive
posted 11-19-2010 02:06 PM
I am unsure if it's on their website, but it's the newer results papers (at least as of October, when I got mine in). It says:
LIMITATION:
Positive result for 31 and/or 34kDa may be present after Lyme vaccination in uninfected persons.
Infection with HSV, EBV, HCV, and/or syphillis (RPR+) may give false (+) results.
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little_olive
posted 11-19-2010 02:29 PM
I must admit, I don't understand why they'd call those bands significant (i.e., mark them with two asterisks to signify they're more important),
and then put a disclaimer right above that which says common viruses can cross-react with them. It's.. just misleading.
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seekhelp
Frequent Contributor (5K+ posts)
Member # 15067
posted 11-19-2010 02:36 PM
Uh oh...you started the Igenex may not be good thread. Prepare to be attacked.
What you say makes sense, but it's not new news. That's WHY they have a band 31 confirmation test, right?
I still don't know if I fully believe Igenex's results at times. Throw the arrows at me. I can take it. lol.
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Hoosiers51
Frequent Contributor (1K+ posts)
Member # 15759
posted 11-19-2010 02:44 PM
littolive,
Did Igenex tell you specifically that 34 can cross react with those viruses? Or did they just say that some of the bands cross react with viruses?
If your 31 shows positive, it could be because of viruses, but the 31 antibody doesn't cross react "per se."
The 31 antibody is Lyme specific itself, it's just that sometimes in laboratory testing, a virus will cause 31 to show up, erroneously.
So it can appear as a false positive, but if it truly WAS the 31 antibody (and you have no way of knowing without the confirmation test), that antibody is known (right now at least) to be Lyme specific, and that is why it was used in the vaccine.
That is why the band 31 confirmation test exists. Because if you really do have the 31 antibody, you do (as far as we know so far) have Lyme.
34, I believe Dr. H has said he thinks it's very specific to Lyme, but things may have changed since I heard that.
(on the powerpoint I am posting below, there is a slide that says,
"31 and 34 controversy"....but no more info.
Wasn't there for the presentation itself, so don't know what he said). (but on page 76 he talks about band 31, but he doesn't go into as much detail as I have heard him go into before on it)
Everything I'm saying above is based off of listening to Dr. H's speeches, or reading his powerpoint slides. I think it represents what Igenex knows now, but keep in mind, things can change.
Littleolive, what you showed "bolded," is moreso about all the bands/the test in general, not really specifically 31 and 34.
As you can see, the first sentence was about 31 and 34, the second sentence was more general towards the whole Western Blot. That is how I read it, at least.
So other infections can give false positives, in general, on the WB.
In my opinion, the BEST thing anyone can do is look at this graph, prepared by one of the Igenex founders.
A picture tells a thousand words. Go to page 78 for the graph.
http://www.lymeinducedautism.com/images/
Lymewhat_is_it_part_3,_LIA.pdf
Anyways, I think there is a lot of misleading information going around.
Igenex is certainly not perpetuating it.
Dr. C's WB explanation is incredibly misleading, my two cents.
There are people that still claim 41 means something, when, Dr. H has basically said "if you had your teeth cleaned in the past year, ignore it."
As far as I'm concerned, 39 is the best guarantee you can get in a single band. However, I wouldn't rule out false positives even in that one.
And remember, the more bands you have, the probability you have Lyme goes up.
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little_olive
LymeNet Contributor
Member # 28063
posted 11-19-2010 03:09 PM
That could be it, Hoosiers, about the viruses cross-reacting with ANY of the bands, but if so, that's even WORSE and my entire post would be pointless...!
I don't even want to think about it.
I will delete my entire thread before I inadventantly cause a fight or even worse, accidentally spread false information from MYSELF!
I just want the truth out there, and how I interpretted what is written on the paper is that only those bands had the potential to interact with those viruses (since each band tests for a different part of the pathogens)...
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Dekrator48
posted 11-19-2010 03:22 PM
I think Igenex included bands 31 and 34 in their criteria because they are found so commonly among lyme patients.
I had the confirmation test done when I had my WB.
I didn't really need to though, since I had more than one lyme specific band show up.
I think the confusion comes in because band 31 is Osp A and band 34 is Osp B, which are both outer surface proteins of the Borrelia bacteria.
That makes them somewhat lyme specific. It is a glitch though, that a virus can make them cross react on the WB.
At least it's easy for most people to know if they had the vaccine or not when it was available.
Maybe it's more accurate to say that they are "significant bands", because they are so very common among lyme patients.
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seekhelp
posted 11-19-2010 03:22 PM
You should leave it. Debate and ideas are important. Look, it brought about the link to that chart which is very helpful.
If you have 23-25, 31, 34, 41, 58, 66, 83-93, any chance it's a false positive?
It sounds like more people need to start seeing Timaca's doc. He seems to be on the ball. I like his philosophy compared to winging it and thinking all is Lyme/cos.
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sixgoofykids
Moderator
Member # 11141
posted 11-19-2010 03:32 PM
Originally posted by seekhelp:
If you have 23-25, 31, 34, 41, 58, 66, 83-93, any chance it's a false positive?
Uh, yeah, I think that shows exposure ..... but it's only important if you're symptomatic.
Were those IgM or IgG? I was IgG positive with eight bands. I sometimes wonder what would show up now .... but not curious enough to pay $200 to find out.
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seekhelp
Frequent Contributor (5K+ posts)
Member # 15067
posted 11-19-2010 03:38 PM
Oddly, my IgM and IgG bands never coincide for the most part.
IgM: 23-25 +++, 31+, 34+, 41 IND, 58+
IgG: 23-25 IND, 31 IND, 34 IND, 41++, 45+, 58+, 83-93+
Makes you wonder when you read this thread. Timaca's articles have explained away positives on 23-25 on the IgM side.
Now 31 and 34 can be viral related.
Dr C in MO seems to be the only one of the planet who thinks band 58 is meaningful.
What if it's all hogwash and cross-reactivity?
I have strong EBV titers on the Early Antigen test that could sway results. I'm certainly symptomatic, but Timaca's doc says viruses could cause all my issues too, right?
I'm curious too Six and would love to retest, but I don't feel like lining Igenex's pocket with another $200+. They've gotten plenty of money from me as that wasn't my only test!
if I had the money, I'd be testing my wife and child to see if I could disprove Igenex's methods and see just how many get positives.
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Pam08
LymeNet Contributor
Member # 19203
posted 11-19-2010 03:52 PM
I think you might be reading that wrong. I interpreted that to say that bands 31 and 34 were used in the vaccination.
Then it says that the test itself can be a false positive due to cross reaction with those viruses.
It didn't say specifically which bands cross react with certain viruses so I don't think it meant specifically bands 31 and 34 cross react.
Actually...the following is from the Igenex website.
It looks like bands 30-31 is what cross reacts and can cause a false positive so you should probably modify your post. BUT you can get a confirmation test for that so it shouldn't be a problem.
quote:
30-31kDA Epitope Confirmation Test (Sensitivity > 97% in Late Lyme; Specificity > 98%)
The Lyme IgG or IgM 30-31kDA confirmation test is a qualitative immunoblot assay that determines whether 30 and/or 31kDA bands present on a Lyme IgG or IgM western blot are due to B. burgdorferi specific antibodies or not.
B. burgdorferi specific epitope(s) - 30 and/or 31kDA, are denatured and separated by SDS polyacrylamide gel electrophoresis, blotted onto nitrocellulose membranes and cut into strips for the use of Lyme 30-31kDA Western Blot Confirmation Test.
It is known that Western blots, especially IgM, can give false positive results with some viruses.
This test would be very useful to rule out false positives when 30 and/or 31kDa bands are present on the Western blots.
Principle:
Patient serum is incubated with 30-31kDA recombinant epitope on Western Blot strips.
If the 30 and/or 31kDa specific antibodies to B. burgdorferi antigens are present, they will bind to the corresponding epitope bands.
After washing the unbound serum off the strip, the bound B. burgdorferi specific antibody reacts with alkaline phosphatase conjugated goat anti-human antibody (IgG or IgM).
After washing the unbound conjugated antibody, the strip reacts with BCIP/NBT, a chromogenic substrate.
A dark purple colored precipitate will develop on the antigen-antibody complexes.
Bands are visualized, scored for intensity relative to the positive and negative controls.
Specificity and Sensitivity
The IGeneX Lyme Western blots determine whether a patient was exposed to B. burgdorferi or not.
The IgG or IgM Western blot has an overall specificity of >96%; and the combined IgG and IgM Western Blots have a sensitivity of 92%.
This is based on a study performed on 142 well characterized serum samples. The Lyme Western blot strips have bound B. burgdorferi proteins that are separated by molecular weight.
Therefore, non-specific proteins present in the B. burgdorferi lysate co-migrate with B. burgdorferi specific proteins.
The non-specific co-migrating proteins can give false positive results as has been demonstrated by us and others.
When we tested Lyme Western blots against a panel of 94 sera from patients with viral infections (confirmed by presence of antibodies to viruses), the assay specificity for Lyme Western blot IgG dropped to 90% and IgM to 81%.
The Lyme IgG Western blot bands 30-31kDa confirmation test improved the specificity for IgG to >97% and for IgM >98% (See table below).
In addition when a panel of very well characterized 30 sera from patients with neuroborreliosis, that were part of an NIH study, (provided by Dr. Fallon, Columbia University) were tested, the assay sensitivity was >97% (29/30 were positive).
Based on this data, we recommend that further testing is not necessary if in addition to 30 and/or 31kDa bands,
two of the following bands (23-25, 34, 39,41 and 83-93 kDa), are present on the Western blot.
Otherwise, the 30-31kDA confirmation test should be used to confirm whether 30-31kDa bands present on the Lyme Western blots are due to B. burgdorferi specific antibodies or not.
If the 30-31kDa confirmation test is negative, we recommend that patient’s sera be tested for viral antibodies.
; specific for Bb (Lyme).