The T-cell proliferative assay in the diagnosis of Lyme disease

Article Abstract:

Lyme disease is a chronic illness transmitted by a tick bite and characterized by a typical rash and early flu-like symptoms. Later manifestations include arthritis, heart rhythm abnormalities, and neurological symptoms. The bacterium that causes the disease is known as Borrelia burgdorferi, and one way of diagnosing Lyme disease is through the detection of antibodies to that bacterium in the blood. Since weeks must elapse before the blood test becomes positive, and since the results are not entirely reliable (some patients who have the disease never develop antibodies in sufficient numbers to make the test positive), researchers have explored other tests for Lyme disease. One such blood test is known as the T cell proliferative assay, and looks for the presence of proteins from the Borrelia bacterium in certain immune system cells, such as T cells. During a two-year period, a group of 67 patients with known Lyme disease was studied. Five of these patients had negative results on the conventional test for Lyme disease. Less than 50 percent of the patients studied had positive results on the T cell proliferative assay. Further, the T cell proliferative assay can be falsely positive in persons with other joint diseases who do not have Lyme disease. However, a few patients who had received antibiotics early in the course of their disease had negative results on the conventional test and positive results on the T cell proliferative assay, indicating that the latter test may have a role in confirming a diagnosis of Lyme disease in that small subset of patients. These findings also suggest that the diagnosis of Lyme disease must still be made clinically. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Measurement, Testing, T cells, Immunoassay, Antibodies

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Test-treatment strategies for patients suspected of having Lyme disease: a cost-effectiveness analysis

Article Abstract:

Based on recently published research, cost-effective tactics for testing and treating patients with suspected Lyme disease have been analyzed and presented. Immediate antibiotic therapy appears to be the most cost-effective treatment strategy for patients with physical evidence highly suggestive of Lyme disease. A two-tiered testing approach using the enzyme-linked immunosorbent assay and Western blot assay appears to be the most cost-effective approach for patients with a reasonable likelihood of having Lyme disease. A conservative approach may be most appropriate for patients with a low likelihood of having Lyme disease.

Health aspects, Care and treatment, Antibiotics

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Laboratory evaluation in the diagnosis of Lyme disease

Article Abstract:

Research suggests that blood testing for Lyme disease should be used cautiously. Guidelines for Lyme disease testing were developed based on statistical analyses performed on Lyme disease research studies published between 1982 and 1996. Blood testing appears to be appropriate for patients with a 20% to 80% likelihood of having the disease. False-positive results are high in patients with less than a 20% likelihood of having Lyme disease. A two-tiered testing approach using enzyme-linked immunosorbent assays and Western blot testing appears to most effectively identify patients with true Lyme disease.

Standards, Western immunoblotting, Western blot

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