Accurate testing for Lyme disease has always been somewhat problematic. Unlike many other conditions, there is no single surefire way to test for chronic Lyme. The symptoms are often reminiscent of the primary symptoms of other chronic disorders, and misdiagnosis is an extremely common occurrence. In fact, it is entirely possible for certain Lyme tests to come back negative, but for the patient to still have Lyme; much of the success of these tests depends on the time of testing, what stage the disease is at, and whereabouts in the body the offending bacteria can be found, or not found as the case may be. Traditionally, the best way to test for Lyme was through a procedure called the ELISpot, but in recent years, tried and tested Lyme labs such as BCA-clinic have transitioned to a new, more effective test: the LymeSpot Revised.
A Lyme diagnosis does not come from a single test. The patient must first present with relevant symptoms to a Lyme-literate doctor or lab, who will try and first decipher if the patient remembers being bitten, or coming into contact with any ticks. As ticks are the only way a person can contract Lyme, this is a useful first step in a positive diagnosis. After symptoms and patient history have been qualified, the doctor can then move to diagnosis tests, which traditionally consists of two stages: an ELISA test followed by a Western blot test to confirm the diagnosis. However, the ELISA returns a false negative far too often, and is considered too unreliable to use as a consistent diagnostic tool.
The ELISpot is the standard method of measurement for an infection of borrelia and its co-infections on a cellular level. It has been used across the world for several years, and is a standardised and disclosed test principle approved by all relevant bodies in the field of medical diagnostics. However, the precision of the test was always in question, which is why a new method has been developed; it’s called the LymeSpot Revised, and it’s designed to deliver far more detailed information to doctors than the ELISpot. The development of this test was supported by BCA-clinic, with the aim of building on the solid foundations of the traditional ELISpot, but creating a much more precise method of diagnosis upon completion. But why is it more precise, and what makes LymeSpot more effective overall than the ELISpot?
The answer to this can be found by looking closely at the symptoms of Lyme. It’s important to first understand that most of the primary grievances of chronic Lyme, including muscle and joint pain, stiffness, aches and constant fatigue, are not direct results of the borrelia bacteria itself. Instead, they are products of the body’s response to the bacteria; in other words, the body’s own immune system inadvertently causes the debilitating set of symptoms due to an over-aggressive response to the invasion. The ELISpot doesn’t take the chronic controlled infection into account, and instead only tests for the presence active infection. LymeSpot Revised does register chronic controlled T cell activity, which is crucial to achieving the differentiation between active infection and chronic controlled infection. Thus, LymeSpot Revised can be considered a one-and-done test, which will outline the best path for treatment for each individual patient.
It’s hard to understate just how important it is to consider both the active infection and chronic controlled angles of Lyme. Depending on the balance of each, a patient’s treatment plan can be, and often is, totally unique. Different parts of the immune systems will fight back against the bacteria in different ways, which explains why the symptoms of chronic Lyme vary for patients all over the world. Treating these two strands of Lyme is a delicate process for doctors, who need to know what they are dealing with before they can prescribe a plan. If the patient is showing active infection but light on chronic inflammation then antibiotics are considered. If it’s the other way around, diet and supplements can help reduce the chronic inflammation before the infection can be tackled.
ELISpot tests for the presence of γ-interferon, which, simply put, means that it tests for an active infection (Active antigen specific T-cells). LymeSpot Revised tests for both γ-interferon and cytokine IL-2, the latter being important in regulating immune responses. To streamline the process, LymeSpot Revised utilises a ‘traffic light’ principle in order to diagnose the patient’s current state of infection. If the test returns as green, this indicates that the active infection needs to be treated over controlled chronic infection, and there is a likelihood that the disease is in its infancy (acute). If the opposite is true, the test will return as red; in this case, Lyme is in its latent stages, and the chronic inflammation needs to be addressed before anything else. If both γ-interferon and cytokine IL-2 are present together, the test will return as a mix of red and green. If this is the case, the best course of action will be decided based on the clinical profile of the patient.
It may sound complicated, but the principles of why LymeSpot Revised is more effective than ELISpot are simple to grasp. The latter only tests for infection, while ignoring a major factor of chronic Lyme – inflammation due to chronic controlled or chronic non-controlled conditions. The former takes both these things into account during the testing, making it easier for doctors to assess the results and plan treatment around each unique case.
If you would like more info on BCA-clinic, or any of its practises or staff, feel free to get in touch anytime.