One of the most difficult elements of Lyme disease is the diagnosis. This goes for both patients and doctors alike. Neither subgroup is very well educated on the subject of Lyme in general, and although visibility has been increasing around the disorder in recent years, misdiagnosis rates are still staggeringly high. The problem is twofold. The first, most obvious issue is that Lyme disease resides in a unique medical grey area; the acute form is an accepted disorder, while the chronic form is considered illegitimate by many medical professionals. Compounding this is the fact that chronic Lyme symptoms are generalised, and often mimic the symptoms of other chronic disorders. This all means far too many patients slip through the diagnostic cracks. But is help on the horizon? Is there a new 15-minute Lyme diagnostic test in the pipeline?
How Is Lyme Disease Diagnosed?
Before we explore this potential new avenue of Lyme treatment, let’s take a look at the traditional way to test for Lyme. It’s a two-tier process (also known as the STT): first an ELISpot, a kind of blood test used to test for many varied forms of illness, then a Western blot test, a complex allay used to detect proteins. When it comes to Lyme, this method specifically tests for the antigens of the Borrelia burgdorferi bacteria, the Lyme-causative agent spread by ticks to their hosts.
So what is the best test to diagnose Lyme disease? Is it the STT process? Well, unfortunately, this test all too often produces a false negative, as chronic Lyme patients suffer equally from inflammation symptoms caused by a faulty immune response, sometimes to the degree that there is very little trace of the initial infection left in their bodies. Therefore, the ELISpot as it’s traditionally used is not a reliable test for Lyme – or at least not reliable enough considering the hundreds of thousands of patients who contract Lyme every year. But a blood test does provide the foundations for newer, more consistent testing.
A New 15-Minute Lyme Diagnostic Test?
The ELISA and Western Blot method requires experienced professionals and several hours in laboratory time to bring to completion. Now, a team led by Sam Sia, professor of biomedical engineering at Columbia Engineering, has come up with a new, rapid form of testing which may dramatically shorten this waiting period. The result of their work is a microfluidic test that can diagnose Lyme to the same degree as the STT, but in a much shorter timespan: fifteen minutes. The team’s hope is that the simple test will be able to be utilised within a doctor’s office, without the need of a laboratory.
Sia’s team worked closely with Maria Gomes-Solecki, from Immuno Technologies, to find a specific sequence of three proteins that could identify antibodies unique to the Borrelia burgdorferi bacteria. Another company, OPKO Health, provided the microfluidic cassettes. During the testing stages, 142 samples were utilised, including those from healthy people from endemic Lyme areas, confirmed early Lyme patients, and those with Lyme arthritis (i.e. late stage chronic patients).
How Accurate Is The Test for Lyme Disease?
As mentioned above, the standard test for Lyme disease is notoriously unreliable. The multiplexed set of biomarkers was found to be more sensitive than standard Lyme disease tests, while also scoring high in specificity. The test was found to be particularly adept at picking up acute Lyme, possibly due to the fact it could detect antibodies that were in high supply during the first weeks after the initial tick bite. While this new test will undoubtedly need further honing and testing, it’s an encouraging development for Lyme patients and doctors alike.
This rapid test joins BCA-clinic’s unique Lyme ELISpot as a new wave of more specific Lyme testing. BCA-clinic assisted development of their test, and now use it exclusively over the traditional ELISpot. It is specifically engineered to test not just for attacking antigens (like the STT), but also memory antigens, which are formed by the immune system after a disease has been eradicated or present for a long time. By testing for these two types of antigen, doctors are able to get a clearer picture on the stage of Lyme a person is suffering from. If attacking antigens are present, it’s likely an active infection; if it’s just memory antigens, then the symptoms are likely predominantly caused by a faulty immune response. This snapshot of the patient’s condition aids treatment immeasurably.
How Is Lyme Disease Treated?
Lyme treatment is entirely specific to the stage of the disease. To treat an active infection, antibiotics are required, while treating an immune response deficiency usually requires nutritional changes and herbal supplements to help the body effectively fight back.
While treatment for Lyme disease is undeniably a hard road, successful, clear-cut diagnosis is a crucial first step. With these advances in testing, the sky-high misdiagnosis rates surrounding Lyme should see an improvement. This in turn will inform more education and visibility around the disease, so that more people can catch it in the early stages when it’s easily treatable. Although there’s still a long way to go, the emergence of a potentially accurate, 15-minute Lyme diagnostic test is more than encouraging.