Bedankt voor het plaatsen Roxy!
Ik begrijp dat deze test ook ingezet zou kunnen gaan worden om te kijken of de lyme op een gegeven moment weg is. Dus ter evaluatie van de AB-behandeling. Dat zou mooi zijn! Op dit moment gebruik ik daar de LTT voor.
VerlorengezondheidM schreef:Wat heb je met die CBO-richtlijnen van max. 4 weken AB aan een goede Lymetest?
Goede vraag...
Gelukkig zijn er ook nog andere manieren om aan meer AB te komen.
En voor degenen die net gebeten zijn is dit een kans om er vroeg bij te kunnen zijn, dan is 4 weken AB bij de meesten voldoende.
Hadden wij dat maar meteen gehad heh...
Voor vervolgonderzoek naar behandeling is zo'n test echt super! Dan kunnen ze daarna ook weer de aanbevelingen in de richtlijn voor de duur en combi's van de AB aanpassen.
Dit is de studie uit 2015 waar naar verwezen wordt:
https://translational-medicine.biomedce ... 015-0701-z
Application of Nanotrap technology for high sensitivity measurement of urinary outer surface protein A carboxyl-terminus domain in early stage Lyme borreliosis
Ruben Magni, Benjamin H. Espina, Ketul Shah, Benjamin Lepene, Christine Mayuga, Temple A. Douglas, Virginia Espina, Sally Rucker, Ross Dunlap, Emanuel F. III Petricoin, Mary Frekko Kilavos, Donald M. Poretz, Gilbert R. Irwin, Samuel M. Shor, Lance A. Liotta and Alessandra LuchiniEmail author
Journal of Translational Medicine201513:346 DOI: 10.1186/s12967-015-0701-z © Magni et al. 2015
Received: 13 May 2015 Accepted: 19 October 2015 Published: 4 November 2015
Abstract
Objectives
Prompt antibiotic treatment of early stage Lyme borreliosis (LB) prevents progression to severe multisystem disease. There is a clinical need to improve the diagnostic specificity of early stage Lyme assays in the period prior to the mounting of a robust serology response. Using a novel analyte harvesting nanotechnology, Nanotrap particles, we evaluated urinary Borrelia Outer surface protein A (OspA) C-terminus peptide in early stage LB before and after treatment, and in patients suspected of late stage disseminated LB.
Method
We employed Nanotrap particles to concentrate urinary OspA and used a highly specific anti-OspA monoclonal antibody (mAb) as a detector of the C-terminus peptides. We mapped the mAb epitope to a narrow specific OspA C-terminal domain OspA236-239 conserved across infectious Borrelia species but with no homology to human proteins and no cross-reactivity with relevant viral and non-Borrelia bacterial proteins. 268 urine samples from patients being evaluated for all categories of LB were collected in a LB endemic area. The urinary OspA assay, blinded to outcome, utilized Nanotrap particle pre-processing, western blotting to evaluate the OspA molecular size, and OspA peptide competition for confirmation.
Results
OspA test characteristics: sensitivity 1.7 pg/mL (lowest limit of detection), % coefficient of variation (CV) = 8 %, dynamic range 1.7–30 pg/mL. Pre-treatment, 24/24 newly diagnosed patients with an erythema migrans (EM) rash were positive for urinary OspA while false positives for asymptomatic patients were 0/117 (Chi squared p < 10−6).
For 10 patients who exhibited persistence of the EM rash during the course of antibiotic therapy, 10/10 were positive for urinary OspA.
Urinary OspA of 8/8 patients switched from detectable to undetectable following symptom resolution post-treatment.
Specificity of the urinary OspA test for the clinical symptoms was 40/40. Specificity of the urinary OspA antigen test for later serology outcome was 87.5 % (21 urinary OspA positive/24 serology positive, Chi squared p = 4.072e−15).
41 of 100 patients under surveillance for persistent LB in an endemic area were positive for urinary OspA protein.
Conclusions
OspA urinary shedding was strongly linked to concurrent active symptoms (e.g. EM rash and arthritis), while resolution of these symptoms after therapy correlated with urinary conversion to OspA negative.
Josie
