This post is a retrospective look back at 2022 publications regarding Lyme Disease and what it might mean for those taking CopperOne for Lyme like symptoms. The blood based tests still fail to deliver. Clinics all over the U.S. offer tests for antibodies in the CSF. Antibody producing centers called tertiary lymphoid organs are introduced.
finding evidence of Borrelia antibodies in the blood
Back in 2019 a Dutch group of scientists published the design of a clinical trial to test a better method to detect chronic Lyme Disease. Some of the short comings of traditional tests include:
- Production of antibody takes time and may decrease if antibiotic treatment clears the Borrelia in the circulation. [1]
- ELISAs and immunoblots used in Europe may be up to 95% for late manifestations, but as low as 50% for early localized disease (EM)
- IgM to IgG-sero conversion antibodies oftentimes remain present in the blood for many years. [1]
The authors used four tests. The desired outcome was for the lymphocyte assay to successfully respond to Borrelia antigens. The outcome of the clinical trial some three years later was that it did not live up to expectations. [2]
- Spirofind Revised (Oxford Immunotec)
- QuantiFERON-LB (QIAGEN Sciences)
- the Lyme iSpot (Autoimmun Diagnostika / Genome Identication Diagnostics), and
- the Lymphocyte Transformation Test-Memory Lymphocyte Immunostimulation Assay (LTT-MELISA, InVitaLab).
While some may think that fibromyalgia is really chronic Lyme Disease, T-lymphocyte reactivity to Borrelia burgdorferi sensu stricto (full antigen), outer surface protein (Osp) did not difer between fibromyalgia and healthy controls. [3]
Chronic Lyme, it really is in your head
This post is not going to waste any more time going over details of blood tests that have failed to detect PTLD. There are plenty of clinics that are testing for this but and antibodies against this bug in the cerebral spinal fluid (CSF). The University of Michigan , University Hospitals, and University of Rochester Medical Center test for LD antibodies in the CSF. Most of these websites have almots the same information regarding other tests that may be ordered as well as the risks of lumbar punctures.
How does Borrelia get from the blood into the CSF. This is covered in the Thompson review. Here are a few images from the review. This review has little to say about Borrelia because we really don’t know that much. [4] The review is a nice way of coming to an understanding to this important barrier.
The reader is invited to visit the previous post brain copper transport. The ATP7A Cu+ transporter is responsible for getting Cu+ into the brain. Failure to do so in Menke’s Disease results in neurological deficits. Perhaps this transporter is also a way to kill Borrelia in the CSF. This post covers transporters in the choroid plexus that might transport niacin as well.
Why are Borrelia antibodies in the CSF?
Even though the Mitsdoerffer and Peters review [5] is focused on the autoimmune disease multiple sclerosis, they have some interesting things to say about tertiary lymph organs in the brain. Antibody producing plasma cells may reside in these organs as well as in the bone marrow.
In the panel on the left, an image of the meninges has been inserted to convey the notion that these layers constitute a place for B cells to take up residence. In the context of this image, the parenchyma is the neurons and glia of the brain proper. Plasma cells are the produces of antibodies we see in the CSF in MS patients and perhaps in LD patients. The image on the right is of more developed structures with more, chemokines, T cells, and a few dendritic cells in the center.
“Further characteristics are a T-cell zone populated by naïve T cells and central memory T cells recruited from the blood; high endothelial venules (HEV); and a network of stromal cells that provide chemokines and extracellular matrix (ECM) for cellular migration and structural integrity” Wikipedia has a good page on tertiary lymph organs that goes beyond LD to tumors, but still does not discuss neuroborreliosis.
Does this search for “the latest” mean anything?
A recent study of neuroborreliosis patients in the Netherlands revealed that many of them and antibodies in their CSF but not their serum. [6] The authors speculated that their results might mean lowering the thresh hold for a lumbar puncture…. which seem to be available in the U.S. at multiple locations. If CopperOne is helping patients with neuroborreliosis, perhaps we need to look to the CSF rather than the blood to see evidence. The Mitsdoerffer and Peters review discussing chemokines and so on associated with tertiary lymph organs that we can speculate exist in LD. The perplexing part is that LD antibodies in the CSF as a measure of killing won’t work for the same reasons why antibodies in the serum don’t always predict bacterial loads.
References
- van de Schoor FR, Baarsma ME, Gauw SA, Joosten LAB, Kullberg BJ, van den Wijngaard CC, Hovius JW. Validation of cellular tests for Lyme borreliosis (VICTORY) study. BMC Infect Dis. 2019 Aug 20;19(1):732. PMC free article
- Baarsma ME, van de Schoor FR, Gauw SA, Vrijmoeth HD, Ursinus J, Goudriaan N, Popa CD, Ter Hofstede HJ, Leeflang MM, Kremer K, van den Wijngaard CC, Kullberg BJ, Joosten LA, Hovius JW. Diagnostic parameters of cellular tests for Lyme borreliosis in Europe (VICTORY study): a case-control study. Lancet Infect Dis. 2022 Sep;22(9):1388-1396.
- Puri BK, Lee GS, Schwarzbach A. Is Fibromyalgia Associated with Borrelia-specific T Lymphocytes? Curr Rheumatol Rev. 2022;18(2):157-159.
- Thompson D, Brissette CA, Watt JA. The choroid plexus and its role in the pathogenesis of neurological infections. Fluids Barriers CNS. 2022 Sep 10;19(1):75. PMC free article
- Mitsdoerffer M, Peters A. Tertiary Lymphoid Organs in Central Nervous System Autoimmunity. Front Immunol. 2016 Oct 25;7:451. PMC free paper
- Zomer TP, Bruinsma R, van Samkar A, Vermeeren YM, Wieberdink RG, van Kooten B, van Bemmel T. Lyme neuroborreliosis with antibodies in cerebrospinal fluid but not in serum. Eur J Neurol. 2022 Nov 12.