New approaches may help solve the Lyme disease diagnosis dilemma

[Andy]

Many, if not most, of these problems are caused by the lack of a reliable test for the infection. “This deficiency in Lyme disease diagnosis is probably the most prevalent thing that is responsible for the controversies of this disease,” says Paul Arnaboldi, an immunologist at New York Medical College in Valhalla.

That’s why Arnaboldi and other researchers are trying to devise better diagnostics (SN: 9/16/17, p. 8). The standard two-part test that’s used now, which has changed little in concept since the 1990s, may miss about half of infected people in the early weeks of illness. The test relies on finding markers that show the immune system is actively engaged. For some people, it takes up to six weeks for those signs to reach detectable levels.

To find better ways to diagnose the disease more reliably and maybe sooner, scientists are trying to identify genetic changes that occur in the body even before the immune system rallies. Other researchers are measuring immune responses that may prove more accurate than existing tests.

The science has advanced enough, according to a review in the March 15 Clinical Infectious Diseases, that within the next few years, tests may finally be able to measure infections directly. The aim is to amplify traces of the Lyme bacteria’s genetic material in the bloodstream. Enough approaches are in various stages of research that some patient advocates have renewed optimism that the problems with testing may finally become a thing of the past.

www.sciencenews.org/article/ticks-lyme-disease-testing-new-approaches

 

[duncan]

A couple of quick observations:

We are in dire need of accurate Lyme diagnostics for the 1st 30 days following a bite. Since it takes roughly that long to galavanize our immune response to Lyme, the more direct the testing is, the better. Accordingly, these efforts are important for that neglected population.

Most of this article is directed at acute diagnostics, and in a way, that is good and to be expected.

However, there is also a gaping hole for direct diagnostics addressing early disseminated and late stage cases. If you look at the historical efforts of the NIH, late stage does not command much of their attention. Late stage is where controversy is alive and thriving, so one might imagine this would get appropriate attention. It does not.

One reason it does not is that it is a tough egg to crack, just as syphilis was, and not much in the way of resources are being directed there.

Another reason, imo, is vested inertia. There are big $'s in the indirect testing market. Perhaps more to the point, if a reliable direct diagnostic does appear for late stage, what happens if it swings unfavorably for the entrenched interests?