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woensdag 25 juli 2012

Anti-neural antibodies in lupus and Lyme

http://www.ncbi.nlm.nih.gov/pubmed/20227484
 
Brain Behav Immun. 2010 Aug;24(6):1018-24. Epub 2010 Mar 18.

Anti-neural antibody reactivity in patients with a history of Lyme borreliosis and persistent symptoms.

Source

Department of Neurology and Neuroscience, Cornell University, New York, NY 10065, USA.

Abstract

Some Lyme disease patients report debilitating chronic symptoms of pain, fatigue, and cognitive deficits despite recommended courses of antibiotic treatment. The mechanisms responsible for these symptoms, collectively referred to as post-Lyme disease syndrome (PLS) or chronic Lyme disease, remain unclear.

We investigated the presence of immune system abnormalities in PLS by assessing the levels of antibodies to neural proteins in patients and controls. Serum samples from PLS patients, post-Lyme disease healthy individuals, patients with systemic lupus erythematosus, and normal healthy individuals were analyzed for anti-neural antibodies by immunoblotting and immunohistochemistry. Anti-neural antibody reactivity was found to be significantly higher in the PLS group than in the post-Lyme healthy (p<0.01) and normal healthy (p<0.01) groups.
The observed heightened antibody reactivity in PLS patients could not be attributed solely to the presence of cross-reactive anti-borrelia antibodies, as the borrelial seronegative patients also exhibited elevated anti-neural antibody levels. Immunohistochemical analysis of PLS serum antibody activity demonstrated binding to cells in the central and peripheral nervous systems. The results provide evidence for the existence of a differential immune system response in PLS, offering new clues about the etiopathogenesis of the disease that may prove useful in devising more effective treatment strategies.
Copyright 2010 Elsevier Inc. All rights reserved.

Source: http://www.ncbi.nlm.nih.gov/pubmed/20227484

Antiphospholipiden in Post Lyme Disease?

http://www.ncbi.nlm.nih.gov/pubmed/21729977
 
Lupus. 2011 Nov;20(13):1372-7. Epub 2011 Jul 5.

Antiphospholipid antibodies in patients with purported 'chronic Lyme disease'.

Source

St Mary's Hospital, Department of Medicine, Waterbury, CT, USA. tgreco@stmh.org

Abstract

BACKGROUND:

Antiphospholipid antibody (aPL) positive patients and patients with purported chronic Lyme disease ('CLD') share many clinical features. After identifying significant aPL in sera of several index patients with 'CLD', we performed aPL tests on all patients referred in whom 'CLD' was suspected, diagnosed or treated.

METHODS:

All patients with suspected, diagnosed or treated 'CLD' and reportedly 'positive' Lyme assays were studied. aPL testing included anticardiolipin antibodies (aCL), anti-beta-2-glycoprotein-1 antibodies (anti-β2GP1) and lupus anticoagulant (LAC). Patients were classified into four newly described categories of CLD and data was analyzed.

RESULTS:

One hundred and six patients were evaluated, of whom 82% had neurologic symptoms and 51% rheumatologic symptoms. Eighty-eight of 106 (83%) patients had positive Lyme serologies (enzyme-linked immunosorbent assay [ELISA] 62/106, 58.4%; western blot [WB] 64/106, 60%), while 18/106 (16.9%) were negative or equivocal. aPL was found in all 'CLD' categories. aCL and/or anti-β2GP1 were positive in 85/106 (80%), with aCL present in 69/106 (65%) and anti-β2GP1 present in 69/106 (65%). For all assays, IgM isotypes predominated: WB 55/64 (85%), aCL 63/69 (91%), anti-β2GP1 52/69 (75%), aCL and/or anti-β2GP1 74/85 (87%). Anti-β2GP1 assays occurred in higher titer than aCL: 36/69 (52%) versus 63/69 (91%), p<0.001. Seventeen patients had aPL-related events. Only 12/106 (11.3%) had true post-Lyme syndromes (PLS), category IV, or late Lyme disease (LLD). Most patients had been treated for Lyme: 82/106 (79%).

CONCLUSION:

aPL occurs frequently in patients with 'CLD'. IgM anti-β2GP1, IgM aCL and IgM WB were frequently found. Documented PLS or LLD was uncommon. The role of aPL in patients with 'CLD' needs further investigation.

Source: http://www.ncbi.nlm.nih.gov/pubmed/21729977

Lupus of Lyme

Reumatologen en ik, het zal nooit wat worden.

Bah, heb er al zoveel spijt van. Echt met een sisser afgelopen.

Ik kreeg mijn klachten niet uitgelegd want het moest in chronologische volgorde en daar liep het al fout. En toen wilde die man weten wat mijn ergste klachten vandaag waren maar voor inspanninsgintolerantie en krachtverlies bleek ie oostindisch doof.

Wie had ooit de diagnose lupus en botschade vastgesteld? Die botscan, dat wilde niets zeggen.

En na wat fysiek onderzoek bleef ie maar doordrammen waarom ik niet kon sporten. Zwemmen, dat was toch iets voor mij? Te koud water? Kom kom, er bestaan zwembaden met warm water. Fietsen? Lopen? Nee, ook niet? Waarom niet? Oma probeerde nog eens als oud-gediende.

Hij wilde mijn onderzoeken van naderbij bekijken en binnen een maand mag ik terugkomen. Mijn dikke map dus achtergelaten. Duizenden euro's studiemateriaal gratis in zijn handen. Dat kan hij in zijn sofa in het gezelschap van een glas cognac eens gaan doorbladeren.

SPORT dat is Luxe. Als ik kon sporten, dan was ik al lang gaan werken!!! Maar daar ben ik natuurlijk niet opgekomen toen ik binnen zat. Wat een kl*thommel.

De enige troost die ik eruit haal, is dat als de botscan volgens hem niets zegt, dat het misschien nog Lyme-artritis of iets van die aard kan zijn. Dat liever dan een systeemziekte dat mijn botten opvreet.