Lyme Disease Testing

The effectiveness of laboratory tests to diagnose Lyme disease is very difficult. The effectiveness of many test methods is between 50-80%. The only definitive and reliable diagnostic marker is the presence of erythema migrans. However, it only occurs in up to a third of people actually infected with Borrelia. Moreover, many people with diagnosed Lyme disease have never noticed a tick, as these nymphs are often not contagious due to their very small shape.

Lyme disease tests can be divided into two groups:

SEROLOGICAL TESTS - they test the level of antibodies generated during the infection.

ELISA test
Standard Lyme test. It is characterized by the identification of specific IgG or IgM antibodies in the serum. IgM antibodies are the first line of the immune system's response. However, there is little or no measurable antibodies to Lyme spirochetes during the first three weeks. Only in the third week the level of these antibodies increases, in the 5th week it reaches its maximum value, and in the 8th week the antibodies disappear. Therefore, undergoing a test after this time is often unreliable. IgG antibodies do not appear until the 6th week of infection and may persist for months or years. However, the effectiveness of the ELISA test is only 40-50%.

Western blot (or immunoblot) test
It consists in looking for antibodies with the help of protein fragments of borrelia bacteria (specific bands). The test can be performed only 4-6 weeks after infection. The reliability of the test is estimated at 70-95%, which is much higher than in the case of the ELISA test.

PMR test
Recommended in the diagnosis of Lyme disease. It is based on the determination of IgG antibodies specific for Borrelia burgdorferi antigens in the cerebrospinal fluid.

Test pc. p. VIsE / C6
The test is used to monitor the effectiveness of Lyme disease treatment. A synthetic C6 peptide from the VlsE protein antigen of Borrelia strains, pathogenic for humans, was used. The concentration of anti-VIsE IgG in most cases drops significantly as a result of successful therapy. It is recommended to measure IgG anti-VIsE titer just before starting treatment and then 6 months after the end of antibiotic therapy.

ELISA, WESTERN BLOT and PMR tests are only used to detect or confirm Lyme disease. They cannot be used for disease monitoring!

DIRECT TESTS - directly detecting the presence of bacteria in the tested material.

PCR test
The test uses the DNA of the spirochetes alone by increasing the amount of material that is analyzed (blood, urine, synovial fluid, cerebrospinal fluid). In the patient's body, however, the spirochetes are often found in small numbers or are not evenly distributed in the tissues, which means that their DNA cannot be detected.

Biopsy and spirochete culture
It involves finding spirochetes in skin biopsy samples and growing them. Unfortunately, this is a long-term and often ineffective method, because the spirochetes often remain at a low level during an infection.

CD57 test
The CD57 test is a useful diagnostic indicator for assessing the severity of the disease. Therefore, it is perfect for assessing the effectiveness of treatment with long-term antibiotic therapy. CD57 NK lymphocytes are a natural defense line to fight the disease, and only Borrelia is able to lower the titer of their cells. This test gives us the opportunity to distinguish Lyme disease from other diseases such as rheumatoid arthritis or multiple sclerosis.

LTT test
The test is used to detect Borrelia infection at the cellular level. The test is positive when specific T-Borrelia lymphocytes are present in the patient's blood. The test is highly sensitive.

KKI test
The test consists in isolating circulating immune complexes (KKIs) from the serum using special techniques and then breaking them down. The anti-coagulant antibodies released from KKI are then detected by Western Blot or ELISA. The KKI test is recommended for people with chronic Lyme disease, in whom serological tests give a negative result, despite the occurrence of symptoms characteristic of Lyme disease. The KKI test will be ineffective in the initial stage of Lyme disease.

ELISPOT test
The test allows to detect a single cell of Borrelia bacteria secreting a given protein at the cellular level. The test is very sensitive and can be used to monitor the course of therapy.