Monica E. Embers, PhD
Associate Professor in the Division of Immunology
Director of Vector-borne Disease Research
Tulane National Primate Research Center
This module presents the most commonly used tests to diagnose Lyme disease, describes their deficiencies, and provides clinicians with important findings regarding the variability in immune responses among infected individuals. How to interpret the two-tier test, especially the western blot, is discussed in detail and in conjunction with the research findings on immune response differences. Finally, the needs and challenges for new diagnostic modalities are considered.
- To describe the common use of the two-tier test
- To break down the details of the western blot and C6 test
- To review data showing variation in antibody responses, which will affect serodiagnoses
- To present the challenges to direct detection, the potential of new technologies, and the need for a “test for cure”
Application for CME credit has been filed with the American Academy of Family Physicians. Determination of credit is pending.
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Philipp, M. T., A. R. Marques, P. T. Fawcett, L. G. Dally and D. S. Martin (2003). “C6 test as an indicator of therapy outcome for patients with localized or disseminated lyme borreliosis.” Journal of Clinical Microbiology 41(11): 4955-4960.
Philipp, M. T., G. P. Wormser, A. R. Marques, S. Bittker, D. S. Martin, J. Nowakowski and L. G. Dally (2005). “A decline in C6 antibody titer occurs in successfully treated patients with culture-confirmed early localized or early disseminated Lyme Borreliosis.” Clin Diagn Lab Immunol 12(9): 1069-1074.
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Embers ME, Hasenkampf NR, Jacobs MB, Philipp MT. Dynamic longitudinal antibody responses during Borrelia burgdorferi infection and antibiotic treatment of rhesus macaques. Clin Vaccine Immunol. 2012 Aug;19(8):1218-26. doi: 10.1128/CVI.00228-12. Epub 2012 Jun 20. PMID: 22718128; PMCID: PMC3416093.
Aucott, J. N., L. A. Crowder and K. B. Kortte (2013). “Development of a foundation for a case definition of post-treatment Lyme disease syndrome.” International Journal of Infectious Diseases 17(6): e443-e449.
Blum, L. K., J. Z. Adamska, D. S. Martin, A. W. Rebman, S. E. Elliott, R. R. L. Cao, M. E. Embers, J. N. Aucott, M. J. Soloski and W. H. Robinson (2018). “Robust B Cell Responses Predict Rapid Resolution of Lyme Disease.” Front Immunol 9: 1634.