i havnt read the liks Adam posted above
but it is well known that Lyme will cause variable bands to appear and dissapear on western blots. both IgG and IgM - but perhaps especially IgM.
this is due to Borrelia's well-established ability to change the outer surface proteins, which it does to try to evade the human immune system.
as the body recognizes one outer surface protein - borrelia changes its makeup and is able to escape immune attack that way - until the body learns this new identity and starts to produce antibodies to the new protein. then the cycle starts over.
It's a very unusual and sophisticated bug in this respect with a large part of its genome given over to pulling off this feature.
thus a person tested with the same western blot test at different time intervals will show up some bands positive which may then fade and others will become positive.
this is actually the reason IgM antibodies are very common in chronic Lyme as the body is seeing each new surface protein the organism expresses as a new infection ( the normal role of IgM antibodies)
there are however additional factors that can also play into this mix.
in particular
all serological tests have limitations in Lyme disease because the disease itself is known to significantly affect the human immune system and in particular, negatively impact the body's ability to make detectable antibodies - even when the organism is proven to be present by PCR or culture.
so a person with lyme may not necessarily or reliably produce antibodies to a surface protien ( antigen) even when the organism is expressing that protein at the time of the test.
secondly, is the issue of the broad genetic variation in the exact makeup of all of these outer surface proteins in the wild populations of different species and strains of borrelia in the environment and in people vs the laboratory cultured strain Borrelia Burgdorfori sensu strictu - strain B31 - upon which most commercial tests are based.
so although those groups with a vested interest in current 2-tier testing will often tell you that the C6 ELISA is very sensitive - and detects all versions of the outer surface protein VlsE uppon which it is based, more recent work has shown beyond dispute that different strains of borrelia that cause lyme disease do not, in fact, make this antigen and as a result, the real-world sensitivity of the test falls to something between 20 and 60 percent depending on which study you read.
for example - I tested negative via C6 ELISA twice but later had positive IgG and IgM antibodies to a whole lysate of B. burgdorferi s.s., B. afzelii, and B. garinii
in a similar way - different western blot manufacturers may use different strains to produce thier kits and so the antigens present may differ from test to test and a source or variation may be introduced this way also.
in reality, no one has yet surveyed and categorized all of the Borrelia organisms that can cause illness in humans - new ones are being discovered in ticks all the time.
these are the common ones currently known to cause Lyme disease in humans:
B. burgdorferi s.s., B. afzelii, B. spielmanii, B. garinii and B. bavariensis as well as the relapsing fever B. Miyamotoi - which may present initially with relapsing fevers - but later appear very much like traditional lyme disease.
for this reason, any Lyme associated band on a western blot should be taken to significantly raise suspicion of Lyme disease in a person with a symptom pattern suggestive of Lyme. But there are no black and white tests available at this time, and in particular, none that can prove Lyme is eradicated or in remission.
and until better tests are available diagnosis remains a clinical one - based on symptoms, history, and reaction to interventions as well as testing.
this is also the reason why several tests are often used as a screen by LLMD's to try to build a more reliable picture of what is likely to be going on.
Post Edited (Garzie) : 12/18/2020 5:59:33 AM (GMT-7)