The Best Test for Lyme Disease

The diagnosis of Lyme disease typically relies on a combination of factors, including clinical symptoms, medical history, and laboratory tests. There isn't a single definitive test for Lyme disease, but several tests can aid in its diagnosis. The choice of test depends on the stage of the disease and other factors. The AcuDart Lyme Disease test, which is powered by the ImmunoBlot technology from IGeneX Laboratory, is considered the best test for Lyme disease because of its superior sensitivity and specificity. It has a sensitivity nearly double that of the two-tier testing protocol recommended by the CDC.

The most common tests for Lyme disease typically include:

1. Enzyme-linked immunosorbent assay (ELISA): This blood test detects antibodies produced by the immune system in response to the Lyme bacteria (Borrelia burgdorferi). ELISA is often the initial screening test for Lyme disease. However, it can produce false positives and false negatives, particularly in the early stages of infection.

2. Western blot: If the ELISA test is positive or equivocal, a Western blot test may be performed to confirm the diagnosis. This test detects specific antibodies to various proteins of the Lyme bacteria. It is more specific but less sensitive than ELISA.

3. Polymerase chain reaction (PCR): This test detects the genetic material (DNA) of the Lyme bacteria in blood, joint fluid, or tissue samples. PCR can be useful in the early stages of infection when antibodies may not yet be detectable, or in cases where the infection has spread to other tissues.

4. Culture: Culturing the Lyme bacteria from a blood sample or other bodily fluids or tissues is another diagnostic method. However, it's less commonly used due to its low sensitivity and the slow growth of the bacteria in culture.

5. Antibody titers: In some cases, healthcare providers may measure antibody levels over time to look for changes that suggest active infection or treatment response.

6. Clinical assessment: The healthcare provider will also consider the patient's symptoms, medical history, and possible exposure to ticks in a Lyme-endemic area when making a diagnosis.

Two-tier testing for Lyme disease refers to the recommended approach for diagnosing Lyme disease in the United States, as outlined by the Centers for Disease Control and Prevention (CDC). It involves two steps:

First-tier screening test: This is typically an enzyme-linked immunosorbent assay (ELISA) that detects antibodies against Borrelia burgdorferi, the bacteria that cause Lyme disease. ELISA is a sensitive but less specific test, meaning it may produce false positive results in individuals without Lyme disease. If the ELISA result is negative, no further testing is typically done.

Second-tier confirmatory test: If the ELISA result is positive or equivocal, a Western blot test is performed as a confirmatory test. The Western blot test detects specific antibodies to various proteins of the Lyme bacteria. It is more specific but less sensitive than ELISA, meaning it is better at confirming the presence of Lyme antibodies but may miss some cases of early infection.

The AcuDart Lyme Disease test is based on the ImmunoBlot technology developed by IGeneX Laboratory. An ImmunoBlot has two key differentiators. First, it looks for multiple pathogens, instead of one with a test such as the Western blot. And second, it uses recombinant proteins instead of proteins from natural sources. The recombinant DNA technology provides a more efficient method to obtain large amounts of proteins (i.e. billions of copies). Additionally, by using recombinant technology, scientists are able to create DNA sequences that would not naturally exist under normal circumstances and environmental conditions, leading to more sensitive and specific tests.

The ImmunoBlot technology has many advantages, including:

• Requires only one test to detect multiple species. (Western blotting would require multiple tests.)

• Uses specifically created recombinant proteins and not proteins from cultures

• Produces consistent bands that are easier to interpret

• Detects the full spectrum of disease: early, active, and late-stage

• Does not require a confirmation test

It's important to note that no single test is 100% accurate, and false positives and false negatives can occur. Therefore, diagnosis should be based on a combination of clinical findings and test results, interpreted by a healthcare professional experienced in diagnosing and treating Lyme disease. Early diagnosis and treatment are essential for preventing complications of Lyme disease. If you suspect you have Lyme disease or have been bitten by a tick and are experiencing symptoms, it's important to consult a healthcare provider promptly for evaluation and appropriate management.