Report Refuting Value of Immune Complexes To Diagnose Lyme Disease Is Invalid

Lyme and associated tick-borne diseases: global challenges in the context of a public health threat

“…Patients and control populations are ill-defined with a high variability in predictive positive and negative values from one test to another. Culture of B. burgdorferi or detection of its genome by polymerase chain reaction (PCR) may occasionally confirm the clinical diagnosis in seronegative patients, however none of these methods are sensitive enough to be considered reliable diagnostic methods, especially in routine practice (Schutzer et al, 1990 ; Nields and Kveton, 1991 ; Chmielewska-Badora et al, 2006 ; Brunner, 2006 ; Assous, 2007 ; Holl-Wieden et al, 2007 ; Aguero-Rosenfeld, 2008 ; Dietrich et al, 2008 ; Wallet et al, 2008 ). As a result, many patients suffering signs and symptoms compatible with Lyme disease, but whose test is negative, are falling by the wayside.…”

“…Several factors leading to seronegativity have been identified in confirmed cases of Lyme disease: (i) the arbitrary cut-off level of tests, (ii) the sequestration of antibodies in immune complexes, (iii) the wide variety of species and subspecies of Borrelia that co-exist in different parts of the world, and (iv) coinfections with other pathogens which may be responsible for some or all of the symptoms or which may alter the immune response (Schutzer et al, 1990 ; Brunner, 2006 ). The complex B. burgdorferi sensu lato includes (Table 1 ): B. burgdorferi sensu stricto (including genetic diversity), B. afzelii, B. garinii (several serotypes) and additional species isolated in different parts of the world (Rudenko et al, 2009 , 2011 ; Ogden et al, 2011 ).…”