Lyme and ANA

[LymeEnigma]

Antinuclear antibodies are not increased in the early phase of Borrelia infection.
Radoslaw Spiewak1,2 , Nimfa M. Stojek1, Jolanta Chmielewska-Badora1
1Department of Occupational Biohazards, Institute of Agricultural Medicine, Lublin, Poland
2Department of Dermatology, VU University Medical Centre, Amsterdam, The Netherlands
Source: Spiewak R, Stojek NM, Chmielewska-Badora J. Antinuclear antibodies are not increased in the early phase of Borrelia infection. Ann Agric Environ Med 2004; 11 (1): 145-148.



Background: In the literature, there are case reports suggesting that Borrelia burgdorferi infection may induce autoimmune diseases dependent on antinuclear antibodies (ANA). The present study was undertaken in order to verify this possibility in a prospective manner.

Methods & Results: The study group comprised 78 consecutive patients (51 women and 27 men, median age 41.5 years) referred to our Department for the serologic diagnosis of Borrelia infection. The patients' sera were tested for Borrelia-specific IgM and IgG (Recombinant Antigen Enzyme Immunoassays, Biomedica). Antibodies against Borrelia were detected in 31 (39.7%) persons. 15 persons (19.2%) had positive IgM, another 15 (19.2%) - positive IgG, and 1 person (3.2%) - both IgM and IgG. Frequent positivity of IgM antibodies suggests that persons in the early phase of infection prevailed in the group. Tests for anti-dsDNA, anti-RNP, anti-Sm antibodies, and a screening test for systemic rheumatic diseases (ANA Rheuma Screen) were carried out using Varelisa Enzyme Immunoassays (Pharmacia&Upjohn). The spectrum of autoimmune diseases covered by these tests included SLE, MCTD, Sjögren's syndrome, scleroderma, polymyositis, and dermatomyositis. ANA were detected in 15 persons (19.2%): anti-dsDNA in 7 (9.0%), anti-RNP in 1 (1.3%), anti-Sm in 2 (2.6%), and ANA Rheuma Screen was positive in 6 persons (7.7%). Statistical analysis of differences in the ANA frequency between Borrelia-positive and -negative groups was carried out using Fishers' exact chi-square test (both without and with sex and age matching). No significant differences were found between the groups.

Conclusion: Based on the above results, we conclude that there is no increase in the frequency of antinuclear antibodies in the early phase of Borrelia infection.

Full article: www.radoslawspiewak.net/2004-1a.htm

[LymeEnigma]

J Rheumatol. 1991 Dec;18(12):1813-8.

Effects of rheumatoid factor, antinuclear antibodies and plasma reagin on the serologic assay for Lyme disease.

Lovece S, Stern R, Kagen LJ. Department of Laboratories, Hospital for Special Surgery, New York, NY 10021.

Rheumatoid factor (RF), antinuclear antibodies (ANA) and the presence of other spirochetal infections have been reported to be the source of false positive serologic tests of Lyme disease. To evaluate this, we studied their effect upon the Lyme assay in use in our clinical laboratory. Of 64 rapid plasma reagin (RPR) test positive sera, 2 had positive Lyme antibody tests, not statistically different than controls. Of 43 RF positive sera, 2 had positive lyme tests, no different than controls, and 1 of 53 ANA containing sera had positive Lyme tests, again, not different from controls. There was no relationship of titer of RPR or ANA with Lyme results, nor of ANA pattern. Sera containing high titer RF, however, had slight interference, producing an increase in equivocal Lyme assay results. From the other point of view, sera that were Lyme test positive had no increased frequency of RPR or RF, but had an increased frequency of ANA. Therefore, neither RPR, RF or ANA were found to markedly interfere with the Lyme assay. However, Lyme antibodies may interfere with the ANA test.

www.ncbi.nlm.nih.gov/pubmed/1795317?ordinalpos=10&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

[LymeEnigma]

Clin Exp Rheumatol. 1996 Mar-Apr;14(2):211-6.Links
Prevalence of anti-neutrophil cytoplasmic antibodies (ANCA) in juvenile chronic arthritis.
Speckmaier M, Röther E, Terreri T, Reiff A, Metzger D, Schuchmann L, Forster J, Peter HH, Brandis M.

University Children's Hospital, Freiburg, Germany.

OBJECTIVE: Sera from 66 children with active JCA of oligoarticular, polyarticular or systemic onset, 13 sera from patients in disease remission, 15 sera from patients with reactive arthritis, and 11 from Lyme arthritis patients were tested for the presence of anti-neutrophil cytoplasmic antibodies (ANCA) in order to evaluate their diagnostic significance in JCA. RESULTS: ANCA were found in 21% (14/66) of the active JCA sera, all showing an atypical pANCA staining pattern using indirect immunofluorescence on ethanol fixed granulocytes. 71% of these sera also showed antinuclear antibodies (ANA) on HEp-2 cells. By additional staining on paraformaldehyde fixed granulocytes to exclude staining artefacts due to ethanol fixation, 2 of the pANCA positive sera showed cytoplasmic staining. In no case did we find nuclear fluorescence suggesting a true cytoplasmic localization of the involved antigens. All ANCA positive sera were negative for anti-MPO and anti-LF antibodies. ANCA prevalence in our study group did not correlate with the disease subgroup, disease duration or other clinical characteristics. However, we found ANCA only in active disease. CONCLUSION: Our data suggest that the diagnostic importance of ANCA in JCA is restricted to only a few JCA patients. In these cases, however, ANCA positivity supports the diagnosis of JCA. Further studies are needed to substantiate this finding, as well as possible subgroup specificities. Standardized techniques of granulocyte fixation and antigen specific tests are needed to produce comparable results in different study groups.

PMID: 8737731 [PubMed - indexed for MEDLINE

www.ncbi.nlm.nih.gov/pubmed/8737731?ordinalpos=6&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

[LymeEnigma]

Scand J Rheumatol Suppl. 1988;75:314-7.Links
Acquired transient autoimmune reactions in Lyme arthritis: correlation between rheumatoid factor and disease activity.
Goebel KM, Krause A, Neurath F.

Department of Medicine, University Hospital, Marburg, West Germany.

Lyme spirochaetal disease (LSD) is a complex multisystem disorder which has been recognized as a separate entity due to its close geographic clustering of affected patients. The study aimed at evaluating the clinical and immunological features of LSD with chronic symptoms of meningoradiculitis, carditis and pauciarticular arthritis. Six patients with LSD and erosive arthritis who developed an increase of serum IgM rheumatoid factor (RF) which correlated with the inflammatory activity of the disease are described in detail. Besides raised IgG antibody titers to Borrelia burgdorferi (B. burgd.) antigen measured by ELISA technique, circulating immune complexes, antinuclear antibodies (ANA) and RF measured by laser nephelometric immunoassay were detected. Increased ANA and RF antibody rates suggest that LSD may closely be linked with transient autoimmune phenomena. Thus, in some cases, B. burgd. antigens might be able to produce a strong polyclonal B-cell stimulation, hence leading to an unspecific autoimmune reaction. But the question remains if transient unspecific autoimmune reactions actually take part in the pathogenesis of LSD.

PMID: 3238365 [PubMed - indexed for MEDLINE

www.ncbi.nlm.nih.gov/pubmed/3238365?ordinalpos=11&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

[nyxie63]

What I'm wondering is if perhaps the lyme triggers an autoimmune response primarily in those with a genetic predisposition for it. Or did the above answer that and I missed it?

[LymeEnigma]

That's the theory, although it seems there are a lot of kinks to iron out, still....