Instead of having to wait for detectable levels of antibodies to arise after infection with Borrelia, patients will now be able to have their blood tested for the bacteria themselves, not their immune system’s response to it. The potential that this research has to revolutionize Lyme disease testing is phenomenal; it could be the promised holy grail of Lyme disease tests, finally solving the riddle of Chronic Lyme disease and post-treatment Lyme disease syndrome.
Early Testing for Lyme Disease
Professor A. T. Charlie Johnson of the Department of Physics and Astronomy in Penn’s School of Arts said “When you’re initially infected with the Lyme disease bacterium, you don’t develop antibodies for many days to a few weeks […] Many people see their physician before antibodies develop, leading to negative serological test results. And after an initial infection, you’re still going to have these antibodies, so using these serological diagnostics won’t make it clear if you’re still infected or not after you’ve been treated with antibiotics.”
Turning Lyme Disease Testing on its Head
Instead of chasing the antibodies like most Lyme disease tests, Johnson, along with graduate student Mitchell Lerner, undergraduate researcher Jennifer Dailey, postdoctoral fellow Brett R. Goldsmith, and Dustin Brisson, an assistant professor of biology decided to approach the problem of Lyme disease testing from the opposite direction. They used laboratory-produced antibodies to detect the presence of Borrelial proteins in such a fashion that they can also measure the concentration of the organism, indicating the strength of infection in a patient’s blood.
Current Problems with Lyme Disease Tests
Obtaining an early diagnosis for Lyme disease is key to successful treatment for most patients, as untreated Lyme disease can cause significant tissue damage in the heart, joints, and nervous system. Current Lyme disease testing methods, including ELISA and Western Blot testing are unable to detect infections during the early stages and even when antibodies have built to detectable levels the tests lack sensitivity and specificity and can produce both false positives and false negatives, creating quite the quandary for physicians and the potential perils of misdiagnosis for patients. Treating late-stage Lyme disease is often more difficult because the bacteria may have changed to a cyst form from a spirochaete form and appear to be able to hide from the immune system to some extent. Cyst-busting drugs and stronger antibiotics may then be necessary to eradicate infection.
Nanotube Conductivity Detects Lyme Disease Infection
This new, nanotechnology-inspired, Lyme disease test promises to be accurate, fast, and able to detect infection even at very preliminary stages, as well as to highlight when treatment has failed to fully eradicate Borrelia in the blood (or synovial fluid). The research was published in the journal Biosensors and Bioelectronics and details how the team built carbon nanotubes that are highly conductive and sensitive to electrical charge and which can be coated with laboratory grown antibodies to Lyme disease bacterial proteins ready to test blood samples. The technology works by measuring the electrical current through the nanotubes to create a known level of conductivity when no antigens are present against which test samples can be assessed so as to deduce the level of antigens present in the blood. The more bacterial proteins in the sample the bigger the difference in conductivity as these antigens bind to the antibodies coating the nanotube and change the flow of electrical current.
How New Lyme Disease Nanotube Test Works
These nanotubes coated with Lyme disease antibodies are, effectively, highly sensitive biosensors that could be used to create tests for many more infectious diseases and, potentially, autoimmune disorders. Having created a baseline measurement for the nanotubes the scientists then submerge them in a sample solution and, according to Johnson, “When we wash away the solution and test the nanotube transistors again, the change in what we measure tells us that how much of the antigen has bound […] And we see the relationship we expect to see, in that the more antigen there was in the solution, the bigger the change in the signal.” The researchers are satisfied that the current sensitivity of the nanotube Lyme disease test is sufficient to detect early infection but they are also investigating ways to make the device about a thousand times more sensitive by binding the protein as close as possible to the nanotube to better influence the electrical signal strength.
A Fool-Proof Lyme Disease Test
This technology would also enable the researchers to create pretty much foolproof Lyme disease tests by attaching a range of different antibodies from a variety of strains of Borrelia and for different proteins from the bacteria. This would significantly reduce the rates of false positives. This new Lyme disease test holds incredible promise for changing the face of Lyme disease diagnosis and management, providing categorical proof of infection for insurance purposes, as well as offering a reliable way to monitor treatment and resolve controversy over persistent Lyme disease infection. “If we were to do this type of test on a person’s blood now, however, we would say the person has the disease,” Johnson said, but it remains to be seen when this incredibly accurate new Lyme disease test will be brought to market.
Mitchell B. Lerner, Jennifer Dailey, Brett R. Goldsmith, Dustin Brisson, A.T. Charlie Johnson. Detecting Lyme disease using antibody-functionalized single-walled carbon nanotube transistors. Biosensors and Bioelectronics, 2013; 45: 163.
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