Serology

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Tissue testing for bacterial signs.

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CPn Titers: What is Significant?

I had my doctor run serologyi on several known pathogens.  These are the results:

Cpn panel updated with D25, D1,25 test results

I recently had a blood test done for Cpni panel to see what I could learn. I realize these tests are not considered accurate. But I was curious & had the opportunity ... so why not?

The panel included C. trachomatis, C. pneumoniae & C. psittaci.

Both the C. trachomatis and C. psittaci results came back normal reference range and said "ANTIBODY NOT DETECTED".

However the C. pneumoniae came back marked high on two fronts.

IgG  1:512 H   (reference range: 1:64)

IgA   1:64  H    (reference range: 1:16)

IgM <1:10

Interpretation = PAST INFECTION

Antibiotics to be available without prescription

This is the news:  In England, possible antibioticsi to be sold over the counter, to treat CHLAMYDIA!

This is the story form http://www.guardian.co.uk/society/2008/aug/06/health<

Oral antibiotics are to be made available for the first time without doctor's prescription under guidelines approved yesterday by the medicines regulator.

A pill to treat chlamydia, the most commonly diagnosed sexually transmitted infection, will become available for purchase in pharmacies across England later this year.

Serological studies on Cpn infections

 

I found a recent 2007 dissertation by M. Paldanius that provides a very good review of the literature and testing procedures for detecting chronic infectionsi and reactivations.  He's on the medical microbiology faculty at the University of Oulu, Finland. His dissertation can be found here: Serological studies on Chlamydia pneumoniae infections<.

 

Case Reports from the Mitchell, Stratton et al patent

patent 6,838,552
                             TABLE 11
Serological and PCRi< Responses to Combination Antibiotic Therapy
Months of
Combination
Pa- Titer Antibiotic

Do I need to worry ?

I had borreliosis last winter and treated it with doxycyclin for 5 weeks 100mg / d.

Last year in summer i had ch. trachomatis which i also treated with a tetracyclin, i don't remember which one exactly. Now to confirm I am no longer infected with borrelia I took a blood test, and tested for borrelia:

IgGi pos but IgM neg. And for chlamydia, and this shows CPni values:

IgA-AK 45 U/ml

IgG-AK 135 U/ml

IgM-AK 1,1 S/CO

 

Method was an EIA. I have dry coughs sometime, that have been bothering me, so I wondered: Do I have to worry? What treatments are available? From reading some posts in this forum, I know that I'm a really light case, but still any help will be greatly appreciated.

 

Thanks

A Test Result is Not a Diagnosis

Editorial (Rant?)

This is one of my own pet medical peeves, stimulated recently by a thread here on Lyme tests and what bands meet criteria, etc. It relates directly to the difficulties with negative tests for Chlamydia pneumoniae. Yes, I know it's a complex issue, but the basic rule is really a simple one:

A serologyi test, either negative or positive, does not a diagnosis make!

Medical diagnosis is a complex art which includes serology, clinical history, symptom patterns, treatment history, and other medical tests. True, some serology carries more weight in the clinical equation that others and may be taken almost defacto as diagnosis. For example, one is treated for many diseasesi on the basis of positive serology, such as for TB or STDi's, even if you are asymptomatic and have nothing obvious in your history.

Testing troughout treatment

Today I was at the doctor and she told me results of tests- my cpni IgAi titers and KFR are high, almost on the same level as in the beggining. So it seems to her my treatment is not very effective. When I took ofloxin my titers rapidly decreased after one moth.

I was better after first two months into the treatment but then I again got worse and last few weeks I am not really well. (I am finishing fourth month)

I know nothing about testing, but it seems to me strange, does anyone have any idea, why it is? I would be grateful for any reasonable answer.

Erythrocyte Sedimentation Rate (ESR)

For some reason, the first thing I saw on the home page of this site is just sinking in. Look at the picture of the parasite-ridden red blood cells on the home page.

No wonder CFSi sometimes shows a low ESR! And the achiness, too, could be due in part to the mechanical difficulty of squeezing those misshapen, oversized RBC's through a capillary.

 Low ESR doesn't exist in the U.S. standard medical training -- it's only associated with inflamatory conditions, and generally only considered significant if it's high (over 20.) I understand that in some of the British standard handbooks, an ESR under 5 is considered abnormal. I found, but don't have the links right now, that low ESR is associated with Giant Cell Arteritisi, another C.Pn. related condition.

Does anyone else who is under treatment for CPNi related conditions happen to know what their ESR was before they started treatment? 

Diagnosis/Serology updated

The Diagnostic Issues< page has been updated with some new material in the Handbook.

Stratton/Mitchell & Siram Case Reports

Does it work?

It has been noted that most users of the combination antibiotic protocolsi commenting here have not been on the treatment long enough to give a big enough pool of reports to feel assured of the efficacy of this approach. I had asked Drs. Stratton, Wheldon, and Powell to perhaps tally up at least some basic numbers from their case experience to help us out with this problem, but this would involve problems of confidentiality and use of private data, etc.  

Then, I suddenly realized that we already have a good list of anecdotal reports of response to treatment reported data available to us... right in the Stratton/Mitchell patent materials! (Sheepish, embarrassed grin). So I took it as a project to summarize this data by disease treated. Occasionally I have used the exact wording from the patent materials as they were brief and descriptive. We have the full text referenced in our treatment and links if you want to see more detail.

All reported had with positive serologyi for Cpni using the highly sensitive tests developed by Stratton/Mitchell. I left out a few whose diagnosis was not clear to me, you can see them in the patent materials #6,884,784
All on some form of the combination antibiotic therapy protocol.

Much ado about a small poll

Summary of our Cpni Treatment Poll:

The poll was out for two weeks, and represents a snapshot of protocol users at this point in time. We had slightly different numbers participating in each section of the poll, perhaps some questions did not have exclusive answers for those voters. Obviously, 25-28 people is not enough to draw scientifically valid results from, but I intend to speculate on some suggestive patterns in the data.

Gender:
Female: 61% (17 votes)
Male: 39% (11 votes)
Total votes: 28
This ratio is commonly reported in CFSi/FM, MSi and other "autoimmune" diseasesi, so is not surprising. We would expect that if more people with Cardiac diseases were searching out Cpn treatment, with a higher male to female ratio, this might change.

Age:
20-29 years = 7% (2 votes)
30-39 years = 14% (4 votes)
40-49 = 32% (9 votes)
50-59 years = 39% (11 votes)
60-69 years = 7% (2 votes)
Total votes: 28
Our largest group is between ages 40 to 59. I suspect that this age does not reflect the period when people are morel likely to be infected, but rather a range where long term persistent infectionsi are have accumulated enough damage to force us to seek out "desperate measures" such as the multi-antibiotic protocol recorded here.

Primary diagnosis:
Over half the total in the poll have a diagnosis of MS. The second largest group are those with a diagnosis of CFS/FMSi. This likely influences the treatment response reported later which suggest that improvements are noticed most after 5 or more pulses.
CFS/FM = 28% (8 votes)
MS = 55% (16 votes)
Asthmai = 3% (1 vote)
Cardiac disease = 3% (1 vote)
OTHER = 10% (3 votes)
Total votes: 29

Serologyi<
Positive blood test for Cpn
48% (12 votes)
Negative blood test for Cpn
16% (4 votes)
Not been tested for Cpn
36% (9 votes)
Total votes: 25
Well over half either have negative or no serology for Cpn, suggesting that they are engaging in a completely empirical (based on symptoms or theoretical connection between disease and Cpn) protocol.

Antibioticsi<
I take AT LEAST TWO of: doxycycline/azithromycin/roxithromycin/rifamcini/minocycline/INHi-: 73% (19 votes)
Single antibiotic only: 20% (5 votes)
I take only INH: 8% (2 votes)
Total votes: 26
This poll speaks for itself. 73% are already on the dual antibiotics, a small number appear to be early in treatment, confirmed by findings below that 40% have not yet done a pulse of bacteriacidal,  and have only added one agent. As INH is used as a single agent with the flagyl pulses in some versions of the Cpn protocol and, together with NACi for the EBi phase I have reported it separately.

Bacteriacidal Agent Used-
I take metronidazolei (Flagyl) for bacteriacidal pulses
81% (13 votes)
I take tinidazole (Tinactini) for bacteriacidal pulses
19% (3 votes)
Total votes: 16

Pulses of bacteriacidal
I've done NO pulses yet of metronidazole/tinidazole
40% (10 votes)
I've done some partial pulses of metronidazole/tinidazole
4% (1 vote)
I have had LESS than 5 full pulses (at least 5 days each) of metronidazole/tinidazole
24% (6 votes)
I have had MORE than 5 full pulses (at least 5 days each) of metronidazole/tinidazole
32% (8 votes)
Total votes: 25
Over half in this small pole have done at least a full pulse of bacteriacidal agent, with only 8 people reporting 5 full pulses or more. This shows that we are still, as a group, in earlier phases of treatment. As the results below suggest, more significant improvement starts to accrue beyond 5 pulses of the bacteriacidal.

Response to treatment-

1. On 1 0r 2 antibiotics ONLY My primary condition is the SAME or WORSE
13% (3 votes)
2. On 1 0r 2 antibiotics ONLY My primary condition is SOMEWHAT improved
13% (3 votes)
3. On 1 0r 2 antibiotics ONLY My primary condition is SIGNIFICANTLY improved
13% (3 votes)
4. Less than 5 full pulses: My primary condition is the SAME or WORSE
13% (3 votes)
5. Less than 5 full pulses: My primary condition SOMEWHAT improved
9% (2 votes)
6. Less than 5 full pulses: My primary condition SIGNIFICANTLY improved
4% (1 vote)
7. MORE than 5 full pulses: My primary condition is the SAME or WORSE
0% (0 votes)
8. MORE than 5 full pulses: My primary condition SOMEWHAT improved
13% (3 votes)
9. MORE than 5 full pulses: My primary condition SIGNIFICANTLY improved
22% (5 votes)
Total votes: 23

These results are more obvious when grouped.
If we collect together everyone in early phase of treatment (#1-6) and we see that 26% are the SAME or WORSE
28% are SOMEWHAT IMPROVED
17% are SIGNIFICANTLY IMPROVED
Actually, to have 35% already reporting any improvement in their condition this early in the protocol is striking to me. I expected less noticeable improvement at this stage, especially given the numbers being treated for otherwise "intractable" diagnoses such as MS and CFS/FM.

But it is when users of the protocol get to 5 pulses (#7-9) or more, in this small sample, that the number in SIGNIFICANTLY IMPROVED seems to begin to creep upwards. Perhaps when we get a better sample of longer term users we will be able to sort out the "magic number" of pulses where more significant improvements take place. From reports in blogs and forums on this site, somewhere around 7-9 pulses seems to be a period where people are feeling much better and more significant changes in their primary diagnosis are occurring.

And one more serology paper

 According to http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=145278<

Clin Diagn Lab Immunol. 2003 January

Measurement of Chlamydia pneumoniae-Specific Immunoglobulin A (IgA) Antibodies by the Microimmunofluorescence (MIF) Method: Comparison of Seven Fluorescein-Labeled Anti-Human IgA Conjugates in an In-House MIF Test Using One Commercial MIF and One Enzyme Immunoassay Kit

 

"...The diagnosis of acute Chlamydia pneumoniae infection is usually based on the demonstration of at least a fourfold increase in immunoglobulin G (IgG) antibody levels in serum samples between the acute phase and the convalescent phase or the presence of IgM antibodies in any serum sample..."

Serodiagnostics of Chlamydial Infections, -- 2002 paper

http://publib.upol.cz/~obd/fulltext/Biomedic146-2/LF11_2002-6.pdf< talks about IgAi and IgM and chronic C. Pn. (Dianna found this one.) Concludes that false positives are rare; false negatives are common. I think.
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