Lab Testing For Infections and Autoimmunity

I’m always on the look-out for novel and interesting labs that are doing cutting-edge testing – especially in the light of working with chronic illnesses such as Lyme disease, autism-spectrum disorders, and autoimmune issues including PANS and PANDAS. Cyrex Labs have been around for a good while, but I’ve recently been learning more about their panels, and I’m liking their offerings. Lab testing for infections and autoimmunity is always a bit of a grey area especially when some infections suppress immune function and are hard to find.

One of the things I’m aware of in working in the world of chronic/ stealth infections is the issue of autoimmunity. I am a believer that chronic infections can trigger autoimmunity in the body. Certainly, in my patients I see a lot of gluten intolerance and Hashimoto’s thyroiditis, both which are autoimmune in nature. I think there is a lot more autoimmunity triggered too – with antibodies being produced against many of our own tissues, including the nervous system itself, which is often a major area of dysfunction in these types of conditions.

I also wonder about some patients in whom we’ve been treating chronic infections for years. How much is it that infection is still present, or could it be that most of the actual infection has been eradicated, and what we’re left with is this autoimmune type response, that leads to the chronicity of symptoms?

How can we tell the difference?

One way is to look at the Cyrex Multiple Autoimmune Reactivity Screen. It is one of their panels that offers a wide array of autoimmune markers.

Parietal cell + ATPase; Intrinsic Factor; ASCA + ANCA; tropomyosin; thyroglobulin; thyroid peroxidase; 21 hydroxyls (adrenal cortex); myocardial peptide; alpha-myosin; phospholipid; lately glycoprotein/ oveary/testis; fibulin; collagen complex; arthritic peptide; osteocyte; cytochrome P450; insulin and islet cell antigen; glutamic acid decarboxylase 65; myelin basic protein; asialoganglioside; alpha and beta tubulin; cerebellar; synapsin.

In my Lyme patients, for example, we might run a DNA Connexions PCR panel, which would give us indicators of which pathogens are still showing up; and then also run an autoimmune reactivity screen. That would help shed some light on how much we’re still dealing with active infection, versus how much we’re dealing with the autoimmune sequelae of infection.

Another Cyrex panel that I like very much is the Pathogen-Associated Immune Reactivity Screen. This panel tests IgG antibody response to a vast array of pathogens. In a perfect world I’d love for this panel to run IgM antibodies as well. I know why they don’t – because from a text-book definition standpoint, chronic/ hidden infections are mediated by IgG, while more acute infections are mediated by IgM – but I have certainly seen many of my chronically ill patients showing IgM positive for Lyme not IgG. Anyway, maybe one day they’ll add that. Even so, it’s a very comprehensive panel and may give clues to infections that have not been brought to light before in that individual.

This is the list of antigens it tests:

Porphyromonas gingivalis; streptococcus mutans; helicobacter pylori; campylobacter jejuni; yersinia enterocolitica; colstridium difficile; candida albicans; rotavirus; entamoeba histolytica; guardia lambía; cryptosporidium; blastocystis hominis; human and chalmydia HSP-60; chlamydias; streptozymes; streptococcal M protein; mycoplasmas; acintobacter; klebsiella; mycobaterium avium; aspergillus; penicillium; stachybotrys chartarum; citrullinated EBV; hepatitis C virus; cytomegalovirus; human herpes virus 6; borrelia burgdorferi; babesia; ehrlichia; bartonella.

Whew! I love this because it covers such a wide range, from oral infections to viruses to gut bugs to stealth pathogens.

I believe these types of tests can give us a window into what’s going on in the chronically ill patient – are we still dealing with infection, or are we now dealing with autoimmune response to chronic infection? Armed with that information we can tailor our treatment protocols more effectively and try to shorten duration of treatment and improve our results, getting people well and happy again!