CSHL conference lands a bull’s eye on Lyme detection

Rash decision: A team of laboratory-diagnostics experts that united at Cold Spring Harbor Laboratory wants to speed up standard Lyme disease-detection protocols. (Photo: CDC)
By GREGORY ZELLER //

A gaggle of academic, public health and commercial-healthcare specialists gathered under Cold Spring Harbor Laboratory’s mighty banner have published findings that could rewrite the book on Lyme disease detection.

When the laboratory-diagnostics experts convened for a 2016 Banbury Center meeting – such gatherings, held at CSHL’s on-campus think tank, are generally regarded among the best international scientific workshops – they focused on Lyme, and specifically, earlier detection of a disease that strikes anew some 300,000 times a year in the United States, according to the Centers for Disease Control and Prevention.

After months of extrapolation and study, those experts published findings Dec. 7 advocating improvements in the early diagnosis of the Lyme infection, by levering advanced technologies that reduce the number of positive tests required.

According to CSHL, current laboratory standards for Lyme detection pit antibodies against Borrelia burgdorferi, the bacteria responsible for the disease, in a “two-tiered protocol” involving a “sensitive first test” followed by an immunoblot assay to “increase specificity.”

Such “indirect detection” serologic tests have been favored since 1994, the laboratory noted, and through the years, “important shortcomings have been identified,” including ineffectiveness in the early weeks of infection.

But in a new study published in Clinical Infectious Diseases, a peer-reviewed medical journal published by Oxford University Press, the experts from the 2016 Banbury Center meeting – after reviewing new genome-sequencing technologies and recent scientific data on the interactions between antibodies and Borrelia burgdorferi proteins – championed a new generation of Lyme disease diagnostics.

The article, titled “Advances in Serodiagnostic Testing for Lyme Disease Are at Hand,” states that routine cases of suspected Lyme disease need only a positive or negative result from a single multiplex assay (or combination of assays). The “Western blot” immunoblot – the secondary assay that “has proven to be confusing to many doctors,” according to CSHL – is no longer required.

So say the 27 authors who affixed their John Hancocks and professional cred to “Advances in Serodiagnostic Testing,” including senior author Steven Schutzer, a professor at Rutgers University’s New Jersey Medical School who co-chaired the 2016 Banbury Center meeting with John Branda, a pathology professor at Massachusetts General Hospital and one of the paper’s numerous co-authors.

Rebecca Leshan: The highest discourse, of course, at Banbury.

Through the med-tech wizardry of recombinant proteins, synthetic peptides and alternative testing protocols, quicker and more efficient next-generation Lyme-diagnosis methods are available now, according to Schutzer.

“We know we can do better,” the senior author said. “It is time to focus attention on getting the latest technologies to doctors so they can more effectively diagnose and treat patients.”

Lyme disease, a bacterial infection transmitted to humans through the bite of infected blacklegged ticks, causes flu-like symptoms – including fever, chills, headaches, joint pain and fatigue – in addition to an infamous “bull’s eye” rash. The rash can last for weeks; the symptoms can come and go for months or even years, and left untreated by antibiotics can spread to the joints, heart and brain.

The Banbury Center has hosted several meetings focused on Lyme disease since its first in 1991, giving hundreds of experts a unique chance to jointly apply decades of scientific advances in the immunobiology of the disease – and to review significant potential advances in detection methods designed to hunt down the main culprit itself, the nefarious Borrelia burgdorferi.

After more than a quarter century of Banbury Center attention, the Clinical Infectious Diseases article reflects a breakthrough-level moment for the detection and treatment of what CSHL calls a “growing public health concern” – and another notch in the center’s impressive belt, according to Banbury Center Director Rebecca Leshan.

“The CID publication is the result of critical assessment by a diverse group of experts that exemplifies the mission of the Cold Spring Harbor Laboratory Banbury Center to support impactful scientific discourse at the highest level,” Leshan said in a statement.