anti-neural antibodies anyone?

I think I may make copies of this and start handing it out to doctors.  Maybe send a copy to that monumental d-bag I briefly tried as a primary care so many years ago in the New England Outback.  This is the one who made a point of telling me “I don’t BELIEVE in chronic Lyme” at my second appointment when I complained of fatigue, eye pain, new joint pain, headaches, and memory problems 4 months after treatment with oral antibiotics for an acute Lyme infection (btw, his mention was the first time I had heard the term).

You know what?   I amgoing to send it to him.  Because it so nicely calls out a particularly obnoxious fallacy, a

image of an "EM" rash typical of lyme disease on a woman's torso

Dyspatient's big fat EM rash. An objective sign of Lyme Disease, until it's faded. File under: "why you should always take a picture"

pseudoscientific belief system dressed up as science because of the class of people who tend to hold and wield it (i.e., those engaged in scientific disciplines/professions).  The “reasoning” of this fallacy goes:  there is no evidence (which I accept) for the existence of this, therefore I will deny the possibility or question of its existence.    Therefore I will deny any attempt to address the cause for it.

The “which I accept” part is the lynch pin of the fallacy.  What one person – doctor, teacher, cashier, or plumber – will accept as real, legitimate, existing, is too often an intangible and mutable mark, arguably as subjective as symptoms like fatigue and nausea.  Think of all the debate over when life begins or ends…we have doctors and theologists and “the rest of us” who have weighed in on this question of existence for as long as we’ve had a discernible existence and not only do we not have an agreed upon answer but we still don’t have good, broadly accepted parameters for the question of what “counts” as evidence and what doesn’t.

When viewed this way, it is clear that what is contended as various scripts from the lyme disease controversies are played out in various doctor’s offices is not a case of this theory vs. that, or the validity of a particular hypothesis….

    like patient s/p acute lyme infection continues to report symptoms.  Is it possible that the acute lyme infection has created some (continuing) pathological state?  If so,  H1:  continuing/chronic lyme; H2: immune response to lyme infection;  H3: effect of treatment for acute lyme infection; etc.

…because all of those hypotheses, hell ANY hypothesis is inconceivable if you will not accept that there is evidence, i.e. if you refuse to accept the existence and validity of the symptoms reported by the patient.  And so what it comes down to is that what is contended is not scientific and not medical.  It more properly falls into the domain of morality and ethics.  It is the validity of one person’s subjective experience over another’s, in this case based on socioeconomic factors.  And when a person’s well being and suffering is on the line, it is one of the worst kinds of misapplications of reason and pseudoscience that I can think of to allow such factors dominate.

Lengthy preamble, I know.  I plead lack of caffeine and a three day long battle with a tenacious touch of migraine.

On to the abstract.  Full text is linked to the title.

Brain Behav Immun. 2010 Aug;24(6):1018-24. Epub 2010 Mar 18.
Anti-neural antibody reactivity in patients with a history of Lyme borreliosis and persistent symptoms.
Chandra A, Wormser GP, Klempner MS, Trevino RP, Crow MK, Latov N, Alaedini A.
Department of Neurology and Neuroscience, Cornell University, New York, NY 10065, USA.

Some Lyme disease patients report debilitating chronic symptoms of pain, fatigue, and cognitive deficits despite recommended courses of antibiotic treatment. The mechanisms responsible for these symptoms, collectively referred to as post-Lyme disease syndrome (PLS) or chronic Lyme disease, remain unclear. We investigated the presence of immune system abnormalities in PLS by assessing the levels of antibodies to neural proteins in patients and controls. Serum samples from PLS patients, post-Lyme disease healthy individuals, patients with systemic lupus erythematosus, and normal healthy individuals were analyzed for anti-neural antibodies by immunoblotting and immunohistochemistry. Anti-neural antibody reactivity was found to be significantly higher in the PLS group than in the post-Lyme healthy

Copyright 2010 Elsevier Inc. All rights reserved.

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