Med Hypotheses. 2008;70,5:967-74. Epub 2007 Nov 5. The association between tick-borne infections, Lyme borreliosis and autism spectrum disorders. Bransfield RC, Wulfman JS, Harvey WT, Usman AI. Department of Psychiatry, Riverview Medical Center, 225 State Route 35, Red Bank, NJ, United States. bransfield@comcast.net Chronic infectious diseases, including tick-borne infections such as Borrelia burgdorferi may have direct effects, promote other infections and create a weakened, sensitized and immunologically vulnerable state during fetal development and infancy leading to increased vulnerability for developing autism spectrum disorders. A dysfunctional synergism with other predisposing and contributing factors may contribute to autism spectrum disorders by provoking innate and adaptive immune reactions to cause and pe rpetuate effects in susceptible individuals that result in inflammation, molecular mimicry, kynurenine pathway changes, increased quinolinic acid and decreased serotonin, oxidative stress, mitochondrial dysfunction and excitotoxicity that impair the development of the amygdala and other neural structures and neural networks resulting in a partial Klüver-Bucy Syndrome and other deficits resulting in autism spectrum disorders and/or exacerbating autism spectrum disorders from other causes throughout life. Support for this hypothesis includes multiple cases of mothers with Lyme disease and children with autism spectrum disorders; fetal neurological abnormalities associated with tick-borne diseases; similarities between tick-borne diseases and autism spectrum disorder regarding symptoms, pathophysiology, immune reactivity, temporal lobe pathology, and 78brain imaging data; positive reactivity in several studies with autistic spectrum disorder patients for Borrelia burgdorferi, 22%, 26% and 20-30%, and 58% for mycoplasma; similar geographic distribution and improvement in autistic symptoms from antibiotic treatment. It is imperative to research these and all possible causes of autism spectrum disorders in order to prevent every preventable case and treat every treatable case until this disease has been eliminated from humanity. 111.5: Journal of Veterinary Diagnostic Investigation Vol. 20 Issue 3, 321-324 Copyright © 2008 by the American Association of Veterinary Laboratory Diagnosticians: Validation of an in-clinic enzyme-linked immunosorbent assay kit for diagnosis of Borrelia burgdorferi infection in horses. Amy L. Johnson1, Thomas J. Divers and Yung-Fu Chang Correspondence: 1Corresponding Author: Amy L. Johnson, Department of Clinical Studies, University of Pennsylvania, New Bolton Center, 382 West Street Road, Kennett Square, PA 19348, e-mail: aljdvm03@gmail.com Confirmation of Borrelia burgdorferi infection in horses has required enzyme-linked immunosorbent assay (ELISA) or Western blot tests performed by reference laboratories. An in-clinic C6 ELISA SNAP kit has been marketed for dogs. This canine kit was evaluated for horses using serum from experimentally infected ponies. Serum samples originated from 2 previous studies. In the first study, 7 ponies were exposed to B. burgdorferi–infected ticks; 4 ponies served as uninfected controls. Serum samples were obtained bimonthly for 9 months. In the second study, 16 ponies were exposed to B. burgdorferi–infected ticks. After confirmation of infection by skin culture, polymerase chain reaction (PCR), and serology, the ponies were allocated to 4 groups that received tetracycline, doxycycline, ceftiofur, or no treatment. Serum samples were obtained monthly, both before and after antibiotic treatments, for 11 months. For the current study, selected samples (n = 220) from both studies were tested with IDEXX SNAP Heartworm Ab/Borrelia burgdorferi Ab/Ehrlichia canis Ab Test Kits. Tested samples included samples taken before infection, from various times postinfection, and after antibiotic treatments. Results from confirmed positive or negative samples were used to determine sensitivity and specificity of the assay. Results indicate that the test kits have fair sensitivity (63%) and very high specificity (100%) for horses recently infected with B. burgdorferi. Validation of this test provides equine practitioners with an inexpensive, in-clinic method to confirm infection, although its moderate sensitivity may result in a moderate chance of a false negative test. Finally, recent reports 14,15 indicate that C6 technology may allow evaluation of successful antibiotic treatment of Lyme disease based on a decreasing titer. Human studies indicate that a decreasing titer is usually seen with successful treatment of early infection but not in cases of chronic infection despite extensive antibiotic treatment.7 SNAP testing of experimentally 79infected ponies successfully treated with antibiotics (based on negative culture and PCR results by the end of the study) revealed that all ponies became negative on SNAP test. Practitioners in Lyme-endemic areas often see horses with persistently positive ELISA results despite long-term antibiotic treatment. It is not known whether those cases represent failure of antibiotic therapy to eliminate the organism, reinfection with B. burgdorferi, or a persistent immune response despite successful treatment. Further research is needed to determine whether C6 technology will better define the infection status of these horse