Lyme borreliosis and autism spectrum disorders.

 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 
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:
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

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