PCR Testing

I've recently suggested to two different people that they go and have PCR tests for Cpn performed on a sample of their blood.  I'm a bit concerned that maybe I shouldn't have suggested the test because I lead them to believe that the test would give them infallible results as to whether or not they have a Cpn infection.  Is that true or not true?

I read something posted here somewhere about the dependability of other testing approaches like micro immunoflorescence (sp?), I believe.  I know that some of the other testing methods aren't very dependable.  What I'm wondering is how PCR testing shapes up by comparison.  Is it a realiable diagnostic approach as opposed to an empirical trial with NAC or one of the bacteriostatics?

Thanks,

John

Joh- This is a technical and complicated problem. See this article from our Research section page here

PCR is the most sensitive of the commercial tests, BUT: it is also highly sensitive to the skill of the lab worker; different primers (which detect particular DNA) are used by different labs so there is no standard; the particular tissue being tested may or may not have adequate Cpn DNA for the test; none of the present PCR tests can detect the presence of the cryptic form; if your Cpn is mostly located in the central nervous system you may be less likely to have any detectable DNA in your blood stream; handling of the specimen can effect everything, ie proper temperature, time to lab, etc.

As an example: my original antigen blood test showed positive, active Cpn indications. Six months into treatment, a PCR blood test showed negative signal for Cpn, yet I know I still had it as my pulse reactions were still quite strong. My original antigen test was from Quest Labs, the PCR test from Labcorp. Both in Midwest (they have labs everywhere, quality not nec consistent).

The reality, as has been repeatedly said by Dr. Stratton, there are no commercially available tests which can be relied on in the absense of other diagnostic considerations (history, symptom pattern, etc). The Vanderbilt tests used something called messenger RNA which turned out to be a much more sensitive indicator and apparently is used by all phases of Cpn. Even so it takes highly skilled operators to get it right.

So once again we are left with: if you take any of the commercially avaiable tests and get a positive score, it affirms you have Cpn. If you get a negative score but have all the other diagnostic and symptom indicators, you still can argue to do an "empirical protocol" and look at the reactions as confirming indicators that you have Cpn or not.

Personally, I think a well done antigen test is just as useful. You might think of having tests done by two labs, say Quest and Immunosciences (a smaller and more controlled venture) to cross-check.

CAP for Chlamydia pneumonia since 11/04. 25yrs CFS & FMS- Currently: 150mg INH, 200 Doxycycline, 500mg MWF Azithromycin, 500mg Tini daily (Continuous protocol)

 

CAP for Cpn 11/04. Dx: 25+yrs CFS & FMS. Currently: 250 aithromycin mwf, doxycycline 100mg BID, restarted Tini pulses; Vit D2000 units, T4 & T3, 6mg Iodoral

Thanks Jim   

That's the sort of feedback I needed.  I'm disappointed that I told my friends that they could use PCR testing as a diagnostic approach.  I do recall knowing about the lack of availability of a commercial test for Cpn but have been confused by reading accounts of people using PCR as a diagnostic tool here.  It's unreliable to say the least.  the Pub Med article/diagram you linked to says it all.

The way in which I went about being diagnosed/diagnosing myself with empirical.  I've suggested that to my friends but they then get fearful that there will be a reaction that they can't handle, can't live with.  I don't know why they can't reason that this is the only path that can lead them to a somewhat normal life. 

As a cost/value analysis, as a question of quality of life, there is no question that the path of treating any of the common illnesses that Cpn causes with the CAP is the way to go.  Even if you do not respond to treatment, the possible benefits outweight the risk of that happening.

So, in any case, thanks for the information and confirmation that I was recently giving bad information. 

On another, unrelated note, I will be sending you a PM about something.

all my best

John

RRMS/EDSS was 4.5, now 4.??? on Wheldon Protocol (nac, doxycycline, azithromycin, metronidazole) since 04/12/2006

best, John

RRMS/EDSS was 4.5, 5, 6, 6.5, 6.9999, 6.5 on Wheldon/Stratton Protocol beginning 04/12/2006
nac 4x600 mg/day
doxycycline 2x100mg/day
azithromycin 3x250mg/day MWF
metronidazole 3x400mg/day then 3x500mg/day

 Far as I know pcr is very accurate as long as its shipped correctly and done by a proper lab. Positives are accurate, negatives sometimes are not and that calls for retesting. PCR is highly accurate for sure.

 But if they are to be tested for chlamydias they should also at the same time be tested for mycoplasmas and possibly lyme. There are different bugs doing the same sorts of things.

 For example -Had I only been tested say for mycoplasma pnuemonia, I wouldnt have found out I was positive for C pneumonia. Have to do the panels so youre being tested for a variety of each.

CAP- doxy and zithro - fibromyalgia, endometriosis, b12 deficiency

CAP- zithro, flagyl, plaquenil - CPN +, fibromyalgia, endometriosis, b12 deficiency

Hi Manycatz   

PCR testing doesn't look dependable at all, at least not the currently commercially available approach which doesn't use the RNA approach that was used at Vanderbilt University.  If you go to the Pub Med article that Jim linked to above, you'll see two tables listed/cited.  See Table 2. 

One of the last two columns on the right side of the table shows the results of testing.  If you view the table and read that column, you can see that only the testing done at Vanderbilt (Sriram et. al) is showing reliable results.  The testing was done with active bacteria.

Here is a link to the table...

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=119969&rendertype=table&id=t2

all my best

John

RRMS/EDSS was 4.5, now 4.??? on Wheldon Protocol (nac, doxycycline, azithromycin, metronidazole) since 04/12/2006

best, John

RRMS/EDSS was 4.5, 5, 6, 6.5, 6.9999, 6.5 on Wheldon/Stratton Protocol beginning 04/12/2006
nac 4x600 mg/day
doxycycline 2x100mg/day
azithromycin 3x250mg/day MWF
metronidazole 3x400mg/day then 3x500mg/day

Just my opinion, based on my own experience with one lab:

 

Before starting CAP, I had numerous PCR tests and ELISA tests run, concurrently. The results of the PCR tests for CPn, MPn, and Parovirus were all negative; while the ELISA results were all positive.

 

Have decided that any future tests that I choose to have done will all be per ELISA.

 

--Minai

 

RRMS, diagnosed 2/04. NAC 4/06. Started Wheldon/Stratton regime 8/30/06. Doxycycline, 8/06, Azith, 10/06. Switched to Roxithromycin 11/06. Psuedo relapse/die-off with hospitalization 1/07. Gad-enhanced MRI of brain and spine shows NO NEW DISEASE ACTIVITY Restarted CAP with NAC and Doxy 2/07. LDN 4/07. Stopped NAC, started Roxi, again 5/07. USA

Interesting, I'm not familiar with EL1SA for Cpn, though I think I've seen it talked about before.  I've had an EL1SA test done about 3 years ago, before I knew about Cpn.  I was looking for food allergies. 

It turned out that I tested as slightly allergic to everthing they tested for with a higher level of allergy to dairy.  I was already a non-dairy consumer and had been for years.

all my best

John

RRMS/EDSS was 4.5, now 4.??? on Wheldon Protocol (nac, doxycycline, azithromycin, metronidazole) since 04/12/2006

best, John

RRMS/EDSS was 4.5, 5, 6, 6.5, 6.9999, 6.5 on Wheldon/Stratton Protocol beginning 04/12/2006
nac 4x600 mg/day
doxycycline 2x100mg/day
azithromycin 3x250mg/day MWF
metronidazole 3x400mg/day then 3x500mg/day

Hi John,

 

Am only guessing that it may be more sensitive than PCR. Your ELISA results for the allergy testing are quite interesting, too!

 

I wasn't a dairy consumer, either, until after diagnosis. Maybe it contributed to lower Vitamin D levels? Have never had them tested, so wouldn't know.

 

But, yes, until the Vanderbilt labs re-open (if/when I have anymore CPn or MPn testing done); I'll probably just stick with ELISA.

 

This is the lab that my prescribing Lyme GP uses: 

 

http://tinyurl.com/2q9zrw

 

 

--Minai Image removed.

 

 

RRMS, diagnosed 2/04. NAC 4/06. Started Wheldon/Stratton regime 8/30/06. Doxycycline, 8/06, Azith, 10/06. Switched to Roxithromycin 11/06. Psuedo relapse/die-off with hospitalization 1/07. Gad-enhanced MRI of brain and spine shows NO NEW DISEASE ACTIVITY Restarted CAP with NAC and Doxy 2/07. LDN 4/07. Stopped NAC, started Roxi, again 5/07. USA