High titers of either immunoglobulin G (IgG) or immunoglobulin M (IgM) antibodies to Borrelia antigens indicate disease, but lower titers can be misleading, because the IgM antibodies may remain after the initial infection, and IgG antibodies may remain for years.The CDC does not recommend urine antigen tests, PCR tests on urine, immunofluorescent staining for cell-wall-deficient forms of B. burgdorferi, and lymphocyte transformation tests. Imaging
Neuroimaging is controversial in whether it provides specific patterns unique to neuroborreliosis, but may aid in differential diagnosis and in understanding the pathophysiology of the disease. Though controversial, some evidence shows certain neuroimaging tests can provide data that are helpful in the diagnosis of a person. Magnetic resonance imaging (MRI) and single-photon emission computed tomography (SPECT) are two of the tests that can identify abnormalities in the brain of a person affected with this disease. Neuroimaging findings in an MRI include lesions in the periventricular white matter, as well as enlarged ventricles and cortical atrophy. The findings are considered somewhat unexceptional because the lesions have been found to be reversible following antibiotic treatment. Images produced using SPECT show numerous areas where an insufficient amount of blood is being delivered to the cortex and subcortical white matter. However, SPECT images are known to be nonspecific because they show a heterogeneous pattern in the imaging. The abnormalities seen in the SPECT images are very similar to those seen in people with cerebral vacuities and Creutzfeldt–Jakob disease, which makes them questionable.
Dornase alfa (proprietary name Pulmozyme from Genentech) is a highly purified solution of recombinant human deoxyribonuclease I (rhDNase), an enzyme which selectively cleaves DNA. Dornase alfa hydrolyzes the DNA present in sputum/mucus of cystic fibrosis patients and reduces viscosity in the lungs, promoting improved clearance of secretions. This protein therapeutic agent is produced in Chinese hamster ovary cells. Cystic fibrosis
Dornase alfa is the most recent therapeutic agent developed with this basic mechanism of action. Prior to the cloning of the human enzyme, bovine DNase I was on the market for many years, though its utility was limited by the inherent antigenic response to a cow protein in the lungs of patients. Other DNases, such as DNase II, have therapeutic potential as well, but no further DNases have been brought to market yet for cystic fibrosis. Dornase alfa is an orphan drug. Contraindications
Hypersensitivity to dornase alfa
Hypersensitivity to Chinese hamster ovary cell products

Economy
Dornase alpha 1000 units (1 mg/ml)2.5ml (2500units) = £18.52 (GBP)

Off label use
Dornase alfa has recently been shown to improve lung function in non-cystic fibrosis pre-term infants atelectasis where other therapies have failed.In studies conducted, Dornase alfa has been thought to help resolve mucus secretion in COVID-19 patients as well as in the treatment of cystic fibrosis, but since it is taken with nebulizer in general use and there is a possibility of aerosolization of the virus, it is not preferred in most medical centers to avoid secondary infections. == References ==