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» LymeNet Flash » Questions and Discussion » Medical Questions » Very Important- Hopkins "New" Conclusions

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Author Topic: Very Important- Hopkins "New" Conclusions
Tincup
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Be sure you are sitting down before reading the following. It is an article from Johns- how many times have we been sued over poor treatment of Lyme disease- Hopkins.

Would love to hear your responses!

Article Here http://www.nature.com/emi/journal/v3/n7/full/emi201453a.html

Here are some highlighted quotes I picked through for those unable to read straight through.

"The actual numbers of PTLDS cases is unknown, but recruitment of these patients for clinical trials has been difficult."

"Although animals do not experience symptoms that might be judged to be PTLDS, in various animal models (mice, dogs and rhesus macaque monkeys), antibiotic therapy with doxycycline, ceftriaxone or tigecycline has not fully eradicated B. burgdorferi, as determined by methods including xenodiagnosis, although viable organisms have not been able to be cultured in conventional culture media."

"These morphological variants have altered antibiotic susceptibilities." [Talking about cyst and L-forms]

"Frontline drugs such as doxycycline and amoxicillin kill the replicating spirochetal form of B. burgdorferi quite effectively, but they exhibit little activity against non-replicating persisters that are enriched in the stationary phase or in biofilm-like aggregates of B. burgdorferi."

"In our preliminary studies, we determined that stationary-phase B. burgdorferi were refractory to killing by the frontline drugs, doxycycline or amoxicillin (Figure 2) and could thus serve as a persister model for drug screens."

"We observed that B. burgdorferi cultures were primarily in the spirochetal form during the log phase (Figure 1B, left panel), but variant forms such as coccoid or round-body forms and micro-colonies were significantly more abundant in stationary-phase cultures (Figure 1B, right panel)."

"These antibiotics [high doses of doxycycline and amoxicillin used for Lyme disease treatment] do not kill the cystic or round-body forms of B. burgdorferi, but metronidazole does have activity against the cystic form of B. burgdorferi."

`````````````````````````````````````

"The results demonstrated that the current antibiotics, doxycycline and amoxicillin, were highly active against log-phase B. burgdorferi but had little activity against stationary-phase B. burgdorferi (Figure 2).

Metronidazole had some activity against log-phase B. burgdorferi but had little activity against stationary-phase B. burgdorferi (Figure 2).

These findings suggest that the current antibiotics used to treat Lyme disease would have little or no activity on B. burgdorferi persisters, if existing, in vivo."

`````````````````````````````````````

***** "Of the 1524 drugs in the FDA-approved drug library tested, 165 had higher activity against B. burgdorferi persisters than doxycycline and amoxicillin." ******

`````````````````````````````````````

"The anti-persister activities of some drugs were significantly higher than the frontline antibiotics, doxycycline and amoxicillin (Table 1).

For example, daptomycin, clofazimine, carbomycin and some cephalosporin antibiotics (such as cefoperazone, cephalothin, cefotiam and cefuroxime) had among the highest activities against stationary-phase B. burgdorferi persisters.

Antimalarial antibiotics(amodiaquine and quinine), aminoglycoside streptomycin, bismuth, tetracycline, and sulfa drugs also had relatively high activity against B. burgdorferi persisters (Table 1).

We also included the currently used Lyme disease treatment antibiotics for comparison with the new active hits.

It is interesting to note that cephalosporin antibiotics, ceftriaxone and cefuroxime, and tigecycline had some activity against persisters, but their anti-persister activities were not as strong as cefoperazone, daptomycin, clofazimine or carbomycin (Table 1).

Doxycycline, amoxicillin, penicillin G, macrolide antibiotics, azithromycin and clarithromycin had relatively poor activity against B. burgdorferi persisters (Table 1)."

`````````````````````````````````````

"Using this rapid method, we screened the FDA approved drug library for activity against non-replicating persisters of B. burgdorferi and identified a number of interesting drug candidates that have excellent anti-persister activity (Table 1).

These include daptomycin, clofazimine, carbomycin, certain cephalosporins, and some sulfa drugs. Most of the candidate drugs are used for treatment of infections other than Lyme disease and would represent a novel use of old drugs for anti-persister activity."

`````````````````````````````````````
"We determined that daptomycin had the highest activity against B. burgdorferi persisters among all the active hits (Table 1, Figure 3D) but had a high MIC (12.5–25 µg/mL) against log-phase organisms (Table 2). ...

Microscope examination revealed spirochetal shaped remnants after daptomycin treatment (Figure 3A), suggesting that the cells were dead and did not change form to coccoid shape, which occurred following cefoperazone and tetracycline treatment (Figures 3E and 3I)."

`````````````````````````````````````

"Here, we observed that carbomycin (Table 1, Figure 3G), a 16-membered macrolide, had higher bactericidal activity against stationary-phase B. burgdorferi than the classic macrolides such as azithromycin, clarithromycin, and erythromycin.

The MIC data (Table 2) demonstrated that carbomycin was also effective against multiplying B. burgdorferi. Macrolides that can penetrate B. burgdorferi cells may have greater activity than penicillin or ceftriaxone. Carbomycin may be a candidate for further investigation to enhance monotherapy treatment of Lyme disease."

`````````````````````````````````````

"Cefoperazone (a third generation cephalosporin) appears to be the best β-lactam antibiotic against stationary-phase B. burgdorferi, followed by some second generation cephalosporins such as cefotiam (Figure 3H), cefmetazole and cefonicid. "

`````````````````````````````````````

"Doxycycline is used clinically as a frontline drug for treating Lyme disease. Doxycycline has low MIC values24 and good activity on multiplying B. burgdorferi. Interestingly, we observed that tetracycline had higher activity against stationary-phase B. burgdorferi persisters than doxycycline (Table 1).

This result is consistent with a previous study, which determined that tetracycline is more active than doxycycline in a minimum bactericidal concentration test."

`````````````````````````````````````

"Here, we observed that clofazimine was highly active against stationary-phase B. burgdorferi persisters (Figure 3F), although the MIC of clofazimine was relatively high (6.25 µg/mL).

The preferential activity of clofazimine against B. burgdorferi persisters may be due to its high lipophilicity and its effects on the membrane. It is of interest to note that clofazimine is known to accumulate in host tissues,37 and this property may allow clofazimine to accumulate to high concentrations and act preferentially against B. burgdorferi persisters if they occur in human tissues."

`````````````````````````````````````

"In addition, some sulfa drugs such as sulfameter and sulfisoxazole were observed to be effective against stationary-phase B. burgdorferi, while sulfamethoxazole exhibited low MIC values (≤0.2 µg/mL). "

`````````````````````````````````````

"While concern remains whether PTLDS is due to persisting organisms, identification of antibiotics that have activity against B. burgdorferi persisters we feel should prompt testing of some antibiotic combinations that could impact either persisters if they exist or presence of antigenic debris, and by whatever mechanisms, study whether such an approach may lead to improved clinical outcomes in Lyme disease including Lyme arthritis or patients with PTLDS."

``````````````````````````````````````

[And here comes Auwaerter's contribution (the editor of the IDSA Lyme Guidelines)- with the Hopkins standard line wedged in there...]

"In summary, this study represents the first high throughput screen against B. burgdorferi in vitro persisters and identified a number of interesting FDA-approved drugs that have excellent anti-persister activity.

Further studies are needed to evaluate these drug candidates in animal models of B. burgdorferi persistence and determine whether they can break the persistence phenomenon the current Lyme disease antibiotics failed to eliminate.

Although the question of B. burgdorferi persistence in humans has been raised, there is no high-quality evidence to support this concept or the idea that additional antibiotic therapy is helpful for patients for PTLDS.

Whether earlier resolution of B. burgdorferi infection, either alone or in combination with current Lyme disease antibiotics, will decrease long term symptoms of fatigue or PTLDS is unknown and will require further study."

The End

BTW- I still do NOT recommend going to Hopkins for Lyme disease.

--------------------
www.TreatTheBite.com
www.DrJonesKids.org
www.MarylandLyme.org
www.LymeDoc.org

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rzh1
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Also in this study it states:

"Some experimental studies have observed at least three morphologic forms of persistent B. burgdorferi: spirochete, spheroplast (or L-form), and cystic or round-body forms.10,20,21 There have been reports of spheroplast or cystic forms in humans, BUT IT IS UNCLEAR whether such morphologic variants exist with any frequency in vivo, and NO STUDY HAS YET EVALUATED a link with clinical disease or determined the effect of antibiotic treatment in humans".

This is a must if you want the mainstream medical profession to believe in persisters.

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Keebler
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-
They ignore so much important work that HAS been done. They just pretend it does not exist because they've kept it out of THEIR journals.

There are so many errors . . . lies . . . misinterpretations here.

For anyone new, do not trust anything you read from Hopkins, Mayo, Yale . . . so many of the university medical groups. Any group or doctor connected with the IDSA. The CDC is pretty much out to lunch, too.

For anyone new, the real research is being done by doctors, scientists, researchers - articles you will find at:

www.ilads.org

www.lymedisease.org

and several others along their line of awareness
-

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WPinVA
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I agree that there are many highly annoying things in there, but it does seem like progress. At least they are now recognizing a lot of things they previously ignored - presence of persistent forms of Lyme, etc.
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cottonbrain
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Tincup, thx for posting this.

I agree with WPinVA -- even if Hopkins has done us harm in the past, perhaps there is something to glean from this report -- I want to approach it with an open mind despite the obvious mistruths toward the end.

I wonder how much of what they report about the various antibiotics is correct?

They list as potential effective killers of 'persisters:'
daptomycin, clofazimine, carbomycin, certain cephalosporins, and some sulfa drugs

Has anyone tried the first three?

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LisaK
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I can't read all the info up there, but I did see that it looks like they are saying they couldn't evaluate the human impact because they couldn't find enough human subjects, is that what it is saying?????

wow.

--------------------
Be thankful in all things- even difficult times and sickness and trials - because there is something GOOD to be seen

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GretaM
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Ahhh...they are just checking off things on the "To Do" list on their way forwards for the lyme vaccine...

Yes, Lisa, you read right. PLDS patients or patients with "persister" cells are difficult to find apparently...

I guess when one has eyes and ears covered, and head buried in the sand...ha!

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rzh1
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Keebler,this research was funded by Lymedisease.org.Look at the acknowledgements,it says:

We thank Lyme Research Alliance and LymeDisease.org for support of this work.

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Tincup
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Cottonbrain said... "I wonder how much of what they report about the various antibiotics is correct?"

Sadly, I have to agree. The fact Hopkins/Auwaerter has been soooooooo bad for soooooooo long, it makes even what appears to be in part possibly good info, appear to be questionable.

And I am still thinking about and looking for their underlying purpose or motive. ??

It's as if a skunk is trying to convince me he, all of a sudden out of the blue, doesn't smell anymore.

--------------------
www.TreatTheBite.com
www.DrJonesKids.org
www.MarylandLyme.org
www.LymeDoc.org

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Tincup
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LisaK said... "I did see that it looks like they are saying they couldn't evaluate the human impact because they couldn't find enough human subjects, is that what it is saying?????"

Yes. I was laughing at that statement! Of course when you treat people so horribly and cause so much destruction you aren't going to get too many "new customers" volunteering to come into your establishment.

Plus, for many years, maybe still even now, they wouldn't accept Lyme patients in their Infectious disease department. My guess is because they were sued by some they did see that were worse off after going there??

If you check out the ancient 2006 IDSA Lyme guidelines (the fine print) that Auwaerter was editor for, you'll see where they dictate what is to be done (king of the castle)- with usually little to no treatment recommended- but admit they only had a very limited number of patients with a specific condition to use as a basis for their garbage conclusions.

Sometimes as few a 3-4 patients were all that were seen by the dozen or so authors, where LLMD's have hundreds of those patients.

--------------------
www.TreatTheBite.com
www.DrJonesKids.org
www.MarylandLyme.org
www.LymeDoc.org

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kungfudao
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I AM TAKING THESE MEDICATIONS:IV, INS paid. [bow] Daptomycin,Ceftaroline (cephoperazone is dis continued)) and Doxyycyclyne.
This is real research paid for by the Lyme research Alliance. Many top Lyme doctors are trying this.
Lyme policy wonk wrote an article on this.
Someone said there is no evidence that Lyme exists in a cyst in the human body. Eva Sapi found bio-film in a human body, but more over, when you have a butterfly as a Caterpillar or cocoon in a bottle it would be clear that would the biological norm. When you see bacteria changing from one form to another that would also be the norm. It explains perfectly why people are still sick. They should be trying to prove that these bacteria don't change into another form not visa versa. There is much research on this.
I AM MAKING IMPROVEMENTS on this Antibiotic protocol. Its only been 12 days. I am scheduled for 3 months.
I might be one of the first to do this. so far so good. feel free to ask Questions on this ,since I just want us all better.

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A.G.
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I did IV Daptomycin/IV Rocephin, oral doxy for 2 months. Was horrible.

I'm still bedbound. No hope left.

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Keebler
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-
I just really hope excellent liver and kidney support is part of any protocol. Without it, I would never take any single Rx for anything.

One (of several) concerns I have with protocols for lyme by those not connected with ILADS line of study is that liver support is so often just never considered. They know nothing about it, or why it's absolutely essential.

For anyone new to all this, a vital part of the foundation of any treatment protocol:

http://flash.lymenet.org/scripts/ultimatebb.cgi?ubb=get_topic;f=3;t=030792;p=0

LIVER & KIDNEY SUPPORT & and several HERXHEIMER support links, too.

Liver / kidney support is also helpful as HEARING PROTECTION as so many Rx can harm hearing. Protections are vital.
-

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Keebler
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However, for controlled studies, use of any supplements can be forbidden as it can offset the finding.

But, I contend, it is absolutely harmful to consider any treatment without adequate liver / kidney / hearing support methods.

So, I'd sure never be in a controlled study.
-

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Aneg
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My co worker and I , which he is a microbiologist, were talking about something similar regarding cysts and spores the other day.

Just because you cannot see it actively causing harm or see it in action does not mean that is does not have the potential to do so when the time is right.

He used spores in the drywall as an example. If you keep the wall dry everything will be fine and they will not replicate, but when moisture conditions are right they will go into action and for lack of better words, come alive.

The same thing is to be said about cysts, spores, ect.

I know for months my hair has been thinning and I was told it was because I was aging, that really annoyed me. I am only 30.

I had a short 10 day dose of cephalosporins( Not for Lyme treatment fyi) a while back and about 3 weeks later my hair started to become fuller again. I am on a tetracycline right now until I find LLMD however it does make sense that it will need to be a myriad of antibiotics to eradicate this disease, not just one will work.... it may for some people but not everyone.

--------------------
Life is short, live it without regrets.

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Aneg
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Also.... My hair is thinning out again.....

--------------------
Life is short, live it without regrets.

Posts: 33 | From DFW | Registered: Sep 2015  |  IP: Logged | Report this post to a Moderator
   

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