Topic: Traditional Lyme disease treatment questioned
Melanie Reber
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Member # 3707
posted
Traditional Lyme disease treatment questioned
By STEVE NERY News Editor, The Star Democrat March 19, 2008
Lyme disease advocacy groups believe a new study reinforces their position that traditional treatment does not effectively eliminate the disease.
A University of California at Davis Center for Comparative Medicine study (published online by the American Society for Microbiology) concludes that traditional treatment of Lyme disease did not kill all Borrelia burgdorferi spirochetes, the tiny organisms responsible for the disease, in mice in the lab.
The study seems to back Lyme advocacy groups' contention that more intensive treatment may be needed at times, although the authors note that more studies are needed to determine the long-term fate of the surviving spirochetes.
Mice were treated with ceftriaxone (a drug commonly used to treat Lyme) or saline (the placebo) for one month, the maximum amount of time recommended by the Infectious Diseases Society of America (IDSA). Treatment started during the early stages three weeks after infection or chronic stage four months after infection.
Tissues of the mice were tested for infection by culture, polymerase chain reaction (during which DNA molecules are amplified for inspection), xenodiagnosis (testing whether clean samples become infected upon exposure), and allograft transplantation (in which organs are taken and put in another mouse).
The tests were performed at one and three months after the completion of treatment. Tissues were also examined for spirochetes by immunohistochemistry, where researchers look for antibodies to mark the presence of the bacteria.
The mice treated with saline tested positive for the spirochetes by culture, whereas the mice treated with antibiotics were consistently culture negative.
Some of the tissues from the mice treated by antibiotics, however, were PCR-positive, and ticks which fed upon those mice picked up the spirochetes. The ticks then went on to transmit the spirochetes to previously uninfected mice, which were also PCR-positive but culture-negative.
"Results indicated that following antibiotic treatment, mice remained infected with non-dividing but infectious spirochetes, particularly when antibiotic treatment was commenced during the chronic stage of infection," the abstract reads.
The authors write that further tests are needed to determine the eventual fate of the remaining spirochetes, which were found hiding in tissue at the base of the heart as well as in tendons or ligaments at joints.
The authors conclude that the overt disease may no longer be present following a month of antibiotic treatment, but the continued presence of B. Burgdorferi may contribute to the persistence of constitutional symptoms. The culture tests, the method favored by the IDSA, "cannot be relied upon as markers of treatment success," they write.
"This latest study once again proved the maximum recommended treatment for Lyme disease failed to eliminate the infectious agent. We need to treat Lyme disease patients until all of their symptoms are gone and not by some arbitrary, cost-effective, insurance friendly guidelines that aren't worth the paper they are written on," said Lucy Barnes, director of the Lyme Disease Education and Support Groups of Maryland.
Barnes is among those who advocate for the International Lyme and Associated Diseases Society (ILADS) treatment guidelines, which provide more flexibility than the Infectious Diseases Society of America's guidelines.
"People, especially children, are going to continue to get sick and stay sick if this disease isn't treated promptly and aggressively. This is another study proving what is being done for people with Lyme is totally inadequate in many cases," Barnes said.
Barnes also decried the ineffective testing method endorsed by the IDSA.
"If this was a test designed to detect cancer and 75 to 90 percent or more of the people who had cancer or HIV were missed, the public outcry would be horrendous. These standard Lyme tests that doctors are depending on to diagnose their patients must be pulled from the market immediately to prevent more harm. Physicians should be clinically diagnosing Lyme as the Centers for Disease Control recommends and treating it until the patients are better, as they would for any other infectious disease," she said.
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sparkle7
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Good article! I wish they would read this on the TV nightly news or CNN. They pay more attention to who Spitzer is screwing than to a potentially crippling disease that is easily transmittable. This can effect 100,000s...
I'm still not so sure that ILIADS has the answer, either... I know they are very helpful but I have my doubts about abx treatment in general - especially for long term untreated cases. We need more research & public awareness.
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The harder you work the luckier you get! Posts: 965 | From Nebraska Cornhuskers fan in Massachusetts | Registered: Dec 2007
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Geneal
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posted
Thanks Melanie for posting this.
It is nice to see some chess players moved to our side for a change.
I hope you are doing well.
Geneal
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map1131
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Good job to you know who!!!!!
Pam
-------------------- "Never, never, never, never, never give up" Winston Churchill Posts: 6478 | From Louisville, Ky | Registered: Jan 2002
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sometimesdilly
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posted
thanks for the article, (umm, Melanie!)and to TinCup for all the work you do.
dilly
[ 19. March 2008, 09:25 PM: Message edited by: sometimesdilly ]
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Marz
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Yes, a great article! I got it too on my google alert email.
But, will this be an isolated study that just fades away or will this idea catch on so that the medical establishment has to take notice!
Have had a bad day in general and it's carrying over into a pessimistic attitude.
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The effectiveness of antibiotic treatment was examined in a mouse model of Lyme borreliosis. Mice were treated with ceftriaxone or saline for one month, commencing during the early (3 weeks) or chronic (4 months) stages of infection with Borrelia burgdorferi. Tissues from mice were tested for infection by culture, polymerase chain reaction (PCR), xenodiagnosis, and transplantation of allografts at 1 and 3 months after completion of treatment.
In addition, tissues were examined for spirochetes by immunohistochemistry. In contrast to saline-treated mice, mice treated with antibiotic were consistently culture-negative, but tissues from some of the mice remained PCR-positive, and spirochetes could be visualized in collagen-rich tissues. Furthermore, when some of the antibiotic treated mice were fed upon by Ixodes scapularis ticks (xenodiagnosis), spirochetes were acquired by the ticks, based upon PCR, and ticks from those cohorts transmitted spirochetes to na�ve SCID mice, which became PCR-positive, but culture-negative.
Results indicated that following antibiotic treatment, mice remained infected with non-dividing but infectious spirochetes, particularly when antibiotic treatment was commenced during the chronic stage of infection.
I had some written feedback from an ISDA thinking doctor with regard to this mouse study that essentially questioned the study design, hence trying to invalidate the implications of the study. I forwarded the ISDA-docs feedback on to the team that conducted this mouse study so that hopefully, in future studies, they can do their best to address ISDA 'concerns'. The scientist responded positively....
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posted
Doc, I agree. That's what I did. Just re-read my post prior to yours and realized I wasn't very clear. I sent it to a couple "ISDA" doctors I've communicated with and to my PCP who is on the fence about all of this who simply said "interesting..." Could tell her wheels were turning.
I think it is worthwhile to forward. I let the MD's know this was one of MANY other studies that had a similar conclusion.
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posted
That's a great article. thank you so much for sharing it. One correction, the organization you referred to is: IDSA, not ISDA. It stands for the Infectious Disease Society of America.
It's also great that you passed on his comments to the researchers. Frankly, in my experience in reading scientific papers, I think the study seems to be well done, and done at a well regarded US institution really helps.
So much of the research that supports our case has been done in Europe, and while it may not seem reasonable to us, it's a fact that American Drs look down on papers done in Europe. They just don't give them the same credit as they do research papers done in the US.
We also need to do what we can to support this type of research. It's really a positive direction and I'm happy to see it.
thanks again.
Patti
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Melanie Reber
Frequent Contributor (5K+ posts)
Member # 3707
posted
If any of you would like to express your gratitude to this reporter and press...
are you familiar w/another article which did a very similar study w/non human primates (monkeys?) and found that the spirochetes seemed to preferentially migrate to the meninges and joints?
I read this article somewhere recently and thought it was here, but I can't seem to find it. It's another great article. In fact, at first I thought it was this one, but then I remembered that ir specified using non-human primates and finding the spirochetes in the meninges and joints.
I'd like to get that reference as well if it rings a bell.
If I find it first I'll post it here.
Thank you,
Patti
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sparkle7
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re: similar study w/non human primates (monkeys?)
Are there "human" primates? Is this a scientific term? Just curious...
I don't mean to be difficult... but are there any studies that abx actually do "cure" Lyme, ever - especially in chronic cases?
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posted
I guess the way I typed it wasn't clear. I typed "w/non human primates"...so it's "NON human primates"... I was just using the same terminology as I recalled the article using. But humans are a type of primate, as I recall.
by the way, I just located the article so here it is:
Titre du document / Document title Localization of Borrelia burgdorferi in the nervous system and other organs in a nonhuman primate model of Lyme disease Auteur(s) / Author(s) CADAVID D. (1 2 3) ; O'NEILL T. (4) ; SCHAEFER H. (3) ; PACHNER A. R. (1 3) ; Affiliation(s) du ou des auteurs / Author(s) Affiliation(s) (1) Department of Neuroscience, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, New Jersey, ETATS-UNIS (2) Department of Neuropathology, Armed Forces Institute of Pathology, Washington, DC, ETATS-UNIS (3) Department of Neurology, Georgetown University Medical Center, Washington, DC, ETATS-UNIS (4) Registry of Comparative Pathology, Armed Forces Institute of Pathology, Washington, DC, ETATS-UNIS
R�sum� / Abstract Lyme borreliosis is caused by infection with the spirochete Borrelia burgdorferi. Nonhuman primates inoculated with the N40 strain of B. burgdorferi develop infection of multiple tissues, including the central (CNS) and peripheral nervous system. In immunocompetent nonhuman primates, spirochetes are present in low numbers in tissues. For this reason, it has been difficult to study their localization and changes in expression of surface proteins. To further investigate this, we inoculated four immunosuppressed adult Macaca mulatta with 1 million spirochetes of the N40 strain of B. burgdorferi, and compared them with three infected immunocompetent animals and two uninfected controls. The brain, spinal cord, peripheral nerves, skeletal muscle, heart, and bladder were obtained at necropsy 4 months later. The spirochetal tissue load was first studied by polymerase chain reaction (PCR)-ELISA of the outer surface protein A (ospA) gene. Immunohistochemistry was used to study the localization and numbers of spirochetes in tissues and the expression of spirochetal proteins and to characterize the inflammatory response. Hematoxylin and eosin and trichrome stains were used to study inflammation and tissue injury. The results showed that the number of spirochetes was significantly higher in immunosuppressed animals. B. burgdorferi in the CNS localized to the leptomeninges, nerve roots, and dorsal root ganglia, but not to the parenchyma. Outside of the CNS, B. burgdorferi localized to endoneurium and to connective tissues of peripheral nerves, skeletal muscle, heart, aorta, and bladder. Although ospA, ospB, ospC, and flagellin were present at the time of inoculation, only flagellin was expressed by spirochetes in tissues 4 months later. Significant inflammation occurred only in the heart, and only immunosuppressed animals had cardiac fiber degeneration and necrosis. Plasma cells were abundant in inflammatory foci of steroid-treated animals. We concluded that B. burgdorferi has a tropism for the meninges in the CNS and for connective tissues elsewhere in the body. Revue / Journal Title Laboratory investigation (Lab. invest.) ISSN 0023-6837 CODEN LAINAW Source / Source 2000, vol. 80, no7, pp. 1043-1054 (2 p.1/2) Langue / Language Anglais
Editeur / Publisher Nature Publishing, New York, NY, ETATS-UNIS (1952) (Revue)
I'm editing this post to add that I'd forgotten that later in the article they did specify macaca mulatta, which are a type of monkey.
I like this article because it demonstrates the spirochetes preference for the meninges and connective tissue. This might be a good article to share w/ our Drs also.
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Melanie Reber
Frequent Contributor (5K+ posts)
Member # 3707
posted
Lyme disease report
"Thank you to Steve Nery and The Star Democrat for the recent article, Traditional Lyme disease treatment questioned.
Your willingness to explore this "taboo" territory is more than appreciated by the far too many patients who have suffered from the decades of misinformation which is so commonly accepted without question."
MELANIE REBER, BA, MLA, Associate ASLA,
Ms. Reber is Executive director of The National Lyme Disease Memorial Park Project, Visit: ] www.LymeMemorial.org .
The Lyme Disease Network is a non-profit organization funded by individual donations. If you would like to support the Network and the LymeNet system of Web services, please send your donations to:
The
Lyme Disease Network of New Jersey 907 Pebble Creek Court,
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