Lingering Bacteria Don't Indicate Chronic Lyme Disease March 31, 2008
The bacteria that cause Lyme disease, the most common tick-borne illness in the United States, can linger in mouse tissues long after a full round of antibiotic treatment is completed, report researchers from the University of California, Davis.
The scientists caution that the discovery does not suggest the presence of chronic disease, nor does it support extended use of antibiotics to treat Lyme disease in humans.
Their findings are reported in the March issue of the journal Antimicrobial Agents and Chemotherapy.
However, they say, the results of this study do set the stage for controlled laboratory research investigating potential therapies for persistent Lyme disease infections.
"Lyme disease is a tough nut to crack. The bacterium Borrelia burgdorferi has evolved to evade the body's immune system so it's not surprising that it can also evade antibiotics," said S. B., lead researcher on the study.
B. is director of the UC Davis Center for Comparative Medicine, a cooperative research center in the schools of Medicine and Veterinary Medicine that investigates animal models of human disease.
"It's important to note that the numbers of residual bacteria identified in this study were very low and there was no evidence that they were causing inflammation," B. said.
"Their presence shouldn't be misconstrued as a sign of chronic disease."
LYME DISEASE BACKGROUND Borrelia burgdorferi, the corkscrew-shaped bacterium that causes Lyme disease, is transmitted to humans and animals through bites from infected deer ticks.
In the United States, Lyme disease is most prevalent in the Northeastern and Great Lakes states, and is present to a lesser extent in Northern California.
Other high-risk Lyme disease areas are scattered throughout the nation, usually in shady, moist deciduous forests where the carrier ticks and their wildlife hosts flourish.
Symptoms of Lyme disease are highly variable and may include fever, headache, fatigue and a skin rash. I
f the infection is not treated, it can spread to the joints, heart and nervous system.
Usually, Lyme disease can be successfully treated with about four weeks of antibiotics. Treatment is most successful during the early stages of infection.
A few patients, particularly those treated during late infection, may experience persistent or recurring symptoms after the antibiotic treatment is finished, in which case a second round of antibiotics may be prescribed.
According to the U.S. Centers for Disease Control and Prevention, antibiotic treatment above and beyond one repeat round has not been shown to be beneficial and has been linked to serious complications, including death.
THE CONTROVERSY
Many of those involved with Lyme disease -- including patients, doctors, researchers and health insurance companies -- are divided over how to treat the ailment when it persists beyond a second round of antibiotics.
Some patients with persistent or recurrent Lyme disease symptoms report experiencing fatigue, joint pain, extreme headaches, facial paralysis and memory loss.
Much of the controversy revolves around debate over whether symptoms reflect continued infection after treatment.
There has been minimal scientific evidence to support the claim that infection with the Lyme disease bacterium can persist in a chronic state following antibiotic treatment.
As a result, treatment guidelines recommend against prescribing long-term antibiotics for persistent Lyme disease symptoms.
Many physicians and health insurance companies refuse to prescribe or pay for extended antibiotic treatments.
THE DAVIS STUDY
Barthold and colleagues studied antibiotic treatments for Borrelia burgdorferi infection in laboratory mice.
One group of mice was treated for one month with the antibiotic ceftriaxone, beginning during the first three weeks of infection.
A second group received the same antibiotic for one month, but beginning at four months after infection, representing a chronic infection.
A third group, serving as the control, received only saline for one month, rather than the antibiotic.
When the antibiotic treatments were completed, DNA analysis showed that small numbers of the Lyme disease-causing bacteria remained in the tissues of the antibiotic-treated mice.
Ticks allowed to feed on these infected mice were also able to acquire and transmit the infectious bacteria.
Curiously, despite the apparent viability of the bacteria, they could not be detected by standard laboratory cultures.
The findings support the theory that the bacteria remain viable and that some bacteria evade antibiotic treatment by taking refuge in collagen-rich tissues, skin, ligaments and tendons.
"Our theory is that these remaining bacteria are in a metabolically dormant, non-dividing state," B. said. "This would explain why we were unable to culture them.
"In future studies we need to look at the long-term fate of these bacteria," he said. "They seem to be non-dividing.
If so, are they permanently crippled by the antibiotics and eventually would die out, or would they grow back over the long term and cause a recurrence of the disease?"
While the residual bacteria do not appear to cause disease, they may contribute to the persistence of Lyme disease symptoms, the researchers suggested.
"This may explain why some Lyme disease patients recover slowly following antibiotic treatment, exhibiting what has been termed "post-Lyme disease syndrome," B. said.
The existence of a small number of sequestered bacteria should not come as a surprise, he added, noting that with disease-causing agents like herpes virus and the bacteria that cause tuberculosis and syphilis, it is not unusual for the infectious organisms to persist at levels that do not actually cause symptoms.
"This is just part of our world of microbes," B. said. "Antibiotics are designed to kill large numbers of bacteria -- to knock them down to the point that the body's immune system can get control of the infection."
Bacteria have evolved the means to survive antibiotics in the natural world, he noted. Furthermore, if disease-causing organisms such as Borrelia have evolved the means to escape clearance by the immune system, it is not surprising that the bacteria that survive antibiotic treatment would not be eliminated.
In the case of Lyme disease, the research findings do not suggest that continued use of antibiotics would succeed in getting rid of the lingering bacteria.
"I suspect that if the initial round of antibiotics hasn't eliminated them, it's not likely that a longer regimen of antibiotics would be any more successful," B. said. "It's more likely that a completely different class of antibiotics would be needed to accomplish that.
This laboratory mouse model will allow us to address those possibilities."
Funding for this study was provided by a U.S. Public Health Service grant from the National Institute of Allergy and Infectious Diseases. Media contact(s):
Posts: 2675 | From ct, usa | Registered: Jan 2004
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Geneal
Frequent Contributor (5K+ posts)
Member # 10375
posted
I just don't get this study...
Four months of no antibiotic therapy is called "chronic"
Then they potentially dismiss chronic Lyme.
Plus, did both groups who had antibiotics, the one initially and at four months,
Get tested and cultured?
If mosquitoes can feed on these antibiotic treated Lyme rodents and still carry bb,
Then the rest of the info isn't worth a garbage bag to me.
Plus....what happened to the control group?
Did they die?
Maybe they were told that their Lyme symptoms were just all in their heads.
I am glad that they found persistent disease....they think.
Hopefully they will theorize that bb can "hide" in a non-dividing state and reoccur
Causing relapse and/or continued symptoms.
Maybe if they address it from that point then the outcome can be more supportive of chronic Lyme.
Hugs,
Geneal
Posts: 6250 | From Louisiana | Registered: Oct 2006
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shazdancer
Frequent Contributor (1K+ posts)
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posted
Geneal, I'm with you, this article makes no sense. Their research was published online at the beginning of the month -- you can read the abstract for free HERE.
The IDSA doctors spoke in one paper about what they called "post-Lyme symptoms." Different from "post-Lyme syndrome," they defined it as symptoms that lingered as the disease slowly resolved. In other words, the patient was cured by antibiotics, but he had to wait for months to recover.
But now the UC-Davis researchers are saying that they are finding bacteria (maybe not a lot, but some) during this "recovery" process.
I am confused.... -- Shaz
Posts: 1558 | From the Berkshires | Registered: Jul 2001
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posted
Makes sense to me. The "new" antibiotic everyone is waiting for is the Marshall Protocol.
Posts: 246 | From Grass Valley, CA | Registered: Jun 2007
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posted
I doubt the thrust of the article is about "post-Lyme symptoms". Even they know that's a crock. That said...kudos for a serious article about the future before us. At least it's honest.
Posts: 731 | From Humble,TX | Registered: Feb 2005
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Michelle M
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posted
quote:Originally posted by B R H: Makes sense to me. The "new" antibiotic everyone is waiting for is the Marshall Protocol.
Your tenacity is nothing short of amazing.
Michelle
Posts: 3193 | From Northern California | Registered: Apr 2005
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Michelle M
Frequent Contributor (1K+ posts)
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posted
I think what this article is saying, in a nutshell, is:
"We really don't know the full implications of our findings just yet.
However, since our findings seem to support the chronic lyme people rather than the IDSA, we want to go out on a limb immediately and theorize about how our findings couldn't possibly mean anything to get into a fluff over."
If the bacteria are so "dormant" and innocuous, how do naive ticks acquire lyme from the infected animals? Doesn't sound so innocent to me. How can they make the claim that the bacteria are so harmless if they're capable of transmission to a naive new host? The fact is they haven't got a clue, and are placating the CDC/IDSA so they'll get more research money.
The very title of the article is misleading and comical, since the study may well indicate just that.
Michelle
Posts: 3193 | From Northern California | Registered: Apr 2005
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sparkle7
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posted
This is interesting. Thanks for posting. I'm going to have to sleep on it...
Posts: 7772 | From Northeast, again... | Registered: Oct 2006
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lymewreck36
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Member # 4395
posted
I slithered out of bed this morning and read this article in my mail box, and had the "deer in the head lights" look on my face.
What the heck!
Mary
Posts: 1032 | From North Carolina | Registered: Aug 2003
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Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
G said..
"Four months of no antibiotic therapy is called "chronic... Then they potentially dismiss chronic Lyme."
Remember this is Mr. Vaccine talking... who is being sat upon by Mr. Duck head and the other IDSA ding-a-lings.
To get published they had to tell the truth... but then they refute what their own study says immediately to be SURE patients don't catch a break or that their previous garbage theories don't loose credibility.
Bottom line.. read the studies bottom line.
They want more money for more research.
And the music goes round and round oh oh oh oh .. oh oh.. and it comes out here.
luvs2ride
Frequent Contributor (1K+ posts)
Member # 8090
posted
I guess I am reading this a little more optimistically.
It doesn't rule out chronic lyme. It just says the lingering bacteria may be dormant and not causing any symptoms. Then they say it needs to be studied longterm to see what, if any, future illness the bacteria may cause. I certainly believe that may have been my story for 10 yrs until I was either reinfected and unaware I had been reinfected or the bacteria became active again.
They say this remaining bacteria needs to be studied longterm. They fully acknowledge that Bb can evade the immune system and therefore should be able to evade abx. They even say rather than lonterm treatment with the same abx, we should be looking for a new abx to kill the remaining bugs. (could be setting the stage for the new vaccine or a new abx)
It is not ruling out the need for more abx treatment, just thinks the abx should be changed.
Seems to me it is giving credence to the persistence of Bb in the body and readily admits the study does not answer any questions at this time. It certainly blows the "easy to cure" theory out of the water.
That is better than calling it "Post Lyme Syndrome". Right?
Luvs
-------------------- When the Power of Love overcomes the Love of Power, there will be Peace. Posts: 3038 | From america | Registered: Oct 2005
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It uses science to express a truth, but soft, seemingly paid for by theory, to make a conclusion, that truly, doesn't seem based in the actual science they discovered. What is the conclusion based on, can anyone tell? (I'm not a logical brainer)
What I want to see is the researchers get more reality based.
Infect the mice.
Watch them for 10, 15, 20 and 30 years without any antibiotic treatment.
Note what the disease does through the course of those time periods.
Administer a round of antibiotics. Note the changes.
treepatrol
Honored Contributor (10K+ posts)
Member # 4117
posted
Same old new spin
-------------------- Do unto others as you would have them do unto you. Remember Iam not a Doctor Just someone struggling like you with Tick Borne Diseases.
posted
As much as we all want to believe active lyme infection is what is making us all sick, this study cannot make that conclusion. It certainly supports the likelihood of 're-infection' but it doesn't support that 'active' infection is what is making many of us sick, everyday for months or years.
I have contacted the individual responsible for the conduct of this study to better understand some of the statements made...particularly the piece about "residual bacteria not causing disease but contributing to the persistence of symptoms".
I have communicated with him in the past and he was very responsive. I will share his response as soon as I get it. I'm hoping for some further insight....
Kristin
Posts: 561 | From mass | Registered: Jul 2007
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treepatrol
Honored Contributor (10K+ posts)
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posted
And another one bites the dust
-------------------- Do unto others as you would have them do unto you. Remember Iam not a Doctor Just someone struggling like you with Tick Borne Diseases.
posted
Thanks, DMC, for posting this study. And thanks, KS, for following up.
Were there other studies which have found residual Lyme bacteria which might contribute to symptoms?
To me this study seems significant since the infectiously diseased drs deny that any chronic symptoms could be due to residual Lyme bacteria in the human body (any symptoms would have to be a brand new infection or an entirely different disease).
Thanks again.
Posts: 175 | From Colorado | Registered: Feb 2007
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One of my thoughts is that this 'dormant infection' may not directly be pathogenic (at that time at least) but that we continue to have symptoms from an over-active immune response. Meaning, maybe our body recognizes this foreign invader (this 'residual bacteria) and our immune system is constantly in fight mode.
Think about it, usually when we are sick, a lot of times it is our immune system doing its job that makes us feel sick (e.g. fevers, inflammation). Also, there have been many threads on here where people note that they rarely get the common colds, flu, etc. Seems to me our immune systems are in fact doing their job....maybe too well!!
Just my theory...
Posts: 561 | From mass | Registered: Jul 2007
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One of my thoughts is that this 'dormant infection' may not directly be pathogenic (at that time at least) but that we continue to have symptoms from an over-active immune response. Meaning, maybe our body recognizes this foreign invader (this 'residual bacteria) and our immune system is constantly in fight mode.
Think about it, usually when we are sick, a lot of times it is our immune system doing its job that makes us feel sick (e.g. fevers, inflammation). Also, there have been many threads on here where people note that they rarely get the common colds, flu, etc. Seems to me our immune systems are in fact doing their job....maybe too well!!
Just my theory...
This is probably pretty close. Bb itself is not directly responsible for the disease symptoms many are left with after conventional antibiotic treatments fail.
The antibiotics themselves cause l-form (cell-wall-deficient) bacteria to be created. These l-forms mix with the unique DNA soup of relatively harmless pathogens each of us has collected thruout our lives. Bb is special in that it has MANY plasmids, making it especially able to greatly add to the soup. Natural selection allows some of the new "species" in the mix to thrive. Some of those "evolve" an ability to disrupt the immune system.
The key is that your body is no longer in control of it's immune system - the bugs are. In fact, some of these bugs are able to hide inside the very cells that would normally kill them - macrophages. Others collect in biofilm protected communities in joints, organs, etc.
As the now inept immune system tries to clear the various infections, other body systems (especially hormonal) are often caught in the crossfire. This is why many end up with various "auto-immune" type diagnoses or at least have symptoms that point in that direction. Hypothyroidism is a classic example.
Posts: 246 | From Grass Valley, CA | Registered: Jun 2007
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David95928
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posted
These people seem to be doing double, backward sumersaults in order to avoid giving any credence to the conclusions their data obviously suggests. They probably want to avoid direct conflict with the IDSA gangsters. Still, their findings are striking and may be another factor in the IDSA's house of cards falling.
-------------------- Dave Posts: 2034 | From CA | Registered: Jan 2003
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David95928
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posted
I will add, academic politics can be quite convoluted. Years ago, I co-authored a study using a specific instrument that people from another university had previously used to study a similar question. As we attempted to reconcile our findings with theirs, we came to the conclusion that the previous authors had not scored the instrument correctly. Rather than take them on directly (I was an assistant professor trying to get tenure and she was the Director of a school) we described the discrepancy and added that we just couldn't understand it. During the same time period, the head of the department of Surgery at a local medical school did surgery on me from which I had complications. He was well known for being a really mean SOB. None of the most prominent local surgeons, most of whom were clinical professors at the same institution would touch me and it got back to me that they were in communication with him about my case. The way I finally got this botched surgery corrected is that one of his colleagues, who was even more influential and was nearing retirement, referred me to a surgeon who was divorced with grown children and whose primary hobby was being the doctor on-hand at the local boxing matches. My inference is that I was referred to a surgeon who was suspected of having mafia connections because he was someone the original surgeon wouldn't dare to mess with. I got a little bit of revenge by sending the original surgeon a registered letter describing how the problem he caused was corrected. My calculation was that he was too narcissistic to include that information when he published using the data set of which my case was a part. It seems I was correct because he has not published on that topic since and I suspect that, rather than acknowledge the truth, he abandoned his data set. I check PubMed about every six months to check and, if he does use the data set from that period and doesn't mention my case, plan to lodge a formal complaint of academic misconduct.
-------------------- Dave Posts: 2034 | From CA | Registered: Jan 2003
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