Tuesday 10 May 2011

SIGNIFICANT GAPS REMAIN IN UNDERSTANDING OF LYME DISEASE

Nat Cap Lyme do an excellent summary of the Institute of Medicine report on “The Critical Needs and Gaps in Understanding Prevention, Amelioration and Resolution of Lyme and Other Tick-Borne Diseases."

'Significant Gaps Remain In Understanding of Lyme Disease.'

Animal models that explore mechanisms of pathogen persistence following antibiotic treatment. Note acknowledgement of persistence!

A diverse group of scientists and physicians with expertise in tick-borne infections discussed a breadth of scientific topics. Some profound insights shared by several of these presenters include:

“Science is not belief, but the will to find out” (Benjamin J. Luft, M.D.)

“Everyone is studying the early stage of this infection, no one is studying the persistent phase of this infection.” (Stephen Barthold, D.V.M., Ph.D.)

“You do not require an antibody response to develop this disease” (Janis J.Weis, Ph.D.)

“Treat the patient, not the test” (Juan Olano, M.D.)

“[For the child] long-term effects last 50-70 years” (Richard F. Jacobs, M.D.)

“…the poor understanding of the true incidence and geographical distribution…I don’t think we have a clue” (Richard F. Jacobs, M.D.)

“How can you say, ‘I’ve treated you for four weeks and therefore you no longer have Lyme disease.’ The fact is, we don’t know!” (Sam T. Donta, M.D.)

“Under-powered studies which purport to demonstrate universal efficacy need to be viewed with circumspection” (Sam T. Donta, M.D.)

“All that shouting drowns out all the complexity and the nuance and the work that needs to be done” (Pamela Weintraub, senior editor at Discover magazine, and author of Cure Unknown: Inside the Lyme Epidemic)

To read Nat Cap's summary of the report click here

To read Gregg Skall's presentation from an earlier post click here

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I was diagnosed with Fibromyalgia, ME/CFS, Arthritis, Muscle weakness, Musculoskeletal disease and Polymyalgia Rheumatica before my doctors realised that I was actually suffering from Lyme disease.

Wednesday 4 May 2011

BORRELIA BURGDORFERI SUSCEPTABILITY

Evaluation of in-vitro antibiotic susceptibility of different morphological forms of Borrelia burgdorferi
Original Research(298) Article views click here

Authors: Sapi E, Kaur N, Anyanwu S, Luecke DF, Datar A, Patel S, Rossi M, Stricker RB
Published Date May 2011 , Volume 2011:4 Pages 97 - 113 DOI 10.2147/IDR.S19201
Eva Sapi1, Navroop Kaur1, Samuel Anyanwu1, David F Luecke1, Akshita Datar1, Seema Patel1, Michael Rossi1, Raphael B Stricker2
1Lyme Disease Research Group, Department of Biology and Environmental Sciences, University of New Haven, New Haven, CT, USA; 2International Lyme and Associated Diseases Society, Bethesda, MD, USA

Background:
Lyme disease is a tick-borne illness caused by the spirochete Borrelia burgdorferi. Although antibiotic therapy is usually effective early in the disease, relapse may occur when administration of antibiotics is discontinued. Studies have suggested that resistance and recurrence of Lyme disease might be due to formation of different morphological forms of B. burgdorferi, namely round bodies (cysts) and biofilm-like colonies. Better understanding of the effect of antibiotics on all morphological forms of B. burgdorferi is therefore crucial to provide effective therapy for Lyme disease.

Methods:
Three morphological forms of B. burgdorferi (spirochetes, round bodies, and biofilm-like colonies) were generated using novel culture methods. Minimum inhibitory concentration and minimum bactericidal concentration of five antimicrobial agents (doxycycline, amoxicillin, tigecycline, metronidazole, and tinidazole) against spirochetal forms of B. burgdorferi were evaluated using the standard published microdilution technique. The susceptibility of spirochetal and round body forms to the antibiotics was then tested using fluorescent microscopy (BacLight™ viability staining) and dark field microscopy (direct cell counting), and these results were compared with the microdilution technique. Qualitative and quantitative effects of the antibiotics against biofilm-like colonies were assessed using fluorescent microscopy and dark field microscopy, respectively.

Results:
Doxycycline reduced spirochetal structures ~90% but increased the number of round body forms about twofold. Amoxicillin reduced spirochetal forms by ~85%–90% and round body forms by ~68%, while treatment with metronidazole led to reduction of spirochetal structures by ~90% and round body forms by ~80%. Tigecycline and tinidazole treatment reduced both spirochetal and round body forms by ~80%–90%. When quantitative effects on biofilm-like colonies were evaluated, the five antibiotics reduced formation of these colonies by only 30%–55%. In terms of qualitative effects, only tinidazole reduced viable organisms by ~90%. Following treatment with the other antibiotics, viable organisms were detected in 70%–85% of the biofilm-like colonies.

Conclusion:

Antibiotics have varying effects on the different morphological forms of B. burgdorferi. Persistence of viable organisms in round body forms and biofilm-like colonies may explain treatment failure and persistent symptoms following antibiotic therapy of Lyme disease.

Keywords: Lyme disease, spirochetes, cysts, round bodies, biofilms

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This is a welcome study, my own experience was that different antibiotics improved some symptoms more than others but then other antibiotics improved different symptoms and the best improvements were on bi therapy.

The lack of access to knowledgeable and experienced doctors in this field unless we have a bottomless purse makes finding the best treatment options for each of us very problematic.

Judith Miklossy says on her website here

'Newer approaches to the treatment of Lyme disease should take into account the frequent co-infection with other pathogens and the need of a more prolonged combination therapy, as it is the case in the treatment of tuberculosis. Even in the doubt of tuberculosis the treatment of the patients with "tritherapy" is necessary for 6 months. It should be an example for the future treatment of Lyme disease. Such treatment, in analogy to tuberculosis and syphilis will substantially prevent extensive healthcare costs in the future.'