Saturday, 8 November 2014

ZHANG ON THE HUNT FOR BETTER ANTIBIOTICS TO TREAT CHRONIC PERSISTENT LYME DISEASE

Ying Zhang, MD, PhD, on the hunt for better treatment options for patients with chronic persistent Lyme Disease.

An Optimized SYBR Green I/PI Assay for Rapid Viability Assessment and Antibiotic Susceptibility Testing for Borrelia burgdorferi 


Abstract


Lyme disease caused by Borrelia burgdorferi is the most common tick-borne disease in the US and Europe. Unlike most bacteria, measurements of growth and viability of B. burgdorferi are challenging. The current B. burgdorferi viability assays based on microscopic counting and PCR are cumbersome and tedious and cannot be used in a high throughput format. Here, we evaluated several commonly used viability assays including MTT and XTT assays, fluorescein diacetate assay, Sytox Green/Hoechst 33342 assay, the commercially available LIVE/DEAD BacLight assay, and SYBR Green I/PI assay by microscopic counting and by automated 96-well plate reader for rapid viability assessment of B. burgdorferi. We found that the optimized SYBR Green I/PI assay based on green to red fluorescence ratio is superior to all the other assays for measuring the viability of B. burgdorferi in terms of sensitivity, accuracy, reliability, and speed in automated 96-well plate format and in comparison with microscopic counting. The BSK-H medium which produced a high background for the LIVE/DEAD BacLight assay did not affect the SYBR Green I/PI assay, and the viability of B. burgdorferi culture could be directly measured using a microtiter plate reader. The SYBR Green I/PI assay was found to reliably assess the viability of planktonic as well as biofilm B. burgdorferi and could be used as a rapid antibiotic susceptibility test. Thus, the SYBR Green I/PI assay provides a more sensitive, rapid and convenient method for evaluating viability and antibiotic susceptibility of B. burgdorferi and can be used for high-throughput drug screens.

Press release http://medicalxpress.com/news/2014-11-drugs-lyme-disease.html 
'Zhang and colleagues used the new test – called the SYBR Green I/PI assay – to identify several antibiotics that showed promise against the persistent bacteria that appear immune to the current Lyme antibiotics That paper has been the most popular on the journal's website, and patients, doctors and researchers have been contacting Zhang interested in testing out the most promising of the newly identified drugs.'
FDA approved drugs for persister cells of Borrelia - links can be found on a previous post  http://lookingatlyme.blogspot.co.uk/2014/07/fda-approved-drugs-for-persister-cells.html 
Some studies have said that up to 20% of patients may suffer symptoms long after early treatment for Lyme Disease but in a presentation by Dr. Adriana Marques at a CDC webinar she claims 'Studies of patients with erythema migrans have shown that 0-40% of the patients have persistent or intermittent non-specific symptoms of mild to moderate intensity 6- 24 months after therapy'
'Zhang said that the impact of the disease can be felt after treatment ends in part because some of the live bacteria remain active in the system after the drugs have finished. With no definitive test for the chronic condition or known drugs to treat it, Zhang said the team’s work can provide extra benefits in this area. 
“There are a significant number of people who are sick and desperate for a cure for their Lyme disease symptoms months and even years after they have been told they are cured of the disease,” Zhang said. “The current drugs we use aren't good enough for these persistent cases. This is why I have been getting so many calls and e-mails about our test and the drugs we have identified.” '
'The study was funded by the Lyme Research Alliance and LymeDisease.org, the press release says. From the abstract:
The SYBR Green I/PI assay was found to reliably assess the viability of planktonic as well as biofilm B. burgdorferi and could be used as a rapid antibiotic susceptibility test. Thus, the SYBR Green I/PI assay provides a more sensitive, rapid and convenient method for evaluating viability and antibiotic susceptibility of B. burgdorferi and can be used for high-throughput drug screens.'
http://commonhealth.wbur.org/2014/11/persistent-lyme-disease-test

A comprehensive report can be found:-   http://lymedisease.org/news/lyme_disease_views/news-breakthrough-test-evaluates-drugs-for-lyme-treatment.html



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