The Emerging Role of Microbial Biofilm in Lyme Neuroborreliosis
https://www.frontiersin.org/articles/10.3389/fneur.2018.01048/full?fbclid=IwAR07DmqiRuCZpUSOeFx9S1GZ8J-Y59JdRa4AVAywKS5kBPulXHPiF0CnjZk#B184
"LNB is the most dangerous manifestation of Lyme disease. Although the early antimicrobial treatment is effective in the majority of patients, persistent forms are relatively common. The mechanisms underlying chronic LNB and other persistent forms of Lyme are unknown. Patients who have late manifestations of LB generally show a slower response to therapy with incomplete resolution. Persistent Borrelia infection requires prolonged antimicrobial treatment, with limited and controversial clinical efficacy. Recent evidences suggest that the antibiotic resistance and the reoccurrence of LB are associated with biofilm-like aggregates, which allow Borrelia spp. to resist to adverse environmental conditions. Several promising FDA-approved drugs have been shown to have excellent anti-persister activity when used in combination while their use in monotherapy regimens showed a poor effectiveness. This notion should be taken into careful consideration for the clinical management of Lyme Disease in order to prevent long-term complications.
In preliminary studies by the clinical Biofilm Ring Test® (cBRT), we found that Borrelia is able to readily produce biofilm within 24–48 h. Diagnostic procedures such as the cBRT, which allow for a rapid biofilm measurement may represent very useful tools for clinical applications (222, 223), since the rapid identification of biofilm-producing Borrelia strains, may help identify forms of LB which are at risk of chronicity (224). Further, characterization of Borrelia biofilm as well as the ensuing inflammatory process will likely provide novel insight to better understand the mechanism(s) concurring to LNB pathogenesis and may offer new therapeutic targets for intervention."
A very useful study with many links to important research.
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