tag:blogger.com,1999:blog-37077707267606767312024-03-05T17:36:50.305+00:00LOOKING AT LYME DISEASE - MSIDSMis diagnosed as Fibromyalgia, ME/CFS, Musculoskeletal Disease,Poly Myalgia Rheumatica - significantly improved when treated for Lyme Disease.
Perhaps more aptly described as Multi-Systemic Infectious Disease Syndrome - MSIDS.Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.comBlogger520125tag:blogger.com,1999:blog-3707770726760676731.post-66606681415629499582023-01-07T13:41:00.003+00:002023-01-07T13:41:27.083+00:00<p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-Hk4zhTeZcO_VCRCkFXV8fyZUhUC7K7hkc1EHgqWkIvLzIkfXvHzlxiH7cgI2nYpDbvXD1P8sdvWYGhVQRTAbPwjKQWshhExv2QFg03zA1lp2DHfadnMvksGlL-1nLW-giO1mWHsepdORo54znTf31-2chhJRm7062SBsFktYfoHK_ijRZLqDSKzU/s1101/323861151_665153368680706_5687054243905111394_n.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1101" data-original-width="789" height="418" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-Hk4zhTeZcO_VCRCkFXV8fyZUhUC7K7hkc1EHgqWkIvLzIkfXvHzlxiH7cgI2nYpDbvXD1P8sdvWYGhVQRTAbPwjKQWshhExv2QFg03zA1lp2DHfadnMvksGlL-1nLW-giO1mWHsepdORo54znTf31-2chhJRm7062SBsFktYfoHK_ijRZLqDSKzU/w299-h418/323861151_665153368680706_5687054243905111394_n.jpg" width="299" /></a></div><br /><div style="text-align: center;"> </div><div style="text-align: center;"><span style="font-family: arial; text-align: center;">It is with great sorrow I am writing to say that Joanne passed away on </span></div><div style="text-align: center;"><span style="font-family: arial;">Wednesday 28th December 2022.</span></div><p></p><div class="separator" style="clear: both; text-align: center;"><span style="font-family: arial;"><br /></span></div><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both;"><span style="font-family: arial;">With Mike by her side she left us after a two year valiant fight against </span></div><div class="separator" style="clear: both;"><span style="font-family: arial;">Triple Negative Breast Cancer.</span></div><div class="separator" style="clear: both;"><span style="font-family: arial;"><br /></span></div><div class="separator" style="clear: both;"><span style="font-family: arial;">Joanne was always busy creating. Be it dressmaking, knitting, jewellery making, upholstery, spinning, weaving or tending to her beautiful garden. She was an inspiration.</span></div><div class="separator" style="clear: both;"><span style="font-family: arial;"><br /></span></div><div class="separator" style="clear: both;"><span style="font-family: arial;">Her battle with Lyme disease for nearly 20 years brought her many challenges but with it many great friends. Despite her own health struggles she never stopped being an advocate for others on their difficult journey though Lyme. Even at the end of her life her efforts to help further the understanding of this dreadful disease never ceased.</span></div><div class="separator" style="clear: both;"><span style="font-family: arial;"><br /></span></div><div class="separator" style="clear: both;"><span style="font-family: arial;">Joanne will be desperately missed by Mike, Rachel, Rebecca and her 7 grandchildren.</span></div></div>Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com0tag:blogger.com,1999:blog-3707770726760676731.post-82074258284756446552022-06-17T11:15:00.204+01:002022-11-21T17:05:02.168+00:00LYME DISEASE TO TRIPLE NEGATIVE BREAST CANCER - Is there a link?<p> </p><p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEifLCUAcbjHhIOTI5ym-Z8MnyNui1I1VlAIUgyZJ-yKphy4u5zY3jxLtbmGaUqhTynDn39AjOSJZL31dEYCiJRiVPuB7KSsZ0xmEL372MCJkkqVEhx7AHGSj4Rj5mU6lJp9TUkkgUDuB7C28LDz57-Dtw947l7oMSPka3I8M9cp2oeJHF9HPksubAVN/s2016/IMG-20220621-WA0005.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEifLCUAcbjHhIOTI5ym-Z8MnyNui1I1VlAIUgyZJ-yKphy4u5zY3jxLtbmGaUqhTynDn39AjOSJZL31dEYCiJRiVPuB7KSsZ0xmEL372MCJkkqVEhx7AHGSj4Rj5mU6lJp9TUkkgUDuB7C28LDz57-Dtw947l7oMSPka3I8M9cp2oeJHF9HPksubAVN/w300-h400/IMG-20220621-WA0005.jpg" width="300" /></a></div><br /><span style="font-family: courier; font-size: medium;"><br /></span><p></p><p><span style="font-family: courier; font-size: medium;">I was diagnosed with Lyme disease from tick bite/s contracted in 2003 and 2005 see my story in right hand column of the web version of this blog or at this link <a href="https://lookingatlyme.blogspot.com/2010/12/my-lyme-disease-is-not-idsa-lyme.html" target="_blank"><span style="color: #2b00fe;">https://lookingatlyme.blogspot.com/2010/12/my-lyme-disease-is-not-idsa-lyme.html</span></a><br />Also a video here</span></p><p><span style="font-family: courier; font-size: large;"> </span><a href="https://lookingatlyme.blogspot.com/2016/02/my-lyme-disease-story-joanne-drayson.html" style="font-family: courier; font-size: large;" target="_blank"><span style="color: #2b00fe;">https://lookingatlyme.blogspot.com/2016/02/my-lyme-disease-story-joanne-drayson.html</span></a></p><p><span style="font-family: courier; font-size: medium;">My daily symptoms have been noticeable by inflammation just about everywhere but variable. </span></p><p><span style="font-family: courier; font-size: medium;">I have tried a variety of treatment and combination treatment over the years many helped but none cured daily symptoms.</span></p><p><span style="font-family: courier; font-size: medium;">I have had gall bladder removed, appendix removed and hospitalised with pneumonia in 2019 found to have Bronchiectasis and I developed diverticulitis in recent years.</span></p><p><span style="font-family: courier; font-size: medium;">I found a breast lump in January 2021 and had a mastectomy in February 2021( no lymph node involved) followed by a diagnosis of Triple Negative Breast Cancer. Chemo 4 x TC (<span style="background-color: white;"><span><span style="box-shadow: none; box-sizing: border-box; outline: 0px;">Docetaxel</span> and Cyclophosphamide ) which was grim.</span></span></span></p><p><span style="font-family: courier; font-size: medium;"><span><span style="background-color: white;"><span>I had been referred to Chest Consultant following pneumonia in 2019 because of constant coughing which had gone hand in hand with my Lyme journey. Certain antibiotics relieved symptoms most especially Bactrim/ Septra/Co-</span></span></span><span>Trimoxazole call it what you like. This is medication which can be used in treating Lyme so double benefit but try getting a doctor to prescribe on NHS. Despite constant request chest consultant would not prescribe without evidence of bacterial infection and as I struggled to cough out sufficient for a sputum sample she decided to do an investigation to remove samples from my lungs. Prior to this she arranged a scan of my chest. This scan showed swollen lymph nodes in my right lung and bronchial branch entering right lung. I was referred back to Breast Consultant in view of history of TNBC. The needle biopsy wasn't sufficient to define what type of cancer I had TNBC or a different lung cancer which might be treated differently. I was referred to St Georges for a mediastinoscopy. I was given my results yesterday and it is a Triple Negative Breast Cancer metastasis.</span></span></p><p><span style="font-family: courier; font-size: medium;">One of the first things I read about TNBC metastasis was even with treatment prognosis was not much more than a year and without treatment maybe 3 months.</span></p><p><span style="font-family: courier; font-size: medium;">Everyone who has seen me in the NHS has been lovely but it took from December 2021 until June 2022 6 months to be referred for chemo therapy - unacceptable.</span></p><p><span style="font-family: courier; font-size: medium;">I am waiting to hear what Oncology will offer but I know there are no good treatments for TNBC.</span></p><p><span style="font-family: courier; font-size: medium;">I joined a Facebook group <a href="https://www.facebook.com/groups/704115853080943" target="_blank">Triple Negative Warriors UK </a> which is a lovely group of ladies sharing their journeys and treatments, but so very sad to hear so many young mums struggling to survive this dreadful cancer. At 72 I am lucky to have had a good life.</span></p><p><span style="font-family: courier; font-size: medium;"><br /></span></p><p><span style="font-family: courier; font-size: medium;">19 years struggling with inflammation so no real surprise to end up with cancer, but I was aware of research Eva Sapi was involved with:-</span></p><h1 class="content-title" style="background-color: white; box-sizing: inherit; clear: initial; font-weight: 400; letter-spacing: -0.01em; line-height: 22.5pt; margin: 20pt 0px 10pt;"><span style="font-family: courier; font-size: small;">Effect of Invasion of <em style="box-sizing: inherit;">Borrelia burgdorferi</em> in Normal and Neoplastic Mammary Epithelial Cells</span></h1><div class="half_rhythm" style="background-color: white; box-sizing: inherit; color: #212121; margin-bottom: 10pt; margin-top: 10pt;"><div class="contrib-group fm-author" style="box-sizing: inherit;"><span style="font-family: courier;"><a class="affpopup" co-class="co-affbox" co-rid="_co_idm139707299841328" href="https://pubmed.ncbi.nlm.nih.gov/?term=Gaur%20G%5BAuthor%5D" style="background-color: transparent; box-sizing: inherit; color: #376faa; white-space: nowrap;">Gauri Gaur</a>,<span style="box-sizing: inherit; line-height: 0; position: relative; top: -0.5em; vertical-align: baseline;">1</span> <a class="affpopup" co-class="co-affbox" co-rid="_co_idm139707299827264" href="https://pubmed.ncbi.nlm.nih.gov/?term=Sawant%20JY%5BAuthor%5D" style="background-color: transparent; box-sizing: inherit; color: #376faa; white-space: nowrap;">Janhavi Y. Sawant</a>,<span style="box-sizing: inherit; line-height: 0; position: relative; top: -0.5em; vertical-align: baseline;">1</span> <a class="affpopup" co-class="co-affbox" co-rid="_co_idm139707299825136" href="https://pubmed.ncbi.nlm.nih.gov/?term=Chavan%20AS%5BAuthor%5D" style="background-color: transparent; box-sizing: inherit; color: #376faa; white-space: nowrap;">Ankita S. Chavan</a>,<span style="box-sizing: inherit; line-height: 0; position: relative; top: -0.5em; vertical-align: baseline;">1</span> <a class="affpopup" co-class="co-affbox" co-rid="_co_idm139707299823008" href="https://pubmed.ncbi.nlm.nih.gov/?term=Khatri%20VA%5BAuthor%5D" style="background-color: transparent; box-sizing: inherit; color: #376faa; white-space: nowrap;">Vishwa A. Khatri</a>,<span style="box-sizing: inherit; line-height: 0; position: relative; top: -0.5em; vertical-align: baseline;">1</span> <a class="affpopup" co-class="co-affbox" co-rid="_co_idm139707221119264" href="https://pubmed.ncbi.nlm.nih.gov/?term=Liu%20YH%5BAuthor%5D" style="background-color: transparent; box-sizing: inherit; color: #376faa; white-space: nowrap;">Yueh-Hsin Liu</a>,<span style="box-sizing: inherit; line-height: 0; position: relative; top: -0.5em; vertical-align: baseline;">1</span> <a class="affpopup" co-class="co-affbox" co-rid="_co_idm139707221117088" href="https://pubmed.ncbi.nlm.nih.gov/?term=Zhang%20M%5BAuthor%5D" style="background-color: transparent; box-sizing: inherit; color: #376faa; white-space: nowrap;">Min Zhang</a>,<span style="box-sizing: inherit; line-height: 0; position: relative; top: -0.5em; vertical-align: baseline;">1,</span><span style="box-sizing: inherit; line-height: 0; position: relative; top: -0.5em; vertical-align: baseline;">2</span> and <a class="affpopup" co-class="co-affbox" co-rid="_co_idm139707221113984" href="https://pubmed.ncbi.nlm.nih.gov/?term=Sapi%20E%5BAuthor%5D" style="background-color: transparent; box-sizing: inherit; color: #376faa; white-space: nowrap;">Eva Sapi</a><span style="box-sizing: inherit; line-height: 0; position: relative; top: -0.5em; vertical-align: baseline;">1,</span><span style="box-sizing: inherit; line-height: 0; position: relative; top: -0.5em; vertical-align: baseline;">*</span></span></div></div><p><span style="font-family: courier;"><a href="https://pubmed.ncbi.nlm.nih.gov/34827233/" target="_blank">https://pubmed.ncbi.nlm.nih.gov/34827233/</a></span></p><p><span style="background-color: white; color: #995733; font-family: courier; letter-spacing: -0.01em;">Abstract</span></p><div style="box-sizing: inherit;"><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; color: #212121; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-family: courier;"><em style="box-sizing: inherit;">Borrelia burgdorferi</em>, the causative agent of Lyme Disease, is known to be able to disseminate and colonize various organs and tissues of its hosts, which is very crucial for its pathogenicity and survival. Recent studies have shown the presence of <em style="box-sizing: inherit;">B. burgdorferi</em> DNA in various breast cancer tissues, in some with poor prognosis, which raises the question about whether <em style="box-sizing: inherit;">B. burgdorferi</em> can interact with mammary epithelial cells and could have any effect on their physiology, including tumorigenic processes. As the model in this study, we have used MCF 10A normal and MDA-MB-231 tumorigenic mammary epithelial cells and infected both cell lines with <em style="box-sizing: inherit;">B. burgdorferi</em>. Our immunofluorescence and confocal microscopy results showed that <em style="box-sizing: inherit;">B. burgdorferi</em> is capable of invading normal epithelial and breast carcinoma cell lines within 24 h; however, the infection rate for the breast carcinoma cell lines was significantly higher. While the infection of epithelial cells with <em style="box-sizing: inherit;">B. burgdorferi</em> did not cause any changes in cell proliferation rates, it showed a significant effect on the invasion and migratory capacity of the breast cancer cells, but not on the normal epithelial cells, as determined by Matrigel invasion and wound healing assays. We have also found that the levels of expression of several epithelial–mesenchymal transition (EMT) markers (fibronectin, vimentin, and Twist1/2) changed, with a significant increase in tissue remodeling marker (MMP-9) in MDA-MB-231 cells demonstrated by quantitative Western blot analyses. This observation further confirmed that <em style="box-sizing: inherit;">B. burgdorferi</em> infection can affect the in vitro migratory and invasive properties of MDA-MB-231 tumorigenic mammary epithelial cells. In summary, our results suggest that <em style="box-sizing: inherit;">B. burgdorferi</em> can invade breast cancer tumor cells and it can increase their tumorigenic phenotype, which urges the need for further studies on whether <em style="box-sizing: inherit;">B. burgdorferi</em> could have any role in breast cancer development.</span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; color: #212121; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-family: courier;"><br /></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #201f1e;"><span style="font-family: courier; font-size: medium;">In 2020 I had a sputum sample examined privately by dark field microscopy. This has revealed the presence of an unknown species of spirochaetes, which could be Treponema denticola but in view of Borrelia infection raises questions - of course the NHS will not investigate this.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #201f1e;"><span style="font-family: courier; font-size: medium;"><br />These are slides Peter took of my sputum sample </span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #201f1e;"><span style="font-family: courier; font-size: medium;"><br /><a href="https://www.flickr.com/photos/76898309@N08/albums/72157713421759722">https://www.flickr.com/photos/76898309@N08/albums/72157713421759722</a></span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="border: 0px; box-sizing: border-box; color: #444444; font-family: courier; font-size: medium; font-stretch: inherit; font-variant-east-asian: inherit; font-variant-numeric: inherit; font-weight: 600; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><br /></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-family: courier; font-size: medium;"><span face="Lato, arial, sans-serif" style="border: 0px; box-sizing: border-box; color: #444444; font-stretch: inherit; font-variant-east-asian: inherit; font-variant-numeric: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">A must watch</span><span face="Lato, arial, sans-serif" style="border: 0px; box-sizing: border-box; color: #444444; font-stretch: inherit; font-variant-east-asian: inherit; font-variant-numeric: inherit; font-weight: 600; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"> - AONM Webinar</span><span face="Lato, arial, sans-serif" style="color: #444444;"> with </span><span face="Lato, arial, sans-serif" style="border: 0px; box-sizing: border-box; color: #444444; font-stretch: inherit; font-variant-east-asian: inherit; font-variant-numeric: inherit; font-weight: 600; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Dr. Eva Sapi –</span><span face="Lato, arial, sans-serif" style="color: #444444;"> </span><span face="Lato, arial, sans-serif" style="border: 0px; box-sizing: border-box; color: #444444; font-stretch: inherit; font-variant-east-asian: inherit; font-variant-numeric: inherit; font-weight: 600; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Potential Connection of Borrelia Infection and Breast Cancer</span><span face="Lato, arial, sans-serif" style="color: #444444;"> on the </span><span face="Lato, arial, sans-serif" style="border: 0px; box-sizing: border-box; color: #444444; font-stretch: inherit; font-variant-east-asian: inherit; font-variant-numeric: inherit; font-weight: 600; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">12 July 2022 at 7pm. </span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="border: 0px; box-sizing: border-box; color: #444444; font-family: courier; font-size: medium; font-stretch: inherit; font-variant-east-asian: inherit; font-variant-numeric: inherit; font-weight: 600; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="https://aonm.org/upcoming_events/">https://aonm.org/upcoming_events/</a></span></p><div class="kvgmc6g5 cxmmr5t8 oygrvhab hcukyx3x c1et5uql ii04i59q" style="background-color: white; color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; margin: 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;"><span style="font-size: medium;">You can find the full recording here as part of AONM's Cancer Webinar Series.</span></div></div><div class="cxmmr5t8 oygrvhab hcukyx3x c1et5uql o9v6fnle ii04i59q" style="background-color: white; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;"><span style="font-family: inherit;"><a class="oajrlxb2 g5ia77u1 qu0x051f esr5mh6w e9989ue4 r7d6kgcz rq0escxv nhd2j8a9 nc684nl6 p7hjln8o kvgmc6g5 cxmmr5t8 oygrvhab hcukyx3x jb3vyjys rz4wbd8a qt6c0cv9 a8nywdso i1ao9s8h esuyzwwr f1sip0of lzcic4wl gpro0wi8 py34i1dx" fg_scanned="1" href="https://aonm.org/cancer-webinar-series/?fbclid=IwAR3bc3ll72ciKzUlVsTXG2evKf4D3LqMSglahtQd1AabP6Zcw25YPvj2FK4" rel="nofollow noopener" role="link" style="-webkit-tap-highlight-color: transparent; background-color: transparent; border-color: initial; border-style: initial; border-width: 0px; box-sizing: border-box; cursor: pointer; display: inline; font-family: inherit; list-style: none; margin: 0px; outline: none; padding: 0px; text-align: inherit; text-decoration-line: none; touch-action: manipulation;" tabindex="0" target="_blank"><span style="color: #2b00fe; font-size: medium;"><b>https://aonm.org/cancer-webinar-series/</b></span></a></span></div></div><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-family: arial; font-size: medium;">Update 29/06/2022<br /><br /></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-family: arial; font-size: medium;">Today I had an Oncology appointment. It went well much better than I had expected.<br /><br /></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-family: arial; font-size: medium;">I expressed my concern that it had taken 6 months to this appointment. The Oncologist explained that the three areas in my lung seen on my scan were tiny and Oncologist and Breast Consultant had not expected them to be triple negative so were surprised when the biopsy results came back positive. Although TNBC is an aggressive cancer and I am now classed as stage 4 because it has metastasised to my lung, he believes my prognosis is likely to be at least a year and probably much longer if I respond to chemotherapy. He suggests oral <span face="arial, sans-serif">Capecitabine<span style="color: #4d5156;"> but I need to have a blood test to check if it is suitable for me.</span></span><br /><br />The tissue from the biopsy from the lung is being tested for PDL-1 marker but because the area was small the Oncologist has already asked for samples from my original breast tumour to be sent for testing so that there is a better chance of getting enough tissue for the best results. <br /><br />If the markers come back positive I could be given immunotherapy as well as chemotherapy probably <span style="color: #4d5156; max-height: 999999px; white-space: break-spaces;">atezolizumab</span><b style="color: #4d5156; font-family: Roboto, "Helvetica Neue", Arial, sans-serif; font-size: 14px; max-height: 999999px; white-space: break-spaces;"> </b>which is now available on NHS when PDL-1 markers are positive. <br /><br /></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-family: arial; font-size: medium;">So I see the Oncologist again in two weeks by which time the results should be back. If the results are negative then immunotherapy would not be available unless under a trial. There are none currently at Guildford. London is not practical travelling distance in my current health situation although The Royal Marsden may be worth checking again. </span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-family: arial; font-size: medium;">I am led to understand that immunotherapy can benefit those of us with chronic Lyme but as different ones work differently it would be stabbing in the dark, but then isn't all Lyme treatment a bit like that anyway.</span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-family: arial; font-size: medium;"><br /></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-family: arial; font-size: medium;">Update 13 July</span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-family: arial; font-size: medium;">I saw my oncologist today. </span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-family: arial; font-size: medium;">PDL-1 markers came back positive which means I would be eligible for immunotherapy drugs on NHS - <b> </b>A<span style="color: #4d5156; max-height: 999999px; white-space: break-spaces;">tezolizumab</span> or </span><span style="color: #333333;"><span style="font-family: arial; font-size: medium;">Pembrolizumab.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #333333;"><span style="font-family: arial; font-size: medium;">I need another PET scan as the last one was in March and also an MRI of head. These will be done in the next few days and will serve as a base line to assess if treatment is working.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #333333;"><span style="font-family: arial; font-size: medium;">I will need a PICC Line fitted because of the frequency of IV treatment.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-size: medium;"><span style="color: #333333;"><span style="font-family: arial;">I see my Oncologist again in two weeks by which time the results will be back and I will start treatment soon afterwards. Ate</span></span><span style="color: #4d5156; font-family: arial; white-space: break-spaces;">zolizumab + Abraxane ( nab- paclitaxel)</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">Both drugs come with nasty side effects so fingers crossed I can tolerate them and they work. If I am unable to take either of the immunotherapy drugs then a future option would be capecitabine as the DPD marker came back ok.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium; white-space: break-spaces;">Meanwhile I developed high blood pressure although currently under control on amlodipine.</span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">I am very pleased to have the opportunity to try the immunotherapy.
All being well I start treatment above on 29 July.
</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: large; white-space: break-spaces;">Alliance Medical completely messed up arranging scans which resulted in a trip to Marylebone London to get Pet scan done in time to start treatment. So much for outsourcing NHS. I sent a strongly worded e mail to BCN because 81 year old husband could not drive neither could either daughter and the prospects of travelling by train at 72 with mBCN and dizzy spells was daunting. The hospital arranged for a taxi for me which was such a relief.</span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">Update 28/7/22</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">
Oncologist rang today to update me on scan results.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">Surprisingly Pet scan shows areas in my lungs have reduced since last scan in March, that is without treatment so he believes it could be my immune system dealing with it although I wonder if it is aspirin I take and maybe Bactrim but we will never know.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">Unfortunately the MRI Head scan shows I have a lesion in the center area of my brain which he has to take is associated to mTNBC. With my Lyme hat on I wonder if it could be Lyme related and asked if the lesion was similar to what would be found in MS patients (knowing MS lesions and Lyme lesions were indistinguishable.) He said not. Because of the position of this he did not think it would be cause of my recent dizzy spells or ear problems which I had been hoping could be underlying cause of dizziness. He asked about headaches which I have been getting pressure type headaches a bit like sinus headache which improves enormously on aspirin although I had stopped that prior to scans. He said that when I start treatment the headaches would likely get worse so I might need to take paracetamol or other things but ok to take aspirin on chemo if it helps. In three months they will repeat scans and if treatment hasn't reduced the brain lesion he will refer me to The Royal Marsden to consider Cyberknife plus there are other treatment choices as mentioned above.
</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">Rather an interesting case study just wish it wasn't mine.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">Update 04/09/22 What a roller coaster this is turning into.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">I started Abraxane plus Atezolizumab 1st cycle on 5/8,12/8,19/8</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">Admitted to hospital 23.08.22 due to much worsening balance mobility issues under observation investigation CT scan and MRI head scan.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">The indication is that the immunotherapy is working because the cancer cells within the brain lesion are less but within the component is a cyst ( fluid filled sac) plus outside the lesion is an odema- inflammation. This is the likely cause of deteriorating symptoms and will be managed with Dexamethasone. I was discharged 25.08.22 to await report from MDT meeting Friday 26.08.22 about SRS - Cyberknife.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">Cyberknife not suitable as it won't remove Cyst area. So another week delay for further Neurosurgery MDT as that could remove lesion with cystic area. </span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">02.09.22 Neurosurgeon refuses surgery based on his opinion that I will have further Matisses so a waste of time - basically he says I'm stuffed anyway. Oncologist utterly furious because he can see that the immunotherapy is working (this chemo doesn't penetrate brain so it has to be immuno reducing cancer cells.) </span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">Best plan would be to remove lesion with neurosurgery and resume immunotherapy with chemo. Such inter-speciality disagreements happen as we Lyme patients know too well.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">So my alternative is to start cycle two of treatment keep monitoring sympoms using scans as required. If dexamethasone can keep odema down and symptoms, Immunotherapy should reduce cancer cells and Cyst component could be drained as and when. I start treatment again on 09.09.22 this having caused a weeks delay.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">Friends with similar experience of the benefits of this operation are encouraging me to see if I can get a second Neurosurgeon opinion maybe UCLhospital London.
Onc not in this week so have sent a request as don't know if it is even possible. I do not want a different Onc - herefore renamed by my good friend J as the Fantastic Dr K. I have every confidence he will fight my corner as best he can.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">I believe if I get the surgery it will give me the best chance for forward quality of life with the benefit of immunotherapy and chemotherapy. </span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">THe MRI scan report was sobering because in 4 weeks the lesion had grown c50%in length and width but importantly cancer cells shrinking it is the cystic fluid which has increased. </span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;"><br /></span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"></span></p><div class="separator" style="background-color: white; clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEidHNjRleUftRptM_qqDEkHXlfsbfnsYP30HnrWrf4zveEQKE4wcEj_sy09hNhT04VIpm_jFrriq-PBZA_CT34CyYPL59KCqGT4D3-HA_R2gd2d6lT-k0i1WNemJKErK4xhI1rsF8o0XpN6BNfqyOyIhPAdfGmJ0rCT3OcxWAysi-KyKArndRvqBLDW/s2424/MRI%20report%20no%20name.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2164" data-original-width="2424" height="572" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEidHNjRleUftRptM_qqDEkHXlfsbfnsYP30HnrWrf4zveEQKE4wcEj_sy09hNhT04VIpm_jFrriq-PBZA_CT34CyYPL59KCqGT4D3-HA_R2gd2d6lT-k0i1WNemJKErK4xhI1rsF8o0XpN6BNfqyOyIhPAdfGmJ0rCT3OcxWAysi-KyKArndRvqBLDW/w640-h572/MRI%20report%20no%20name.jpg" width="640" /></a></div><br /><div class="separator" style="background-color: white; clear: both; text-align: center;"><br /></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><br /></span></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><span style="color: #4d5156; font-family: arial; font-size: medium;">So yet another battle on my hands but life is full of twists and turns, I am now enjoying my bed downstairs and use of downstairs shower room originally built when incapacitated with Lyme.<br />Mike has been amazingly supportive - the best. </span></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><span style="color: #4d5156; font-family: arial; font-size: medium;">Lots of family visits and home prepared food parcels. </span></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><span style="color: #4d5156; font-family: arial; font-size: medium;">Plus making the most of educating doctors in Lyme. </span></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><span style="color: #4d5156; font-family: arial; font-size: medium;">Wish me luck. x</span></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><br /></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><br /></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><br /></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><span style="font-family: courier; font-size: medium;">Update 13.09.22</span></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><span style="font-family: courier; font-size: medium;">I contacted Dr Eva Sapi to ask if she could investigate breast cancer tumour unfortunately she can't because it is an Academic lab not a clinical lab. </span></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><span style="font-family: courier; font-size: medium;"><br /></span></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><span style="font-family: courier; font-size: medium;">I now have the report on why Neuro surgery was refused. </span></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><span style="font-family: courier; font-size: medium;"><br /><span style="line-height: 107%;">Solitary Lesion. <br />
MDT discussion and follow up treatment plan<br />
Surgical cyst drainage is an option but close to critical neural structures,
therefore not resectable. <br />
MDT recommeds whole brain radiotherapy and close follow up.</span></span></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><span style="line-height: 107%;"><span style="font-family: courier; font-size: medium;"><br /></span></span></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><span style="line-height: 107%;"><span style="font-family: courier; font-size: medium;">I started Atezolizumab plus Abraxane on. 09.09.22 so far so good, only mild tolerable symtoms of headache and upset stomach. </span></span></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><span style="line-height: 107%;"><span style="font-family: courier; font-size: medium;"><br /></span></span></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><span style="line-height: 107%;"><span style="font-family: courier; font-size: medium;">I think the Dexamethasone is helping reduce brain Odema because the last trip for chemo felt much more comfortable traveling in the car, for the last few weeks my head felt my brain was swishing around as we went over any tiny bump or dip or turn in the road stop or start. Fingers crossed it is dex helping although the insomnia is tiring.</span></span></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><span style="font-family: "Times New Roman",serif; font-size: 12pt; line-height: 107%; mso-ansi-language: EN-GB; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;"><br /></span></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><br /></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><span style="font-family: "Times New Roman",serif; font-size: 12pt; line-height: 107%; mso-ansi-language: EN-GB; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;"><br /></span></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><br /></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><br /></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfgDACWw6vDm7i2ZFcQJB0E9xXjzrqAUcJjPAw0-FcKjBj9GB48ogHxTmd7RaaqmyA26ypRne9YHNNbt6LuSJXkjz0k1r7AGaTK9rySFbkwj0l4FRIgYxXatTEvnnAFg6Y0HdNsDIlWFEABWj1CJRBLBCM2M7YXWnIVtwoeV0WeZjN1EMoFCXB8P9R/s3504/Brain%20surgery%20report.no%20personal%20details.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="3504" data-original-width="2552" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfgDACWw6vDm7i2ZFcQJB0E9xXjzrqAUcJjPAw0-FcKjBj9GB48ogHxTmd7RaaqmyA26ypRne9YHNNbt6LuSJXkjz0k1r7AGaTK9rySFbkwj0l4FRIgYxXatTEvnnAFg6Y0HdNsDIlWFEABWj1CJRBLBCM2M7YXWnIVtwoeV0WeZjN1EMoFCXB8P9R/w466-h640/Brain%20surgery%20report.no%20personal%20details.jpg" width="466" /></a></div><br /><span style="background-color: white; color: #4d5156; font-family: arial; font-size: medium;"><br /><span style="white-space: break-spaces;"><br /></span></span><p style="background-color: white;"></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-size: medium;"><span style="font-family: courier; white-space: break-spaces;"><span style="color: black; text-align: center; white-space: normal;">I have entertained myself during the midnight hours of what I believe are Dexamethasone insomnia with watching Dr Neil Spector's presentation on a collaborative project with Dr Ed Breitschwerdt, Dr Tim Haystead and Monica Embers. If successfully brought to an anticipated conclusion it won't just change the landscape of Lyme Borreliosis but no doubt many other chronic Diseases which may be caused by Lyme.</span></span></span></p><div class="separator" style="background-color: white; clear: both; text-align: center;"><br /></div><div class="separator" style="background-color: white; clear: both; text-align: center;"><iframe allowfullscreen="" class="BLOG_video_class" height="266" src="https://www.youtube.com/embed/FfzdTqfw82Q" width="320" youtube-src-id="FfzdTqfw82Q"></iframe></div><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><br /></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-size: medium;"><span style="font-family: courier; white-space: break-spaces;"><span style="color: black; text-align: center; white-space: normal;">I was particularly intrigued with the use of Verteporfin immunotherapy especially as a quick search shows that it is showing promise in treating TNBC and Glioblastoma (suggestive to me that it might help other brain cancers.) It is another pdl-1 immunotherapy drug. </span></span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-size: medium;"><span style="font-family: courier; white-space: break-spaces;"><span style="color: black; text-align: center; white-space: normal;">Talking about Glioblastomas I have also been listening to this fascinating interview with Dr Alan MacDonald. In which he covers the following important topics.</span></span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-family: courier; font-size: medium;"><span style="color: #4d5156;"><span style="white-space: break-spaces;"><span style="color: black; text-align: center; white-space: normal;">Lewy body Dementia </span></span></span><span style="text-align: center;">He has found Lewy body neurons containing Borrelia Burgdorferi + Borrelia Miyamotoi double infection.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-family: courier; font-size: medium;"><span style="text-align: center;">Blood</span><span style="text-align: center;">stream Borrelia spirochetes are coated with Borrelia antibodies.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="text-align: center;"><span style="font-family: courier; font-size: medium;">Borrelia Hepatitis caused by dual infection Miyamitoi and Burgdorferi</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="text-align: center;"><span style="font-family: courier; font-size: medium;">Chronic Lymphocitic Leukaemia single case demonstrates Borrelia spirochetes inside Leukemic cells in blood.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="text-align: center;"><span style="font-family: courier; font-size: medium;">Glioblastoma brain tumours (5 cases) Contain Borrelia spirochetes INSIDE individual tumour cells.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="text-align: center;"><span style="font-family: courier; font-size: medium;">Lyme Disease suicide patient with Borrelia spirochetes inside brain neurons in autopsy brain.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-size: medium;"><span style="font-family: courier; white-space: break-spaces;"><span style="color: black; text-align: center; white-space: normal;"><br /></span></span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-family: courier; font-size: medium;"><span><span><span style="text-align: center;"><a href="https://tickbootcamp.com/episode-300-ahead-of-the-curve-an-interview-with-dr-alan-mcdonald/?fbclid=IwAR3O9AdicmWR7ioOAV904_vpYeMBv2G1zJ_Qp6OpDUWwW1KiQre9wGSgVz4">https://tickbootcamp.com/episode-300-ahead-of-the-curve-an-interview-with-dr-alan-mcdonald/?</a></span></span></span><a href="https://tickbootcamp.com/episode-300-ahead-of-the-curve-an-interview-with-dr-alan-mcdonald/?fbclid=IwAR3O9AdicmWR7ioOAV904_vpYeMBv2G1zJ_Qp6OpDUWwW1KiQre9wGSgVz4" style="text-align: center;">fbclid=IwAR3O9AdicmWR7ioOAV904_vpYeMBv2G1zJ_Qp6OpDUWwW1KiQre9wGSgVz4</a></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-family: courier; font-size: medium;"><br /></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-family: courier; font-size: medium;">Dr MacDonald provides his services free. He struggles to get his work published because of the cost of publishing so has set up a Go fund me pageto help finance publishing his work </span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><a href="https://www.gofundme.com/f/borrelia-research-microscopic-discovery"><span style="font-family: courier; font-size: medium;">https://www.gofundme.com/f/borrelia-research-microscopic-discovery</span></a></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-family: courier; font-size: medium;">I can't think of a more worthwhile cause. Every one of us will have somone we love impacted by these diseases where Dr MacDonald has found links to Borrelia ( not every case clearly but some cases in every disease maybe and certainly in a number of cancers.</span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-family: courier; font-size: medium;">Other researchers who later found Borrelia in Alzheimer brains </span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="font-family: courier; font-size: medium;"></span></p><blockquote style="background-color: white; color: #201f1e; font-family: "Segoe UI", "Segoe UI Web (West European)", "Segoe UI", -apple-system, BlinkMacSystemFont, Roboto, "Helvetica Neue", sans-serif; font-size: 15px;" type="cite"><div style="border: 0px; color: inherit; font: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><div class="x_elementToProof" style="border: 0px; color: inherit; font-family: Calibri, Helvetica, sans-serif; font-size: 12pt; font-stretch: inherit; font-variant-east-asian: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><div style="border: 0px; font-family: inherit; font-size: 15px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><div style="border: 0px; color: inherit; font: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><div style="border: 0px; color: inherit; font: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><div style="border: 0px; color: inherit; font-family: Calibri, sans-serif; font-size: 11pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0cm; padding: 0px; vertical-align: baseline;"><span color="inherit" style="border: 0px; font-family: inherit; font-size: 11.5pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Judith Miklossy - found Borrelia in Alzheimer brains but also found dental spirochetes in Alzheimer brains and assisted Lancashire university dental college with their research. Miklossy has several published papers. her website </span><span color="inherit" style="border: 0px; font: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a data-auth="NotApplicable" data-linkindex="17" href="https://nam12.safelinks.protection.outlook.com/?url=https%3A%2F%2Fmiklossy.ch%2F&data=05%7C01%7C%7C6e836bc329674f1c978108da917a8712%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637982252695041566%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=7gvaHHL17NduZR9ztJdSIHTDrVqRRaHmnWPYFZQ2ZCI%3D&reserved=0" rel="noopener noreferrer" style="border: 0px; color: blue; font: inherit; margin: 0px; padding: 0px; vertical-align: baseline;" target="_blank"><span color="inherit" style="border: 0px; font-family: inherit; font-size: 11.5pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">https://miklossy.ch/</span></a></span></div></div><p class="x_x_xmsonormal" style="font-family: Calibri, sans-serif; font-size: 11pt; margin: 0cm;"><span color="inherit" style="border: 0px; font-family: inherit; font-size: 12pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"> </span></p><div style="border: 0px; color: inherit; font: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><p class="x_x_xmsonormal" style="font-family: Calibri, sans-serif; font-size: 11pt; margin: 0cm;"><span color="inherit" style="border: 0px; font-family: inherit; font-size: 11.5pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"> </span></p></div><div style="border: 0px; color: inherit; font: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><div style="border: 0px; color: inherit; font-family: Calibri, sans-serif; font-size: 11pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0cm; padding: 0px; vertical-align: baseline;"><span color="inherit" style="border: 0px; font-family: inherit; font-size: 11.5pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Herbert B Allen presented at our last Symposium about Spirochetes and Alzheimer's. I don't have that presentation to hand but found this interesting interview </span><span color="inherit" style="border: 0px; font: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a data-auth="NotApplicable" data-linkindex="18" href="https://nam12.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3DMr17woXH5Ec&data=05%7C01%7C%7C6e836bc329674f1c978108da917a8712%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637982252695197797%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=%2FqY4%2FflS5yp4UqmxyEayP5tedr%2BU0Ef6TmtMf6cdZBM%3D&reserved=0" rel="noopener noreferrer" style="border: 0px; color: blue; font: inherit; margin: 0px; padding: 0px; vertical-align: baseline;" target="_blank"><span color="inherit" style="border: 0px; font-family: inherit; font-size: 11.5pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">https://www.youtube.com/watch?v=Mr17woXH5Ec</span></a></span></div></div><p class="x_x_xmsonormal" style="font-family: Calibri, sans-serif; font-size: 11pt; margin: 0cm;"><span color="inherit" style="border: 0px; font-family: inherit; font-size: 12pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"> </span></p><div style="border: 0px; color: inherit; font: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><p class="x_x_xmsonormal" style="font-family: Calibri, sans-serif; font-size: 11pt; margin: 0cm;"><span color="inherit" style="border: 0px; font-family: inherit; font-size: 11.5pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"> </span></p></div><div style="border: 0px; color: inherit; font: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><div style="border: 0px; color: inherit; font-family: Calibri, sans-serif; font-size: 11pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0cm; padding: 0px; vertical-align: baseline;"><span color="inherit" style="border: 0px; font-family: inherit; font-size: 11.5pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Monica Embers recently published -</span></div></div><div style="border: 0px; color: inherit; font: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><p class="x_x_xmsonormal" style="font-family: Calibri, sans-serif; font-size: 11pt; margin: 0cm;"><span color="inherit" style="border: 0px; font-family: inherit; font-size: 11.5pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"> </span></p></div><div style="border: 0px; color: inherit; font: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><div style="border: 0px; color: inherit; font-family: Calibri, sans-serif; font-size: 11pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0cm; padding: 0px; vertical-align: baseline;"><span color="inherit" style="border: 0px; font-family: inherit; font-size: 11.5pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">"Detecting Borrelia Spirochetes: A Case Study With Validation Among Autopsy Specimens."</span></div></div><div style="border: 0px; color: inherit; font: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><div style="border: 0px; color: inherit; font-family: Calibri, sans-serif; font-size: 11pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0cm; padding: 0px; vertical-align: baseline;"><span color="inherit" style="border: 0px; font: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a data-auth="NotApplicable" data-linkindex="19" href="https://nam12.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC8141553%2F&data=05%7C01%7C%7C6e836bc329674f1c978108da917a8712%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637982252695197797%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=glyKagXGvlGTib1KXr6itcMA7QfMXMWd8r8zSZiqBoA%3D&reserved=0" rel="noopener noreferrer" style="border: 0px; color: blue; font: inherit; margin: 0px; padding: 0px; vertical-align: baseline;" target="_blank"><span color="inherit" style="border: 0px; font-family: inherit; font-size: 11.5pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8141553/</span></a></span></div></div><p class="x_x_xmsonormal" style="font-family: Calibri, sans-serif; font-size: 11pt; margin: 0cm;"><span color="inherit" style="border: 0px; font-family: inherit; font-size: 12pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"> </span></p><div style="border: 0px; color: inherit; font: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><p class="x_x_xmsonormal" style="font-family: Calibri, sans-serif; font-size: 11pt; margin: 0cm;"><span color="inherit" style="border: 0px; font-family: inherit; font-size: 11.5pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"> </span></p></div><div style="border: 0px; color: inherit; font: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><div style="border: 0px; color: inherit; font-family: Calibri, sans-serif; font-size: 11pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0cm; padding: 0px; vertical-align: baseline;"><span color="inherit" style="border: 0px; font: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a data-auth="NotApplicable" data-linkindex="20" href="https://nam12.safelinks.protection.outlook.com/?url=https%3A%2F%2Finvisible.international%2Ftulane-researcher-asks-could-chronic-lyme-contribute-to-alzheimers-dementia%2F%3Ffbclid%3DIwAR1ZY7T3JAbQ2sggtGddGl6q3wMKFprseBRozn4tY30rzTgcC1G-Cn800gs&data=05%7C01%7C%7C6e836bc329674f1c978108da917a8712%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637982252695197797%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=SMZ3S8C%2F2vySw%2BSoGwnvbpG1IWcYrj%2FoS8c02tn7s8I%3D&reserved=0" rel="noopener noreferrer" style="border: 0px; color: blue; font: inherit; margin: 0px; padding: 0px; vertical-align: baseline;" target="_blank"><span color="inherit" style="border: 0px; font-family: inherit; font-size: 11.5pt; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">https://invisible.international/tulane-researcher-asks-could-chronic-lyme-contribute-to-alzheimers-dementia/?fbclid=IwAR1ZY7T3JAbQ2sggtGddGl6q3wMKFprseBRozn4tY30rzTgcC1G-Cn800gs</span></a></span></div></div></div></div></div></div></blockquote><p style="background-color: white;"><br /></p><p style="background-color: white;"> Update 05/10/22</p><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">Overall good news. Which is a bit rare with this journey.</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">The MRI head shows</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">1. The odema next to brain lesion has reduced with Dexamethasone. I must continue on 6mg a day.</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">2. <a style="color: #385898; cursor: pointer; font-family: inherit;" tabindex="-1"></a>The solid part of the brain lesion has reduced to virtually nothing - which I understand are the cancer cells. This is attributed to Atezolizumab which penetrates the brain ( Abraxane chemo does not)</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">3. The brain lession has again increased in size, the first four weeks it increased by 50% but I don't have the details this time yet. However this increase is in the cystic fluid part of the lession.</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">4. As previously discussed with me and previously Neurosurgeon at St Georges Tooting he will this evening refer me to St. Georges to drain the cystic fluid. ( previously they were unable to do brain surgery because it was too close to critical neural structures and suggested managing it by draining the fluid - hopefully they can avoid these for a drain.</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">5. I must stop Aspirin at least a week before surgery.</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">6. I will start my 3rd cycle 1st week of Abraxane/Atezolizumab on Friday. But it will be interrupted by surgery date and then resumed after surgery.</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">7. After Cycle 3 is completed I will also have a Pet scan to check out what is happening in my mediastinum (lung lymph nodes ) Before chemo/Immunotherapy these had appeared to reduce, so Oncologist was not unduly concerned about them.</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">8. Dr MacDonald has offerred to investigate Cystic fluid re Borrelia if I can send him a sample, Oncologist was ok with that but I need to discuss with and when I speak to Neurosugeon. They will of course do their own investigations which will not include Borrelia even if they do deep sequencing as it won't be properly primed.</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">9. Most importantly I was able to discuss my interest in finding a way to access Verterporfin.</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">a. It is a PDL1 immunotherapy drug not one that NHS would use for TNBC metasteses</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">b. there was a good study of its effectiveness for TNBC done by Royal Free.</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">c. There was a clinical Trial at Massachusetts hospital but not sure if accessible or ongoing.</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">d. There is another clinical trial to treat Glioblastoma - suggestive it could be beneficial to treat brain lesion.</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">e. Costs £1,000 a shot as opposed compared to £12000 Atezolizumab per coarse + other costs.</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">f. Verterporfin is absorbed by Borrelia which I have and Borrelia is then killed by oxygen produced with light therapy.</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">He promised to look into it but not holding my breath. I recognise that Cancer shape shifts and morphs so Atezolizumab may not always be my magic, but I have good reason to think Verterporfin could be. Especially watching De Neil Spector's video presentation. posted previously in this post.</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;"><br /></span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">Feeling positive. </span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;"><br /></span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;"><br /></span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">Update 23.10.22</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;"><br /></span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">The report from MRI head scan 3.10.22</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;"><br /></span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">Says slight increase in the size of the lesion due to an increase in the cystic fluid portion.</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;"><br /></span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">On Wednesday 19.10.22 I reported to Oncologist a detertioration in my left foot leg and left hand coordination problems.</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;"><br /></span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">On Thursday further deteriration of a sort of internal chore balance/jittery feeling so that either sitting or standing is difficult to fully balance with this feeling. I believe this was relared to my two previous falls. </span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;"><br /></span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">I had another fall due to this on Thursday evening 20.10.22</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><br /></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">What a disaster. I lifted a cold chip pan fryer ( I don't touch hot pans Mike deals with them) from a cupboard walked two steps lost balance threw the fryer in the air bumped head on stair side, fell to bottom with a bump only to sit in cold oil as it gradually spread across the kitchen floor soaking into my trousers socks sandall etc.</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;"><br /></span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">Trying to get upright again was problematic even with the good old chair method and Mike - hilarious really as we slid aeound in oil. But at last I was upright, showered and dressed and poor Mike spent all evening soaking up cold oil and disposing of a broken chip fryer. </span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;"><br /></span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">I reported the deterioration and fall to Oncology nurses and was advised by oncologist to increase Dexamethasone to 8 mg until I see Neurosurgeon. </span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;"><br /></span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">I have an appointment on Monday 24.10.22 to see Neurosurgeon to discuss draining cystic fluid from brain. I will be admitted Tuesday evening, ready for surgery Wednesday 26.10.22</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;"><br /></span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><span style="background-color: white;">Can't come soon enough.</span></div><div dir="auto" style="color: #050505; font-family: "Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif; font-size: 15px;"><br /></div><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">Update 21.11.22</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;"></span></span></p><div class="separator" style="clear: both; text-align: center;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhBPZKVRAuXTY-RXvNa0velL6V6HG1bQBVf3sdeTId7D6rtboayC0ioFIJJRQ6g2-5tq2zepBFCps6dj_iNhUNpsq1Bn8wA0yZHIJOAhRaDgeK8BJ_265srsAm_Du_yATamOBjxqUvYPpY7SROB6PG9nORHw7OB_3k24xiKaZ02AchRejOUCxaXQF_t/s417/Single%20breast%20cancer%20cell%20-with%20borrelia%20in%20cytoplasm%20-%20annotated.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="414" data-original-width="417" height="398" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhBPZKVRAuXTY-RXvNa0velL6V6HG1bQBVf3sdeTId7D6rtboayC0ioFIJJRQ6g2-5tq2zepBFCps6dj_iNhUNpsq1Bn8wA0yZHIJOAhRaDgeK8BJ_265srsAm_Du_yATamOBjxqUvYPpY7SROB6PG9nORHw7OB_3k24xiKaZ02AchRejOUCxaXQF_t/w400-h398/Single%20breast%20cancer%20cell%20-with%20borrelia%20in%20cytoplasm%20-%20annotated.jpg" width="400" /></a></span></span></div><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;"><br />The cystic brain fluid was removed by the Neurosurgeon and samples were sent to Dr Alan MacDonald for analysis. </span></span><p></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">Dr MacDonald found many images showing Borrelia Burgdorferi in the cystic fluid from my metastic brain lesion caused by Triple Negative Breast cancer, above is just one image.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">Tomorrow, Wednesday and Thursday I go to Chelsea Marsden to have a three day course of steriotatic/Cyberknife radiosurgery to my brain lesion. Effectively to disable the brain lesion to prevent further cancer cells or further cystic fluid entering the lesion.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;">Fingers crossed all goes well.</span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;"><br /></span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;"><br /></span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;"><br /></span></span></p><p class="p p-first-last" id="__p1" style="background-color: white; box-sizing: inherit; hyphens: none; line-height: inherit; margin: 20pt 0px;"><span style="color: #4d5156; font-family: arial; font-size: medium;"><span style="white-space: break-spaces;"><br /></span></span></p></div>Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com2tag:blogger.com,1999:blog-3707770726760676731.post-21560334969544274482019-07-20T09:25:00.000+01:002019-07-20T09:25:21.400+01:00WERE TICKS USED IN BIOWARFARE EXPERIMENTS?<div dir="ltr" style="text-align: left;" trbidi="on">
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The House passed a bill this month that would order the Pentagon's inspector general to investigate whether the Defense Department weaponized ticks. Stanford University science writer Kris Newby, in a new book called "Bitten," hints that such experiments may have led to Lyme disease's rapid spread. Newby says that congressional inquiry into the matter "is exactly what I wanted to happen.'' And CQ Roll Call defense writer John Donnelly explains what Congress has asked the Pentagon to do and why many experts doubt it caused the public health crisis. </div>
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<a href="https://podcasts.apple.com/us/podcast/did-the-pentagon-weaponize-ticks/id1050795708?i=1000444870570">https://podcasts.apple.com/us/podcast/did-the-pentagon-weaponize-ticks/id1050795708?i=1000444870570</a><br />
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<span aria-label="Did the Pentagon weaponize ticks?" class="product-header__title" style="box-sizing: inherit; display: block; font-family: "SF Pro Display", "SF Pro Icons", "Apple WebExp Icons Custom", "Helvetica Neue", Helvetica, Arial, sans-serif; font-size: 24px; font-weight: 700; letter-spacing: 0.023em; line-height: 1.25;"></span></h1>
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<span style="font-size: large;"><span style="color: #262626; font-family: CNN Condensed, CNN, Helvetica Neue, Helvetica, Arial, Utkal, sans-serif;"><span style="font-weight: 500; letter-spacing: -0.01em;">Fox News </span></span></span></h1>
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<span style="background-color: white;">Did the Pentagon's weaponization of ticks lead to the spread of Lyme disease?</span></h1>
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<a href="https://video.foxnews.com/v/6061802165001/#sp=show-clips">https://video.foxnews.com/v/6061802165001/#sp=show-clips</a></div>
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<span style="font-size: large;">House of Representatives orders Pentagon to investigate whether ticks were once used as biological weapons</span></h1>
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<cite class="el-editorial-source" style="background-color: #fefefe; box-sizing: border-box; color: #262626; font-family: "CNN Condensed", CNN, "Helvetica Neue", Helvetica, Arial, Utkal, sans-serif; font-feature-settings: "kern"; font-size: 18px; font-style: normal; font-weight: 700; text-rendering: optimizelegibility;">(CNN)</cite><span style="background-color: #fefefe; color: #262626; font-family: CNN, "Helvetica Neue", Helvetica, Arial, Utkal, sans-serif; font-size: 18px;">The US House of Representatives has ordered an investigation into</span><span style="background-color: #fefefe; box-sizing: border-box; color: #262626; font-family: CNN, "Helvetica Neue", Helvetica, Arial, Utkal, sans-serif; font-size: 18px; font-weight: 700;"> </span><span style="background-color: #fefefe; color: #262626; font-family: CNN, "Helvetica Neue", Helvetica, Arial, Utkal, sans-serif; font-size: 18px;">whether the Department of Defense experimented with ticks and other insects as biological weapons.</span></div>
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<a href="https://edition.cnn.com/2019/07/17/politics/lyme-disease-amendment-investigation/index.html?fbclid=IwAR3VMJLxtWT5htgGsQrluvAAaF-3zw37PFkhpEWOVN3AxhHFIutVuRTB2n0">https://edition.cnn.com/2019/07/17/politics/lyme-disease-amendment-investigation/index.html?fbclid=IwAR3VMJLxtWT5htgGsQrluvAAaF-3zw37PFkhpEWOVN3AxhHFIutVuRTB2n0</a></div>
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News media amplify question of weaponized Lyme disease</h1>
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<a href="https://www.lymedisease.org/news-media-weaponized-lyme/?fbclid=IwAR1wYwrzK8D8oWSmPsdAjt6ui0Lkg1Y4hijWhRkSJECeQXQoceLXBjDqBQo">https://www.lymedisease.org/news-media-weaponized-lyme/?fbclid=IwAR1wYwrzK8D8oWSmPsdAjt6ui0Lkg1Y4hijWhRkSJECeQXQoceLXBjDqBQo</a></div>
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<span style="font-size: large;">UK media</span> </div>
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Daily Mail </div>
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<span style="font-size: 34px;">House bill orders Pentagon to reveal if they used diseased ticks in biological warfare experiments</span><br /><a href="https://www.dailymail.co.uk/news/article-7256309/House-bill-orders-Pentagon-reveal-used-diseased-ticks-biological-warfare-experiments.html?fbclid=IwAR2KFwzFTCQ3TDLWHmaM0gFCLu27ge-PjV2gbNr-G_3_5XgPUqp9JP79IQw"><span style="font-size: small;">https://www.dailymail.co.uk/news/article-7256309/House-bill-orders-Pentagon-reveal-used-diseased-ticks-biological-warfare-experiments.html?fbclid=IwAR2KFwzFTCQ3TDLWHmaM0gFCLu27ge-PjV2gbNr-G_3_5XgPUqp9JP79IQw</span></a></h2>
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The Guardian</div>
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<span style="background-color: white; color: #121212; font-family: "Guardian Egyptian Web", Georgia, serif; font-size: 34px; font-variant-ligatures: common-ligatures;">House orders Pentagon to review if it exposed Americans to weaponised ticks</span><a href="https://www.theguardian.com/us-news/2019/jul/16/pentagon-review-weaponised-ticks-lyme-disease?CMP=share_btn_fb&fbclid=IwAR2WBkIAjJO66RsGWPdn_JS-8dIW7_xsR3pwDivXqjOSf92VwEr40K6EzFo">https://www.theguardian.com/us-news/2019/jul/16/pentagon-review-weaponised-ticks-lyme-disease?CMP=share_btn_fb&fbclid=IwAR2WBkIAjJO66RsGWPdn_JS-8dIW7_xsR3pwDivXqjOSf92VwEr40K6EzFo</a></div>
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The Telegraph</div>
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<span style="font-size: large;">US urged to investigate whether ticks were developed as biological weapons amid rise in Lyme disease. </span></h1>
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<a href="https://www.telegraph.co.uk/news/2019/07/17/pentagon-asked-investigate-whether-ticks-experimented-biological/?WT.mc_id=tmg_share_fb&fbclid=IwAR3J6Feo7Zw8XFjrfM3uhEQdMWwy7kVM91yqXcan46Ghbc-ucfNILYzQR7k">https://www.telegraph.co.uk/news/2019/07/17/pentagon-asked-investigate-whether-ticks-experimented-biological/?WT.mc_id=tmg_share_fb&fbclid=IwAR3J6Feo7Zw8XFjrfM3uhEQdMWwy7kVM91yqXcan46Ghbc-ucfNILYzQR7k</a></div>
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US Pentagon is told to investigate claims that Lyme disease is escaped bioweapon from cold war</h1>
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<a href="https://www.bmj.com/content/366/bmj.l4784?fbclid=IwAR3VkzFacHKUABMvhdU2ChKkHp_XVtMn3Pf8TJMuHQRcQrbb_9fWUnEH5xE">https://www.bmj.com/content/366/bmj.l4784?fbclid=IwAR3VkzFacHKUABMvhdU2ChKkHp_XVtMn3Pf8TJMuHQRcQrbb_9fWUnEH5xE</a></div>
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<span style="font-size: large;">Germany </span></div>
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<span class="headline-intro" style="color: black; display: block; font-size: 1.125rem;"><span style="vertical-align: inherit;">Lyme Disease</span></span><span class="headline" style="color: #990000; font-size: 2rem;">Pentagon is designed to check if it has released tampered ticks</span></h2>
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<a href="https://www.spiegel.de/gesundheit/diagnose/borreliose-pentagon-soll-pruefen-ob-es-veraenderte-zecken-freigesetzt-hat-a-1277705.html">https://www.spiegel.de/gesundheit/diagnose/borreliose-pentagon-soll-pruefen-ob-es-veraenderte-zecken-freigesetzt-hat-a-1277705.html</a> </div>
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<span style="font-size: large;">France </span><br />Le Monde</div>
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<span style="box-sizing: inherit; font-size: small; vertical-align: inherit;">In the United States, elected officials want to know if the army has used ticks as biological weapons</span></h1>
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<a href="https://www.lemonde.fr/international/article/2019/07/17/maladie-de-lyme-les-deputes-americains-veulent-savoir-si-l-armee-a-utilise-des-tiques-comme-armes-biologiques_5490385_3210.html?fbclid=IwAR3aNFjeqGIr4PUoDDnU_pVERCljErpDhr4mT3BIq9CcNmYL-hxHVEOUIq8">https://www.lemonde.fr/international/article/2019/07/17/maladie-de-lyme-les-deputes-americains-veulent-savoir-si-l-armee-a-utilise-des-tiques-comme-armes-biologiques_5490385_3210.html?fbclid=IwAR3aNFjeqGIr4PUoDDnU_pVERCljErpDhr4mT3BIq9CcNmYL-hxHVEOUIq8</a></div>
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An earlier post on this blog - <a href="https://lookingatlyme.blogspot.com/2019/04/secret-history-of-lyme-disease-and.html">https://lookingatlyme.blogspot.com/2019/04/secret-history-of-lyme-disease-and.html</a> </div>
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Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com0tag:blogger.com,1999:blog-3707770726760676731.post-56504664322077548072019-04-29T11:23:00.000+01:002019-04-29T11:23:55.303+01:00SECRET HISTORY OF LYME DISEASE AND A BIOWEAPONS LINK.<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="background-color: white; color: #0a0a0a; font-family: Roboto, Arial, sans-serif; font-size: 14px; white-space: pre-wrap;">UNDER OUR SKIN Director Andy Abrahams Wilson interviews Kris Newby, author of "Bitten: The Secret History of Lyme Disease and Biological Weapons." May 1, 2019
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<span style="font-family: verdana, sans-serif;">From Kris Newby Senior Producer of Under our Skin.<br />'I’m happy to announce that my narrative nonfiction book, “BITTEN: The Secret History of Lyme Disease and Biological Weapons,” can now be pre-ordered from your favorite book retailer:<a href="https://www.harpercollins.com/9780062896278/bitten/" style="color: #888888; text-decoration-line: none;" target="_blank"> <span style="color: #365899;"><span style="cursor: pointer;">https://www.harpercollins.com/9780062896278/bitten/</span></span></a></span></div>
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<span style="font-family: verdana, sans-serif;">About 5 years ago, I received a videotaped interview of Lyme discoverer Willy Burgdorfer saying that the Lyme disease outbreak was caused by a bioweapons experiment gone wrong. It was a stunning confession given<span class="text_exposed_show" style="display: inline;"> his reputation, and I knew I couldn’t walk away from it.</span></span></div>
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<span style="font-family: verdana, sans-serif;">BITTEN takes readers on my investigation of this claim, starting with Willy’s role in weaponizing ticks, fleas, and mosquitoes for the U.S. military’s bioweapons program, and ending with evidence supporting the theory that this epidemic began around Long Island Sound in 1968 as fallout from a secret bioweapons release.' </span></div>
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<span style="font-family: verdana, sans-serif;">An earlier post about this new book Bitten </span><a href="https://lookingatlyme.blogspot.com/2019/01/willy-burgdorfer-lyme-disease.html">https://lookingatlyme.blogspot.com/2019/01/willy-burgdorfer-lyme-disease.html</a> </div>
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Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com0tag:blogger.com,1999:blog-3707770726760676731.post-54439648009334652102019-02-05T11:01:00.001+00:002019-02-05T11:01:42.535+00:00LYME DISEASE AN EASY WAY TO DESTROY YOUR BRAIN<div dir="ltr" style="text-align: left;" trbidi="on">
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Lyme Disease and Dementia, Alzheimer, Parkinson, Autism, an Easy Way to Destroy your Brain</h2>
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<span class="qodef-quote-author" style="-webkit-tap-highlight-color: transparent; background: 0px 0px rgb(255, 255, 255); border: 0px; box-sizing: border-box; color: #797979; font-family: georgia, sans-serif; font-size: 16px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">DR. JOSE LAPENTA </span><span style="background-color: white; color: #797979; font-family: georgia, sans-serif; font-size: 15px;"></span><br style="background-color: white; box-sizing: border-box; color: #797979; font-family: georgia, sans-serif; font-size: 15px;" /><span style="background-color: white; color: #797979; font-family: georgia, sans-serif; font-size: 15px;">Lapenta JM</span></div>
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<span style="font-family: Verdana, sans-serif;">Abstract</span></h5>
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<span style="font-family: Verdana, sans-serif;">Lyme disease or Chronic Erythema Migrans whose first clinical description was made by Afzelius in 1908, and its causative agent the spirochete Borrelia Burgdorferi was discovered 73 years later by Willy Burgorfer in 1981. Lyme disease is spread by a tick bite of the family Ixodidae, Ixodes scapularis and many others. Among the numerous species described, Borrelia Burgdorferi is disseminated mainly in the United States, Borrelia garinii and Borrelia Afzelii in Europe and Asia. In addition to producing skin lesions in infected people, and multi-organ side effects, the spirochete is able to reach the human brain and could produce dementia, Alzheimer, Parkinson and Autism. In this investigation we will make a chronological description of the events that lead to neuronal involvement. Just as the spirochete of syphilis, Treponema pallidum, produces neurosyphilis in its tertiary stage, also the Borrelia is able to reach the brain, and produce collateral damage, a term called neuroborreliosis, and among its most lethal effects may cause dementia, Alzheimer, Parkinson and Autism and hence the so-called post-treatment syndrome of Lyme disease.</span></div>
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<span style="font-size: 15px;"><a href="https://www.ommegaonline.org/article-details/Lyme-disease-and-dementia,-Alzheimer,-Parkinson,-Autism,-an-easy-way-to-destroy-your-brain./1992?fbclid=IwAR3NwbIUI3a3pQvxYyTIoBVVz0OPZ0BwGmYPWv4XVAR8W5D9xHPswUkyV_Q#.XFT1KRxWx6g.facebook"><span style="font-family: Verdana, sans-serif;">https://www.ommegaonline.org/article-details/Lyme-disease-and-dementia,-Alzheimer,-Parkinson,-Autism,-an-easy-way-to-destroy-your-brain./1992?fbclid=IwAR3NwbIUI3a3pQvxYyTIoBVVz0OPZ0BwGmYPWv4XVAR8W5D9xHPswUkyV_Q#.XFT1KRxWx6g.facebook</span></a></span></div>
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<span style="font-family: Verdana, sans-serif;">This is an excellent article worth reading in full. It documents the history of Lyme discovery and research with very useful links to published papers.<br /></span></div>
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<span style="font-family: Verdana, sans-serif;">Conclusion</span></h5>
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<span style="font-family: Verdana, sans-serif;"><span class="CharOverride-1" style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">• Lyme “neuroborreliosis” was not born in the 80s when it began to be mentioned in scientific studies after its causative agent, the </span><span style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; font-style: italic; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Borrelia Burgdorferi</span><span class="CharOverride-1" style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> was discovered by Willy Burgoderfer in 1981 and its presence in the human brain was later confirmed. He was born in 1922 when the French Garin and Bujadoux described for the first time the meningoradiculitis lymphocytic with its neurological manifestations.</span></span></div>
<div class="Basic-Paragraph ParaOverride-5" style="background: 0px 0px rgb(255, 255, 255); border: 0px; box-sizing: border-box; font-size: 15px; outline: 0px; padding: 0px; text-align: justify; vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span class="CharOverride-1" style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">• We demonstrate chronologically and scientifically that </span><span style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; font-style: italic; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Borrelia Burgdorferi</span><span class="CharOverride-1" style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> and its species can conquer the human brain and produce dementia, Parkinson’s, Alzheimer’s and Autism.</span></span></div>
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<span style="font-family: Verdana, sans-serif;"><span class="CharOverride-1" style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">• Unlike </span><span style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; font-style: italic; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Treponema pallidum</span><span class="CharOverride-1" style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">, which only in the tertiary stage of syphilis is when it produces dementia (neurosyphilis); </span><span style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; font-style: italic; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Borrelia Burgdorferi</span><span class="CharOverride-1" style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> (Lyme) in its secondary and tertiary stage produces neuropsychiatric manifestations (neuroborreliosis).</span></span></div>
<div class="Basic-Paragraph ParaOverride-5" style="background: 0px 0px rgb(255, 255, 255); border: 0px; box-sizing: border-box; font-size: 15px; outline: 0px; padding: 0px; text-align: justify; vertical-align: baseline;">
<span class="CharOverride-1" style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="font-family: Verdana, sans-serif;">• Lyme disease can present as pure neurological forms, without the presence of Erythema Chronicum Migrans (ECM); this fact is what in many cases makes the diagnosis difficult.</span></span></div>
<div class="Basic-Paragraph ParaOverride-5" style="background: 0px 0px rgb(255, 255, 255); border: 0px; box-sizing: border-box; font-size: 15px; outline: 0px; padding: 0px; text-align: justify; vertical-align: baseline;">
<span style="font-family: Verdana, sans-serif;"><span class="CharOverride-1" style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">• Several highly specific diagnostic tests appeared to detect </span><span style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; font-style: italic; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Borrelia Burgdorferi</span><span class="CharOverride-1" style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">, even surpassing those proposed by the CDC.</span></span></div>
<div class="Basic-Paragraph ParaOverride-5" style="background: 0px 0px rgb(255, 255, 255); border: 0px; box-sizing: border-box; font-size: 15px; outline: 0px; padding: 0px; text-align: justify; vertical-align: baseline;">
<span class="CharOverride-1" style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="font-family: Verdana, sans-serif;">• The World Health Organization(WHO) recognized the code “Lyme Neuroborreliosis”, “Dementia due to Lyme” this year of 2018 in the ICD-11 and the “demyelination of the central nervous system due to Lyme borreliosis”</span></span></div>
<div class="Basic-Paragraph ParaOverride-5" style="background: 0px 0px rgb(255, 255, 255); border: 0px; box-sizing: border-box; font-size: 15px; outline: 0px; padding: 0px; text-align: justify; vertical-align: baseline;">
<span class="CharOverride-1" style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="font-family: Verdana, sans-serif;">• Clinical diseases not recognized: “Alzheimer due to Lyme”, “Parkinson due to Lyme”, but assuming that “dementia” is a common symptom of Alzheimer’s, its tacit recognition is understood; like the case of Parkinson’s, because the demyelination of the central nervous system and the chronic infection of the brain by Borrelia species can cause symptoms of Parkinsonism. Also the “Autism due to Lyme” was not recognized but like the previously described, it is supposed to be included in the term “neuroborreliosis due to Lyme”</span></span></div>
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<span class="CharOverride-1" style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="font-family: Verdana, sans-serif;">• The Post-Treatment Lyme Disease Syndrome (PTLDS), was not recognized by the WHO; it was extensively reviewed in this research and which was described more than 20 years ago, will be the subject of a forthcoming investigation.</span></span></div>
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<span class="CharOverride-1" style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="font-family: Verdana, sans-serif;">• Finally, the Lyme disease, now it is not only a dermatological disease, is a neuropsychiatric illness that can easy destroy your brain, if it is not detected and treated at time.</span></span></div>
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<span style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; font-weight: bold; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="font-family: Verdana, sans-serif;">Comments</span></span></div>
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<span class="CharOverride-1" style="-webkit-tap-highlight-color: transparent; background: 0px 0px; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="font-family: Verdana, sans-serif;"> If we include Alzheimer’s disease, Parkinson’s disease and Autism within the spectrum “Lyme neuroborreliosis” code, only Post-Treatment Lyme Disease Syndrome (PTLDS) will be left out in this investigation.</span></span></div>
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Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com0tag:blogger.com,1999:blog-3707770726760676731.post-37388836493650827822019-01-20T10:20:00.000+00:002019-04-29T11:17:21.126+01:00WILLY BURGDORFER - LYME DISEASE A BIOWEAPONS EXPERIMENT GONE WRONG. <div dir="ltr" style="text-align: left;" trbidi="on">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj7SirZh4XSWJJrMSB19CZvvpjyqdrDn2hQtq8j1d35shtChtkQndI4BWrAb06K6R8zCIpgqpbLZ2quK-PpqhEKyPe2KTgBnl7DNIlzfAGdd_OP1AR2H9H7WlsHUbzkFh3MFUlZ3-LrZoI/s1600/Bitten.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="648" data-original-width="430" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj7SirZh4XSWJJrMSB19CZvvpjyqdrDn2hQtq8j1d35shtChtkQndI4BWrAb06K6R8zCIpgqpbLZ2quK-PpqhEKyPe2KTgBnl7DNIlzfAGdd_OP1AR2H9H7WlsHUbzkFh3MFUlZ3-LrZoI/s320/Bitten.jpg" width="211" /></a></div>
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<span style="font-family: "verdana" , sans-serif;">From Kris Newby Senior Producer of Under our Skin.<br />'I’m happy to announce that my narrative nonfiction book, “BITTEN: The Secret History of Lyme Disease and Biological Weapons,” can now be pre-ordered from your favorite book retailer:<a href="https://www.harpercollins.com/9780062896278/bitten/" target="_blank"> <span style="color: #365899;"><span style="cursor: pointer;">https://www.harpercollins.com/9780062896278/bitten/</span></span></a></span></div>
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<span style="font-family: "verdana" , sans-serif;">About 5 years ago, I received a videotaped interview of Lyme discoverer Willy Burgdorfer saying that the Lyme disease outbreak was caused by a bioweapons experiment gone wrong. It was a stunning confession given<span class="text_exposed_show" style="display: inline;"> his reputation, and I knew I couldn’t walk away from it.</span></span></div>
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<span style="font-family: "verdana" , sans-serif;">BITTEN takes readers on my investigation of this claim, starting with Willy’s role in weaponizing ticks, fleas, and mosquitoes for the U.S. military’s bioweapons program, and ending with evidence supporting the theory that this epidemic began around Long Island Sound in 1968 as fallout from a secret bioweapons release.'</span></div>
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The epilogue of BITTEN: </div>
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“I believe that history will judge the tick-borne disease outbreak that began in 1968 to be one of the worst public health failures of the last century … The myopic focus on only one of the tick diseases, Lyme disease, has led to treatment delays and fatalities in patients who have serious mixed infections. Physicians urgently need rapid screening tests and the freedom to use clinical judgement in treating these complex patient cases — without the real and present danger of losing their medical licenses.”</div>
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If you want to join Kris in this campaign to educate a worldwide audience on the importance of increasing funding and treatment options for tick-borne diseases, here’s how you can help:<br />
Preorder the book *now* if you think you’ll eventually want to read it: TV, radio and podcasters are currently using these tallies to prioritize and schedule author interviews for May, Lyme awareness month.</div>
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Word-of-mouth makes a difference: Forward this email to your Lyme-community lists.</div>
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Please send Kris any media or celebrity connections that might be helpful in this campaign.</div>
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Do you have conferences, Lyme groups, or indie bookstores where you’d like Kris to give a talk? HarperCollins will be sending me on a book tour May through the summer and I’ll add these to my list.</div>
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Thanks in advance for your support!<br />
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Under Our Skin - <a href="http://underourskin.com/film/">http://underourskin.com/film/</a><br /></div>
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Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com5tag:blogger.com,1999:blog-3707770726760676731.post-92104910990987426902019-01-04T20:03:00.000+00:002019-01-06T19:32:09.327+00:00THE SCIENCE ON CHRONIC OR PERSISTENT LYME INFECTION/DISEASE<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Time to stop voicing opinions and look at the science available on LYME DISEASE.
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Lets start 2019 voicing science thank you</span><span style="background-color: transparent; color: black; font-family: "arial"; font-size: 13.999999999999998pt; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;"> </span><a class="account-group js-account-group js-action-profile js-user-profile-link js-nav" data-user-id="930454483334828032" href="https://twitter.com/LymeBook" style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; color: #14171a; display: inline !important; flex-shrink: 1; font-family: "Segoe UI", Arial, sans-serif; font-size: 14px; margin-right: 5px; overflow: hidden; text-decoration-line: none;"><span class="FullNameGroup" style="display: inline !important; max-width: 100%;"><strong class="fullname show-popup-with-id u-textTruncate " data-aria-label-part="" style="display: inline !important; max-width: 100%; overflow-wrap: normal !important; overflow: hidden !important; text-overflow: ellipsis !important; white-space: nowrap !important; word-break: break-all;">Dr. Steven Phillips & Dana Parish</strong></span></a></div>
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<a class="account-group js-account-group js-action-profile js-user-profile-link js-nav" data-user-id="930454483334828032" href="https://twitter.com/LymeBook" style="background: transparent; color: #14171a; display: inline-flex; flex-shrink: 1; margin-right: 5px; overflow: hidden; text-decoration-line: none;"><span class="FullNameGroup" style="display: flex; max-width: 100%;"><span class="UserBadges" style="font-size: 0.9em;"></span><span class="UserNameBreak"> </span></span><span class="username u-dir u-textTruncate" data-aria-label-part="" dir="ltr" style="color: #657786; direction: ltr; max-width: 100%; overflow-wrap: normal; overflow: hidden; text-overflow: ellipsis; unicode-bidi: embed; white-space: nowrap;">@LymeBook</span></a><small class="time" style="color: #657786; font-size: 14px; margin-right: 5px; white-space: nowrap;"> <a class="tweet-timestamp js-permalink js-nav js-tooltip" data-conversation-id="1080868577866067968" href="https://twitter.com/LymeBook/status/1080868577866067968" style="background: transparent; color: #657786; text-decoration-line: none;" title="8:48 am - 3 Jan 2019"><span aria-hidden="true" class="_timestamp js-short-timestamp js-relative-timestamp" data-long-form="true" data-time-ms="1546534125000" data-time="1546534125">1h</span><span class="u-hiddenVisually" data-aria-label-part="last" style="border: 0px !important; clip: rect(1px, 1px, 1px, 1px) !important; font-size: 1px !important; height: 1px !important; overflow: hidden !important; padding: 0px !important; position: absolute !important; width: 1px !important;">1 hour ago</span></a></small><br />
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Here’s an updated chronic/ persistent Lyme ref list with links to pubmed which you can share freely.</div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Basic science (mostly) Lyme/Borrelia references referring to chronic or persistent infection</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">/disease </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Howe Mayer Barbour </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(NIAID, Rocky Mountain Labs) </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">A single recombinant plasmid expressing</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">two major outer surface proteins of Lyme disease spirochete Science 1985;227:645-5</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;"> </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/3969554" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/3969554 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">The </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronicity </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">of some of the manifestations of Lyme disease, such as the oligoarticular arthritis </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">and meningoradiculitis, </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">suggests that the </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">host cannot effectively rid itself of the infecting agent</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Alternatively, the host’s immune response to the spirochete may actually induce or accentuate the </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">pathological lesions associated with this disorder. Thus, knowledge of the balance struck between</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">the host’s immune system and the spirochete during </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection may be a key to understanding </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">the pathogenesis of Lyme disease. </span><br />
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<span style="font-family: "arial"; font-weight: 700; white-space: pre;">Johnson, Kodner, Russell In vitro and in vivo susceptibility of Lyme disease spirochete,</span><br />
<span style="color: black; font-family: "arial"; font-style: italic; font-weight: 700; vertical-align: baseline; white-space: pre;">B burgdorferi, </span><span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">to four antimicrobial agents Antimicrob Agents Chemother 1987:</span><br />
<span style="color: #000099; font-family: "arial"; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/3566246" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/3566246 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">These observations are particularly important, since the </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">forms of Lyme disease and related </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">disorders appear to be due to the </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persistence </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">of </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B. burgdorferi </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in the affected sites </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(4,17,19,26,27). </span><br />
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<span style="font-family: "arial"; font-weight: 700; white-space: pre;">Johnson, Russell - US Patent 4,721,617 - Vaccine against Lyme disease January 26, 1998: </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">...The </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">forms of the disease </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">such as arthritis (joint involvement), acrodermatitis chronica </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">atrophicans </span><span style="font-family: "arial"; white-space: pre;">(skin involvement), and Bannwart’s [sic] syndrome (neurological involvement) may </span><br />
<span style="font-family: "arial"; white-space: pre;">last for months to years </span><span style="font-family: "arial"; white-space: pre;">are are associated with the persistence of the spirochete... </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">The infection may be treated at any time with antibiotics such as penicillin, erythromycin, tetracycline,</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">and </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">ceftriaxone. </span><span style="color: #e32400; font-family: "arial"; vertical-align: baseline; white-space: pre;">Once infection has occurred, however. the drugs may not purge the host of the </span><br />
<span style="color: #e32400; font-family: "arial"; vertical-align: baseline; white-space: pre;">spirochete but </span><span style="color: #e32400; font-family: "arial"; vertical-align: baseline; white-space: pre;">may only act to control the </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: #e32400; font-family: "arial"; vertical-align: baseline; white-space: pre;">forms of the disease</span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">. Complications such as </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">arthritis and fatigue may </span><span style="font-family: "arial"; white-space: pre;">continue for several years after diagnosis and treatment. </span><br />
<span style="font-family: "arial"; white-space: pre;"><br /></span></div>
<span id="docs-internal-guid-32b86e87-7fff-252e-b30f-e89cc9f1c08f"><span style="font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">Dattwyler, Volkman, Halperin, Luft, Thomas, Golightly. Specific immune responses in Lyme borreliosis: Characterization of T and B cell responses to </span><span style="font-family: "arial"; font-style: italic; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">Borrelia burgdorferi </span><span style="font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">Ann NY Acad Sci 1988: </span></span><br />
<span style="color: #000099; font-family: "arial"; font-size: 10pt; white-space: pre;"><br /></span>
<span style="color: #000099; font-family: "arial"; font-size: 10pt; white-space: pre;"><br /></span>
<span style="color: #000099; font-family: "arial"; font-size: 10pt; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/3263829" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/3263829 </a></span><br />
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme borreliosis, </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection, is a </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic progressive </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">involving multiple</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">organ systems </span><span style="font-family: "arial"; white-space: pre;">including the skin, the central and peripheral nervous systems, the heart, liver,</span><br />
<span style="font-family: "arial"; white-space: pre;">and kidney, and the </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">musculoskeletal system (1-3). </span><span style="color: #e32400; font-family: "arial"; vertical-align: baseline; white-space: pre;">As in other </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: #e32400; font-family: "arial"; vertical-align: baseline; white-space: pre;">infectious diseases</span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">, </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">host responses to this infecting </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">microorganism play a major role in shaping the clinical </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">expression of this </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">persistent </span><span style="color: #e32400; font-family: "arial"; vertical-align: baseline; white-space: pre;">spirochetosis</span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">As with any infection, the immune response plays a pivotal role in the containment of the invading</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">microorganism. In any </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">infection, the microbe must evolve strategies to avoid eradication</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">by the </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">host. Such strategies include suppression of the host’s defenses; evasion of host defenses </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">through antigen</span><span style="font-family: "arial"; white-space: pre;">ic </span><span style="font-family: "arial"; white-space: pre;">mimicry or antigenic variation; or invasion of immunologically privileged sites... </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Erythema </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">chronicum </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">migrans (ECM) has classically been the best marker of Lyme borreliosis. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Bergstrom </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(Sweden) </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Bundoc Barbour </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(U TX San Antonio)</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">, Molecular analysis of linear </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">plasmid-encoded </span><span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">major surface proteins, OspA and OspB, of the Lyme disease spirochaete </span><br />
<span style="color: black; font-family: "arial"; font-style: italic; font-weight: 700; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">Molecular Microbiology 1989: </span><br />
<span style="color: #000099; font-family: "arial"; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/2761388" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/2761388 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">“In many patients the </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection of some tissues, particularly the brain and joints, persists for years </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">and can </span><span style="color: #e32400; font-family: "arial"; vertical-align: baseline; white-space: pre;">be severely disabling. These forms of </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: #e32400; font-family: "arial"; vertical-align: baseline; white-space: pre;">Lyme borreliosis are a consequence of </span><br />
<span style="color: #e32400; font-family: "arial"; vertical-align: baseline; white-space: pre;">the host’s </span><span style="color: #e32400; font-family: "arial"; vertical-align: baseline; white-space: pre;">inability to rid itself of the infecting agent </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">and are perhaps also caused by the development </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">of an </span><span style="font-family: "arial"; white-space: pre;">autoimmune immunological reaction (Steere et al, 1979).” </span><br />
<span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;"><br /></span>
<span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">Aberer, Brunner, Suchanek, Klade, Barbour </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">(UT San Antonio)</span><span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">, Stanek, Lassmann </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">(Univ Vienna) </span><br />
<span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">Molecular mimicry and Lyme borreliosis: A shared antigenic determinant between </span><br />
<span style="color: black; font-family: "arial"; font-style: italic; font-weight: 700; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">and human tissue Ann Neuro 1989: </span><br />
<span style="color: #000099; font-family: "arial"; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/2481425" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/2481425 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">By testing monoclonal antibodies directed against various borrelia antigens, we found an antigenic </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">determinant shared by the 41 kDa flagella protein and human tissue, especially prominent on </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">myelin</span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">ated </span><span style="font-family: "arial"; white-space: pre;">fibers of human peripheral nerve, on nerve cells and axons of the central nervous </span><br />
<span style="font-family: "arial"; white-space: pre;">system, as well as on </span><span style="font-family: "arial"; white-space: pre;">certain epithelial cells (including joint synovia) and on heart muscle cells. </span><br />
<span style="font-family: "arial"; white-space: pre;">Immune reactions against such a </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">shared antigen could play a pathogenic role in </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">organ</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">manifestations of Lyme borreliosis. </span></div>
<span id="docs-internal-guid-e0d3c5a6-7fff-d029-858d-4b956a9a81a1"></span><br />
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">... Besides the various neurological diseases and Lyme arthritis, fatal respiratory distress syndrom</span><span style="font-family: "arial"; white-space: pre;">e</span><br />
<span style="font-family: "arial"; white-space: pre;"> (6), </span><span style="font-family: "arial"; white-space: pre;">hepatitis (5), endomyopericarditis (7) and interstitial nephritis (4) have been described.</span><br />
<span style="font-family: "arial"; white-space: pre;">However, if autoimmune </span><span style="font-family: "arial"; white-space: pre;">reactions are important for these alterations, additional factors, such </span><br />
<span style="font-family: "arial"; white-space: pre;">as local antigen presentation and </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">histocompatibility antigen expression, must also be involved</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">because the </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">manifestations in Lyme borreliosis </span><span style="font-family: "arial"; white-space: pre;">are so variable. </span></div>
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<span style="font-family: "arial"; font-weight: 700; white-space: pre;">Luft Gorevic Halperin Volkman Dattwyler A perspective on the treatment of Lyme </span><br />
<span style="font-family: "arial"; font-weight: 700; white-space: pre;">borreliosis Rev Infect Dis 1989 Sep-Oct; 11 Suppl 6: </span><br />
<span style="color: #000099; font-family: "arial"; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/2682965">https://www.ncbi.nlm.nih.gov/pubmed/2682965</a> </span><br />
<span style="color: #000099; font-family: "arial"; white-space: pre;"><br /></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Abstract </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">...Clinical studies have documented the efficacy of antibiotics, but therapy has failed</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in as many as 50% of cases of </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection.. </span></div>
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<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Persistent </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection can produce various </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">insidious and </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">dermatologic, </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">neurologic, and rheumatologic manifestations [3-15]. The pathophysiologic mechanisms involved</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in the </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">phase of this illness </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">remain incompletely defined, It has not been determined whether</span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">persistent </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">symptoms are secondary to some immunologic process or whether anything short of</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">total eradication of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">is sufficient for ultimate cure and resolution of symptoms. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Dattwyler Volkman Luft Immunologic aspects of Lyme borreliosis Rev Infect Dis 1989 </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Sep-Oct; 11, Suppl 6: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/2682961" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/2682961 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">As in any </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infectious disease, host responses are thought to play a major role in shaping </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">the clinical expression of this illness. These responses include and early and vigorous T cell </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">response to the presence of the Lyme spirochete and a more slowly evolving B cell response</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(16,17). </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">The failure of early antimicrobial therapy to completely eradicate the infection and the subsequent</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">development of a </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">illness </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">make this disease especially difficult to diagnose in patients</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">who do not develop a mature antibody response. However, specific T cell and/or local humoral</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">responses may be demonstrable in patients who lack diagnostic levels of circulating antibodies </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">to </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(17,24-26). </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Dattwyler Luft Antibiotic treatment of Lyme borreliosis Biomed & Pharmacother 1989: </span><br />
<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/2686769">https://www.ncbi.nlm.nih.gov/pubmed/2686769</a> </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">It is now recognized that only by understanding the different lines of investigation in Europe an</span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">d</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">the US can we achieve a true appreciation of the multiplicity of acute and </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">disease </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">manifestations due to </span><span style="color: black; font-family: "arial"; font-style: italic; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">infection. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">If not effectively treated during the local or the acute disseminated phase of infection, a </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">phase of infection can develop. Clinical manifestations observed during this </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">phase include </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">meningitis, meningoradiculitis, encephalitis, peripheral neuropathy, </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">lymphocytoma, ACA and arthritis </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><span id="docs-internal-guid-81c3e032-7fff-520f-a4cc-78aec35e0e2b"></span></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">It is now well recognized that late neurological disorders are common in </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection</span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">,</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">that CNS infection can be documented by demonstrating intrathecal anti- </span><span style="color: black; font-family: "arial"; font-style: italic; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">antibody </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">production, and that CNS infection is frequently associated with </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">headache and a </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">profound sense of fatigue which may indicate a </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">encephalopathic state. </span><br />
<span style="font-family: "arial"; font-weight: 700; white-space: pre;"><br /></span>
<span style="font-family: "arial"; font-weight: 700; white-space: pre;">Duray Histopathology of clinical phases of human Lyme disease Rheum Dis Clin North</span><br />
<span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;"> Am </span><span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">1989: </span><span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;"> </span><span style="color: #000099; font-family: "arial"; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/2685926" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/2685926 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme borreliosis in humans can be divided into acute, subacute and </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">states of inflammation </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">with variable degrees of dysfunction. (15, 31-34). Multisystem involvement appears to be random </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">and unpredictable, with </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">states of </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persistence </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in some cases</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. </span></div>
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<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme borreliosis A </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">subset of patients go on to </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic, persistent </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">disease in the </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">presence of continuing spirochetes in selected sites </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">with continuing inflammation and humoral</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">immunologic reactions. These manifestations are not inevitable because the disease process </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">may be completed at the end of each prior phase of the inflammatory illness, and not progress </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">any further. However, </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme borrelial disease occurs worldwide predilecting for the skin </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">and central and peripheral nervous systems in Europe, (6,9) and in the muscular skeletal system,</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">particularly the joints and synovium, in North America (29, 53). This target organ selectivity in </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">either hemisphere in </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">disease is a phenomenon not well understood but may relate to </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">minor differences in the North American versus the European strains of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. </span></div>
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<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Cutaneous Involvement The skin is involved in </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">disease as a consequence of </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">the continuing presence of the spirochete in deep dermal and subcutaneous tissues. This may</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">take place over a period ranging from many months to several years. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Acrodermatitis </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Chronica </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Atrophicans (ACA) ACA is a peculiar, </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, long-term Lyme dermatosis </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">defined clinically as a purple, red-rubor discoloration of the skin, generally of the acral limbs, </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">hands, wrists, forearms, elbows, or ankles and lower legs... </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Speculation of the Histopathogenesis ...With continuing infection, demyelination is thought to occur </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in some humans. Demyelination may result from immunologic cross reactivity directed against </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">variable major protein in a given infection. Regardless, demyelination does seem to be fundamental</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">to many of the neurologic manifestations in </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme neural infections. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Brandt Riley Radolf Norgard Immunogenic integral membrane proteins of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">are lipoproteins Infect Immun 1990: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/2318538" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/2318538 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease, a tick-borne infection caused by the spirochete </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, is a </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">disorder characterized by dermatologic, rheumatologic, cardiac, and neurological manifestations</span><span style="font-family: "arial"; white-space: pre;">. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">...While differences between these infections and between their causative organisms undoubtedly </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">exists, it is plausible that </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">and </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">T pallidum </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">share some parasitic strategies and that </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">common host immune mechanisms are operative in the containment of both </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">diseases. </span></div>
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<span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">Wallich Moter Simon Ebnet Heiberger Kramer The </span><span style="color: black; font-family: "arial"; font-style: italic; font-weight: 700; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">flagellum- associated </span><br />
<span style="font-family: "arial"; font-weight: 700; white-space: pre;">41-kilodalton antigen (flagellin): Molecular cloning, expression and amplification of the </span><br />
<span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">gene Infect Immun 1990: </span><span style="color: #000099; font-family: "arial"; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/2341173">https://www.ncbi.nlm.nih.gov/pubmed/2341173</a> </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">In humans Lyme disease appears as a </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic progressive </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">disease that involves multiple </span><span style="font-family: "arial"; white-space: pre;">organs,</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"> including the heart, the liver, the kidneys, the musculoskeletal system, the skin, and the central </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">and peripheral nervous systems. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Ma Sturrock Weis Intracellular localization of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">within human endothelial cells </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Infect Immun 1991: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/1987083">https://www.ncbi.nlm.nih.gov/pubmed/1987083</a> </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">The demonstration of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Bb </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">within endothelial cells suggests that intracellular localization may be</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">a potential mechanism by which the organism escapes from the immune response of the host</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">and may contribute to </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persistence </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">of the organism during the later stages of Lyme disease</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Szczepanski Benach Lyme borreliosis: Host responses to </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Microbiol </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Rev 1991: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/2030671">https://www.ncbi.nlm.nih.gov/pubmed/2030671</a> </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">...This multisystemic and </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">tick-borne spirochetosis </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">is of world-wide distribution and has </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">been the subject of various mongraphs (18,66,113,121) and recent reviews (5,47,114)... In this</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">article, we will focus on studies investigating interactions between the spirochetes and the host. </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">In so doing, we will attempt to present current hypotheses of how the disease progresses and </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">to indicate the directions for future investigations into the </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">nature of Lyme disease</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">...How do spirochetes evade the immune response? Is the </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">condition in Lyme disease </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">the result of antigenic variability such as is seen in the relapsing fever borrelia (8,9), or is the </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">condition </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">associated with persistent antigen perpetuated by a specific immune response </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">to the spirochete? Does an autoreactive condition arise as a result of molecular mimicry between </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">the bacterium and host. leading to a continuous cycle of injury in the patient? </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Coleman Benach Characterization of antigenic determinants of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">shared </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">by other bacteria JID 1992: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/1372635" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/1372635 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">“Lyme disease is a </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, multisystem disorder involving the skin, nervous system, joints and </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">heart [1]” </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><span id="docs-internal-guid-fbb7c883-7fff-30bd-c510-a721e3742a5c"></span></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">“The B cell response in Lyme disease is characterized by the early recognition of a limited number </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">of </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">antigens. In the </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: #e32400; font-family: "arial"; vertical-align: baseline; white-space: pre;">phase of the disease</span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">, a much larger repertoire of antigens is recognized (5,6)” </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Bergstrom Garon Barbour MacDougall Extrachromosomal elements of spirochetes Res </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Microbiol 1992: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/1475522" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/1475522 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">...During Lyme borreliosis, caused by </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B. burgdorferi</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">is often established. In Lyme </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">borreliosis, this is characterized by an </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">inability of the immune system to clear the infection</span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">. </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">Perhaps this is a means by which </span><span style="color: black; font-family: "arial"; font-style: italic; vertical-align: baseline; white-space: pre;">B. burgdorferi </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">increases its probability of transmission to new </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">hosts... </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Dorward Huguenel Davis Garon Interactions between extracellular </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">proteins and non-</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">-directed Immunoglobulin M antibodies Infect Immun 1992:</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;"> </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/1541558" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/1541558 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Infection with the spirochete </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">causes the acute and </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">manifestations of Lyme </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">borreliosis. Despite considerable work on humoral and cell-mediated responses to infection, which</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">has recently been reviewed, the pathogenic mechanisms that contribute to </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">disease induced </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">by this spirochete remain obscure... However, the </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persistent </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infections documented in humans </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">and animal models indicate that </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">immune clearance is either rare or nonexistent </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(24,25) </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">24 = Steere Lyme disease NEJM 1989 25 = Szczepanski Benach Lyme borreliosis Host responses </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">to </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Microbiol Rev 1991 </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Luft Mudri Jiang Dattwyler Gorevic Fischer Munoz Dunn Schubach The 93- kilodalton </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">protein of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">An immunodominant protoplasmic cylinder antigen </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Infect Immun 1992: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/1398941" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/1398941 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">In many untreated cases, the acute infection is self limiting and becomes latent only to recrudesce </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">later in life as a </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection involving the joints, heart, nervous system, or skin. The symptoms</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">associated with the </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection may be vague and not associated with demonstrable clinical </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">signs of disease. It is unclear whether the vague symptoms of late disease can be attributed to </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">an actual ongoing infection or whether they result from some other pathogenic mechanism. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">... patients with evidence of </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection have been reported to have negative serum antibody</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">titers (23,35,41,72). </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><span id="docs-internal-guid-fdfd2cd8-7fff-8f18-7711-4cbcbed40c72"></span></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Montgomery Nathanson Malawista The fate of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi, </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">the agent for Lyme disease, </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">in mouse macrophages. Destruction, survival, recovery J Immunol 1993:</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;"> </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/8423346" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/8423346 </a></span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;"><br /></span>
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">Abstract ...Persistence of spirochetes within macrophages provides a possible pathogenetic </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">mechanism for </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">or recurrent Lyme disease in man. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">... Although most patients are cured by antibiotic therapy, </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease may sometimes </span><br />
<span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">progress or recur despite therapy, perhaps because spirochetes survive in privileged sites </span><br />
<span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">away from the immune system or antibiotic, such as the central nervous system or inside cells</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Although spirochetes become more difficult to find as Lyme disease progresses in vivo, there is</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">reason to believe that they are driving the illness throughout its course. Evidence in favor of a </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">reservoir of live spirochetes includes the frequent response of late symptoms to antibiotics, the </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">enlarging antigen specificity of immune sera from patients in later stages of disease, suggesting </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">newly exposed spirochetal </span><span style="font-family: "arial"; white-space: pre;">epitopes (2), and the occasional identification of spirochetes in affected </span><br />
<span style="font-family: "arial"; white-space: pre;">areas (3,4). Inasmuch as the macrophage acts as a reservoir for numerous other infectious agents, </span><br />
<span style="font-family: "arial"; white-space: pre;">we investigated whether it might serve a similar role in Lyme disease. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Discussion </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">... Our results show that </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">can survive via a route that is distinct kinetically </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">from its prominent pathway of degradation, and that such organisms retain the ability to multiply... </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Barbour Fish The biological and social phenomenon of Lyme disease Science 1993: </span><br />
<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/8503006" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/8503006 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Late Lyme disease is not likely to show a clear improvement within the time frame of the therapy</span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">,</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">at least not for the standardly recommended period. Not surprisingly, there is controversy about </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">whether the appropriate treatment duration for </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: #e32400; font-family: "arial"; vertical-align: baseline; white-space: pre;">Lyme </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">disease is measured in weeks or</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">months (5, 68, 78). </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Golightly Laboratory considerations in diagnosis and management of Lyme borreliosis </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">J</span><span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;"> Clin Path 1993: </span><span style="color: #000099; font-family: "arial"; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/8438790" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/8438790 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">When clinical findings are consistent with late or </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">disease (e.g. arthritis) a negative </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">result militates against the diagnosis. </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease samples are generally positive in </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">high titer )13,46). This may be true even in the case of recently treated patients because titers </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">may remain positive for years despite successful treatment. Nevertheless, there are exception,</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">and negative, low, or decreasing titers, although uncommon in untreated </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">,</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">may occur. (46-48). </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Fikrig Bockenstedt Barthold Chen Ali-Salaam Telford Flavell Sera from patients with</span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease protect mice from Lyme borreliosis JID 1994: </span><br />
<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/8158028" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/8158028 </a></span></div>
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<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><span id="docs-internal-guid-1bf9bd2b-7fff-0b1f-be90-bb542ebb4c47"><span style="color: black; vertical-align: baseline;">“These studies show that some humans </span><span style="color: #e32400; font-weight: 700; vertical-align: baseline;">chronically </span><span style="color: black; vertical-align: baseline;">infected with </span><span style="color: black; font-style: italic; vertical-align: baseline;">B. burgdorferi </span><span style="color: black; vertical-align: baseline;">produce protective </span></span></span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">antibodies. Our data showing that sera from patients with late- but not early-stage Lyme disease </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">can partly protect mice from infection correlates with our clinical observations. In general, patients</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">with </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">Lyme disease do not develop new episodes of erythema migrans (unpublished data).</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">In contrast, patients with erythema migrans that were treated with antibiotics early in the course of </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">infection appear susceptible to reinfection with </span><span style="color: black; font-family: "arial"; font-style: italic; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">since they can develop erythema </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">migrans after new tick bites. This suggests that patients with </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">Lyme disease may be </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">immune to reinfection with borreliae while patients with early Lyme disease are not, The fact that</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">some patients with chronic disease do not develop OspA or OspB antibodies further suggests that</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">other </span><span style="color: black; font-family: "arial"; font-style: italic; vertical-align: baseline; white-space: pre;">B. burgdorferi </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">antigens may play a role in protective immunity,” </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Radolf Role of outer membrane architecture in immune evasion by </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Treponema pallidum </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">and </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Trends Microbiol 1994: </span><br />
<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/7812663" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/7812663 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Determining the precise location of spirochetes within </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">tissues </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronically </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infected </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">with </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">has been difficult. However, when spirochetes are visualized in such tissue specimens, they appear </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">to be extracellular. Dissemination of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in the blood also occurs in </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronically </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infected </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">immunocompetent mice</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, despite the presence of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">-specific antibodies. Such observations </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">provide the rationale for studying the molecular architecture of the Lyme-disease spirochete within </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">the context of immune evasion. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">In contrast to </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">T pallidum</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, which appears to have no surface lipoproteins, there is overwhelming </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">evidence that borrelial lipoproteins are found on the surface of organisms cultivated in vitro. If the</span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">se</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">molecules are such accessible immune targets, why are spirochetes not cleared rapidly during </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">natural or experimental infection? This question is even more paradoxical in that sera from </span><br />
<span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronically </span><span style="color: #e32400; font-family: "arial"; vertical-align: baseline; white-space: pre;">infected individuals </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">may be borreliacidal in vitro (49). The answer appears to involve </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">both genetic mechanisms for downregulating the expression of surface lipoproteins at various</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">times during infection and also the slective repression of antibody responses against specific</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">proteins, particularly OspA and OspB (Refs 14,40,50). The ultimate effects of these poorly </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">understood dynamic processes are dramatic reductions in both the immunogenicity of the </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">spirochetal surface and the absolute number of targets for potentially borreliacidal antibodies. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Steere Lyme disease: A growing threat to urban populations Proc Natl Acad Sci 1994: </span><br />
<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/8146126" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/8146126 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">...Late or persistent infection (stage 3) usually begins months to years later and typically consists </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">of intermittent or </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">arthritis (19), </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">neurologic involvement (48-51), or acrodermatitis </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronica </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">atrophicans (52). </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Bergstrom Barbour Magnarelli, “Background of the invention” section in U.S. patent </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">description for “DNA encoding </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">OspA and a method for diagnosing</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;"> </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">infection” 12.10.96 (filed 10.3.94): </span></div>
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<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><span id="docs-internal-guid-30e93d3a-7fff-6303-e138-2f7b8cee5658"><span style="color: black; vertical-align: baseline;">“In many patients the infection of some tissues, particularly the brain and joints, </span><span style="color: #e32400; font-weight: 700; vertical-align: baseline;">persists </span><span style="color: black; vertical-align: baseline;">for </span></span></span><br />
<span style="font-family: "arial"; white-space: pre;">years and </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">can be severely disabling. These forms of </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">Lyme disease are a consequence </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">of the </span><span style="color: #e32400; font-family: "arial"; vertical-align: baseline; white-space: pre;">host</span><span style="color: #e32400; font-family: "arial"; vertical-align: baseline; white-space: pre;">’s </span><span style="color: #e32400; font-family: "arial"; vertical-align: baseline; white-space: pre;">inability to rid itself of the infectious agent </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">and perhaps the development of an autoimmune </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">reactiom </span><span style="font-family: "arial"; white-space: pre;">(7) </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">7 = Steere et al, Early clinical manifestations of Lyme disease Ann Intern Med 1983, 99:76-72 </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Radolf Goldberg Bourell Baker Jones Norgard Characterization of outer membranes isolated </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">from </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">, the Lyme disease spirochete Infect Immun 1995: </span><br />
<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/7768594" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/7768594 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Humoral immune response against OM proteins during </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease. A poorly understood </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">aspect of Lyme disease concerns the </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">inability of host immune responses to eradicate persistent </span></div>
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<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">spirochetal infection</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. Although rising antibody titers to </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Bb </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">and expanding reactivity to spirochetal </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">antigens have been well documented during persistent infection in a variety of mammalian hosts</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(39), </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">it is not known how much of this antibody response is directed against surface-exposed </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">borrelial proteins (and, therefore, is capable of contributing to bacterial clearance). </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Cox Akins Bourell Lahdenne Norgard Radolf Limited surface exposure of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">outer surface lipoproteins Proc Natl Acad Sci USA 1996: </span><br />
<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/8755587">https://www.ncbi.nlm.nih.gov/pubmed/8755587</a> </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">...Our finding that these highly abundant immunogens have only limited surface exposure prompts </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">a major revision of current concepts of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">ultrastructure and its relationship to immune </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">evasion during </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Norgard Arndt Akins Curetty Harrich Radolf Activation of human monocytic cells by </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Treponema pallidum </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">and </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">and synthetic lipopeptides proceeds via</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">pathway distinct from that of lipopolysaccharide but involves transcriptional activator </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">NF-kB Infect Immun 1996: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/8751937">https://www.ncbi.nlm.nih.gov/pubmed/8751937</a> </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Syphillis and Lyme disease are </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infections caused by the pathogenic spirochetes </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">T</span><span style="color: black; font-family: "arial"; font-style: italic; vertical-align: baseline; white-space: pre;">reponema pallidum </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">and </span><span style="color: black; font-family: "arial"; font-style: italic; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi</span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">, respectively. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">The observation that proinflammatory activity is a “generic” property of spirochetal lipoproteins </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">raises the intriguing possibility that lipoproteins unrelated to OspA or OspB which are expressed </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">exclusively during the course of infection can promote the inflammatory processes that engender </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">clinical manifestations in </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease. This contention can be evaluated by examining </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">the proinflammatory properties of borrelial lipoproteins expressed exclusively during the mammalian </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">phase of the spirochete life cycle. </span></div>
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<span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">Wooten Modur McIntyre Weis </span><span style="color: black; font-family: "arial"; font-style: italic; font-weight: 700; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">outer membrane protein A induces </span><br />
<span style="font-family: "arial"; font-weight: 700; white-space: pre;">nuclear translocation of nuclear factor-kappa B and inflammatory activation in human </span><br />
<span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">endothelial cells J Immunol 1996: </span><span style="color: #000099; font-family: "arial"; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/8906837" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/8906837 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">...OspA expression can reappear late in disease, and this re-expression may contribute to the </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">inflammation associated with </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease (58). </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Nanagara, Duray Schumacher Ultrastructural demonstration of spirochetal antigens in </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">synovial fluid and synovial membrane in </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease: Possible factors contributing </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">to </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persistence of organisms </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Human Pathology 1996: </span><br />
<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/8892586" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/8892586 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Electron microscopy adds further evidence for </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persistence </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">of spirochetal antigens in the joint in </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease. Locations of spirochetes or spirochetal antigens both intracellulary and </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">extracellulary in deep synovial connective tissue as reported here suggest sites at which spirochaetes </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">may elude host immune response and antibiotic treatment. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">In our EM study, there was strong evidence of ongoing vascular injury in acute and also in </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme synovium. These feature of vasulopathy were not related to the total duration of arthritis. </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">The signs of active vascular injury, found even in long-standing </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme arthritis (patient 3) </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">may be evidence of repeated microvascular insults, occurring during each episode of arthritis. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">If spirochetes are already sequestered in tissue that is inaccessible to antibiotics such as in the </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">fibrinous and collagen tissue or within fibroblasts, high-dose parenteral antibiotics (54), or combination </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">therapies (55, 56) with long duration may be needed to kill the living spirochetes. Failure of antibiotic </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">treatment in </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme arthritis may also be explained by spirochetal antigens that exist in</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">the joint and perpetuate immune response in genetically predisposed patients. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Bunikis Noppa Östberg Barbour Bergström Surface exposure and species specificity of</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">immunoreactive domain of a 66-kilodalton outer membrane protein (P66) of the </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">spp. that cause Lyme disease Infect Immun 1996: </span><br />
<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/8945554" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/8945554 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">...Later, hematogenous spread of the borreliae may occur causing </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">dermatologic, neurologic, </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">and arthritic complications... </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><span id="docs-internal-guid-23561f60-7fff-06d9-ad8f-f6b383e38893"></span></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">...</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">These proteins may also contribute to the development of </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease by undergoing </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">subtle antigenic changes which give rise to immunoevasive mutants (13,19,20,33). </span></div>
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<span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">Norris, Barbour et al, U.S. patent description for “VMP-like sequences of pathogenic Borrelia”</span><span style="font-family: "arial"; font-weight: 700; white-space: pre;">,</span><br />
<span style="font-family: "arial"; font-weight: 700; white-space: pre;">4.13.04 (filed 2.20.97 -> 8.16.02) Norris, U.S patent description for “VMP-like sequences </span><br />
<span style="font-family: "arial"; font-weight: 700; white-space: pre;">of pathogenic Borrelia species and strains” 8.25.15 (filed 4.21.14) </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">“The infection, if untreated, commonly persists for months to years despite the occurrence of host </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">antibody and cellular responses; this observation indicates effective evasion of the immune response. </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease may be disabling (particularly in its </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">form), and thus there is a need for effective </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">therapeutics and prophylactic treatment.” </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Philipp Duray Piesman Xu The outer surface protein A (OspA) vaccine against Lyme disease </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Efficacy in rhesus monkey Vaccine 1997: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/9413097">https://www.ncbi.nlm.nih.gov/pubmed/9413097</a> </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">... although timely administration of appropriate antibiotics is usually curative, </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">long courses of therapy </span><br />
<span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">may be required if the infection is allowed to become </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, and </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in some patients there is no </span><br />
<span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">response to therapy at all</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Zhang Barbour Norris Antigenic variation in Lyme by promiscuous recombination VMP-like </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">sequence cassettes Cell 1997: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/9108482" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/9108482 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">... it is likely that VlsE plays an important role in some aspect of infection... and that antigenic </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">variation merely permits surface expression of this protein </span><span style="background-color: transparent; color: #fd3f36; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">without leading to elimination of the </span><br />
<span style="background-color: transparent; color: #fd3f36; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">bacteria by the host’s immune response. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Koomey Bacterial pathogenesis: A variation on variation in Lyme Curr Bio 1997:</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;"> </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/9285701" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/9285701 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Abstract: The discovery of antigenic variation in </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, the bacterium that causes Lyme </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">disease, provides a potential explanation for the </span><span style="background-color: transparent; color: #fd2c14; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #fd2c14; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">nature of infection </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">as well as new insights</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">into the genetic structure of highly recombinogenic loci responsible for combinatorial genetic diversification. </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">... And now the Lyme disease pathogen, </span><span style="color: black; font-family: "arial"; font-style: italic; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">can be added to this list; the recent </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">discovery of antigenic variation in this species may explain the </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">nature of Lyme disease. </span></div>
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<span style="font-family: "arial"; font-weight: 700; white-space: pre;">Barbour Zückert Genome sequencing. New tricks of tick-borne pathogen Nature 1997: </span><br />
<span style="color: #000099; font-family: "arial"; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/9403678" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/9403678 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">“Determination of the </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">genome has opened doors for investigation and closed just a</span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">s</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">many. By understanding the biosynthetic and transport limitations of </span><span style="color: black; font-family: "arial"; font-style: italic; vertical-align: baseline; white-space: pre;">B burgdorferi</span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">, we may be able</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">to develop a medium in which to grow as-yet uncultivable </span><span style="color: black; font-family: "arial"; font-style: italic; vertical-align: baseline; white-space: pre;">Borrelia </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">spp. The results encourage </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">study of a more metabolically competent spirochaete, such as the free-living </span><span style="color: black; font-family: "arial"; font-style: italic; vertical-align: baseline; white-space: pre;">Spirochaeta aurantia</span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">, f</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">or a better understanding of how this ancient group of bacteria evolved, and to identify catalytic </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">molecules of industrial importance. But the sequence does not explain the </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">persistence </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">of the disease </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">in some people yet not in others;...” </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Phillips Mattman Hulinska Moayad, Proposal for reliable culture of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">from patients </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">with </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme, even those previously extensively treated Infection 1998:</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;"> </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/9861561">https://www.ncbi.nlm.nih.gov/pubmed/9861561</a> </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Chronic Lyme disease is a controversial topic. Even after extended antibiotic treatment, </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persistent </span><br />
<span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease has been strongly suggested by the persistence of borrelial </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">antigen, as demonstrated by polymerase chain reaction (3,4)... </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">...This study proves that chronic Lyme disease is of </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infectious etiology</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, and that even antibiotic </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">treatment well in excess of current recommendations is not necessarily curative. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Liang Philipp An immunodominant conserved region within the variable domain of VlsE, </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">the variable surface antigen of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">J Immunol 1999:</span><br />
<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/10553085" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/10553085 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Discussion </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">The sequence conservation of the six invariable regions across strain and genospecies barriers </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">indicates that these regions are important in whichever role VlsE may play in the physiology of</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"> </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi. </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">One would therefore expect that such sequences are </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">not </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">antigenic in hosts with </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">a </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">or would be otherwise inaccessible to Ab, either because they </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">are conformationally buried withing the VlsE molecule or are unavailable on the spirochetal surface.</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"> </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">[BUT...] In addition, 35 of 41 human serum samples collected in the Northeast and Midwest of the </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">US from patients with acute or </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease also reacted with the C6 peptide... </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">... The immunodominance of IR6 was further underscored by the long term persistence of </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">anti-C6 Abs in infected monkeys and in patients with </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease (not shown). </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><span id="docs-internal-guid-e868f4b6-7fff-da98-938f-df80f53399cb"><span style="vertical-align: baseline;">... What then is the role of the antigenicity and immunodominance of IR6? It has been hypothesized </span></span></span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><span style="vertical-align: baseline;">that </span><span style="color: #e32400; font-weight: 700; vertical-align: baseline;">chronic </span><span style="vertical-align: baseline;">host exposure to immunodominant Ags or epitopes diverts the immune system from </span></span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><span style="vertical-align: baseline;">responding </span></span><span style="font-family: "arial"; white-space: pre;">to less antigenic but functionally important Ags or epitopes, thus serving as a protective </span><br />
<span style="font-family: "arial"; white-space: pre;">strategy </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">for </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">persistent </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">pathogens (30). </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Hemmer Gran Zhao Marques Pascal Tzou Kondo Cortese Bielekova Straus McFarland Houghten </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Simon Pinilla Martin Identification of candidate T-cell epitopes and molecular mimics in </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease Nature Med 1999</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/10581079" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/10581079 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">In </span><span style="background-color: transparent; color: #fc2d29; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #fc2d29; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infectious diseases such as Lyme disease</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, immune-mediated damage may add to the </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">effects of direct infection by means of molecular mimicry to tissue autoantigens. Here, we describe </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">a new method to effectively identify both microbial epitopes and candidate autoantigens. The approach </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">combines data acquisition by positional scanning peptide combinatorial libraries and biometric </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">data analysis by generation of scoring matrices. In a </span><span style="background-color: transparent; color: #fe2c1c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">patient with </span><span style="background-color: transparent; color: #fe2c1c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #fe2c1c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">neuroborreliosis</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, we show </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">that this strategy leads to the identification of potentially relevant T-cell targets derived from both </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">and the host. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">In </span><span style="background-color: transparent; color: #fe2f2a; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #fe2f2a; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">CNS lesions</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, vasculitis and lymphocytic infiltrates both indicate involvement of cell-mediated </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">autoimmunity, but little is known about the specific </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B. burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">antigens that may be involved </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in CNS Lyme disease. Moreover, information is scarce on which CNS antigens may be relevant </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">as target autoantigens in this condition [5,23]. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Coburn </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(NEMC) </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Chege Magoun Bodary </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(Genentech) </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Leong </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(U Mass Worcester) </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Characterization </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">of a candidate </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><span style="background-color: transparent; color: black; font-family: "courier new"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">3-chain integrin ligand identified using a phage display </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">library Mol Microbiol 1999: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/10594819" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/10594819 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">...A remarkable aspect of this infection is that, in the absence of appropriate antibiotic therapy, the </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">bacteria are able to establish </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection even in the face of an intact immune system... </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">As is the case in humans, in animals the spirochaete is able to disseminate widely and avoid clearance </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">by the immune system, thereby establishing </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Straubinger Straubinger Summers Jacobson Status of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">infection after </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">antibiotic treatment and the effects of corticosteroids: An experimental study J Infect Dis 2000: </span><br />
<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/10720533" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/10720533 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><span id="docs-internal-guid-03f244d6-7fff-279d-74c3-87472b90ddc0"><span style="vertical-align: baseline;">... Patients with acute Lyme borreliosis are normally highly responsive to therapy and even chronic </span></span></span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><span style="vertical-align: baseline;">cases shows a favorable response to antibiotic treatment (23). However, patients may show relapses </span></span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><span style="vertical-align: baseline;">weeks to years after antibiotic therapy (24), which raises the question of reinfection or reactivation </span></span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><span style="vertical-align: baseline;">of the primary infection. It appears that </span><span style="font-style: italic; vertical-align: baseline;">B burgdorferi </span><span style="vertical-align: baseline;">can survive antibiotic therapy either by residing </span></span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><span style="vertical-align: baseline;">in privileged sites provided by the host or by using other strategies... </span></span><br />
<span style="font-family: "arial"; white-space: pre;"><br /></span>
<span style="font-family: "arial"; white-space: pre;">In conclusion, the canine model of acute Lyme arthritis has provided further insight into this disease.</span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">We were able to investigate the status of the infection >360 days after antibiotic treatment and </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">to collect data relevant to the </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">course of the disease seen in humans. We demonstrated </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">that </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">silent infection with </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">can be converted into active disease. </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Positive PCR </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">results after therapy may reflect low-level persistent infection. Further research is needed to uncover </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">the mechanisms that enable </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">to gain a </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">permanent </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">foothold in the mammalian host.</span><br />
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Straubinger </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(College of Veterinary Medicine, Cornell) </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">PCR-based quantification of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">organisms in canine tissues over 500-day postinfection period J Clin Micro 2000: </span><br />
<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/10834975">https://www.ncbi.nlm.nih.gov/pubmed/10834975</a> </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">In this study, q-PCR was used to quantify </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">populations in skin tissue and blood samples </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">of beagle dogs collected sequentially over a period of more than 500 days. To determine whether </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">the number of borrelia organisms is correlated with clinical disease and whether antibiotic therapy </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">eliminates the organisms in tissues, three groups of four dogs were each treated with different antibiotics </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">for a 30- day period, and data for these animals were compared to those for untreated dogs. </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">This experimental model was used because Lyme borreliosis is very similar to the disease in humans </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(1,28). Our studies have shown that despite a vigorous immune response of the dog, </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">is not eliminated and the bacterium establishes a </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persistent </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection, </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">particularly in collagen-rich </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">tissue (10). </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">In summary, real-time PCR allowed a quantitative insight into the host-bacterium interaction in </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">canine Lyme borreliosis: ... (iii) </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">antibiotic therapy reduced the load of </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">organisms in </span><br />
<span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">the host but failed to eradicate the agent</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. This technique will benefit future studies designed to </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">solve the exact mechanisms by which </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">establishes a </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persistent </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">and triggers </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">an inflammatory response in tissue. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Beerman Lochnit Geyer Groscurth Filgueira The lipid component of lipoproteins from </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Structural analysis, antigenicity and presentation via human dendritic cells Biochem Biophys </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Comm 2000: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/10673388">https://www.ncbi.nlm.nih.gov/pubmed/10673388</a> </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi sensu stricto </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">strain LW2 [27], a tendon isolate of a patient suffering from </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease... </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme borreliosis is characterized by </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">manifestations that coexist with a measurable immune </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">response </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Seshu Skare The many faces of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">J Mol Microbiol Biotech 2000: </span><br />
<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/11075919" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/11075919 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><span id="docs-internal-guid-a8be6b4f-7fff-8e31-a83f-4cab8d80c06b"></span></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Identification of such variable determinants may shed light on additional escape variants selected</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">for by the host and would help explain the </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">associated with Lyme borreliosis. </span></div>
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<span style="font-family: "arial"; font-weight: 700; white-space: pre;">Pachner Cadavid Shu Dail Pachner Hodzic Barthold Central and peripheral nervous system </span><br />
<span style="font-family: "arial"; font-weight: 700; white-space: pre;">infection, immunity and inflammation in the NHP model of Lyme borreliosis Ann Neurol 2001:</span><br />
<span style="color: #000099; font-family: "arial"; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/11558789" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/11558789 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Abstract: ... </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">These data demonstrate that Lyme neuroborreliosis is a </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persistent </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, that </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">spirochetal presence is a necessary but not sufficient condition for inflammation, and that antibody </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">measured in serum may not predict the severity of infection. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">This manuscript presents for the first time a combined analysis of spirochetal load, immunological </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">response to the spirochete in the CSF and serum, and inflammation in infected tissues in a large </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">group of animals in the NHP [nonhuman primate] model of LNB [Lyme neuroborreliosis]. The work </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">showed that </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">is widely disseminated throughout the central and peripheral nervous system, </span><br />
<span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">a strong host immune response attacks the spirochete but is unable to clear the organism</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, and there</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">is widespread inflammation in which presence of spirochete is necessary but not sufficient to cause </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">inflammation. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Burgdorfer, Arthropod Borne Spirochetoses: Historical Perspective Eur J Clin Microbiol </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Infect Dis 2001: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/11245316" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/11245316 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">This test is presently hailed as a potential breakthrough for reliable diagnosis of Lyme disease in </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">p</span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">atients with late or </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">illness. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Martin </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(NINDS/NIH) </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Gran Zhao Markovic-Plese Bielekova Marques </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(NIAID/NIH) </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Sung Hemmer </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(NINDS/NIH, Univ Marburg) </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Simon McFarland Pinilla </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(Torrey Pines </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">Institute, San Diego) </span><br />
<span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">Molecular mimicry and antigen-specific T cell responses in MS and </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">CNS Lyme disease</span><br />
<span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">J Autoimmunity 2001: </span></div>
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<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/11334482" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/11334482 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">We already utilized this search strategy for the identification of both </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">-derived sequences,</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">the causative agent of Lyme disease, and to human proteins, for a clone (CSF-3) that was isolated </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">from the CSF of a patient with </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">CNS Lyme disease (25 </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">= Hemmer et al </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Nature Med </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">1999</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">). </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><span id="docs-internal-guid-70e28f15-7fff-ec62-7baf-2e8c6e8899dc"><span style="font-weight: 700; vertical-align: baseline;">Hudson </span><span style="vertical-align: baseline;">(USDA, Athens, GA) Frye Quinn </span><span style="font-weight: 700; vertical-align: baseline;">Gherardini </span><span style="vertical-align: baseline;">(Univ Georgia, Athens) </span><span style="font-weight: 700; vertical-align: baseline;">Increased expression </span></span></span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><span style="font-weight: 700; vertical-align: baseline;">of </span><span style="font-style: italic; font-weight: 700; vertical-align: baseline;">B burgdorferi </span><span style="font-weight: 700; vertical-align: baseline;">vlsE in response to human endothelial cell </span></span><span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">membranes Mol Microbiol 2001: </span><br />
<span style="color: #000099; font-family: "arial"; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/11454215" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/11454215 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">As </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">disseminates to various sites in the body, other cell types and conditions are encountered,</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">which could trigger additional changes in gene expression that are essential for maintaining an infection. </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Identifying the genes that are involved in establishing and maintaining a </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">is essential </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">for understanding the pathogenesis of Lyme disease. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">McDowell Sung Hu Marconi Evidence that variable regions of central domain of VlsE are antigenic </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">during infection with Lyme disease spirochetes Infect Immun 2002:</span><br />
<a href="https://www.ncbi.nlm.nih.gov/pubmed/12117928" target="_blank"><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;"> </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">https://www.ncbi.nlm.nih.gov/pubmed/12117928 </span></a></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">The </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">nature of Lyme disease and the genetic and antigenic diversity of the Lyme disease </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">spirochetes suggest that antigenic variation may play an important role in immune evasion. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Vrethem Hellblom Widlund Ahi Danielsson Emerudh Forsberg </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">symptoms are common </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">in patients with neuroborreliosis — a questionnaire follow-up study Acta Neurol Scand 2002: </span><br />
<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/12225315">https://www.ncbi.nlm.nih.gov/pubmed/12225315</a> </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">OBJECTIVES: </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">The existence of chronic neuroborreliosis is controversial. The aim of our study was </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">to investigate the existence and kind of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">persistent symptoms in patients previously treated </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">because </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">of neurological symptoms as a result of neuroborreliosis. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">MATERIALS AND METHODS: </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: sub; white-space: pre;">A total of 106 patients with neuroborreliosis, according to established </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: sub; white-space: pre;">criteria, and a control group of 123 </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">patients with Borrelia induced erythema migrans diagnosed </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in a general practitioner office were studied. A questionnaire was sent to patients and controls </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">concerning their health situation. Time from onset of neurological symptoms to the questionnaire </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">send out was 32 months (mean) for the patients with neuroborreliosis and 33 months (mean) for </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">the controls. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">RESULTS: </span></div>
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<span style="background-color: transparent; color: #ff2600; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Fifty per cent of the individuals in the patient group compared with 16% of the individuals in the control </span><br />
<span style="background-color: transparent; color: #ff2600; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">group showed </span><span style="background-color: transparent; color: #ff2600; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persistent </span><span style="background-color: transparent; color: #ff2600; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">complaints after their Borrelia infection (P < 0.0001)</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. The most significant </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">differences between the groups were the presence of neuropsychiatric symptoms such as headache,</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: sub; white-space: pre;">attention problems, memory difficulties and depression. Paresthesia, pain and persistent facial palsy </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: sub; white-space: pre;">was </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">also significantly more common in patients treated because of neuroborreliosis. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><span id="docs-internal-guid-22a35cd4-7fff-6f80-d816-77a8c35804ea"></span></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">CONCLUSION: </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Our study shows that </span><span style="background-color: transparent; color: #ff2600; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persisting </span><span style="background-color: transparent; color: #ff2600; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">neurological symptoms are common after a </span><br />
<span style="background-color: transparent; color: #ff2600; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">neuroborreliosis infection</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. The pathological mechanisms that lay behind the development of </span><br />
<span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">symptoms, however, are still uncertain.</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: sub; white-space: pre;"> </span></div>
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<span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">Widhe Ernerudh </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">(Univ Linkoping, Sweden) </span><span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">Cytokines in Lyme borreliosis Lack of early TNF-alpha </span><br />
<span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">and transforming growth factor-beta responses are associated with </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">neuroborreliosis </span><br />
<span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">Immunology 2002: </span><span style="color: #000099; font-family: "arial"; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/12225362" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/12225362 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">In Europe, neuroborreliosis (NB) is a common manifestation, with the risk of developing into a </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">disease. Several reports suggest the occurrence of </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persistent </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">or </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">reappearing </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">neurological symptoms</span><br />
<span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in 20-50% of NB patients treated </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(3-5). </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Diterich Hartung </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">induced tolerance as model of persistence via immunosupression </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Infection Immunity 2003: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/12819085" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/12819085 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">“If left untreated, infection with </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">sensu lato may lead to </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme borreliosis. It is </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">still unknown how this pathogen manages to persist in the host in the presence of competent immune </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">cells</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">.” [p.3979] </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">“If infection with this pathogen is not treated adequately with antibiotics, it may lead to a </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">multisystemic disorder which is difficult to cure</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">.” [p.3979] </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">“Blood cells from </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">patients sufffering from </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persistent </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">LB </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">released significantly lower levels of proinflammatory </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">cytokines (i.e. TNF-alpha and gamma interferon) in response to either a Borrelia-specific stimulus </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">or LPS than cells from healthy volunteers (8). [p. 3979] </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">“Understanding the immunopathology of LB is still a major challenge. Although it induces strong </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">immune activation, e.g. in phases of arthritis, the causative agent of LB persist and leads to a </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic</span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">pathology in the immunocompetent host</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. Of note, the inflammatory episodes associated with LB </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">are typically self- limiting and the site of manifestation often changes, e.g. between different joints.</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">These phenomena suggest counterregulatory anti-inflammatory mechanisms, and the long phases </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">of latency indicate phases of immune evasion. [p. 3984-85] </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Ekerfelt Jarefors Tynngard Hedlund Sander Bergstrom Forsberg Ernerudh Phenotypes indicating </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">cytolytic properties of Borrelia-specific interferon-gamma secreting cells in </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">neuroborreliosis J Neuroimmunol 2003: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/14644037" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/14644037 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: sub; white-space: pre;"><span id="docs-internal-guid-4e6ee4f8-7fff-c726-3f16-c9d1e7711eab"><span style="vertical-align: baseline;">Abstract: The immuno-pathogenetic mechanisms underlying </span><span style="color: #ff2600; font-weight: 700; vertical-align: baseline;">chronic </span><span style="vertical-align: baseline;">Lyme neuroborreliosis are </span></span></span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: sub; white-space: pre;"><span style="vertical-align: baseline;">mainly unknown. Human Borrelia burgdorferi (Bb) infection is associated with Bb-specific secretion </span></span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">of interferon-gamma (IFN-gamma), which may be important for the elimination of Bb, but this may </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">also cause tissue injury. In order to increase the understanding of the pathogenic mechanisms </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">in </span><span style="color: #ff2600; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">neuroborreliosis, we investigated which cell types that secrete IFN-gamma. Blood </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">mononuclear cells from 13 patients with neuroborreliosis and/or acrodermatitis chronicum atrophicans </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">were stimulated with Bb antigen and the phenotypes of the induced IFN-gamma-secreting cells </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">were analyzed with three different approaches. Cells expressing CD8 or TCR gamma delta, which </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">both have cytolytic properties, were the main phenotypes of IFN-gamma-secreting cells, indicating that</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">tissue injury in </span><span style="color: #ff2600; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">neuroborreliosis may be mediated by cytotoxic cells. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Singh Girschick Toll-like receptors in </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">-induced inflammation Clin Microbiol </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Infect 2006: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/16842565">https://www.ncbi.nlm.nih.gov/pubmed/16842565</a> </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Although </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B. burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">can induce a strong bactericidal immune activation, e.g., in phases of arthritis, </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">the causative agent of Lyme borreliosis </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">seems to be able to </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persist </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in humans, </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">which probably </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">contributes to a </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">pathology in the immunocompetent host </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(11). A </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">remitting and episodic </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">course of inflammation </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">has been described, indicating a </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">repetitive confrontation of the immune </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">system with spirochaetal components </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(43). </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Cassiani-Ingoni Cabral Marques Martin </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">induces TLR1 and TLR2 in human microglia </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">and peripheral blood monocytes but differentially regulates HLA-class II expression J Neuropathol </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Exp Neurol 2006: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/16783164" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/16783164 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Because nervous system manifestations of Lyme disease occur frequently, besides the </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">involvement of the skin, the heart, and the joints, and because the CNS is considered an immunoprivileged </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">organ, it is important to understand which factors contribute to tissue inflammation in the CNS. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Larsson Andersson Pelkonen Guo Nordstrand Bergstrom Persistent brain infection and disease </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">reactivation in relapsing fever borreliosis Microbes Infect 2006: </span><br />
<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/16782384" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/16782384 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">The closely related spirochetal pathogens </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi sensu lato </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">and </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Treponema pallidum </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">are associated with </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persistent </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">disease and infection of the brain</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, causing neurological disorders </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">denoted Lyme neuroborreliosis </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">and neurosyphilis, respectively... </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: sub; white-space: pre;"><span id="docs-internal-guid-18d0c626-7fff-1a60-dbef-0fec0a9dd235"><span style="vertical-align: baseline;">...We hypothesized that </span><span style="color: #e32400; vertical-align: baseline;">like Lyme disease and syphilis</span><span style="vertical-align: baseline;">, certain relapsing fever infections may be </span></span></span><br />
<span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">persistent </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">in nature, providing a bacterial reservoir for potential infection of naive vectors... </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">...Intriguingly, </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B duttonii </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">is far more persistent in the blood than the other species tested, and can cause </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">a quantifiable persistent residual brain infection for at least 270 days. In addition, host immunosuppression </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">enables these bacteria to re-enter the blood and achieve densities similar to those of the initial </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection. We also present further evidence of bacterial immune evasion since animals with residual </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">brain infection display a gene expression profile consistent with uninfected controls. Thus, </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">the experiments </span><br />
<span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in this study challenge the current paradigm of relapsing fever as an acute disease to include in some </span><br />
<span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">cases silent infection, in which bacteria can </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persist </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in an immune privileged site that provides a reservoir </span><br />
<span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">for reactivation. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Cabello Godfrey Newman Hidden in plain sight: </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">and extracellular matrix Trends in </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Microbiol 2007: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/17600717" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/17600717 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Better knowledge of ... genetic and structural bases for these interactions of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Bb </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">with extracellular matrix </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">will be required before understanding of </span><span style="background-color: transparent; color: #ff3127; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persistence </span><span style="background-color: transparent; color: #ff3127; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">of </span><span style="background-color: transparent; color: #ff3127; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Bb </span><span style="background-color: transparent; color: #ff3127; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in tissues and development of </span><span style="background-color: transparent; color: #ff3127; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><br />
<span style="background-color: transparent; color: #ff3127; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infections </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">can be achieved </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Bb</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">... causes a </span><span style="background-color: transparent; color: #ff322c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #ff322c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">extracellular infection </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">[2]} </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Here we suggest that these interactions are of great importance in </span><span style="background-color: transparent; color: #fd2c25; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #fd2c25; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infections with this organi</span><span style="color: #fd2c25; font-family: "arial"; white-space: pre;">sm </span><br />
<span style="color: #fd2c25; font-family: "arial"; white-space: pre;"><br /></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Interaction of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">with ECM is important for </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic infection </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Interaction between Bb with the ECM (24), a hydrated complex of fibrous and non-fibrous proteins </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">and proteoglycans, and specifically collagen (or its associated molecules), appears to be essential </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">for persistence and </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">...ability of this pathogen to produce acute and </span><span style="background-color: transparent; color: #fc2f37; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #fc2f37; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infections</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Grygorczuk et al </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(Poland) </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Concentration of TGF-beta1 in supernatant of PBMCs cultures from </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">patients with early disseminated and </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme borreliosis Adv Med Sci 2007:</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;"> </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/18217413">https://www.ncbi.nlm.nih.gov/pubmed/18217413</a> </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Hodzic Barthold Persistence B burgdorferi following antibiotic treatment in mice Antimicrob </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Agents Chemother 2008: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/18316520" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/18316520 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: sub; white-space: pre;"><span id="docs-internal-guid-3f416163-7fff-7312-21a8-392c70b8d76b"><span style="vertical-align: baseline;">Abstract: ... Results indicated that </span><span style="color: #ee220c; vertical-align: baseline;">following antibiotic treatment, mice remained infected with nondividing</span></span></span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: sub; white-space: pre;"><span style="color: #ee220c; vertical-align: baseline;">but infectious spirochetes</span><span style="vertical-align: baseline;">, particularly when antibiotic treatment was commenced during the </span><span style="color: #ee220c; font-weight: 700; vertical-align: baseline;">chronic</span></span><br />
<span style="font-family: "arial"; white-space: pre;">stage of infection. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">The current study further investigated the issue of B burgdorferi persistence following antibiotic the</span><span style="font-family: "arial"; white-space: pre;">rapy</span><br />
<span style="font-family: "arial"; white-space: pre;"> by examining mice treated with ceftriaxone during the early stage of infection compared to mice treated </span><br />
<span style="font-family: "arial"; white-space: pre;">during the late stage of infection. A recent study has shown that there are significant shifts into or</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">preferential survival of spirochetes in collagen during </span><span style="color: #ee220c; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">chronic </span><span style="color: #ee220c; font-family: "arial"; vertical-align: baseline; white-space: pre;">infection </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">(7), which may facilitate im</span><span style="font-family: "arial"; white-space: pre;">mune </span><br />
<span style="font-family: "arial"; white-space: pre;">evasion and impact effectiveness of antibiotics. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Xu Liang </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(LSU) </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Modification of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">to overproduce OspA or VlsE alters its infectious </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">behavior Microbiology 2008: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/18957595" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/18957595 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Within mammals, however, </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">ospA </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">expression is essentially repressed, while </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">vlsE </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">expression is </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">unregulated, especially during </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection of immunocompetent hosts (Liang et al, 2004b). </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">After dissemination, humoral responses greatly upregulate vlsE in all tissues, an event consistent </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">with the critical role of VlsE in immune evasion during </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection of immunocompetent hosts </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Bankhead & Chaconas, 2007; Zhang et al, 1997)</span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Barthold Hodzic Imai Feng Yang Luft Ineffectiveness of tigecycline against persistent </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Antimicrob Agents Chemother 2010: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/19995919" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/19995919 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">... the immune system is needed to fully eliminate the remaining spirochetes. However, therein lies </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">the challenge, since </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">has evolved to </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persistently infect </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">fully immunocompetent </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">hosts</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Persistent infection </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">has been shown to be </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">the rule, rather than the norm, in a variety </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">of laboratory animal species</span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">including mice, rats, </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Peromyscus leucopus</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, hamsters, gerbils, guinea pigs,</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">rabbits, dogs, and nonhuman primates. Based upon culture and/or PCR, </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persistent infections </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">have </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">also been documented in humans </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">from both Europe (3,36,43,46,65,67,71,74) and the US (14,19,47). </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Therefore, the “mop up” phase, which is dependent upon the immune system, is likely to be ineffective </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">against an agent such as </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, which is highly effective at evading host clearance. </span><br />
<span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">... </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">At all phases of these events, spirochetes cannot be cultured, and their numbers are very low, suggesting </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">a viable but slowly dividing or nondividing population (27). These features fit the paradigm of multidrug </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">tolerance or “recalcitrance to eradication” by antibiotics that occurs among a variety of persistent bacterial </span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">and fungal infections (reviewed in references 30,38, 39). </span></div>
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<span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">These results challenge prevailing dogma about effectiveness of antibiotics for eliminating </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><br />
<span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, and therefore further work is critically needed. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><span id="docs-internal-guid-fc6c8536-7fff-d746-71af-79ae7201efb2"></span></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Embers Barthold Borda Bowers Doyle Hodzic Jacobs Hasenkampf Martin </span><br />
<span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">Narasimhan Phillippi-Falkenstein Purcell Ratterree Philipp </span><span style="color: #ee220c; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">Persistence </span><span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">of </span><span style="color: black; font-family: "arial"; font-style: italic; font-weight: 700; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">in rhesus macaques following antibiotic treatment of disseminated infection PLoS One 2012: </span><br />
<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/22253822" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/22253822 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">...These results demonstrate that </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B. burgdorferi </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">can withstand antibiotic treatment, administered </span><br />
<span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">post- dissemination, in a primate host. </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Though </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B. burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">is not known to possess resistance mechanisms </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">and is susceptible to the standard antibiotics (doxycycline, ceftriaxone) in vitro, it appears to become</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">tolerant post-dissemination in the primate host. This finding raises important questions about the </span><br />
<span style="font-family: "arial"; white-space: pre;">pathogenicity of antibiotic-tolerant persisters and whether or not they can contribute to symptoms </span><br />
<span style="font-family: "arial"; white-space: pre;">post- treatment. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Muller Damage collagen elastic fibres by </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">- Known and new clinical histopathological </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">aspects Open Neuro 2012: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/23986790" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/23986790 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">“Tendons and ligaments are a structurally and topographically ideal retreat for Borrelia. Their involvement </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">is a further factor to indicate a </span><span style="background-color: transparent; color: #fd2e31; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #fd2e31; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">course of the disease</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. Serological antibody diagnostic techniques </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">proved to be inadequate in cases such as this, possibly because the formation of antibodies is inhibited </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">by the pathogen [11]”” </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Kenedy Lenhart Akins The role of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">outer surface proteins FEMS Immunology </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">and Med Microbiol 2012: </span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/22540535" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/22540535 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">These spirochetes are unique in that they can cause </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection and persist in the infected human,</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">even though a robust humoral and cellular immune response is produced by the infected host. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Infected individuals that do not receive antibiotic therapy are at risk for developing </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">forms of the </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">disease which can result in various disorders of the heart, nervous system, and joints. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">13th International Conference on Lyme borreliosis and other tick borne diseases - Boston - </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Aug 2013: </span><br />
<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.frontiersin.org/books/%2013th_International_Conference_on_Lyme_Borreliosis_and_other_tick_Borne_Diseases_/357" target="_blank">https://www.frontiersin.org/books/ 13th_International_Conference_on_Lyme_Borreliosis_and_other_tick_Borne_Diseases_/357 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Abstract A066 (D054) - p.114 Nepereny Vrzal </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(Bioveta, Czech Republic) </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Sensitivity of different </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">genospecies to dog serum complement </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;"><span id="docs-internal-guid-08ba24a9-7fff-3811-8cc4-dd979d4917b4" style="font-weight: normal;"></span></span></div>
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<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease is a </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">multisystem infectious disease </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">that is the most common arthropod-borne </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infectious disease both in Europe and in the United States. </span></div>
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<span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">Abstract A083 (P045) - p. 128 Troy Norris Hu </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">(Tufts, U Texas Houston) </span><span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">Understanding barriers </span><br />
<span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">to </span><span style="color: black; font-family: "arial"; font-style: italic; font-weight: 700; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">dissemination during infection using massively parallel sequencing </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">is an invasive spirochetal pathogen that can cause acute and </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infections </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in the</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">skin, heart, joints and central nervous system of infected mammalian hosts. Following transmission into </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">a mammalian host through the bite of an </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Ixodes scapularis </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">tick, the bacteria establish infection a</span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">t</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">the inoculation site and then </span><span style="color: #e32400; font-family: "arial"; vertical-align: baseline; white-space: pre;">quickly disseminate to distal tissues initiating </span><span style="color: #e32400; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">long-term colonization</span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">.</span><br />
<span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">In this process, </span><span style="color: black; font-family: "arial"; font-style: italic; vertical-align: baseline; white-space: pre;">B burdorferi </span><span style="color: black; font-family: "arial"; vertical-align: baseline; white-space: pre;">encounters multiple potential barriers to infection including adapting </span><span style="font-family: "arial"; white-space: pre;">to </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">environmental changes in nutrients, pH and temperature, breaking through tissue barriers to invasion and</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">dissemination, and evading host immune responses. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Abstract B017 (P016) - p.150 Embers Jacobs </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(Tulane Primate Research Ctr, Covington, LA) </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Tick-mediated </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">infection on nonhuman primates for assessment of antibiotic </span><span style="font-family: "arial"; font-weight: 700; white-space: pre;">efficacy </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">.</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">.. The causative agent, </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, can </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronically </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infect humans, causing rash, arthritis, carditis, and </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">neurological dysfunction. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Abstract B029 (D021) - p. 162 Blenk </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(EuromedClinic, Fuerth, Germany) </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Straubinger Schuster </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Ünsal-Kirici Steinhaven Schütt Komorowki </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(EUROIMMUN AG, Luebeck, Germany) </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Relevance </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">of quantitative determination of IgG antibodies against VlsE as an activity marker in the </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">monitoring of treated Lyme borreliosis: A retrospective study </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Archived (-80C) sera from patients with confirmed or suspected Lyme disease from our Lyme outpatient </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">clinic were used as sample material. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Results: A significant drop in the titer of anti-VlsE antibodies could be detected as early as 6-8 </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">weeks after successful treatment </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in all active </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme infections, </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">inc Lyme arthritis, ACA, </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">acute neuroborreliosis and </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">other active </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">stages of Lyme infection</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. This decrease in anti-VlsE </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">correlated with a reduction in clinical symptoms. The absence of an anti-VlsE titer virtually excludes </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">a </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">florid </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme infection </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(control panel of healthy individuals, n=105). Strongly positive anti-vlsE </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">values (>1000 RU/ml) in untreated patients are to 99% an indication of an </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">active </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Conclusion: Quantitative determination of anti-VlsE IgG is suitable - always under consideration of </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">clinical symptoms - for confirmation of diagnosis and as an activity marker for monitoring patients </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">with </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">active </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme borreliosis </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">before and after treatment. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><span id="docs-internal-guid-36131d52-7fff-9101-8595-2c9691eca977"></span></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Abstract B037 (D035) - p.170 Chan Marras Schutzer Parveen Development of a novel nucleic </span><br />
<span style="font-family: "arial"; font-weight: 700; white-space: pre;">acid-based diagnostic assay for Lyme disease: </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">The infection with </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">can result in acute to </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">... We anticipate that </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">pre-enrichment of the spirochetes present in the blood by culture before conducting the rt-PCR will </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">further improve sensitivity and specificity of the assay such that it can be used as a </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">diagnosis of </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">early to </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">stages of infection </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">by Lyme spirochetes </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Abstract B048 (D055) Eshoo Crowder Schutzer Aucott Direct molecular detection of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">from whole blood and CSF of patients with acute and </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic Lyme disease </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(revised) </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">... </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Results will also be presented on the analysis of a large set (>200) of CSF specimens collected </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in Germany from patients with acute and </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">neuroborreliosis</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Abstract B053 Reye Muller </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(Nat’l Public Health Lab, Luxembourg) </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">From prevalence studies </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">to the development of novel diagnostic tests for Lyme disease </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Therefore, antigen-specific B-cells will be isolated and compared on a single cell level between acute, </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, and resolved </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">patients</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Abstract B076 (D018) - p. 207 Guadulupe Javier Lyme neuroborreliosis is highly prevalent in </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">tertiary care hospitals of Central- southeast Mexico </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Results: We studied 650 patients and confirmed Lyme Neuroborreliosis in 132 (20.3%). The acute </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">disseminated stage was documented ion 100 (75.7%) with facial palsy, lymphocytic meningitis, </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">poliradiculopathy 27 cases, and the </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">stage </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in 32 (24%) of the cases with encephalomyelitis. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Conclusions: This is the first report of Lyme neuroborreliosis in central of Latin-American, and presents </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">as disseminated and a </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">stage</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Kelesidis Cross talk between spirochetal lipoproteins and immunity Frontiers Immunol 2014: </span><br />
<span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/25071771" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/25071771 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;"><span id="docs-internal-guid-608b6f17-7fff-ec80-cec3-6ed59c0f86cd" style="font-weight: normal;"></span></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">“Lipopeptides in combination with other antigens from spirochetes facilitates the transition from innate </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">to prolonged adaptive immune responses that contribute to </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">manifestations of spirochetal diseases </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">such as syphilis and Lyme disease (11). “ </span><br />
<span style="color: black; font-family: "arial"; font-weight: 700; text-align: left; vertical-align: baseline; white-space: pre;"><br /></span>
<span style="color: black; font-family: "arial"; font-weight: 700; text-align: left; vertical-align: baseline; white-space: pre;">Hodzic Imai Feng Barthold Resurgence of </span><span style="color: #ee220c; font-family: "arial"; font-weight: 700; text-align: left; vertical-align: baseline; white-space: pre;">persisting </span><span style="color: black; font-family: "arial"; font-weight: 700; text-align: left; vertical-align: baseline; white-space: pre;">non-cultivable </span><span style="color: black; font-family: "arial"; font-style: italic; font-weight: 700; text-align: left; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi </span><br />
<span style="font-family: "arial"; font-weight: 700; text-align: left; white-space: pre;">following antibiotic treatment in mice PLoS One 2014: </span><br />
<span style="color: #000099; font-family: "arial"; text-align: left; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/24466286">https://www.ncbi.nlm.nih.gov/pubmed/24466286</a> </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Abstract: The agent of Lyme borreliosis, </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, evades host immunity and establishes </span><br />
<span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">persistent infections </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in its varied mammalian hosts. This </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">persistent </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">biology may pose challenges to </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">effective antibiotic treatment. Experimental studies in dogs, mice, and non-human primates have </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">found </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">persistence </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">of </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B. burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">DNA following treatment with a variety of antibiotics, but persisting </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">spirochetes are non-cultivable. </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Persistence </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">of B. burgdorferi DNA has been documented in humans </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">following treatment, but the significance remains unknown... </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Experimental animal studies have shown that </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia burgdorferi</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, the agent of Lyme borreliosis,</span><br />
<span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">consistently establishes persistent infections in a variety of immunocompetent hosts, </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">including laboratory </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">mice (1), white-footed mice (</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Peromyscus leucopus</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">) (2,3,4), rats (5), hamsters (6), guinea pigs (7), gerbils (8),</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">dogs (9), and nonhuman primates, including rhesus macaques (</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Macaca mulatta</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">) (10) and baboons </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Papio spp</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">.) (11). Clinical evidence extends this paradigm to humans (12). </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Persistence </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">is an essential </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">strategy for a complex </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">life cycle in both ticks and reservoir hosts, and likely pertains to </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">incidental hosts, such as humans. </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Persistent </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">biology may pose a challenge in antibiotic therapy, though </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">antibiotics ameliorate the majority of host persisting bacteria, by virtue of their immune-evasion </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">biology, may survive in hosts that are unable to clear infection. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Discussion </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">This study validates a mouse model that can be used for investigation of post-antibiotic </span><br />
<span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">persistence </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">of non-cultivable </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">... </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Results of this study demonstrated </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">not only </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">persistence</span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, but also </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">resurgence </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">of non-cultivable </span><br />
<span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: #ee220c; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in tissues of mice at up to 12 months following antibiotic treatment</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, despite the continued </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">inability to culture spirochetes fro the tissues... </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Although various animal studies may each have their flaws (as do human clinical studies), the comparative</span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">evidence in dogs, mice, non-human primates, and perhaps humans, is compelling, and suggests that </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">something unique is happening with </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">following antibiotic treatment... </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Rogovskyy </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(College Vet Med,Texas A&M) </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Zelikovsky </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(Dept Computer Sci, Georgia State </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Univ) </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Antibody response to Lyme disease spirochetes in context of VlsE- mediated immune </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">evasion Infect Immun 2016:<a href="https://www.blogger.com/goog_1761057859"> </a></span><span style="background-color: transparent; color: #000099; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/27799330">https://www.ncbi.nlm.nih.gov/pubmed/27799330</a> </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">When missed and therefore left untreated, LD </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">becomes </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, presenting itself as skin lesions, </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">arthritis, and carditis and occasionally with subsequent nervous system involvement. </span><br />
<span style="font-family: "arial"; font-weight: 700; white-space: pre;"><br /></span>
<span style="font-family: "arial"; font-weight: 700; white-space: pre;">Grillon Westermann Cantero Jaulhac Voordouw Kapps Collin Barthel Ehret- Sabatier Boulanger </span><br />
<span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">identification of </span><span style="color: black; font-family: "arial"; font-style: italic; font-weight: 700; vertical-align: baseline; white-space: pre;">Borrelia </span><span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">protein candidates in mouse skin for potential diagnosis of disseminated </span><br />
<span style="color: black; font-family: "arial"; font-weight: 700; vertical-align: baseline; white-space: pre;">Lyme borreliosis Nature Sci Rep 2017: </span><span style="color: #000099; font-family: "arial"; vertical-align: baseline; white-space: pre;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/29196626" target="_blank">https://www.ncbi.nlm.nih.gov/pubmed/29196626 </a></span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">In competent reservoir hosts, </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">Borrelia </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">pathogens establish a </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">c</span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">hronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">infection </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in the skin and other </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">organs such as the heart, bladder and joints. </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">15th International Conference on Lyme borreliosis and other tick borne diseases - Atlanta </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">- Sept 2018: </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Poster P51 Crowley Casselli </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(Univ ND) </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Highland </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(USDA) </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Tourand Bankhead </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">(Wash State Univ) </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">A novel plasmid-encoded factor is essential for efficient colonization of host tissues by the </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">Lyme disease spirochete: </span></div>
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<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">With over 300,000 cases per year, Lyme disease is the most common tick-borne disease in North America. </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">While antibiotic therapies exist, they are only effective when administered soon after exposure, which </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">is challenging given the difficulty of diagnosis and detection of the etiological agent, </span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">, </span><br />
<span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">in infected patients. The </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">most dangerous aspect of infection with </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: italic; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">B burgdorferi </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">is the pathogen’s ability </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">to disseminate from the blood stream and colonize distal tissues, leading to </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre;">chronic </span><span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">and potentially </span><br />
<span style="background-color: transparent; color: #e32400; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">severe disease manifestations</span><span style="background-color: transparent; color: black; font-family: "arial"; font-style: normal; font-variant: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre;">. </span></div>
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Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com0tag:blogger.com,1999:blog-3707770726760676731.post-83647980255398592512018-12-29T22:08:00.000+00:002019-01-01T10:49:20.585+00:00LYME DISEASE THE WORST MEDICAL DISGRACE OF ALL TIME.<div dir="ltr" style="text-align: left;" trbidi="on">
<span style="font-family: "verdana" , sans-serif;">Dr. Joe Burrascano talking on ILADS video.</span><br />
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;">Listen and weep for all the thousands of patients that our Governments have deliberately turned their back on and left untreated, despite having tools available to diagnose and treat for Chronic Lyme Disease. The worst medical disgrace of all time.</span><br />
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<iframe allowfullscreen="" frameborder="0" height="270" mozallowfullscreen="" src="https://player.vimeo.com/video/306846706?title=0&byline=0&portrait=0" webkitallowfullscreen="" width="480"></iframe><br />
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<br />
<a href="https://vimeo.com/306846706">History of Lyme Disease by Joseph J. Burrascano, Jr. MD.</a> from <a href="https://vimeo.com/user36592082">ILADS</a> on <a href="https://vimeo.com/">Vimeo</a>.<br />
<br />
<br />
<span style="font-family: "verdana" , sans-serif;">"Back in 1990/1991 the NIH developed their famous Gold stain and believe it or not, for the first time in history and also the last time in history the government agreed with what we(ILADS) were doing.</span><br />
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;">So the Gold stain was a method for detecting Borrelia, they used Borrelia specific antibodies that were bound to gold nanoparticles and they incubated that with the specimen and using electron microscope they photographed the result and they could actually see the aggregates of gold under the electron microscope and that would be a positive test in fact some of them actually showed whole spirochetes coated with gold, I have some beautiful photographs of shadowed spirochetes on electron microscope from them.</span><br />
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;">So they did ( I had to look this up to give you the exact thing.) They discovered that Borrelia even when in their dormant state were secreting what they called bio products, membrane bound vesicles they called them blebs and some of them were empty but some of them contained Borrelia DNA. Now we know that these are plasma fragments that allow Borrelia to communicate one to the other they also secreted what they called an S layer the letter S , S stands for slyme and the terminology today S is what a bacteria produces to make a biofilm. So there it was back in 1990 agreeing with what Alan MacDonald said in 1985- Borrelia do make biofilms. So here they found it.</span><br />
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;">So what did NIH do with this gold stain, well first they studied in animals, they studied dogs and mice and of course ticks. They found that in infected animals they could detect these gold stained spirochetes in the bladder, heart, brain, liver and spleen and blood of these infected animals, urine and tears as well as in the ticks themselves. Em! and then they started to do studies in humans and doctor Ken Liegner, myself, </span><span style="font-family: verdana, sans-serif;">Paul Lavoie, Dorothy Pietrucha and others all contributed to that, a total of 73 patients were studied and again we had samples of tears, totally 50 samples of tears were collected - they found Borrelia in 47 or 48 samples of those 50 tears, that's how amazingly sensitive this test was.</span><br />
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;">With mouse urine they could dilute it 10 fold and still get a positive test, the test was 100% specific for Lyme borrelia. It did not pick up Relapsing fever Borrelia or Leptospira or other spirochetes that they tested, they did a lot of negative controls in animals and humans and never had a false positive, so it is a really solid test.</span><br />
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;">So then they got patient specimens from us, there were 73 patients these were all chronic Lyme patients whose treatments were ranged from many months upto 3 years and the mean duration of treatment was 13 1/2 months and 53% of these patients were still spilling living Borrelia antigens, these bio products that they could see. The other thing that they found, if you tested people who were still symptomatic -ok-em- and then you stopped the antibiotics and let at least 3 or 4 weeks go by and then tested them 100% were positive for Lyme. Exactly what I found in my studies five years earlier with IV therapy, if someone is still symptomatic when treatment ends and you let several weeks go by, by culture and this gold stain you can show they are still spilling Lyme living organisms. That's pretty cool.</span><br />
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;">So what ever happened to this great Gold stain - you know what, Nothing! When this whole thing came out the NIH stopped the funding for the gold stain, they made them close the whole thing down and never again did they ask front line Lyme doctors to contribute specimens to their studies. So there's some politics one more time."</span><br />
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<a href="https://www.ilads.org/dr-burrascano-happy-holidays/?fbclid=IwAR1f5tiputP9shjUtJeeOE5q14QSrZ4e3j8J4t6SpTKywrojpFdOi8EcBCQ"><span style="font-family: "verdana" , sans-serif;">https://www.ilads.org/dr-burrascano-happy-holidays/?fbclid=IwAR1f5tiputP9shjUtJeeOE5q14QSrZ4e3j8J4t6SpTKywrojpFdOi8EcBCQ</span></a><br />
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<span style="font-family: "verdana" , sans-serif;">The above extract starts at 27.45 mins but listen to the whole presentation.</span><br />
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<span style="font-family: "verdana" , sans-serif;">International Lyme and Associated Diseases ILADS website can be found - </span><br />
<span style="font-family: "verdana" , sans-serif;"><a href="https://www.ilads.org/" target="_blank">https://www.ilads.org/ </a></span></div>
Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com7tag:blogger.com,1999:blog-3707770726760676731.post-51853814645674026572018-12-22T14:32:00.000+00:002018-12-22T14:32:06.291+00:00LYME DISEASE LESSONS NEEDED FOR INFECTIOUS DISEASES SOCIETY OF IRELAND AND MANY OTHER DOCTORS.<div dir="ltr" style="text-align: left;" trbidi="on">
<span style="font-family: Verdana, sans-serif;">On November 28th, 2018, the Oireachtas Joint Committee on Health, heard
evidence from patients, patient advocates and professionals about Lyme disease.
The Infectious Disease Society of Ireland (IDSI), submitted a statement
authored by twenty eight of its members.</span><br />
<br />
<span style="font-family: Verdana, sans-serif;"> <span style="background-color: #ffffee; color: #cc3333; font-weight: 700;">Vector-borne Infection - Research, Analysis, Strategy</span><span style="background-color: #ffffee; color: #cc3333; font-weight: 700;"> (</span><span style="background-color: white;"><span style="color: #cc0000; font-weight: 700;">VIRAS) </span>has written an excellent and detailed response to the IDSI challenging many points, this can be viewed at -</span></span><br />
<span style="font-family: Verdana, sans-serif;"><span style="background-color: white;"><br /><a href="http://counsellingme.com/VIRAS/VIRAS_response_to_IDSI.html?fbclid=IwAR0nqSTyYa9pG-NWk3n506AgX6JpXZUCEB2qH_TVievKKyqtHzuOq_5qOe0">http://counsellingme.com/VIRAS/VIRAS_response_to_IDSI.html?fbclid=IwAR0nqSTyYa9pG-NWk3n506AgX6JpXZUCEB2qH_TVievKKyqtHzuOq_5qOe0</a></span></span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span>
<span style="font-family: Verdana, sans-serif;">A copy of the IDSI statement 'had not been provided to Dr
John Lambert, who gave evidence in person at the hearing, even though he is a
member of the IDSI. Dr Lambert is knowledgeable and experienced regarding
Lyme borreliosis and its coinfections, having had years of first-hand experience
in diagnosing and treating patients. This exclusion was discourteous - to put it
mildly. </span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span>
<span style="font-family: Verdana, sans-serif;">Before reading from sections of the IDSI statement during the hearing, Senator
Colm Burke remarked, “Other than the Chairperson, none of us are qualified
medical practitioners, so we have to rely on advice given to us by medical
practitioners.”</span><br />
<br />
<span style="font-family: Verdana, sans-serif;"> (Video:<a href="https://www.oireachtas.ie/en/oireachtas-tv/video-archive/committees/2131/?fbclid=IwAR2FzW3-pqsCL_Jkzytcv_fA_abMfIG9RpXO8IIl_xriwfvRAt90NlwLwGc" target="_blank"> https://www.oireachtas.ie/en/oireachtas-tv/video-archive/committees/2131/?fbclid=IwAR2FzW3-pqsCL_Jkzytcv_fA_abMfIG9RpXO8IIl_xriwfvRAt90NlwLwGc</a> at 1:49:30) </span><br />
<br />
<span style="font-family: Verdana, sans-serif;">This statement had implications for those providing evidence to the committee,
especially those who are ‘qualified medical practitioners’. Evidence should
provide government committees with information which they can weigh to
inform policy and professional witnesses have an obligation to give evidence
which is reliable and balanced. </span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span>
<span style="font-family: Verdana, sans-serif;">The IDSI statement showed that the authors had adopted wholesale, the
Infectious Disease Society of America (IDSA) position on Lyme disease. The
IDSI statement endorsed the outdated IDSA guidelines and repeated IDSA
opinions on important aspects of the disease and patient care. </span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span>
<span style="font-family: Verdana, sans-serif;">When second-hand opinions are submitted as evidence, the onus to verify the
reliability of those opinions rests with the witnesses. As Senator Burke’s
comment made clear, it was not for the committee to discern the veracity of the
evidence because, “we have to rely on advice given to us by medical
practitioners”. Therefore the twenty eight authors of the IDSI statement were
severally responsible for verifying the opinions which they submitted as evidence
to the committee.<br /></span><br />
<span style="font-family: Verdana, sans-serif;"><b>The following quotes are from the IDSI Statement to the Health
Committee which were presented as bullet-points in the Introduction
section of the document.</b><br /> <b>“We seek to ensure that all patients under our care, including those
with Lyme disease, receive the highest quality of evidence based care” </b></span><br />
<b><span style="font-family: Verdana, sans-serif;"><br /></span></b>
<span style="font-family: Verdana, sans-serif;">“Evidence based care” does not exist for Lyme borreliosis. The National Institute
for Clinical and Care Excellence (NICE – England) guideline for Lyme disease was published on April 11th 2018. The development of the guideline included a
comprehensive literature review. Published research was rated according to its
quality and risk of bias. NICE found that almost every piece of evidence was of
‘low’ or ‘very low quality’ or at ‘high’ or ‘very high’ risk of bias. NICE found no
good quality evidence to inform any aspect of patient care. See Table 1 for the
source and ratings of evidence used for various sections of the guideline.<br />It is misleading for the authors of the IDSI statement to claim that they provide,
“the highest quality of evidence based care”, because there is no good quality
evidence available - not that NICE with all their resources could discover.
In the absence of any good evidence, the NICE guideline committee made
recommendations “Based on the experience and opinion of the Guideline
Committee”. One problem with opinions is that they could be swayed by the
influence of vested interests. These interests could include associations with patent holders, vaccine developers, test-kit manufacturers and investors,
research sponsors and funding, medical insurance and reinsurance companies.
The value to interested groups in controlling the narrative and perceptions
around Lyme borreliosis, could run into billions of dollars over time. In view of
the interests involved, uncritical adoption of opinions which could be influenced
by these sources would be a dereliction of the duty that doctors owe to their
patients."<br /><br /><br /><br />I don't propose to copy and paste the whole VIRAS response as the link to the original is provided above and below. It is full of very interesting points, with references, that are frequently overlooked or ignored by Infectious Diseases Consultants and doctors who are all too happy to parrot the outdated IDSA guidelines. One of those is the misuse of the term (PTLDS) Post Treatment Lyme Disease Syndrome - who decides when testing is reliable, </span><span style="font-family: Verdana, sans-serif;">when treatment is sufficient,</span><span style="font-family: Verdana, sans-serif;"> and whether patients are sick? are questions as patients we often ask. </span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span>
<span style="font-family: Verdana, sans-serif;">I was particularly pleased to read VIRAS response </span><span style="font-family: Verdana, sans-serif;">"We can assuage the IDSI’s concerns about “non-accredited diagnostics” because
there is no such thing. It is laboratories which gain accreditation to perform a
test, if they have demonstrated that they can manage the test materials and
protocol properly. This does not validate or make any judgement about the
quality or accuracy of a test – only the competency of the laboratory to follow
procedures. </span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span>
<span style="font-family: Verdana, sans-serif;">On the topic of “unvalidated, exploratory diagnostics”, it appears that the
authors of the IDSI statement are unaware that the two-tier (ELISA, Western
Blot) test is not a validated diagnostic protocol and was not designed to be used
as such. The two tier test is hopelessly insensitive. E.g., Cook and Puri (2017)
report that two-tier Lyme borreliosis testing produces around 500 times more
false-negative results than test protocols for HIV. The company which supplies
test kits to the Lyme borreliosis Reference Laboratory for England, published
figures showing that Two-tier testing had only 55.3% sensitivity for ‘all Lyme
disease patients’ and it detected only 41% of culture-positive patients." (read on) </span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span>
<span style="font-family: Verdana, sans-serif;">VIRAS also propose a little research experiment the IDSI could do to try and solve some of the controversy.<br /></span><br />
<span style="font-family: Verdana, sans-serif;"><a href="http://counsellingme.com/VIRAS/VIRAS_response_to_IDSI.html?fbclid=IwAR0nqSTyYa9pG-NWk3n506AgX6JpXZUCEB2qH_TVievKKyqtHzuOq_5qOe0">http://counsellingme.com/VIRAS/VIRAS_response_to_IDSI.html?fbclid=IwAR0nqSTyYa9pG-NWk3n506AgX6JpXZUCEB2qH_TVievKKyqtHzuOq_5qOe0</a></span></div>
Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com0tag:blogger.com,1999:blog-3707770726760676731.post-31456675279690628122018-12-06T11:38:00.000+00:002018-12-06T11:38:58.972+00:00BORRELIA AND BIOFILM - LYME DISEASE<div dir="ltr" style="text-align: left;" trbidi="on">
<h1 style="background-color: white; box-sizing: border-box; line-height: 1.15em; margin: 30px 0px; outline: 0px !important;">
<span style="color: #020202; font-family: MuseoSans, Georgia, Times New Roman, Times, serif;"><span style="font-size: 40px;">The Emerging Role of Microbial Biofilm in Lyme Neuroborreliosis</span></span><br /><span style="color: #020202; font-family: MuseoSans, Georgia, Times New Roman, Times, serif; font-size: small;"><span style="font-weight: normal;"><a href="https://www.frontiersin.org/articles/10.3389/fneur.2018.01048/full?fbclid=IwAR07DmqiRuCZpUSOeFx9S1GZ8J-Y59JdRa4AVAywKS5kBPulXHPiF0CnjZk#B184">https://www.frontiersin.org/articles/10.3389/fneur.2018.01048/full?fbclid=IwAR07DmqiRuCZpUSOeFx9S1GZ8J-Y59JdRa4AVAywKS5kBPulXHPiF0CnjZk#B184</a></span></span></h1>
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<span style="font-family: Verdana, sans-serif; font-size: large;"><b>"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 <i style="box-sizing: border-box; outline: 0px !important;">Borrelia</i> 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 <i style="box-sizing: border-box; outline: 0px !important;">Borrelia</i> 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.</b></span></div>
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<span style="font-family: Verdana, sans-serif; font-size: large;"><b>In preliminary studies by the clinical Biofilm Ring Test<span style="box-sizing: border-box; line-height: 0; outline: 0px !important; position: relative; top: -0.5em; vertical-align: baseline;">®</span> (cBRT), we found that <i style="box-sizing: border-box; outline: 0px !important;">Borrelia</i> 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 (<a href="https://www.frontiersin.org/articles/10.3389/fneur.2018.01048/full?fbclid=IwAR07DmqiRuCZpUSOeFx9S1GZ8J-Y59JdRa4AVAywKS5kBPulXHPiF0CnjZk#B222" style="background-color: transparent; box-sizing: border-box; color: rgb(213, 68, 73) !important; outline: none; text-decoration-line: none; word-break: break-word;">222</a>, <a href="https://www.frontiersin.org/articles/10.3389/fneur.2018.01048/full?fbclid=IwAR07DmqiRuCZpUSOeFx9S1GZ8J-Y59JdRa4AVAywKS5kBPulXHPiF0CnjZk#B223" style="background-color: transparent; box-sizing: border-box; color: rgb(213, 68, 73) !important; outline: none; text-decoration-line: none; word-break: break-word;">223</a>), since the rapid identification of biofilm-producing <i style="box-sizing: border-box; outline: 0px !important;">Borrelia</i> strains, may help identify forms of LB which are at risk of chronicity (<a href="https://www.frontiersin.org/articles/10.3389/fneur.2018.01048/full?fbclid=IwAR07DmqiRuCZpUSOeFx9S1GZ8J-Y59JdRa4AVAywKS5kBPulXHPiF0CnjZk#B224" style="background-color: transparent; box-sizing: border-box; color: rgb(213, 68, 73) !important; outline: none; text-decoration-line: none; word-break: break-word;">224</a>). Further, characterization of <i style="box-sizing: border-box; outline: 0px !important;">Borrelia</i> 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."</b></span></div>
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<span style="font-family: Verdana, sans-serif;">A very useful study with many links to important research.</span></div>
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Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com0tag:blogger.com,1999:blog-3707770726760676731.post-48460267347928045572018-11-27T10:04:00.000+00:002018-11-27T10:04:02.551+00:00EXPOSING MYTHS ON TICK ATTACHMENT TIMES - LYME DISEASE WITHIN 12 HOURS<div dir="ltr" style="text-align: left;" trbidi="on">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgczP_JLwRQHQwP17kqEyaz5q7CyvjVyKMVYJ4HBd4AZRla2q0oTuVg-sQFDyTH0SSX5ss6Sl8xg4IC4aDRpi63rVIwWQuKmhBgWf0ofIWO24GhqmDsvesJv1EEQWdneiUuITgF5StoDQA/s1600/IMG_20160718_153702196.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1600" data-original-width="1535" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgczP_JLwRQHQwP17kqEyaz5q7CyvjVyKMVYJ4HBd4AZRla2q0oTuVg-sQFDyTH0SSX5ss6Sl8xg4IC4aDRpi63rVIwWQuKmhBgWf0ofIWO24GhqmDsvesJv1EEQWdneiUuITgF5StoDQA/s320/IMG_20160718_153702196.jpg" width="306" /></a></div>
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LYME DISEASE: A STUDY ON THE SPEED OF TRANSMISSION BY INFECTED TICKS</div>
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Ticks have three lifecycle stages that can bite humans – larva, nymph and adult –, but bacteria are usually transmitted through bites from nymphs, which are higher in density and often go unnoticed because of their small size.</div>
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The amount of time a tick must remain attached to transmit bacteria to the vertebrate host is an essential parameter in assessing the risk of transmission and identifying measures to prevent infection. It is generally accepted that the longer a tick remains attached, the higher the risk of transmission. In Europe, it is regularly stated that there is a real risk of transmission only after 24 hours of attachment.</div>
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In this study, we used a mouse model to determine the kinetics of infection by <em style="box-sizing: inherit; margin-top: 0px;">Ixodes ricinus</em>ticks (nymphs and adult females) infected with various European and North American strains or species of <em style="box-sizing: inherit;">Borrelia</em>. We also compared the dissemination of various strains and species of <em style="box-sizing: inherit; margin-bottom: 0px;">Borrelia</em> by different modes of inoculation (via infected ticks or by injection of bacteria).</div>
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Unlike the American strains, <b>all the European species of <em style="box-sizing: inherit; margin-top: 0px;">B. burgdorferi</em> that we studied were detected in the salivary glands of adult ticks before a blood meal, suggesting the possibility of rapid transmission of the bacteria following a bite. </b>The results were consistent with this theory: <b>infection occurred within 24 hours of a bite from an adult tick.</b> Moreover, our analysis shows that <b>nymphs infected by European species of <em style="box-sizing: inherit;">B.</em> <em style="box-sizing: inherit;">burgdorferi </em>are capable of transmitting these pathogens within 12 hours of attachment</b>. Our study proves that <em style="box-sizing: inherit;">B.</em><em style="box-sizing: inherit; margin-bottom: 0px;">burgdorferi </em>can be transmitted more quickly than stated in the literature. It is therefore vital to remove ticks as soon as possible after being bitten to prevent infection.</div>
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Furthermore, <b>the study shows that the tropism of <em style="box-sizing: inherit; margin-top: 0px;">Borrelia </em>varies depending on the strain and species studied, which explains the variety of clinical manifestations of Lyme borreliosis. </b>We also demonstrate a difference in the tropism of <em style="box-sizing: inherit; margin-bottom: 0px;">Borrelia</em> following a tick bite, confirming the role of tick saliva in the efficacy of infection and dissemination in vertebrate hosts. </div>
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<span style="color: #414144; font-family: Brandon, Arial, Helvetica, sans-serif;"><span style="font-size: 18px;"><a href="https://www.pasteur.fr/en/research-journal/news/lyme-disease-study-speed-transmission-infected-ticks">https://www.pasteur.fr/en/research-journal/news/lyme-disease-study-speed-transmission-infected-ticks</a></span></span></div>
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<span style="color: #414144; font-family: Brandon, Arial, Helvetica, sans-serif;"><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6079464/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6079464/</a></span></div>
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an earlier paper </div>
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Lyme borreliosis: a review of data on transmission time after tick attachment.</h1>
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Cook MJ.</div>
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<a href="https://www.ncbi.nlm.nih.gov/pubmed/25565881">https://www.ncbi.nlm.nih.gov/pubmed/25565881</a><br /><span style="font-size: 0.923em;"><br /></span></div>
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<span style="font-size: 0.923em;">Interesting observations from Dr Alan MacDonald<br /></span></div>
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<span style="font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 13.6309px;"><a href="https://lookingatlyme.blogspot.com/2012/09/rapid-transmission-of-infections-from.html">https://lookingatlyme.blogspot.com/2012/09/rapid-transmission-of-infections-from.html</a></span></span></div>
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Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com0tag:blogger.com,1999:blog-3707770726760676731.post-30491809528485705422018-11-24T20:56:00.000+00:002018-11-24T20:58:26.661+00:00WELSH PARLIAMENT AND SCOTTISH PARLIAMENT INVESTIGATE LYME DISEASE<div dir="ltr" style="text-align: left;" trbidi="on">
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<yt-formatted-string class="style-scope ytd-video-primary-info-renderer" style="--yt-endpoint-color: hsl(206.1, 79.3%, 52.7%);">Dr. Robert Bransfield: Presentation on Lyme for Welsh Parliament</yt-formatted-string></h1>
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<yt-formatted-string class="style-scope ytd-video-primary-info-renderer" style="--yt-endpoint-color: hsl(206.1, 79.3%, 52.7%);"><span style="background-color: white; color: #111111; font-family: "roboto" , "arial" , sans-serif; font-size: 14px; white-space: pre-wrap;">"Many patients with [Lyme and other] tick-borne illnesses are given other diagnoses and are told their impairments cannot be cured and can only be managed. As a result, some of these patients are given the diagnosis of multiple sclerosis, motor neuron disease, myalgic encephalomyelitis / chronic fatigue syndrome, “bodily distress syndrome,” and a number of mental illnesses and these diagnostic errors obstructs access to more effective treatments."
"Caution must be used in considering the symptoms as having a psychogenic basis, such as hypochondriasis, somatization disorder, or a psychosomatic condition. If a complex, progressive multisystemic illness begins in a person who had been reasonably healthy throughout most of their life, the likelihood that this is psychosomatic or has some other psychogenic basis is very remote."</span></yt-formatted-string></div>
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<yt-formatted-string class="style-scope ytd-video-primary-info-renderer" style="--yt-endpoint-color: hsl(206.1, 79.3%, 52.7%);"><span style="background-color: white; color: #111111; font-family: "roboto" , "arial" , sans-serif; font-size: 14px; white-space: pre-wrap;"><br /></span></yt-formatted-string></div>
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<yt-formatted-string class="style-scope ytd-video-primary-info-renderer" style="--yt-endpoint-color: hsl(206.1, 79.3%, 52.7%);"><span style="background-color: white;"><span style="color: #111111; font-family: "roboto" , "arial" , sans-serif;"><span style="font-size: 14px; white-space: pre-wrap;">Thank you Dr Bransfield for this excellent presentation to the Welsh Parliament summarizing the situation regarding this complex disease. For those who know little about Lyme disease and that includes most doctors then this is an important presentation to listen to.</span></span></span></yt-formatted-string></div>
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<span style="color: #111111; font-family: "roboto" , "arial" , sans-serif;"><span style="font-size: 14px; white-space: pre-wrap;">From Jenna Luché-Thayer Linkedin</span></span></div>
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<span style="color: #111111; font-family: "roboto" , "arial" , sans-serif;"><span style="font-size: 14px; white-space: pre-wrap;"> <a href="https://www.linkedin.com/pulse/breaking-news-julia-morgan-wales-member-assembly-lyme-luche-thayer/?fbclid=IwAR1crzkP_oK-CHr3RuQD7UsIWBFYtQNKNAUsl5IFS4o4GZeiIWuM5I5RlMI">https://www.linkedin.com/pulse/breaking-news-julia-morgan-wales-member-assembly-lyme-luche-thayer/?fbclid=IwAR1crzkP_oK-CHr3RuQD7UsIWBFYtQNKNAUsl5IFS4o4GZeiIWuM5I5RlMI</a></span></span><yt-formatted-string class="style-scope ytd-video-primary-info-renderer" style="--yt-endpoint-color: hsl(206.1, 79.3%, 52.7%);"><span style="background-color: white;"><span style="color: #111111; font-family: "roboto" , "arial" , sans-serif;">
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<h3 style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: rgba(0, 0, 0, 0.9); font-family: -apple-system, system-ui, BlinkMacSystemFont, "Segoe UI", Roboto, "Helvetica Neue", "Fira Sans", Ubuntu, Oxygen, "Oxygen Sans", Cantarell, "Droid Sans", "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Emoji", "Segoe UI Symbol", "Lucida Grande", Helvetica, Arial, sans-serif; line-height: 1.4; margin: 2.4rem 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<span style="font-size: small;">Jenna Luché-Thayer. November 21, 2018 </span></h3>
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Friends,</h3>
<h3 style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: rgba(0, 0, 0, 0.9); font-family: -apple-system, system-ui, BlinkMacSystemFont, "Segoe UI", Roboto, "Helvetica Neue", "Fira Sans", Ubuntu, Oxygen, "Oxygen Sans", Cantarell, "Droid Sans", "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Emoji", "Segoe UI Symbol", "Lucida Grande", Helvetica, Arial, sans-serif; line-height: 1.4; margin: 2.4rem 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
Good news! The Wales Member of Assembly (Parliament) Julia Morgan sponsored a November 20, 2018 meeting on Lyme in the historic and beautiful Pierhead Building next to the Welsh Assembly in Cardiff, Wales.</h3>
<h3 style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: rgba(0, 0, 0, 0.9); font-family: -apple-system, system-ui, BlinkMacSystemFont, "Segoe UI", Roboto, "Helvetica Neue", "Fira Sans", Ubuntu, Oxygen, "Oxygen Sans", Cantarell, "Droid Sans", "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Emoji", "Segoe UI Symbol", "Lucida Grande", Helvetica, Arial, sans-serif; line-height: 1.4; margin: 2.4rem 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<span style="font-size: small;">The initiative to hold the meeting came from the hard work of Welsh Lyme, ME/CFS and Morgellons advocate Mark Morgan (no relation to Julia Morgan).</span></h3>
<h3 style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: rgba(0, 0, 0, 0.9); font-family: -apple-system, system-ui, BlinkMacSystemFont, "Segoe UI", Roboto, "Helvetica Neue", "Fira Sans", Ubuntu, Oxygen, "Oxygen Sans", Cantarell, "Droid Sans", "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Emoji", "Segoe UI Symbol", "Lucida Grande", Helvetica, Arial, sans-serif; line-height: 1.4; margin: 2.4rem 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<span style="font-size: small;">Mark invited Dr. Robert Bransfield to give an overview of the illness and distinguish the psychiatric complications from Lyme in contrast to misapplications of wrongful psychosomatic labels, such as Medically Unexplained Symptoms and Post Treatment Lyme Disease Syndrome.</span></h3>
<h3 style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: rgba(0, 0, 0, 0.9); font-family: -apple-system, system-ui, BlinkMacSystemFont, "Segoe UI", Roboto, "Helvetica Neue", "Fira Sans", Ubuntu, Oxygen, "Oxygen Sans", Cantarell, "Droid Sans", "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Emoji", "Segoe UI Symbol", "Lucida Grande", Helvetica, Arial, sans-serif; line-height: 1.4; margin: 2.4rem 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<span style="font-size: small;">Michael Cook, a UK expert on the poor reliability of the current two tier Lyme testing used in the UK (and worldwide) presented on the topic of diagnostics.</span></h3>
<h3 style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: rgba(0, 0, 0, 0.9); font-family: -apple-system, system-ui, BlinkMacSystemFont, "Segoe UI", Roboto, "Helvetica Neue", "Fira Sans", Ubuntu, Oxygen, "Oxygen Sans", Cantarell, "Droid Sans", "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Emoji", "Segoe UI Symbol", "Lucida Grande", Helvetica, Arial, sans-serif; line-height: 1.4; margin: 2.4rem 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<span style="font-size: small;">I presented on the World Health Organization's planned changes for recognizing Lyme in the new medical codes (ICD11) and how the ICD10 and previous versions of the ICD codes contributed to 14 human rights abuses across 11 human rights treatises and were based on corrupted and suppressed science.</span></h3>
<h3 style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: rgba(0, 0, 0, 0.9); font-family: -apple-system, system-ui, BlinkMacSystemFont, "Segoe UI", Roboto, "Helvetica Neue", "Fira Sans", Ubuntu, Oxygen, "Oxygen Sans", Cantarell, "Droid Sans", "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Emoji", "Segoe UI Symbol", "Lucida Grande", Helvetica, Arial, sans-serif; line-height: 1.4; margin: 2.4rem 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<span style="font-size: small;">Meeting participants included representatives from the National Health Service’s public health and scientific research divisions, the government's division of parks, general members of the public including advocates for ME/CFS and another Member of Assembly.</span></h3>
<h3 style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: rgba(0, 0, 0, 0.9); font-family: -apple-system, system-ui, BlinkMacSystemFont, "Segoe UI", Roboto, "Helvetica Neue", "Fira Sans", Ubuntu, Oxygen, "Oxygen Sans", Cantarell, "Droid Sans", "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Emoji", "Segoe UI Symbol", "Lucida Grande", Helvetica, Arial, sans-serif; line-height: 1.4; margin: 2.4rem 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<span style="font-size: small;">The participants stayed for some time following the presentations and Q & A to engage the advocates. The engagement included casual and friendly debates between the representatives from the National Health Services and the advocates. </span></h3>
<h3 style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: rgba(0, 0, 0, 0.9); font-family: -apple-system, system-ui, BlinkMacSystemFont, "Segoe UI", Roboto, "Helvetica Neue", "Fira Sans", Ubuntu, Oxygen, "Oxygen Sans", Cantarell, "Droid Sans", "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Emoji", "Segoe UI Symbol", "Lucida Grande", Helvetica, Arial, sans-serif; line-height: 1.4; margin: 2.4rem 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<span style="font-size: small;">Following her attendance of the Lyme meeting, Member of Assembly Julia Morgan immediately attended a General Assembly meeting where she requested to the Wales Assembly they host a debate on Lyme borreliosis.</span></h3>
<h3 style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: rgba(0, 0, 0, 0.9); font-family: -apple-system, system-ui, BlinkMacSystemFont, "Segoe UI", Roboto, "Helvetica Neue", "Fira Sans", Ubuntu, Oxygen, "Oxygen Sans", Cantarell, "Droid Sans", "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Emoji", "Segoe UI Symbol", "Lucida Grande", Helvetica, Arial, sans-serif; line-height: 1.4; margin: 2.4rem 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<span style="font-size: small;">She spoke of how Mark Morgan had been advocating to raise the profile and awareness of Lyme in Wales. Julia Morgan stated there is little known about Lyme by the general public and that the disease causes many complications and great suffering.</span></h3>
<h3 style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: rgba(0, 0, 0, 0.9); font-family: -apple-system, system-ui, BlinkMacSystemFont, "Segoe UI", Roboto, "Helvetica Neue", "Fira Sans", Ubuntu, Oxygen, "Oxygen Sans", Cantarell, "Droid Sans", "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Emoji", "Segoe UI Symbol", "Lucida Grande", Helvetica, Arial, sans-serif; line-height: 1.4; margin: 2.4rem 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<span style="font-size: small;">The initial response by the chair of the meeting was to speak of the public education that has been implemented.</span></h3>
<h3 style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: rgba(0, 0, 0, 0.9); font-family: -apple-system, system-ui, BlinkMacSystemFont, "Segoe UI", Roboto, "Helvetica Neue", "Fira Sans", Ubuntu, Oxygen, "Oxygen Sans", Cantarell, "Droid Sans", "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Emoji", "Segoe UI Symbol", "Lucida Grande", Helvetica, Arial, sans-serif; line-height: 1.4; margin: 2.4rem 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<span style="font-size: small;">However, I believe that Julia Morgan and advocate Mark Morgan will be able to secure this Assembly debate in Wales. As Julia Morgan said in her presentation to the Wales Assembly, [paraphrased] <em style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">‘there have been recent Lyme debates held in the Scottish Commons, the UK House of Commons, the UK House of Lords and the European Union Parliament’.</em></span></h3>
<h3 style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: rgba(0, 0, 0, 0.9); font-family: -apple-system, system-ui, BlinkMacSystemFont, "Segoe UI", Roboto, "Helvetica Neue", "Fira Sans", Ubuntu, Oxygen, "Oxygen Sans", Cantarell, "Droid Sans", "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Emoji", "Segoe UI Symbol", "Lucida Grande", Helvetica, Arial, sans-serif; line-height: 1.4; margin: 2.4rem 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<span style="font-size: small;">In closing, it is clear that advocates need to press forward with political mobilizing and lawsuits against fraud and other corrupt practices that abuse the human rights of this patient population.</span></h3>
<h3 style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: rgba(0, 0, 0, 0.9); font-family: -apple-system, system-ui, BlinkMacSystemFont, "Segoe UI", Roboto, "Helvetica Neue", "Fira Sans", Ubuntu, Oxygen, "Oxygen Sans", Cantarell, "Droid Sans", "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Emoji", "Segoe UI Symbol", "Lucida Grande", Helvetica, Arial, sans-serif; line-height: 1.4; margin: 2.4rem 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<span style="font-size: small;">These kinds of political and legal actions are proving to be more effective for prioritizing and addressing patients needs than depending on 'entities required to address Lyme' such as the US Tick Borne Diseases Working Group and the UK's NICE Lyme Guidelines Committee. Such entities have built in anti-patient bias because they are very polluted by a majority who deny:</span></h3>
<h3 style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: rgba(0, 0, 0, 0.9); font-family: -apple-system, system-ui, BlinkMacSystemFont, "Segoe UI", Roboto, "Helvetica Neue", "Fira Sans", Ubuntu, Oxygen, "Oxygen Sans", Cantarell, "Droid Sans", "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Emoji", "Segoe UI Symbol", "Lucida Grande", Helvetica, Arial, sans-serif; line-height: 1.4; margin: 2.4rem 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<span style="font-size: small;">—the uncontrolled spread of the epidemic</span></h3>
<h3 style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: rgba(0, 0, 0, 0.9); font-family: -apple-system, system-ui, BlinkMacSystemFont, "Segoe UI", Roboto, "Helvetica Neue", "Fira Sans", Ubuntu, Oxygen, "Oxygen Sans", Cantarell, "Droid Sans", "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Emoji", "Segoe UI Symbol", "Lucida Grande", Helvetica, Arial, sans-serif; line-height: 1.4; margin: 2.4rem 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<span style="font-size: small;">—many life threatening complications caused by the infection</span></h3>
<h3 style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: rgba(0, 0, 0, 0.9); font-family: -apple-system, system-ui, BlinkMacSystemFont, "Segoe UI", Roboto, "Helvetica Neue", "Fira Sans", Ubuntu, Oxygen, "Oxygen Sans", Cantarell, "Droid Sans", "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Emoji", "Segoe UI Symbol", "Lucida Grande", Helvetica, Arial, sans-serif; line-height: 1.4; margin: 2.4rem 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<span style="font-size: small;">—how the infection is able to persist and cause on-going damage following antimicrobial therapy</span></h3>
<h3 style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: rgba(0, 0, 0, 0.9); font-family: -apple-system, system-ui, BlinkMacSystemFont, "Segoe UI", Roboto, "Helvetica Neue", "Fira Sans", Ubuntu, Oxygen, "Oxygen Sans", Cantarell, "Droid Sans", "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Emoji", "Segoe UI Symbol", "Lucida Grande", Helvetica, Arial, sans-serif; line-height: 1.4; margin: 2.4rem 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<span style="font-size: small;">—the immunosuppressive nature of the disease</span></h3>
<h3 style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: rgba(0, 0, 0, 0.9); font-family: -apple-system, system-ui, BlinkMacSystemFont, "Segoe UI", Roboto, "Helvetica Neue", "Fira Sans", Ubuntu, Oxygen, "Oxygen Sans", Cantarell, "Droid Sans", "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Emoji", "Segoe UI Symbol", "Lucida Grande", Helvetica, Arial, sans-serif; line-height: 1.4; margin: 2.4rem 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<span style="font-size: small;">Additionally, many of the participants in the US Tick Borne Diseases Working Group and subcommittees appear comfortable taking 100s of 1000s and millions of dollars for Lyme research to produce nothing that benefits the patient populations.</span></h3>
<h3 style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: rgba(0, 0, 0, 0.9); font-family: -apple-system, system-ui, BlinkMacSystemFont, "Segoe UI", Roboto, "Helvetica Neue", "Fira Sans", Ubuntu, Oxygen, "Oxygen Sans", Cantarell, "Droid Sans", "Apple Color Emoji", "Segoe UI Emoji", "Segoe UI Emoji", "Segoe UI Symbol", "Lucida Grande", Helvetica, Arial, sans-serif; line-height: 1.4; margin: 2.4rem 0px; outline: 0px; padding: 0px; vertical-align: baseline;">
<span style="font-size: small;">In contrast, strategic political and legal actions by advocates can:</span></h3>
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<span style="font-size: small;">—set free long suppressed and valid science</span></h3>
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<span style="font-size: small;">—open access to existing and future diagnostic and medical care options</span></h3>
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<span style="font-size: small;">—secure our human rights. </span></h3>
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<span style="font-size: small;">Faithfully,</span></h3>
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<span style="font-size: small;">Jenna</span></h3>
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<span style="font-size: small;">also</span></div>
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<span style="font-size: small;"> </span><a href="https://www.linkedin.com/pulse/breaking-news-scottish-parliamentarians-take-lyme-jenna-luche-thayer/?fbclid=IwAR3ondpevGkUngr26nM-NzBe9LuiQlNs24VQB1t0ZR4uPmwksqHy9ONFycg">https://www.linkedin.com/pulse/breaking-news-scottish-parliamentarians-take-lyme-jenna-luche-thayer/?fbclid=IwAR3ondpevGkUngr26nM-NzBe9LuiQlNs24VQB1t0ZR4uPmwksqHy9ONFycg</a></div>
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<span style="font-size: large;">BREAKING NEWS: Scottish Parliamentarians Take On Lyme</span></h2>
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<span style="font-size: small;"> </span>Jenna Luché-Thayer. November 22, 2018</h3>
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<span style="font-size: small;">FRIENDS,</span></h3>
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<span style="font-size: small;">On November 22, 2018 Scottish Lyme Advocate Janey Cringean and I met with Scottish Parliamentarians Alexander Burnett and Donald Cameron. Both Alexander Burnett and Donald Cameron represent rural constituents where animal husbandry is a livelihood, as is farming. For these reasons, their constituents are at risk for zoonotic diseases (animal to human transmission of diseases) and vector borne illness including those transmitted by ticks. </span></h3>
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<span style="font-size: small;">Both the two Parliamentarians have genuine concern and established records for protecting the health and well being of their constituents. In addition, they understand the clear links between health and economic productivity versus poor health and economic burden.</span></h3>
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<span style="font-size: small;">Janey and I had a 45 minute audience with the two Parliamentarians. This generous amount of time allowed for deep and frank discussion regarding how obstruction to valid diagnosis and treatments have been driven by the globally disseminated US Lyme policies. We discussed how the 2006 Lyme Guidelines by the Infectious Diseases Society of America are riddled with many conflicts of interests that suppress relevant science and how they stand in sharp contrast to patent language by the same Guidelines’ authors and their affiliates.</span></h3>
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<span style="font-size: small;">For example, one year following the release of the 2006 IDSA Lyme Guidelines that describes ‘<em style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Lyme as easy to diagnose, treat and cure’</em>, Guideline co-author Raymond J. Dattwyler [et al] in filed patent <em style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">No. 7605248 Recombinant constructs of Borrelia burgdorferi.</em> This patent states:</span></h3>
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<span style="font-size: small;">“Currently, Lyme Disease is treated with a range of antibiotics, e.g., tetracyclines, penicillin and cephalosporins. However, such treatment is not always successful in clearing the infection …Treatment is often delayed due to improper diagnosis with the deleterious effect that the infection proceeds to a chronic condition … One of the factors contributing to delayed treatment is the lack of effective diagnostic tools.”</span></h3>
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<span style="font-size: small;">The two Parliamentarians were surprised to learn:</span></h3>
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<span style="font-size: small;">— US Government officials are allowed to earn money off patents and in partnership with private enterprises</span></h3>
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<span style="font-size: small;">— there are CDC and NIH officials who hold Lyme patents</span></h3>
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<span style="font-size: small;">— these officials have the power to repudiate and dismiss patent products that compete with their own, or patents held by their agencies. </span></h3>
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<span style="font-size: small;">These elected representatives quickly understood how Post Treatment Lyme Disease Syndrome has been used to falsely claim a person is a hypochondriac or malingerer, when in fact severe and disabling symptoms are usually due to the treatment failure. This treatment failure is tied to the discriminatory practices of restricted care for Lyme patients, discrimination that stands in contrast to the extended antimicrobials provided to many patient groups suffering from other infectious agents. </span></h3>
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<span style="font-size: small;">Both Parliamentarians embraced the recognition of the seriousness of the disease as validated in the ICD11. They spoke about ensuring their government would actively support the new ICD11 codes for Lyme. They also indicated they would act to support additional efforts to remove the institutionalized obstacles to diagnosis and care.</span></h3>
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<span style="font-size: small;">Our conversation also focused on the high costs of undiagnosed, untreated or undertreated Lyme versus the costs of diagnosis and care. The recent findings from the US that Lyme is costing the US between 25 to 75 billion dollars a year underscores the foolishness and irresponsibility of ignoring the epidemic and denying treatment options that meet international standards.</span></h3>
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<span style="font-size: small;">In closing, I want to emphasize how political work by Janey Cringean and her colleagues have resulted in the Scottish Parliament’s attention to the epidemic in a concrete manner. The Scottish Parliament have held a debate on Lyme and there are actions being considered that will improve access to diagnostic and treatment options. Janey Cringean and her colleagues have made some solid allies who share common goals and can lead some critically important advances with regards to addressing this epidemic and improving patient access to diagnosis and treatment options.</span></h3>
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<span style="font-size: small;">Lyme advocates need to organize political action to make changes!</span></h3>
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<span style="font-size: small;">It is very fortunate that Scotland does not have the same corrupting and perverse incentives surrounding the Lyme epidemic that has created the human rights abuse and failures by the US government.</span></h3>
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<span style="font-size: small;">Recently, it appears that some members of the US Tick Borne Diseases Work Group have tried to gain international support by indicating there are opportunities for joint research projects—mostly funded by US dollars—with Lyme and TBD doctors and scientists in other countries. These members appear to have a recruitment strategy that has the potential partners adopt their language and bias—for example, encourage potential partners to use Post Treatment Lyme Disease Syndrome. To note, the target for these US funded research incentives appear to be non US Lyme leaders who clearly state Lyme infection can be persistent and immunosuppressive requiring extended treatment and have resisted the fraud of Post Treatment Lyme Disease Syndrome.</span></h3>
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<span style="font-size: small;">Healthcare sector corruption is a cost few countries can afford. Decades of conflicts of interests and corrupted US Lyme policies need to be repudiated by other nations.</span></h3>
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<span style="font-size: small;">Despite attempts that appear to want to corrupt Lyme science on a global scale, I anticipate many countries will address the epidemic for sound public health, cost and humanitarian reasons. Ultimately, the claim by the CDC and Tick Borne Diseases Work Group that <em style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">‘other countries look to the US for leadership in Lyme and tick borne diseases’</em> will prove to be absurdly arrogant and delusional. </span></h3>
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<span style="font-size: small;">Faithfully,</span></h3>
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<span style="font-size: small;">Jenna</span></h3>
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<span style="font-size: small;">Jenna Luché-Thayer. <em style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">30+ years working globally on the rights of the marginalized. </em>Former Senior Advisor to the United Nations and the US Government. Director, Ad Hoc Committee for Health Equity in ICD11 Borreliosis Codes. Founder, Global Network on Institutional Discrimination, Inc. —<em style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Holding institutions accountable for political and scientific solutions. </em>Email <a href="http://mailto:jennaluche@gmail.com/" rel="nofollow noopener" style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; color: #665ed0; font-weight: normal; margin: 0px; overflow-wrap: break-word; padding: 0px; text-decoration-line: none; vertical-align: baseline;" target="_blank"><span style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; box-sizing: border-box; font-weight: 600; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">jennaluche@gmail.com</span></a></span></h3>
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Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com0tag:blogger.com,1999:blog-3707770726760676731.post-41672692783522800682018-11-16T21:36:00.000+00:002018-11-16T22:21:56.022+00:00EUROPEAN PARLIAMENT RECOGNISES SERIOUS PROBLEMS WITH LYME DISEASE INCLUDING DIAGNOSIS, TESTING & TREATMENT<div dir="ltr" style="text-align: left;" trbidi="on">
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MEPs call for a European plan to combat Lyme disease</h2>
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MEPs have today adopted, for the first time, a resolution on Lyme disease, or Lyme borreliosis, an infectious bacterial disease in humans and in various species of domestic and wild animals, caused transmitted to humans through the bite of a tick.</div>
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Lyme borreliosis is the most common zoonotic disease in Europe, with an estimated one million cases, which are expanding geographically.</div>
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The resolution adopted by MEPs today calls for on the European Commission to draw up a plan to combat Lyme disease, to accompany mandatory reporting in all Member States, better exchange of best practice, additional funding of the methods for diagnosing and treating Lyme disease and the promotion of research efforts.</div>
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F<strong style="color: inherit;">rédérique Ries MEP, co-author of the resolution,</strong> commented after its adoption today;</div>
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<em>“For the first time, the European Parliament has adopted a resolution on Lyme disease, which is timely given the growing risk this disease poses to Europeans. We need a European plan to tackle this growing continent wide health problem. ”</em></div>
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<em>“Treatment gaps mean that one million Europeans are struggling to receive the treatment they deserve, in the face of an overly conservative medical response. We denounce the fact that so many patients are being let down; they are entitled to effective treatment, including 100% reliable serological testing.”</em></div>
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<em><br />“Europe must continue to fund research on "Lyme" because its diagnosis is complex and it takes various clinical forms.”</em></div>
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ENDS</div>
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<span style="color: #646565; font-family: "alde_open_sansregular" , "arial" , sans-serif;"><span style="font-size: 20.8px;"><a href="https://alde.eu/en/news/1203-meps-call-for-a-european-plan-to-combat-lyme-disease/">https://alde.eu/en/news/1203-meps-call-for-a-european-plan-to-combat-lyme-disease/</a> </span></span></div>
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<span style="color: #646565; font-family: "alde_open_sansregular" , "arial" , sans-serif;"><span style="font-size: 20.8px;"><a href="https://www.europeaninterest.eu/article/parliament-calls-alarming-spread-lyme-disease-tackled/?fbclid=IwAR0XeF9Sgtcie3MFk2WfaASp2yxE5IY6HIX1AuF-BEkmEtsJ6gYJH-Wz1Gc">https://www.europeaninterest.eu/article/parliament-calls-alarming-spread-lyme-disease-tackled/?fbclid=IwAR0XeF9Sgtcie3MFk2WfaASp2yxE5IY6HIX1AuF-BEkmEtsJ6gYJH-Wz1Gc</a> </span></span></div>
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<span style="color: #47494c; font-family: "lato" , sans-serif; font-size: 15px;">A number of Irish MEPs have welcomed a European Parliament vote calling for better diagnosis and treatment of Lyme disease. </span></div>
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<a href="https://www.irishexaminer.com/breakingnews/ireland/irish-meps-welcome-vote-calling-for-better-treatment-of-lyme-disease-885749.html">https://www.irishexaminer.com/breakingnews/ireland/irish-meps-welcome-vote-calling-for-better-treatment-of-lyme-disease-885749.html</a> </div>
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<span style="box-sizing: border-box; font-weight: 700;">Therapeutic wandering</span></div>
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“There is no European consensus regarding the treatment, the diagnosis and the detection of Lyme disease,” the resolution pointed out.</div>
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“From country to country, the diagnostic and treatment guidelines prove to be very different, forcing some sufferers to undertake a form of ‘therapeutic wandering’, crossing Europe to find solutions adapted to their infection,” Rivasi explained.</div>
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<a href="https://www.euractiv.com/section/health-consumers/news/le-parlement-europeen-alerte-sur-la-maladie-de-lyme/?fbclid=IwAR3cCgwhdWExZcwnlw4DVWnHOzYFg4PgE_64iuCQ1YJ-1XstsyQzXcITIrI">https://www.euractiv.com/section/health-consumers/news/le-parlement-europeen-alerte-sur-la-maladie-de-lyme/?fbclid=IwAR3cCgwhdWExZcwnlw4DVWnHOzYFg4PgE_64iuCQ1YJ-1XstsyQzXcITIrI</a> </div>
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<span style="background-color: #fbfbfb; color: #195b92; font-family: "arial" , "helvetica" , sans-serif; font-size: 12px; font-weight: 700;">Lyme disease (Borreliosis) (debate)</span></div>
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<a href="http://www.europarl.europa.eu/plenary/en/vod.html?mode=unit&vodLanguage=EN&vodId=1542272031088&fbclid=IwAR30IbwrHXCWz3rPc7Muoi1avJjLxyJeSh4RHABMAvwGDLGYxTxaToxOmQg#">http://www.europarl.europa.eu/plenary/en/vod.html?mode=unit&vodLanguage=EN&vodId=1542272031088&fbclid=IwAR30IbwrHXCWz3rPc7Muoi1avJjLxyJeSh4RHABMAvwGDLGYxTxaToxOmQg#</a> </div>
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Motion for a resolution </div>
<table border="0" cellpadding="5" cellspacing="0" class="doc_box_header" style="border: 1px solid rgb(0, 119, 190); color: black; font-family: Arial, Helvetica, sans-serif; font-size: 16px; margin: 0px; width: 100%px;"><tbody style="border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; margin: 0px;">
<tr style="border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; margin: 0px;" valign="top"><td align="left" class="doc_title" style="background-image: url("/img/struct/navigation/gradient_blue.gif"); border: 0px; color: #6679b4; font-size: 0.8em; font-style: inherit; font-weight: bold; margin: 0px;"> European Parliament resolution on Lyme disease (Borreliosis) (<a href="http://www.europarl.europa.eu/oeil/popups/ficheprocedure.do?lang=en&reference=2018/2774(RSP)" style="color: #ffae63; text-decoration-line: none;">2018/2774(RSP)</a>) </td><td align="left" style="background-image: url("/img/struct/navigation/gradient_blue.gif"); border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; margin: 0px;"></td><td align="right" style="background-image: url("/img/struct/navigation/gradient_blue.gif"); border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; margin: 0px;"><table align="right" border="0" cellpadding="0" cellspacing="0" style="border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; margin: 0px;"><tbody style="border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; margin: 0px;">
<tr style="border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; margin: 0px;"><td class="numPEA_doc" nowrap="nowrap" style="border: 1px solid rgb(197, 197, 199); color: #333333; font-size: 1em; font-style: inherit; font-weight: inherit; margin: 0px; padding: 2px; text-align: center;"><span class="contents" style="color: #666666; font-size: 0.75em;">B8‑0514/2018</span></td></tr>
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<tr class="contents" style="border: 0px; color: #666666; font-size: 0.75em; font-style: inherit; margin: 0px;" valign="top"><td colspan="3" style="border: 0px; font-family: inherit; font-style: inherit; font-weight: inherit; margin: 0px;"><div style="margin: 0pt 0pt 12pt;">
<span style="font-style: italic;">The European Parliament</span>,</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
– having regard to the question to the Commission on Lyme disease (Borreliosis) (<a href="http://www.europarl.europa.eu/sides/getDoc.do?type=OQ&reference=O-2018-000088&language=EN" style="color: #ffae63; font-weight: bold; text-decoration-line: none;">O-000088/2018</a> – B8-0417/2018),</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
– having regard to the motion for a resolution of the Committee on the Environment, Public Health and Food Safety,</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
– having regard to the European Centre for Disease Prevention and Control report relating to a systematic literature review on the diagnostic accuracy of serological tests for Lyme borreliosis,</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
– having regard to the Expert Network consultation meeting on Lyme borreliosis surveillance in the European Union held in January 2016 in Stockholm,</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
– having regard to Decision No 2119/98/EC of the European Parliament and of the Council of 24 September 1998 setting up a network for the epidemiological surveillance and control of communicable diseases in the Community<a href="http://www.europarl.europa.eu/sides/getDoc.do?pubRef=-%2F%2FEP%2F%2FTEXT+MOTION+B8-2018-0514+0+DOC+XML+V0%2F%2FEN&fbclid=IwAR1c7LBdV1wEWaOCfVVo4Zu_Tp4DZqHlGPEz-1LouOKf_H41pEQ791daC6k#_part1_def1" name="_part1_ref1" style="color: #ffae63; font-weight: bold; text-decoration-line: none;"><span class="sup" style="font-size: 0.8em; vertical-align: super;">(1)</span></a>,</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
– having regard to Rules 128(5) and 123(2) of its Rules of Procedure,</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
A. whereas the right to health is a fundamental right recognised by the European Treaties, in particular in Article 168 of the Treaty on the Functioning of the European Union (TFEU);</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
B. whereas Lyme disease, or Lyme borreliosis, is a bacterial disease caused by the bacterium Borrelia burgdorferi, and is transmitted to humans through the bite of a tick, which itself is contaminated by the bacterium; whereas Lyme disease is an infectious disease in humans and in various species of domestic and wild animals, and is transmitted by ticks;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
C. whereas Lyme borreliosis is the most common zoonotic disease in Europe, with an estimated 650 000 - 850 000 cases and a higher incidence in Central Europe; whereas infection occurs in the spring-summer semester (from April to October), and borreliosis is recognised as an occupational disease for farmers, forestry workers and field researchers in the countries in which it is present;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
D. whereas infected ticks and the disease seem to be expanding geographically, with instances now also being recorded at higher altitudes and latitudes, as well as in towns and cities; whereas the suspected causes are, among other things, changes in land use<span style="font-style: italic;">, inter alia</span> through the afforestation of low-quality land or the expansion of invasive plants, climate change, global warming, excessive humidity and other activities related to human behaviour;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
E. whereas there is no European consensus on the treatment, diagnosis and screening of Lyme disease and national practices vary;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
F. whereas a bite by an infected tick and the symptoms of Lyme disease can go unnoticed or even in some cases be asymptomatic, which can sometimes lead to severe complications and permanent damage similar to that of a chronic disease, in particular when the patient is not promptly diagnosed;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
G. whereas more reliable early diagnosis of Lyme disease will significantly reduce the number of later-stage cases, thus improving the quality of life of patients; whereas it will also reduce the financial burden of the disease, leading to savings of approximately EUR 330 million in healthcare costs already during the first 5 years, according to managers of the DualDur EU research project;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
H. whereas many patients are neither promptly diagnosed nor have access to suitable treatment; whereas they feel deprived and ignored by the public authorities and some continue to have persistent symptoms that can lead to chronic disease;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
I. whereas there is currently no vaccine available for Lyme disease;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
J. whereas the true burden of Lyme borreliosis in the EU is unknown due to the lack of statistics on this disease and the very wide variety of applied case definitions, laboratory methods used and surveillance systems;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
K. whereas there is no ICD code separation between early-stage and late-stage Lyme disease; whereas there are no individual ICD codes for the different late-stage Lyme disease symptoms;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
L. whereas the ILADS (International Lyme and Associated Diseases Society) treatment practice guidelines differ from those of IDSA (Infectious Diseases Society of America) and these differences between the two approaches to the disease also have an impact on treatment practices in the EU;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
M. whereas a profound understanding of the mechanism which turns Lyme disease into a chronic disease is lacking;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
N. whereas health professionals have been sounding the alarm about this health issue for nearly a decade, as have patients’ associations and whistle-blowers;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
O. whereas, although well known to medical science, Lyme disease is still underdiagnosed, in particular because of the difficulties encountered in the detection of symptoms and the absence of appropriate diagnostic tests;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
P. whereas the screening tests used for Lyme disease are not always able to provide accurate results, one such example being the Elisa test which only detects one infection at a time;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
Q. whereas many Europeans are constantly exposed to Lyme borreliosis through their professional activities (farmers, forestry workers, researchers and students carrying out field research such as biologists, geologists, surveyors or archaeologists);</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
R. whereas the medical profession often follows outdated recommendations on Lyme disease that do not take sufficient account of research developments;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
1. Expresses its concern at the alarming proportions of the spread of Lyme disease in the European population, with around 1 million citizens suffering from the disease according to the census methods used;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
2. Recalls that all Member States, to varying degrees, are experiencing an upsurge in Lyme borreliosis, making it a European health problem;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
3. Welcomes the funding allocated to date by the Union for research into the early detection and future treatment of Lyme borreliosis (some EUR 16 million through projects such as ANTIDotE, ID-LYME and LYMEDIADEX);</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
4. Calls for additional funding of the methods for diagnosing and treating Lyme disease; encourages, to that end, the promotion of research efforts, in terms both of increased allocation of funds and the exchange of epidemiological data, including data on the distribution and prevalence of pathogenic and non-pathogenic genospecies;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
5. Calls for additional international cooperation on research into Lyme disease;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
6. Encourages the Commission to collect as much information as possible on Lyme disease screening methods or on treatments administered in the Member States;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
7. Calls for mandatory reporting in all Member States affected by Lyme disease;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
8. Calls on the Commission to facilitate cooperation and the exchange of best practices among Member States in terms of the monitoring, diagnosis and treatment of Lyme disease;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
9. Welcomes the inclusion by certain Member States of Lyme disease in their national surveillance systems on the basis of a specific methodology;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
10. Calls on the Commission to put in place uniform surveillance programmes and to work together with the Member States on facilitating the standardisation of diagnostic tests and treatments; calls on the Commission to recognise borreliosis as an occupational disease for agricultural and forestry workers, as well as for field scientists (such as biologists, geologists, surveyors or archaeologists);</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
11. Calls for individual tick prevention and control measures in the Member States in order to contain the spread of the Borrelia bacteria;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
12. Calls for the development of evidence-based guidance on clinical and laboratory diagnosis of Lyme borreliosis; calls for ICD code separation between early-stage and late-stage Lyme disease; calls also for individual ICD codes for the different late-stage Lyme disease symptoms;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
13. Requests that the Commission publish guidelines based on best practices within the EU with regard to the training of general practitioners so as to facilitate the diagnosis and screening of Lyme disease;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
14. Asks Member States to expand the use of clinical examination so that doctors can diagnose Lyme disease even if the serology tests are negative, in order to help patients break the ‘therapeutic deadlock’;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
15. Calls on the Commission to assess the magnitude of the phenomenon of some patients spending a long time seeking appropriate diagnosis and treatment of Lyme disease, in particular the cross-border movements of patients seeking treatment and the financial consequences thereof;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
16. Calls for the planning and creation of innovative projects that can contribute to improved data gathering and the greater effectiveness of education and awareness-raising activities;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
17. Welcomes the Commission implementing decision on the communicable diseases and related special health issues to be covered by epidemiological surveillance as well as relevant definitions<a href="http://www.europarl.europa.eu/sides/getDoc.do?pubRef=-%2F%2FEP%2F%2FTEXT+MOTION+B8-2018-0514+0+DOC+XML+V0%2F%2FEN&fbclid=IwAR1c7LBdV1wEWaOCfVVo4Zu_Tp4DZqHlGPEz-1LouOKf_H41pEQ791daC6k#_part1_def2" name="_part1_ref2" style="color: #ffae63; font-weight: bold; text-decoration-line: none;"><span class="sup" style="font-size: 0.8em; vertical-align: super;">(2)</span></a>, that includes Lyme neuroborreliosis in the communicable diseases list;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
18. Emphasises that the addition of Lyme disease to the European epidemiological surveillance network is enabling patients to benefit from the advantages of a robust and structured health system that permits permanent communication between competent national authorities, rapid and reliable identification of cases of Borreliosis Lyme in the Union, mutual assistance in the field of analysis and interpretation of surveillance data collected, and deployment of devices necessary to stop its spread in humans;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
19. Invites the Member States, which will be able to call on the Commission’s logistical support, to set up an information and awareness campaign to alert the population and all those concerned to the existence of Lyme disease, first and foremost in the regions most affected by its spread;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
20. Calls on the Commission to draw up a European plan to combat Lyme disease that is commensurate with the seriousness of this silent epidemic; encourages the set-up of a European network on Lyme disease that includes relevant stakeholders;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
21. Calls on the Commission and the Member States to publish common prevention guidelines for those at high risk of getting Lyme disease, such as outdoors workers, as well as standardised diagnostic and treatment guidelines;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
22. Calls on the Commission to introduce preventive tests and a method for rapidly treating and monitoring the course of Lyme borreliosis infections among professionals in the agroforestry sector and scientists involved in gathering field data;</div>
<div style="margin: 0pt 0pt 12pt 28.35pt; text-indent: -28.35pt;">
23. Instructs its President to forward this resolution to the Commission.</div>
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</div>
<div class="content" style="background-color: white;">
<a href="http://www.europarl.europa.eu/sides/getDoc.do?pubRef=-%2F%2FEP%2F%2FTEXT+MOTION+B8-2018-0514+0+DOC+XML+V0%2F%2FEN&fbclid=IwAR1c7LBdV1wEWaOCfVVo4Zu_Tp4DZqHlGPEz-1LouOKf_H41pEQ791daC6k">http://www.europarl.europa.eu/sides/getDoc.do?pubRef=-%2F%2FEP%2F%2FTEXT+MOTION+B8-2018-0514+0+DOC+XML+V0%2F%2FEN&fbclid=IwAR1c7LBdV1wEWaOCfVVo4Zu_Tp4DZqHlGPEz-1LouOKf_H41pEQ791daC6k</a> <br />
<br />
<br />
European Parliament
2014-2019
TEXTS ADOPTED
Provisional edition
P8_TA-PROV(2018)0465
Lyme disease (Borreliosis)
European Parliament resolution of 15 November 2018 on Lyme disease (Borreliosis)
(2018/2774(RSP)) <br />
<a href="http://www.europarl.europa.eu/sides/getDoc.do?pubRef=-%2F%2FEP%2F%2FTEXT+TA+P8-TA-2018-0465+0+DOC+XML+V0%2F%2FEN&language=EN&fbclid=IwAR2PSFRPSH8D6BbkBYr9qcv5DL-Brwr0x7AGsoNqzHo6k_HK2JAlldOOEM8">http://www.europarl.europa.eu/sides/getDoc.do?pubRef=-%2F%2FEP%2F%2FTEXT+TA+P8-TA-2018-0465+0+DOC+XML+V0%2F%2FEN&language=EN&fbclid=IwAR2PSFRPSH8D6BbkBYr9qcv5DL-Brwr0x7AGsoNqzHo6k_HK2JAlldOOEM8</a><br />
<br />
'A. whereas the right to health is a fundamental right recognised by the European Treaties,
in particular in Article 168 of the Treaty on the Functioning of the European Union
(TFEU);<br />
B. whereas Lyme disease, or Lyme borreliosis, is a bacterial disease caused by the
bacterium Borrelia burgdorferi, and is transmitted to humans through the bite of a tick,
which itself is contaminated by the bacterium; whereas Lyme disease is an infectious
disease in humans and in various species of domestic and wild animals;<br />
C. whereas Lyme borreliosis is the most common zoonotic disease in Europe, with an
estimated 650 000 - 850 000 cases and a higher incidence in Central Europe; whereas
infection occurs in the spring-summer semester (from April to October), and borreliosis
1 OJ L 268, 3.10.1998, p. 1.
is recognised as an occupational disease for farmers, forestry workers and field
researchers in the countries in which it is present;<br />
D. whereas infected ticks and the disease seem to be expanding geographically, with
instances now also being recorded at higher altitudes and latitudes, as well as in towns
and cities; whereas the suspected causes are, among other things, changes in land use,
inter alia through the afforestation of low-quality land or the expansion of invasive
plants, climate change, global warming, excessive humidity and other activities related
to human behaviour;<br />
E. whereas there is no European consensus on the treatment, diagnosis and screening of
Lyme disease and national practices vary;<br />
F. whereas a bite by an infected tick and the symptoms of Lyme disease can go unnoticed
or even in some cases be asymptomatic, which can sometimes lead to severe
complications and permanent damage similar to that of a chronic disease, in particular
when the patient is not promptly diagnosed;
G. whereas more reliable early diagnosis of Lyme disease will significantly reduce the
number of later-stage cases, thus improving the quality of life of patients; whereas it
will also reduce the financial burden of the disease, leading to savings of approximately
EUR 330 million in healthcare costs already during the first 5 years, according to
managers of the DualDur EU research project;<br />
H. whereas many patients are neither promptly diagnosed nor have access to suitable
treatment; whereas they feel deprived and ignored by the public authorities and some
continue to have persistent symptoms that can lead to chronic disease;<br />
I. whereas there is currently no vaccine available for Lyme disease;<br />
J. whereas the true burden of Lyme borreliosis in the EU is unknown due to the lack of
statistics on this disease and the very wide variety of applied case definitions, laboratory
methods used and surveillance systems;<br />
K. whereas there is no ICD code separation between early-stage and late-stage Lyme
disease; whereas there are no individual ICD codes for the different late-stage Lyme
disease symptoms;<br />
L. <b><span style="font-size: large;">whereas the ILADS (International Lyme and Associated Diseases Society) treatment
practice guidelines differ from those of IDSA (Infectious Diseases Society of America)
and these differences between the two approaches to the disease also have an impact on
treatment practices in the EU;</span></b><br />
M. whereas a profound understanding of the mechanism which turns Lyme disease into a
chronic disease is lacking;<br />
N. whereas health professionals have been sounding the alarm about this health issue for
nearly a decade, as have patients’ associations and whistle-blowers;<br />
O. whereas, although well known to medical science, Lyme disease is still underdiagnosed,
in particular because of the difficulties encountered in the detection of symptoms and
the absence of appropriate diagnostic tests;<br />
P. whereas the screening tests used for Lyme disease are not always able to provide
accurate results, one such example being the Elisa test which only detects one infection
at a time;<br />
Q. whereas many Europeans are constantly exposed to Lyme borreliosis through their
professional activities (farmers, forestry workers, researchers and students carrying out
field research such as biologists, geologists, surveyors or archaeologists);<br />
R. whereas the medical profession often follows outdated recommendations on Lyme
disease that do not take sufficient account of research developments;'</div>
</div>
Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com0tag:blogger.com,1999:blog-3707770726760676731.post-77743320390988636472018-09-29T22:56:00.000+01:002018-09-29T22:56:19.589+01:00HOW MANY DOCTORS HAVE TO BE INFECTED WITH LYME DISEASE?<div dir="ltr" style="text-align: left;" trbidi="on">
<div id="x_yui_3_16_0_ym19_1_1538256673723_2753" style="color: #1d2129; margin-bottom: 6px; margin-top: 0px;">
<span style="font-family: Verdana, sans-serif;">Back <b>in 1986</b>, a US patent was filed for a vaccine against Lyme disease by Dr. Russell Johnson (PhD), Department of Microbiology and Immunology from University of Minnesota.</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2754" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">In his patent application, several important points were highlighted when describing Lyme disease.</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2755" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">1:<b> the spirochete could persist causing chronic forms of the disease</b></span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2756" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">2: <b>once infection has occurred, antibiotic therapy might not 'purge the host of the spirochete but only act to control the chronic forms of the disease' (thus once infection established, antibiotics control but do not eradicate the infection)</b></span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2757" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">3: <b>maternal-fetal transmission of Borrelia burgdorferi has resulted in neonatal death</b></span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2758" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">4: <b>for every symptomatic infection, there is at least one asymptomatic infection</b>.</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2759" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">****</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2760" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">This is indeed troubling and highlights that persistence of this organism and maternal-fetal transmission are both well acknowledged entities.</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2761" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">As an FYI: There have been cases in the peer reviewed literature of asymptomatic mothers with NO HISTORY of tick bite or EM rash - transmitting Bb in utero to their baby - thus remarkably resembling congenital syphilis which is also a spirochete infection. (Lampert, 1986; MacDonald, 1989; Dattwyler et al, 1989; Trevisan etal, 1997; Maraspin et al, 1999; Horst, 2003; Onk, 2005).</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2762" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">There has been a report of confirmation of Bb spirochetes identified in three placentas by silver stain. 2 of these placentas were further tested using PCR and B. burgdorferi confirmed. All of these mothers were asymptomatic and would be considered seronegative (they had borderline ELISA's and negative or equivocal WB). Authors identified no relationship between placental spirochetes and results of the ELISA and WB and authors suggested long-term follow-up of infants born to mothers w placental spirochetes. (Figueroa et al, 1996)</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2763" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">There have also been cases of seronegative mothers also transmitting Bb to their baby in utero (Lavoie et al 1987), (Weber et al, 1988*), (Macdonald, 1989), (Dattwyler, 1989).</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2764" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">Excerpt from patent below:</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2765" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">"The chronic forms of the disease such as arthritis (joint involvement), acrodermatitis chronica atrophicans (skin involvement), and Bannwarth's syndrome (neurological involvement) may last for months to years and are associated with the persistence of the spirochete.</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2766" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">A case of maternal-fetal transmission of B. burgdorferi resulting in neonatal death has been reported. Domestic animals such as the dog also develop arthritis and lameness to this tick-borne infection. For every symptomatic infection, there is at least one asymptomatic infection. Lyme disease is presently the most commonly reported tick-borne disease in the United States.</span></div>
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<span style="font-family: Verdana, sans-serif;">The infection may be treated at any time with antibiotics such as penicillin, erythromycin, tetracycline, and ceftriaxone. Once infection has occurred, however, the drugs may not purge the host of the spirochete but may only act to control the chronic forms of the disease. Complications such as arthritis and fatigue may continue for several years after diagnosis and treatment. "</span></div>
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<span style="font-family: Verdana, sans-serif;">Citations:</span></div>
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<span style="font-family: Verdana, sans-serif;">Lampert, R. Infantile multisystem inflammatory disease: another case of a new syndrome. Eur J Pediatr (1986) 144:593-596</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2772" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">Macdonald, AB. Human fetal borreliosis, toxemia of pregnancy and fetal death. Zentralbl Bakteriol Mikorbiol Hyg (A). 1986;263(1-2):189-200.</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2773" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">Burgdorfer, W. The Enlarging Spectrum of Tick-Borne Spirochetosis: R. R. Parker Memorial Address. Reviews of the Infectious Diseases, Vol 8, No. 6. Nov/Dec 1986</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2774" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">Lavoie PE, Lattner BP, Duray P. H et al. Culture positive, seronegative, transplacental Lyme borreliosis infant mortality. Arthritis Rheum; 1987. p. S50.</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2775" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">MacDonald A, Benach J, Burgdorfer W. Stillbirth following Maternal Lyme Disease. New York State Journal of Medicine vol 87, November 1987.</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2776" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">Weber K, Bratzke H, Neubert UWE et al. Borrelia Burgdorferi in a newborn despite oral penicillin for Lyme borreliosis during pregnancy. Pediatric Infectious Disease Journal Vol 7, No 4, 286-289, 1988 *(initially mother's sera was negative for Bb antibodies by IFA - so she would have been considered seronegative. A few years later, storied sera was re-examined and tested w ELISA IgM and positive).</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2777" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">Macdonald, AB. Gestational Lyme borreliosis. Implications for the fetus. Rheum Dis Clin North Am. 1989;15(4):657-77.</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2778" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">Dattwyler R, Volkman D and Luft B. Immunologic aspects of Lyme borreliosis. Review of Infectious Diseases Vol 11(6) 1989.</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2779" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">Horst, H. (abstract no W/TH-P-20). In: Abstracts (book 1) of the 4th International Conference on Lyme borreliosis. Stockholm, Sweden, p 56.</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2780" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">Trevison G, Stinco G, Cinco M. Neonatal skin lesions due to a spirochetal infection: a case of congenital Lyme borreliosis? Journal of Dermatology, 1997, 36, 677.</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2781" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">Maraspin V, Cimperman J, Lotric-Furlan, S et al. Erythema migrans in pregnancy. Wein Klin Wochenschr (1999) 111/22-23:933-940.</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2782" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">Gardner, T. Lyme disease. In: Remington JK, J. editor. Infectious Diseases of the Fetus and Newborn, 5th ed: Saunders; 2001.</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2783" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">Horst, H. Borrelieninfektion in der Schwangerscharft und durch Bluttransfusionen. In H. Horst (ed.) Zeckenborreliose Lyme-Krankheit bei Mensch und Tier (4th ed., pp. 132-137). Balingn, Germany: Spitta Vergag GmbH & Co., KG. **translated from German</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2784" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">Onk G, Acun C, Kalayci M et al. Gestational Lyme Disease as a rare cause of congenital hydrocephalus. J Turkish German Gynecol Assoc, Vol 6(2); 2005-156-157.</span></div>
<div id="x_yui_3_16_0_ym19_1_1538256673723_2785" style="color: #1d2129; margin-bottom: 6px; margin-top: 6px;">
<span style="font-family: Verdana, sans-serif;">Figueroa R, Bracero LA, Augero-Rosenfeld, M et al. Confirmation of Borrelia Burgdorferi spirochetes by polymerase chain reaction in placentas of women with reactive serology for Lyme antibodies. Gynecol Obstet Invest. 1996;41(4):240-3.</span></div>
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<span style="font-family: Verdana, sans-serif;">** this is not meant to be a discussion of the Lyme vaccine, rather highlighting how this organism had been described in 1989.</span></div>
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<span style="font-family: Verdana, sans-serif;"><br />This was written by Sue Burke Faber who kindly gave permission for me to post on my blog. </span></div>
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<span style="font-family: Verdana, sans-serif;">For over 30 years our Government Health Authorities have been blindsided about Lyme Disease leaving thousands of patients suffering without appropriate treatment, based on opinions, when science was readily available that showed it to be a persistent infection, chronic and capable of maternal transmission.</span></div>
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<span style="font-family: Verdana, sans-serif;">Every day doctors tell sick patients that their short course of antibiotics has eradicated their infection and their remaining symptoms are now magically something else but not Lyme Disease.</span></div>
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<span style="font-family: Verdana, sans-serif;"><br /><b>How many sick patients will it take before doctors wake up to what is going on? </b></span></div>
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<span style="font-family: Verdana, sans-serif;"><b>How many sick Doctors have to be infected with Lyme Disease before they convince their colleagues to use their brains and medical training to understand this disease?</b></span></div>
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Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com1tag:blogger.com,1999:blog-3707770726760676731.post-34159114645551149232018-07-27T12:08:00.000+01:002018-07-27T12:16:15.072+01:00WORLD HEALTH ORGANISATION RECOGNISES SERIOUS AND POTENTIALLY FATAL CONSEQUENCES OF LYME DISEASE THAT OUR GOVERNMENTS IGNORE.<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="background-color: white;">To view above Just add Lyme into the search browser below</span></div>
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The World Health Organization’s (WHO) International Classification of Diseases (ICD) are used globally to diagnose, treat and undertake surveillance of disease and injuries.</h3>
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The ICD codes were recently revised and the ICD11 Report was formally adopted in June 2018 by the United Nations and its implementation will begin in 2019.</h3>
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The US Federal Tick-Borne Disease Working Group’s draft Report to Congress was released to the public in July 2018.</h3>
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The WHO document recognizes three significant, potentially fatal complications from Lyme borreliosis. In contrast, these serious complications are missing or minimized in the Tick-Borne Disease Working Group’s draft 2018 Report to Congress.</h3>
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<span style="background: 0px 0px; border: 0px; box-sizing: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><u style="box-sizing: inherit;">WHO ICD11 Process</u></span></h3>
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WHO has recognized Lyme borreliosis to be a ‘disease of consequence’ since the 1990s. Nevertheless, despite improved practices of transparency for the ICD11 revisions, the subject of Lyme borreliosis was uniquely shrouded in secrecy.</h3>
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In fact, WHO has not had a publicly-acknowledged Topic Advisory Group assigned to review Lyme borreliosis since 1993.</h3>
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The Ad Hoc Committee for Health Equity in ICD11 Borreliosis Codes is an international, all voluntary, professional committee formed to improve the ICD codes for Lyme and Relapsing Fever borreliosis and address the human rights violations generated by inadequate codes. WHO verified acceptance of the Ad Hoc Committee’s Report <em style="background: 0px 0px; border: 0px; box-sizing: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">UPDATING ICD11 Borreliosis Diagnostic Codes, Edition One: March 29, </em>2017. This Report provided comprehensive recommendations on how the codes should be updated.</h3>
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In June 2017, members of the Ad Hoc Committee, with renowned scientist Judith Miklossy, shared these concerns and documentation regarding Lyme and dementia directly with Dr. Shekhar Saxena, the senior WHO official responsible for addressing dementia.</h3>
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The Ad Hoc Committee also met with Dainius Pūras, the United Nations (UN) Special Rapporteur on the right to health. The report <em style="background: 0px 0px; border: 0px; box-sizing: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">UPDATING ICD11 Borreliosis Diagnostic Codes, Edition One: March 29, 2017 </em>was entered into record by the Special Rapporteur. This meeting focused on Lyme borreliosis ICD code issues that:</h3>
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× appeared to be largely based on science that is rife with conflicts of interests (COIs) and promoted by the Infectious Diseases Society of America (IDSA)</h3>
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× ignored many of the serious and potentially fatal complications from the disease</h3>
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× contributed to human rights abuses across the globe</h3>
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These meetings were followed by on-going media campaigns to inform the public, government and UN officials on the shortfalls of the Lyme borreliosis ICD codes.</h3>
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<span style="background: 0px 0px; border: 0px; box-sizing: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><u style="box-sizing: inherit;">Governments’ Actions on Lyme Borreliosis</u></span></h3>
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Meanwhile, the governments of Canada, the United Kingdom, Ireland and the USA developed treatment Guidelines and/or key policy documents for Lyme borreliosis during the ICD efforts by the Ad Hoc Committee.</h3>
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These policy documents, including the Tick-Borne Disease Working Group’s 2018 draft Report to Congress, ignore and/or minimize:</h3>
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× Congenital Lyme borreliosis</h3>
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× Dementia due to Lyme Disease</h3>
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× Central Nervous System demyelination due to Lyme borreliosis</h3>
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These policy documents, supposedly developed with stakeholder input, failed to integrate the public comments and scientific publications that describe these debilitating, disabling and potentially fatal complications from Lyme borreliosis.</h3>
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These documents have either ignored the robust peer-reviewed material describing these conditions and/or based their publications on science that is rife with COIs and promoted by the IDSA. In many cases, recommendations related to these potentially fatal complications were restricted to ‘requires more study.’</h3>
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These documents also emphasize a syndrome that has never been validated, known as the Post Treatment Lyme Disease Syndrome (PTLDS). PTLDS is presented as part of a mix of terms that includes ‘<em style="background: 0px 0px; border: 0px; box-sizing: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">an illness all in the patients’ heads</em>’ on page 75 of the 2018 draft Report to Congress.</h3>
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The draft Report makes multiple use of the PTLDS term to refer to 'complications from Lyme infection' yet also states ‘<em style="background: 0px 0px; border: 0px; box-sizing: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">This report does not represent a particular stance on these issues</em>’ (page 75).</h3>
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Furthermore, the draft Report references articles authored by the Tick-Borne Disease Working Group’s Chair John Aucott. Since assuming his post as Chair, Aucott has published multiple articles promoting PTLDS. On page 104 of the draft Report, his article links PTLDS to the psychosomatic condition referred to as ‘medically unexplained syndrome’ or MUS.[1]</h3>
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Why does Chair Aucott conflate MUS with PTLDS? Does the Chair Aucott not know that MUS has been repudiated by the American Psychiatric Association and deleted from the DSM-5?</h3>
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Or, does this conflation have anything to do with Aucott’s patent for CCL19, a biomarker diagnostic he claims can be used to determine PTLDS? [2]</h3>
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<span style="background: 0px 0px; border: 0px; box-sizing: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><u style="box-sizing: inherit;">Conclusions</u></span></h3>
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Regardless of what the answers to these questions are, a couple of things are very clear.</h3>
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The Ad Hoc Committee efforts to update the Lyme borreliosis ICD codes were serendipitous because many persons in the UN system have friends and family devastated by this disease. Fortunately, the BETA platform was open for global review, and the initial rejection of Ad Hoc Committee’s recommendations were revisited.</h3>
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The ICD11 codes recognize some previously ignored complications from Lyme borreliosis. Among other previously un-elaborated codes for the disease, the new codes include these potentially fatal complications:</h3>
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× <span style="background: 0px 0px; border: 0px; box-sizing: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">1C1G.2 Congenital Lyme borreliosis</span></h3>
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× <span style="background: 0px 0px; border: 0px; box-sizing: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">6D85.Y Dementia due to Lyme Disease </span>(Dementia due to other specified diseases classified elsewhere)</h3>
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× <span style="background: 0px 0px; border: 0px; box-sizing: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">8A45.0Y Central Nervous System demyelination due to Lyme borreliosis </span>(Other Specified white matter disorders due to infections)</h3>
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Furthermore, there is additional flexibility under the ‘Coding Note’ for Lyme borreliosis:<em style="background: 0px 0px; border: 0px; box-sizing: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"></em></h3>
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× <span style="background: 0px 0px; border: 0px; box-sizing: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Use additional code if desired, to identify any associated condition.</span></h3>
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× <span style="background: 0px 0px; border: 0px; box-sizing: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Use additional code, if desired, to identify any sequelae.</span></h3>
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× <span style="background: 0px 0px; border: 0px; box-sizing: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">“The extension code 'Cause of late effect' is used in addition to both codes to show the relationship between the causative condition and the resulting sequelae.<em style="background: 0px 0px; border: 0px; box-sizing: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"></em></span></h3>
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This means that immediate complications or sequelae (later complications) from Lyme infection can be identified and attached to the Lyme borreliosis code and used to show relationship to the infection.</h3>
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<span style="background: 0px 0px; border: 0px; box-sizing: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><u style="box-sizing: inherit;">One Last Observation</u></span></h3>
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The ICD11 codes were developed in a collaborative manner with most countries represented. The Lyme borreliosis ICD codes present an understanding of the disease that is missing from multiple governmental and medical society Lyme Guidelines and the 2018 Draft Report to Congress.</h3>
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The Tick-Borne Disease Working Group claims,</h3>
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<em style="background: 0px 0px; border: 0px; box-sizing: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">“The international community is looking to the United States for leadership, science, and innovation on how best to address tick-borne diseases.” </em>[see page 81 of 2018 draft Report to Congress].</h3>
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Unfortunately, for Lyme borreliosis, this US leadership cannot be found in the Tick Borne-Disease Working Group, the Centers for Disease Prevention and Control (CDC), the National Institute of Health (NIH) or the IDSA.</h3>
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There are many officials and medical and scientific professionals across the globe who follow the biased science promoted by the IDSA, CDC and NIH. The Lyme Guidelines developed by the Canadian, UK and Irish governments and the Tick-Borne Disease Working Group’s 2018 draft Report all share this science that is riddled with COIs.</h3>
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However, in key institutions like WHO, the truth of this disease is starting to overcome the propaganda.</h3>
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The WHO’s ICD11 Lyme borreliosis codes clearly make fools of many.</h3>
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<span style="background-color: white;"><span style="font-family: "verdana" , sans-serif;">Extracts from <a aria-describedby="js_1hc" aria-owns="js_1er" data-hovercard-prefer-more-content-show="1" data-hovercard-referer="ARTteMMPbvCmlmVROsNipuJfHmb1nJuZqgtjkKQBf_PWXNdDqm1I1Kt7M-dP4_Gpsng" data-hovercard="/ajax/hovercard/user.php?id=100011527417750&extragetparams=%7B%22hc_ref%22%3A%22ARTteMMPbvCmlmVROsNipuJfHmb1nJuZqgtjkKQBf_PWXNdDqm1I1Kt7M-dP4_Gpsng%22%2C%22fref%22%3A%22nf%22%7D" href="https://www.facebook.com/profile.php?id=100011527417750&hc_ref=ARTteMMPbvCmlmVROsNipuJfHmb1nJuZqgtjkKQBf_PWXNdDqm1I1Kt7M-dP4_Gpsng&fref=nf" id="js_1hd" style="color: #365899; cursor: pointer; font-weight: 600;">Jenna Luche-Thayer</a><span style="color: #616770; font-weight: 600;"> - </span>for further information on this and into the investigations with United Nations on the human rights abuse of Lyme patients and their treating doctors can be read on Jenna's LinkedIn account<span style="color: #616770;"> </span><span style="color: #616770; font-weight: 600;"> </span><span style="color: #616770;"><b><a href="https://www.linkedin.com/in/jenna-luche-thayer-b75b902b/detail/recent-activity/posts/">https://www.linkedin.com/in/jenna-luche-thayer-b75b902b/detail/recent-activity/posts/</a> </b></span></span></span></div>
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Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com0tag:blogger.com,1999:blog-3707770726760676731.post-45303108394247327862018-07-10T19:36:00.000+01:002018-07-11T12:35:01.707+01:00MULTIPLE SCLEROSIS AND INFECTION<div dir="ltr" style="text-align: left;" trbidi="on">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiiF4MW8dV8ZABzG3SKF2K_QCPodMygmAqGAj5KQNXaGTex7s0TncOCTVXrmNFQOY6-dRNYLOGdOWLaARXGjSY1RrWG-IRmrepu7yjHW_OGiQ3d6nE-T-Ogb3LVEtJ0e2t3xfDeR_CDNk0/s1600/steiner-22-ms.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="268" data-original-width="357" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiiF4MW8dV8ZABzG3SKF2K_QCPodMygmAqGAj5KQNXaGTex7s0TncOCTVXrmNFQOY6-dRNYLOGdOWLaARXGjSY1RrWG-IRmrepu7yjHW_OGiQ3d6nE-T-Ogb3LVEtJ0e2t3xfDeR_CDNk0/s400/steiner-22-ms.png" width="400" /></a></div>
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<span style="font-family: "verdana" , sans-serif;">'Dr. Gabriel Steiner had clearly shown that in about one in every ten brain-autopsies he could find spirochetes using his own silver-stain. We still use Steiner’s stain today to detect spirochetes, but for some reason we don’t acknowledge his discovery of spirochetes being associated with Multiple Sclerosis.' </span></h3>
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<a href="https://durayresearch.wordpress.com/about-2/seven-provocative-findings-p5/" style="background-color: transparent;"><span style="font-family: "verdana" , sans-serif; font-size: x-small;">https://durayresearch.wordpress.com/about-2/seven-provocative-findings-p5/</span></a></h3>
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<span style="font-family: "verdana" , sans-serif; font-size: small;">Further images of spirochetes from Steiner's work </span></h4>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQ-Pj4-NYz3VjnM5u2OJgfAixjxLvhc7pmyrEem5uEDbtM0b_s8vSTinoqW8ifK_ReLJWCuyWVAKLjrNSJ3eW4-cPGC0EJ-lt2DcCG0yJz5MOvnLkFykFnQm-TNd1qX2x6py5eQD8K6r0/s1600/Steiner+stains.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1214" data-original-width="1600" height="302" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQ-Pj4-NYz3VjnM5u2OJgfAixjxLvhc7pmyrEem5uEDbtM0b_s8vSTinoqW8ifK_ReLJWCuyWVAKLjrNSJ3eW4-cPGC0EJ-lt2DcCG0yJz5MOvnLkFykFnQm-TNd1qX2x6py5eQD8K6r0/s400/Steiner+stains.jpg" width="400" /></a></div>
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<span style="font-family: "verdana" , sans-serif;">The early history of MS and the MS society.</span></h3>
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<span style="font-family: "verdana" , sans-serif;">There is a whole history between Dr. Gabriel Steiner, Dr. Rose Ichelson and the MS society and Time magazine.</span></div>
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<span style="font-family: "verdana" , sans-serif;">I wrote up the story on an old computer in 1992. Seems lost to the ages.</span></div>
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<span style="font-family: "verdana" , sans-serif;">The story is basically is this: Dr. Steiner associates spirochetes in the brains of deceased MS patients in Germany in 1922 to 1933</span></div>
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<span style="font-family: "verdana" , sans-serif;">Dr. Steiner is Jewish so he leaves Germany for Ann Arbor Michigan. Dr. Steiner is a revered teacher and takes on several graduate students. One of is students is Lida Mattman.</span></div>
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Dr. Steiner publishes only three more major papers in America on MS that associates spirochetes with MS. 1952-1956</div>
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Dr. Steiner worked on American MS patients and after finding spirochetes in American MS patients 1952, Dr. Steiner wrote a position paper on MS and named the spirochete myelaphthora or myelin-eating spirochete.</div>
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Steiner went on to state that he thought it was an entirely new species Borrelia.</div>
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At first the American medical community was excited,but the tide changed quickly. People who didn't understand science had the last word in a Time Magazine article in 1957.</div>
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Dr. Rose Ichelson was a microbiologist with 30+ years of experience, a woman who stopped two epidemics in Philadelphia and was mentioned by Eleanor Roosevelt as a female scientist that young girls should emulate.</div>
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Dr.Ichelson read Steiner's work with great interest.</div>
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Rose on several occasions cultured spirochetes from the CSF of MS patients and then published in 1956.</div>
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She gained the attention of TIME magazine who did an article in 1957.</div>
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That same year the inexperienced MS society was formed and was run by none scientists. They said MS was not caused by an infection because rarely did both identical twins or spouses get MS, therefore no infection was being passed. (Of course the infection is not passed from person to person but from TICKs to people.)</div>
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This statement shattered Dr. Ichelson's career and she was openly ridiculed, in a large part her struggle was because of her jealous boss, who literally stole a research grant out from under Rose to do his virus theory of MS.</div>
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Thus ending Rose's career in ridicule and internal politics. She died a few years later and all her lab books and papers were lost in a Philadelphia Town Hall fire.</div>
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The final insult from the MS society was ironically that the MS society after saying MS was not caused by an infection , they wholeheartedly embraced the Virus-theory of MS as put forth by Rose's ex boss.</div>
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<span style="color: #1d2129;">Dr. Rose Ichelson PhD should be honored much in the same way Rosaline Franklin (DNA) is honored with an annual science award for research.Why Philadelphia doesn't wake up and make a statue of her I don't understand.</span><br />
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<span style="color: #1d2129;"><a href="https://molecularsolution.wordpress.com/2011/02/20/spirochetes-found-in-multiple-sclerosis-patients/">https://molecularsolution.wordpress.com/2011/02/20/spirochetes-found-in-multiple-sclerosis-patients/</a> ( a list of numerous published studies on spirochetes and MS)</span></div>
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<span style="font-family: "verdana" , sans-serif;">The above was copied from Thomas Grier Facebook post with his permission to share. (<a href="https://www.facebook.com/thomas.grier1">https://www.facebook.com/thomas.grier1</a> )</span><span style="font-family: "verdana" , sans-serif;">, </span><br />
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<span style="font-family: "verdana" , sans-serif;">To learn more about the association of MS and other illnesses with Borrelia go to -</span>
<span style="font-family: "verdana" , sans-serif;"><span style="background-color: white; color: #404040;">Dr. Paul Duray Research Fellowship Endowment </span> <a href="https://durayresearch.wordpress.com/" target="_blank">https://durayresearch.wordpress.com/</a> </span><br />
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<span style="font-family: "verdana" , sans-serif;">with special attention to - </span><span style="font-family: "verdana" , sans-serif;"><a href="https://durayresearch.wordpress.com/about-2/seven-provocative-findings-p5/">https://durayresearch.wordpress.com/about-2/seven-provocative-findings-p5/</a></span></div>
Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com0tag:blogger.com,1999:blog-3707770726760676731.post-69791066961985887492018-06-13T13:01:00.002+01:002018-06-13T13:01:42.082+01:00CHRONIC LYME DISEASE -THE DISEASE NICE DOESN'T RECOGNISE<div dir="ltr" style="text-align: left;" trbidi="on">
<iframe allowfullscreen="" frameborder="0" height="360" src="https://player.vimeo.com/video/271962463" width="480"></iframe><br />
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<span style="font-family: "courier new" , "courier" , monospace;">An excellent presentation from Dr Kenneth Liegner well worth listening to, discussing so much detailed information historic and present.<br />Kenneth's comment on my Facebook post- '<span style="background-color: white; color: #1d2129;">You are welcome. What is going on worldwide must be framed in terms of Human Rights issues - and - corruption in the Health Care Sector.'</span></span><br />
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<span style="font-family: "courier new" , "courier" , monospace;"><span style="background-color: white; color: #1d2129;">Another excellent presentation from the same conference Dr Brian Fallon</span></span><br />
<span style="color: #1d2129; font-family: "courier new" , "courier" , monospace;"><iframe allowfullscreen="" frameborder="0" height="360" mozallowfullscreen="" src="https://player.vimeo.com/video/271963297" webkitallowfullscreen="" width="480"></iframe></span><br />
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<span style="color: #1d2129; font-family: "courier new" , "courier" , monospace;"><a href="https://vimeo.com/271963297">Part 1 of 4 of the Lyme Society’s Tick-Borne Disease Education Conference with Brian Fallon, MD</a> from <a href="https://vimeo.com/user14686770">Andy Levison</a> on <a href="https://vimeo.com/">Vimeo</a>.</span><br />
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<span style="color: #1d2129; font-family: "courier new" , "courier" , monospace;">Other excellentpresentations<br /><br />Dr Robert Bransfield <a href="http://smoothshots.com/video/271963870">http://smoothshots.com/video/271963870</a></span><br />
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<span style="color: #1d2129; font-family: "courier new" , "courier" , monospace;">and Pat Smith <a href="https://vimeo.com/271989760?from=outro-embed">https://vimeo.com/271989760?from=outro-embed</a></span><br />
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Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com0tag:blogger.com,1999:blog-3707770726760676731.post-66946157083522417132018-03-12T18:39:00.001+00:002018-03-12T18:39:10.479+00:00BREAKTHROUGH IN FRANCE FOR TREATING CHRONIC LYME PATIENTS<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="box-sizing: border-box; vertical-align: inherit;">Plan Lyme: Christian Perronne announces "a big step forward" for the sick</span></h1>
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<span style="box-sizing: border-box; vertical-align: inherit;">From La Montague on their front page please go to this link ad translate to read the full article </span><br />
<span style="box-sizing: border-box; vertical-align: inherit;"><br /><a href="https://www.lamontagne.fr/clermont-ferrand/sante/2018/03/11/plan-lyme-christian-perronne-annonce-une-grande-avancee-pour-les-malades_12768540.html">https://www.lamontagne.fr/clermont-ferrand/sante/2018/03/11/plan-lyme-christian-perronne-annonce-une-grande-avancee-pour-les-malades_12768540.html</a></span><br />
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extracts -<br />
<span style="background-color: white; color: #333f48; font-family: "Open Sans", sans-serif; font-size: 17px;">'The national protocol for diagnosis and care promised in the Lyme plan, launched in September 2016 by Marisol Touraine, then Minister of Health, will be unveiled in the coming weeks.</span><span style="background-color: white; color: #333f48; font-family: "Open Sans", sans-serif; font-size: 17px;">For the patients as for the doctors, it will be "a big advance", promises professor Christian Perronne, specialist of the Lyme disease and member of the working group in charge of elaborating the new recommendations.'</span><span style="background-color: white; color: #333f48; font-family: "Open Sans", sans-serif; font-size: 17px;"><br /></span><br />
<span style="background-color: white; box-sizing: border-box; color: #333f48; font-family: "Open Sans", sans-serif; font-size: 17px; vertical-align: inherit;">'Since June, there have been new scientific references proving the existence of chronic Lyme disease, so I will insist on that. </span><span style="background-color: white; box-sizing: border-box; color: #333f48; font-family: "Open Sans", sans-serif; font-size: 17px; vertical-align: inherit;">There are also known publications, which I did not highlight enough last year, and which show the persistence of clinical signs in many patients after the official three weeks of antibiotics. </span><span style="background-color: white; box-sizing: border-box; color: #333f48; font-family: "Open Sans", sans-serif; font-size: 17px; vertical-align: inherit;">There are at least fifteen publications that find Borrelia bacteria in men who have received short-term treatment. </span><span style="background-color: white; box-sizing: border-box; color: #333f48; font-family: "Open Sans", sans-serif; font-size: 17px; vertical-align: inherit;">All data overlap, so can not say that chronic Lyme does not exist.'</span><br />
<span style="background-color: white; box-sizing: border-box; color: #333f48; font-family: "Open Sans", sans-serif; font-size: 17px; vertical-align: inherit;"><span style="box-sizing: border-box; vertical-align: inherit;"><br /></span></span>
<span style="background-color: white; box-sizing: border-box; color: #333f48; font-family: "Open Sans", sans-serif; font-size: 17px; vertical-align: inherit;"><span style="box-sizing: border-box; vertical-align: inherit;"><br /></span></span>
<span style="background-color: white; box-sizing: border-box; color: #333f48; font-family: "Open Sans", sans-serif; font-size: 17px; vertical-align: inherit;"><span style="box-sizing: border-box; vertical-align: inherit;">'there will be no maximum for the duration of an antibiotic treatment. </span><span style="box-sizing: border-box; vertical-align: inherit;">It will be left to the discretion of the doctor. </span><span style="box-sizing: border-box; vertical-align: inherit;">You can not set a maximum for the simple reason that there has been no research on Lyme for thirty years. </span><span style="box-sizing: border-box; vertical-align: inherit;">We have no data, all the studies that have been done have been limited to three months. </span><span style="box-sizing: border-box; vertical-align: inherit;">Now, we will be able to monitor patients, record practices, see what works best ... It was the goal of the working group, frame what is being done to try to evolve. </span><span style="box-sizing: border-box; vertical-align: inherit;">Our approach is pragmatic, it leaves the door open ... And it suits me well.'</span></span><br />
<span style="background-color: white; box-sizing: border-box; color: #333f48; font-family: "Open Sans", sans-serif; font-size: 17px; vertical-align: inherit;"><span style="box-sizing: border-box; vertical-align: inherit;"><br /></span></span>
<span style="background-color: white; box-sizing: border-box; color: #333f48; font-family: "Open Sans", sans-serif; font-size: 17px; vertical-align: inherit;"><span style="box-sizing: border-box; vertical-align: inherit;"><span style="box-sizing: border-box; vertical-align: inherit;">'"It is common not to see a 100% permanent cure," notes Professor Perronne. </span><span style="box-sizing: border-box; vertical-align: inherit;">"We see people who always keep a little tired, we see others who resume a normal life, but who have seizures, more or less long, more or less regular.They are tired, they have disorders of the memory ... "It shows that the Borrelia is still there, even if it is under control".'</span></span></span><br />
<span style="background-color: white; box-sizing: border-box; color: #333f48; font-family: "Open Sans", sans-serif; font-size: 17px; vertical-align: inherit;"><span style="box-sizing: border-box; vertical-align: inherit;"><span style="box-sizing: border-box; vertical-align: inherit;"><br /></span></span></span>
<span style="background-color: white; box-sizing: border-box; color: #333f48; font-family: "Open Sans", sans-serif; font-size: 17px; vertical-align: inherit;"><span style="box-sizing: border-box; vertical-align: inherit;"><span style="box-sizing: border-box; vertical-align: inherit;">Thanks to </span></span></span><em style="background-color: white; box-sizing: border-box; color: #333f48; font-family: "Open Sans", sans-serif; font-size: 17px;"><span style="box-sizing: border-box; font-weight: 700;"><span style="box-sizing: border-box; vertical-align: inherit;"><span style="box-sizing: border-box; vertical-align: inherit;">Isabelle Vachias </span></span></span></em><span style="background-color: white; color: #333f48; font-family: "Open Sans", sans-serif; font-size: 17px;">For this excellent article</span><br />
<span style="background-color: white; color: #333f48; font-family: "Open Sans", sans-serif; font-size: 17px;"><br /></span>
<span style="background-color: white; color: #333f48; font-family: "Open Sans", sans-serif; font-size: 17px;">Bravo France for leading the World in the treatment of Lyme Disease.</span><br />
<span style="background-color: white; color: #333f48; font-family: "Open Sans", sans-serif; font-size: 17px;">Heartfelt Thanks to Prof Christian Perronne for his dedicated work.</span><br />
<span style="background-color: white; box-sizing: border-box; color: #333f48; font-family: "Open Sans", sans-serif; font-size: 17px; vertical-align: inherit;">Previous posts can be found <a href="https://lookingatlyme.blogspot.co.uk/search?q=Perronne">https://lookingatlyme.blogspot.co.uk/search?q=Perronne</a></span></div>
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Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com0tag:blogger.com,1999:blog-3707770726760676731.post-12096385268724140102018-02-21T16:41:00.000+00:002018-02-21T16:41:00.077+00:00BREACHES OF GUIDELINE DEVELOPMENT RULES BY NICE - LYME DISEASE<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<h3 style="text-align: left;">
<span style="font-family: Verdana, sans-serif; font-size: large;">Breaches of Guideline development rules by NICE
and members of the Guideline Development
Committee for NG10007, Lyme disease</span></h3>
<span style="font-family: Verdana, sans-serif; font-size: large;">from Vector-Borne Infection
Research-Analysis-Strategy
February 2018</span><br />
<span style="font-family: Verdana, sans-serif; font-size: large;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: large;">NICE break their own rules
On September 25th 2017, in a betrayal of public trust and in breach of their own
official rules, NICE pre-emptively published comments about the draft Lyme
disease guideline, which the public and medical professionals would reasonably
believe to be reliable and authoritative. Whereas the draft was not ready for
use, contains serious errors and omissions, was based on a minimal amount of
poor quality evidence and was entirely unfit for purpose. </span><br />
<span style="font-family: Verdana, sans-serif; font-size: large;">The Chairman of the Guideline Development Committee (GDC) for Lyme disease,
Professor Saul Faust, is quoted in numerous articles in newspapers, journals and
online - including Twitter, misrepresenting the draft version, as though it is valid,
authoritative and ready for use by doctors and patients.
4
Furthermore, Professor Gillian Leng, Deputy Chief Executive Officer at NICE, has
participated in this breach of protocol by adding her official opinions and
endorsement to these incomplete guidelines.
The expected publication date for the guidelines is April 4th, 2018. The purpose
of publishing the draft was supposedly to allow a 6 week period for Stakeholders
to evaluate the document and provide comments and evidence to be considered
by NICE before producing the final version for use</span><br />
<span style="font-family: Verdana, sans-serif; font-size: large;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: large;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: large;">Professor Gillian Leng - Deputy Chief Executive of NICE </span><br />
<span style="font-family: Verdana, sans-serif; font-size: large;">A small selection of statements appearing in the media and NICE’s own website
quoting Professor Leng, published on the same day that the DRAFT guideline
was released for stakeholder review</span><br />
<span style="font-family: Verdana, sans-serif; font-size: large;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: large;">We are unaware of any information that Professor Leng is an expert on Lyme
disease, and question the appropriateness of her unqualified public statement
that, “Lyme disease is easy to treat”. The draft guideline shows clearly that
there was a minimal amount of evidence available for making treatment
recommendations, none of which was UK based and all of which was of ‘low’ or
‘very low quality’. Professor Leng must therefore have access to some privileged
and undisclosed source of knowledge about the treatment of Lyme disease,
enabling her to supersede the actual content of the draft guideline. </span><br />
<span style="font-family: Verdana, sans-serif; font-size: large;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: large;">This is not
“transparency”.
Due to pre-emptive and exclusive media exposure, Professor Leng’s comment
now constitutes an official opinion and assurance by a NICE senior officer, preempting
alternative views and evidence which could be provided by
Stakeholders, individual members of the NICE GDC, etc. The general public,
6
patients, medical professionals and even Stakeholder Groups could hardly be
blamed for accepting and trusting information provided by the NICE Deputy
Chief Executive. Yet Professor Leng’s unqualified statements could result in
foreseeable and serious harm to those patients whose Lyme disease is not ‘easy
to treat’.</span><br />
<span style="font-family: Verdana, sans-serif; font-size: large;"><br /></span>
<br />
<span style="font-family: Verdana, sans-serif; font-size: large;">Professor Saul Faust - Chairman of the NICE Guideline Development
Committee for Lyme disease
A small selection of statements in national newspapers, health related magazines
and online, quoting Professor Saul Faust, published on the same day that the
DRAFT guideline was published for stakeholder review</span><br />
<span style="font-family: Verdana, sans-serif; font-size: large;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: large;">If Professor Faust wished to avoid ‘confrontational politics’ it would have made
more sense for him not to make misleading remarks on a subject he clearly does
not understand. Firstly, the numerous points of argument around Lyme disease,
are not disagreements between ‘scientists and patients’, that is misleading and is
in fact, indulging in ‘confrontational politics’.
The disagreements are between on the one hand; scientists and doctors, and on
the other hand; other scientists and doctors. </span><br />
<span style="font-family: Verdana, sans-serif; font-size: large;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: large;">Patients, some of whom have
already lost everything to Lyme disease, have every right to participate in these
debates that directly impact on their health and wellbeing – just as they have
the right to participate in the development of the Lyme disease guideline
produced by NICE. </span><br />
<span style="font-family: Verdana, sans-serif; font-size: large;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: large;">Professor Faust’s statement implies that some patients are in conflict with
scientists per se. This indicates bias against the credibility of patients and
patient campaign groups, whose views he evidently considers to be inferior with
the implication that they must be irrational. He also considers patients to be too
stupid to be able to discriminate between ‘unscrupulous private providers’ and
legitimate practitioners. Exactly how Professor Faust formed this derogatory
view of patients and patient campaigners is unknown to us, as he does not
appear to have any dealings with Lyme disease patients. Therefore it appears
that the Chairman of the GDC has been influenced by some ‘unscrupulous
private provider’ of misleading information about patients, and is now prejudiced
against a very large number of the very patients who are supposed to be helped
by the NICE guideline.
This back-door psychologisation of patients and campaigners may have
originated from Public Health England (PHE). In a document prepared by PHE of
which Dr Tim Brooks was a co-author and who is currently a NICE GDC member,
and submitted to the Health and Safety Executive (HSE), are these remarks:
(<a href="http://www.hse.gov.uk/aboutus/meetings/committees/acdp/161012/acdp_99_p62.pdf" target="_blank">http://www.hse.gov.uk/aboutus/meetings/committees/acdp/161012/acdp_99_p62.pdf </a></span><br />
<span style="font-family: Verdana, sans-serif; font-size: large;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: large;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: large;">The draft only specifies the use of insensitive tests while misrepresenting their
reliability – for newly presenting patients. Patients over the past 30+ years who
were not investigated and denied a diagnosis and treatment because they never
had a blood test, or had a negative blood-test, are not even considered, even
though some of those chronically infected patients will have suffered decades of
ill health. These patients must have been diagnosed with something. But
NICE have evaded this entire issue. </span><br />
<span style="font-family: Verdana, sans-serif; font-size: large;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: large;">Even for new patients, the insensitive tests will predictably lead to a substantial
proportion of infected patients getting a delayed diagnosis and others not
getting diagnosed at all. NICE claim to produce ‘evidence-based’ guidelines. </span><br />
<span style="font-family: Verdana, sans-serif; font-size: large;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: large;">In
the case of Lyme disease they have proffered a draft guideline based on smoke
and mirrors and produced by a committee whose Chair evidently has a negative
view of patients, and ‘experts’ who apparently believe that a laboratory test
Sensitivity of 41% can be represented as “high sensitivity” with no qualifications. </span><br />
<span style="font-family: Verdana, sans-serif; font-size: large;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: large;">There is no excuse for deceiving doctors, patients, the public and the
government about the unreliability of serological tests for Lyme disease.
Objective facts do not require propaganda. Sensitivity figures are stated as a
percentage and do not require interpretation or exaggeration. </span><br />
<span style="font-family: Verdana, sans-serif; font-size: large;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: large;">A credible
Stakeholder Consultation should not be pre-empted by publication of official
endorsements for a draft that is entirely unfit for purpose. </span><br />
<span style="font-family: Verdana, sans-serif; font-size: large;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: large;">A Guideline
Development Committee should be unbiased and objective. </span><br />
<span style="font-family: Verdana, sans-serif; font-size: large;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: large;">The Guideline
Committee and draft NICE guideline for Lyme disease fails in regard to all these
requirements and more. </span><br />
<span style="font-family: Verdana, sans-serif; font-size: large;"><br /></span>
<span style="font-family: Verdana, sans-serif; font-size: large;">We request that the publication of the Guidance is cancelled and the GDC
discharged.<br /><br />Please go to this link for full details<br /><a href="http://counsellingme.com/VIRAS/VIRAScomplaintNICE.pdf" target="_blank"> http://counsellingme.com/VIRAS/VIRAScomplaintNICE.pdf </a> </span></div>
Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com0tag:blogger.com,1999:blog-3707770726760676731.post-82578932443637213562018-02-21T11:59:00.002+00:002018-07-04T08:53:03.861+01:00INTERVENTION NECESSARY ON NICE LYME DISEASE GUIDELINE <div dir="ltr" style="text-align: left;" trbidi="on">
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<div style="box-sizing: border-box; color: #363135; font-family: "Change Calibre", "Helvetica Neue", Helvetica, Arial, Tahoma, sans-serif; font-size: 20px;">
Petition to The Secretary of State for Health</div>
<div style="box-sizing: border-box; color: #363135; font-family: "Change Calibre", "Helvetica Neue", Helvetica, Arial, Tahoma, sans-serif; font-size: 20px; margin-top: 1.5em;">
We hereby petition The Secretary of State for Health (SoSH) to intervene and to give direction to The National Institute for Health and Care Excellence (NICE) to review and modify its guideline methodologies and procedures with respect to the forthcoming guideline GID-NG10007; Lyme Disease (Lyme Guidelines), due for publication on 4 April 2018, as the current standards represent a significant failure in the performance of its functions.</div>
<div style="box-sizing: border-box; color: #363135; font-family: "Change Calibre", "Helvetica Neue", Helvetica, Arial, Tahoma, sans-serif; font-size: 20px; margin-top: 1.5em;">
The Lyme Guidelines if published, will necessarily mean that the SoSH is failing in his duties and they will:</div>
<div style="box-sizing: border-box; color: #363135; font-family: "Change Calibre", "Helvetica Neue", Helvetica, Arial, Tahoma, sans-serif; font-size: 20px; margin-top: 1.5em;">
(a) contravene NICE’s own remit with respect to reducing uncertainty in all respects of prevention, patient management and treatment. The data clearly does not represent the Lyme disease patient population, as a whole, and as such it will not improve patient health or outcomes; and</div>
<div style="box-sizing: border-box; color: #363135; font-family: "Change Calibre", "Helvetica Neue", Helvetica, Arial, Tahoma, sans-serif; font-size: 20px; margin-top: 1.5em;">
(b) due to shortcomings and an unwillingness, to date, to revise the process, it will inadvertently fail to respect, protect or fulfil patients’ human rights under the following UN treaties (as detailed in Joint Fact Sheet WHO/OHCHR/323):</div>
<div style="box-sizing: border-box; color: #363135; font-family: "Change Calibre", "Helvetica Neue", Helvetica, Arial, Tahoma, sans-serif; font-size: 20px; margin-top: 1.5em;">
International Covenant on Economic, Social and Cultural Rights (ICESCR), 1966 Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), 1979</div>
<div style="box-sizing: border-box; color: #363135; font-family: "Change Calibre", "Helvetica Neue", Helvetica, Arial, Tahoma, sans-serif; font-size: 20px; margin-top: 1.5em;">
Convention on the Rights of the Child (CRC), 1989</div>
<div style="box-sizing: border-box; color: #363135; font-family: "Change Calibre", "Helvetica Neue", Helvetica, Arial, Tahoma, sans-serif; font-size: 20px; margin-top: 1.5em;">
European Social Charter, 1961</div>
<div style="box-sizing: border-box; color: #363135; font-family: "Change Calibre", "Helvetica Neue", Helvetica, Arial, Tahoma, sans-serif; font-size: 20px; margin-top: 1.5em;">
and under the Human Rights Act 1998; and the Lyme Guidelines certainly do not “reflect the values of society” to which NICE are committed</div>
<div style="box-sizing: border-box; margin-top: 1.5em;">
<span style="color: #363135; font-family: change calibre, helvetica neue, helvetica, arial, tahoma, sans-serif;"><span style="font-size: 20px;">Click on the link below to read the detail in this petition that explains why lives will be put at risk.<br /></span></span><br />
<span style="color: #363135; font-family: change calibre, helvetica neue, helvetica, arial, tahoma, sans-serif;"><span style="font-size: 20px;">Please sign this important petition </span></span><br /><span style="color: #363135; font-family: change calibre, helvetica neue, helvetica, arial, tahoma, sans-serif;"><span style="font-size: 20px;"><a href="https://www.change.org/p/secretary-of-state-for-health-of-the-united-kingdom-petition-to-the-secretary-of-state-for-health-uk-re-nice-guidelines-on-lyme-disease">https://www.change.org/p/secretary-of-state-for-health-of-the-united-kingdom-petition-to-the-secretary-of-state-for-health-uk-re-nice-guidelines-on-lyme-disease</a></span></span><br />
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<br /></div>
</div>
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</div>
<script src="https://static.change.org/product/embeds/v1/change-embeds.js" type="text/javascript"></script></div>
Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com0tag:blogger.com,1999:blog-3707770726760676731.post-15561702275751290252017-12-29T11:11:00.001+00:002017-12-29T11:11:27.406+00:00DRUG DISCOVERY METHODS FOR CHRONIC LYME DISEASE<div dir="ltr" style="text-align: left;" trbidi="on">
<span style="background-color: white; color: #323232; font-family: "Open Sans", sans-serif; font-size: 16px;">“Our goal is to find alternatives to antibiotics to treat Lyme disease, which is caused by the Borrelia burgdorferi bacterium, and illnesses that arise from the Bartonella pathogen,” said </span><a href="https://medicine.duke.edu/faculty/neil-lee-spector-md" style="background-color: white; box-sizing: border-box; color: #00569d; font-family: "Open Sans", sans-serif; font-size: 16px; text-decoration-line: none;" target="_blank">Neil Spector</a><span style="background-color: white; color: #323232; font-family: "Open Sans", sans-serif; font-size: 16px;">, M.D., the Sandra Coates Associate Professor Breast Cancer Research at </span><a href="http://www.dukecancerinstitute.org/" style="background-color: white; box-sizing: border-box; color: #00569d; font-family: "Open Sans", sans-serif; font-size: 16px; text-decoration-line: none;" target="_blank">Duke Cancer Institute</a><span style="background-color: white; color: #323232; font-family: "Open Sans", sans-serif; font-size: 16px;"> and the study’s co-principal investigator.</span><br />
<span style="background-color: white; color: #323232; font-family: "Open Sans", sans-serif; font-size: 16px;">“We’re hoping to move from isolating targets to identifying potential drugs to testing in animal models within three years – so a very aggressive timeline,” said Spector, who was a Lyme patient himself and nearly died from complications of disease. “Our goal is to identify drugs that will target the Achilles’ heel of these pathogens while sparing the normal gut microbiome.”</span><br />
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Lyme Study Uses Drug Discovery Methods That Have Fueled Cancer Breakthroughs</h2>
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Labs at Duke and other academic centers collaborate to identify alternatives to antibiotics</h4>
<div>
<span style="color: #323232; font-family: Open Sans, sans-serif;"><a href="https://corporate.dukehealth.org/news-listing/lyme-study-uses-drug-discovery-methods-have-fueled-cancer-breakthroughs">https://corporate.dukehealth.org/news-listing/lyme-study-uses-drug-discovery-methods-have-fueled-cancer-breakthroughs</a> </span></div>
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Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com0tag:blogger.com,1999:blog-3707770726760676731.post-32506184020443067092017-12-29T10:09:00.000+00:002017-12-29T10:09:14.375+00:00CHRONIC PERSISTENT LYME DISEASE IN NON HUMAN PRIMATES<div dir="ltr" style="text-align: left;" trbidi="on">
<span style="font-family: Verdana, sans-serif;">Two important new studies :-</span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span>
<h1 id="artTitle" style="background-color: white; box-sizing: border-box; color: #333333; font-size: 26px; font-weight: normal; line-height: 1.25; margin: 0px 0px 0.625rem; padding: 0px; text-rendering: optimizeLegibility;">
<span style="font-family: Verdana, sans-serif;">Variable manifestations, diverse seroreactivity and post-treatment persistence in non-human primates exposed to <i style="box-sizing: border-box; line-height: inherit;">Borrelia burgdorferi</i> by tick feeding</span></h1>
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<a href="http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0189071"><span style="font-family: Verdana, sans-serif;">http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0189071</span></a></div>
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<span style="font-family: Verdana, sans-serif;">Abstract</span></h2>
<span style="font-family: Verdana, sans-serif;"><a class="link-target" href="https://www.blogger.com/null" id="article1.front1.article-meta1.abstract1.p1" name="article1.front1.article-meta1.abstract1.p1" style="background-color: white; box-sizing: border-box; color: #3c63af; font-size: 16px; line-height: inherit;"></a></span><div style="background-color: white; box-sizing: border-box; color: #333333; font-size: 0.8125rem; line-height: 1.125rem; margin-bottom: 0.8125rem; padding: 0px; text-rendering: optimizeLegibility; word-wrap: break-word;">
<span style="font-family: Verdana, sans-serif;">The efficacy and accepted regimen of antibiotic treatment for Lyme disease has been a point of significant contention among physicians and patients. While experimental studies in animals have offered evidence of post-treatment persistence of <em style="box-sizing: border-box; line-height: inherit;">Borrelia burgdorferi</em>, variations in methodology, detection methods and limitations of the models have led to some uncertainty with respect to translation of these results to human infection. With all stages of clinical Lyme disease having previously been described in nonhuman primates, this animal model was selected in order to most closely mimic human infection and response to treatment. Rhesus macaques were inoculated with <em style="box-sizing: border-box; line-height: inherit;">B</em>. <em style="box-sizing: border-box; line-height: inherit;">burgdorferi</em> by tick bite and a portion were treated with recommended doses of doxycycline for 28 days at four months post-inoculation. Signs of infection, clinical pathology, and antibody responses to a set of five antigens were monitored throughout the ~1.2 year study. Persistence of <em style="box-sizing: border-box; line-height: inherit;">B</em>. <em style="box-sizing: border-box; line-height: inherit;">burgdorferi</em> was evaluated using xenodiagnosis, bioassays in mice, multiple methods of molecular detection, immunostaining with polyclonal and monoclonal antibodies and an <em style="box-sizing: border-box; line-height: inherit;">in vivo</em> culture system. Our results demonstrate host-dependent signs of infection and variation in antibody responses. In addition, we observed evidence of persistent, intact, metabolically-active <em style="box-sizing: border-box; line-height: inherit;">B</em>. <em style="box-sizing: border-box; line-height: inherit;">burgdorferi</em> after antibiotic treatment of disseminated infection and showed that persistence may not be reflected by maintenance of specific antibody production by the host.</span></div>
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<span style="font-family: Verdana, sans-serif;">Late Disseminated Lyme Disease: Associated Pathology and Spirochete Persistence Post-Treatment in Rhesus Macaques</span></h1>
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<a href="http://ajp.amjpathol.org/article/S0002-9440%2817%2930894-5/fulltext"><span style="font-family: Verdana, sans-serif;">http://ajp.amjpathol.org/article/S0002-9440%2817%2930894-5/fulltext</span></a></div>
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<span style="font-family: Verdana, sans-serif;">Non-human primates currently serve as the best experimental model for Lyme disease due to their close genetic homology with humans and demonstration of all three phases of disease following infection with <em>Borreliella (Borrelia) burgdorferi (</em>Bb<em>)</em>. We investigated the pathology associated with late disseminated Lyme disease (12 to 13 months following tick inoculation) in doxycycline-treated (28 days; 5mg/kg, oral, 2x/day) and untreated rhesus macaques (Rm). Minimal to moderate lymphoplasmacytic inflammation, with a predilection for perivascular spaces and collagenous tissues, was observed in multiple tissues including the cerebral leptomeninges, brainstem, peripheral nerves from both fore and hind limbs, stifle synovium and perisynovial adipose tissue, urinary bladder, skeletal muscle, myocardium, and visceral pericardium. Indirect immunofluorescence assays (IFA) combining monoclonal (outer surface protein A) and polyclonal antibodies were performed on all tissue sections containing inflammation. Rare morphologically intact spirochetes were observed in the brains of two treated Rm, the heart of one treated Rm<em>,</em> and adjacent to a peripheral nerve of an untreated animal. <em>Borrelia</em>antigen staining of probable spirochete cross-sections was also observed in heart, skeletal muscle, and near peripheral nerves of both treated and untreated animals. These findings support the notion that chronic Lyme disease symptoms can be attributable to residual inflammation in and around tissues that harbor a low burden of persistent host-adapted spirochetes and/or residual antigen. </span></div>
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<span style="font-family: Verdana, sans-serif;">Various reports of this study give details - </span></div>
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<span style="font-family: Verdana, sans-serif;">Tulane University announcement -</span></div>
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<span style="font-family: Verdana, sans-serif; font-size: large;">Study finds Lyme bacteria can survive antibiotic treatment months after infection</span></h4>
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<span style="color: #333333; font-family: Verdana, sans-serif;"><span style="font-size: 12px;"><a href="http://news.tulane.edu/pr/study-finds-lyme-bacteria-can-survive-after-antibiotic-treatment-months-after-infection">http://news.tulane.edu/pr/study-finds-lyme-bacteria-can-survive-after-antibiotic-treatment-months-after-infection</a></span></span></div>
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<span style="font-family: Verdana, sans-serif;">Outbreak news Today -</span></div>
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<span style="font-family: Verdana, sans-serif;">Lyme disease: Borrelia burgdorferi survive 28-day course of antibiotics months after infection, according to study</span></h1>
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<span style="color: #333333; font-family: Verdana, sans-serif;"><span style="font-size: 12px;"><a href="http://outbreaknewstoday.com/lyme-disease-borrelia-burgdorferi-survive-28-day-course-antibiotics-months-infection-according-study-47121/">http://outbreaknewstoday.com/lyme-disease-borrelia-burgdorferi-survive-28-day-course-antibiotics-months-infection-according-study-47121/</a> </span></span></div>
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<span style="color: #333333; font-family: Verdana, sans-serif;"><span style="font-size: 12px;">Lyme Disease.org </span></span></div>
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<span style="font-family: Verdana, sans-serif;"> New study finds Lyme bacteria survive a 28-day course of antibiotics</span></h1>
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<span style="color: #333333; font-family: Verdana, sans-serif;"><span style="font-size: 12px;"><a href="https://www.lymedisease.org/lyme-study-embers/" target="_blank">https://www.lymedisease.org/lyme-study-embers/ </a></span></span></div>
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<span style="font-family: Verdana, sans-serif;">An excellent in depth look can also be found here-<a href="http://counsellingme.com/VIRAS/Embers.html" target="_blank"> http://counsellingme.com/VIRAS/Embers.html</a></span></div>
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Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com0tag:blogger.com,1999:blog-3707770726760676731.post-62863170620317795172017-12-29T09:45:00.002+00:002017-12-29T09:45:42.529+00:00LAWSUIT FOR LYME DISEASE<div dir="ltr" style="text-align: left;" trbidi="on">
<span style="font-family: ProximaNova, "Helvetica Neue", Helvetica, Roboto, Arial, sans-serif; font-size: 18px;">'A </span><a class="bn-clickable" data-beacon-parsed="true" data-beacon="{"p":{"lnid":"lawsuit","mpid":1,"plid":"https://www.courthousenews.com/insurers-accused-conspiring-deny-lyme-disease-coverage/"}}" data-rapid-parsed="slk" data-rapid_p="1" data-v9y="1" data-ylk="subsec:paragraph;cpos:2" href="https://www.courthousenews.com/insurers-accused-conspiring-deny-lyme-disease-coverage/" rel="nofollow" style="box-shadow: rgb(13, 190, 152) 0px -2px 0px inset; box-sizing: inherit; color: black; font-family: ProximaNova, "Helvetica Neue", Helvetica, Roboto, Arial, sans-serif; font-size: 18px; text-decoration-line: none;" target="_blank">lawsuit</a><span style="font-family: ProximaNova, "Helvetica Neue", Helvetica, Roboto, Arial, sans-serif; font-size: 18px;"> asserts that the design and implementation of Lyme disease care–as outlined in the </span><a class="bn-clickable" data-beacon-parsed="true" data-beacon="{"p":{"lnid":"treatment guidelines","mpid":2,"plid":"https://watermark.silverchair.com/43-9-1089.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAaAwggGcBgkqhkiG9w0BBwagggGNMIIBiQIBADCCAYIGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMAXubfnZpQT51mxHVAgEQgIIBUybY7hwTC_fqFenEuJCp4QtIGAvi7qVlMTqb9F1-egm_XuX2sP8HsHkjD_N-lpjeenlwX-ZIr0zxfCHGLwNN2Cc6NS_TjWGz1cRX11W_uSLyjp-XFGE-1ADgN9lshunJ7p1Jn4VOtO9_cx3AFPvobZc5GC91Smr-4OeQoqahRtSMtcsxzjGBOaY9rA4-2vQEZEcAQUH0boZha88V46HqFLJT6WPH6ynEBhK7ttEvrQ7WzfLWZAqW9CrBXLy7tp3zFEurRm1MYIAKX_DQMMH8AvGyOt2L_piqPvNjgojkn5JJAIdzLIwxF0aMMTAjhoJw95FS1yWxGMMAayfeZ3TZkD8S5lAmzxWSz6lw9ELlXbTlKu4hkI8IO3AwWUATwQLOTIZaKa9mPyA_FCZX211FA-iUgM7xwyPGFfgm8ocUvAtQ0DxdKDhpToBibhngHDt-Dtni3w"}}" data-rapid-parsed="slk" data-rapid_p="2" data-v9y="1" data-ylk="subsec:paragraph;cpos:2" href="https://watermark.silverchair.com/43-9-1089.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAaAwggGcBgkqhkiG9w0BBwagggGNMIIBiQIBADCCAYIGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMAXubfnZpQT51mxHVAgEQgIIBUybY7hwTC_fqFenEuJCp4QtIGAvi7qVlMTqb9F1-egm_XuX2sP8HsHkjD_N-lpjeenlwX-ZIr0zxfCHGLwNN2Cc6NS_TjWGz1cRX11W_uSLyjp-XFGE-1ADgN9lshunJ7p1Jn4VOtO9_cx3AFPvobZc5GC91Smr-4OeQoqahRtSMtcsxzjGBOaY9rA4-2vQEZEcAQUH0boZha88V46HqFLJT6WPH6ynEBhK7ttEvrQ7WzfLWZAqW9CrBXLy7tp3zFEurRm1MYIAKX_DQMMH8AvGyOt2L_piqPvNjgojkn5JJAIdzLIwxF0aMMTAjhoJw95FS1yWxGMMAayfeZ3TZkD8S5lAmzxWSz6lw9ELlXbTlKu4hkI8IO3AwWUATwQLOTIZaKa9mPyA_FCZX211FA-iUgM7xwyPGFfgm8ocUvAtQ0DxdKDhpToBibhngHDt-Dtni3w" rel="nofollow" style="box-shadow: rgb(13, 190, 152) 0px -2px 0px inset; box-sizing: inherit; color: black; font-family: ProximaNova, "Helvetica Neue", Helvetica, Roboto, Arial, sans-serif; font-size: 18px; text-decoration-line: none;" target="_blank">treatment guidelines</a><span style="font-family: ProximaNova, "Helvetica Neue", Helvetica, Roboto, Arial, sans-serif; font-size: 18px;"> of the Infectious Diseases Society of America—is rooted in corruption.' </span><br />
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<span style="font-family: Verdana, sans-serif;">Mary Beth Pfeiffer is an investigative journalist and writes for the Huffington Post her recent article - 10 points about suing the architects of Lyme policy - as a task force meets to review it.</span><br />
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<span style="font-family: Verdana, sans-serif;">To read the full article go to this link -</span><br />
<span style="font-family: Verdana, sans-serif;"> </span><span style="font-family: Verdana, sans-serif;"><a href="https://www.huffingtonpost.com/entry/10-points-about-suing-the-architects-of-lyme-policy_us_5a2764bbe4b0650db4d40bb5">https://www.huffingtonpost.com/entry/10-points-about-suing-the-architects-of-lyme-policy_us_5a2764bbe4b0650db4d40bb5</a></span></div>
Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com0tag:blogger.com,1999:blog-3707770726760676731.post-47069104985875778412017-11-17T12:17:00.002+00:002017-11-17T12:17:52.226+00:00ADDRESSING GLOBAL OBSTACLES TO CARE OF BORRELIOSIS PATIENTS (LYME AND RELAPSING FEVER)<div dir="ltr" style="text-align: left;" trbidi="on">
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Jenna Luché-Thayer: Addressing Systemic Obstacles in the Borreliosis Pandemic </h1>
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<span style="background-color: white;"><span style="font-family: Verdana, sans-serif;"><span style="color: #111111;"><span style="white-space: pre-wrap;">Jenna Luché-Thayer gave this presentation at the International Lyme and Associated Diseases Society (ILADS) Annual Scientific Conference in Boston, November 10, 2017. Jenna is the founder of the Ad Hoc Committee for Health Equity in ICD11 Borreliosis Codes.
In this presentation, Jenna explains how the Ad Committee is trying to address global obstacles to care experienced by Lyme and relapsing fever borreliosis patients and describes how you can use this information to address these human rights abuses. The Ad Hoc Committee was formed in 2016 to:
update the World Health Organization’s (WHO) International Classification of Disease (ICD) codes for Lyme borreliosis (LB)
demonstrate how the outdated codes are contributing to human rights violations
The Ad Hoc Committee members:
represent Asia Pacific region, Africa, North and South America and Eastern, Western and Northern Europe
represent scientific, medical and human rights experts, clinicians and professors across well respected academic and research centers and as advisors to governments and WHO
have worked on borreliosis for two and three decades
have many hundreds of peer-reviewed publications and studies
The Ad Hoc Committee’s report, Updating ICD11 Borreliosis Diagnostic Codes was accepted by WHO prior to the March 30, 2017 deadline for code revisions. Also, as per WHO’s required rules and process for ICD revisions, each recommendation with supporting references was entered onto the WHO ICD Beta Platform.
The Updating ICD11 Borreliosis Diagnostic Codes report was also submitted to Dr. Dainius Pūras, the United Nations Human Rights Council’s Special Rapporteur for the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.
The Ad Hoc Committee was then invited to meet with Dr. Pūras in his official capacity on June 7, 2017 —an event that does not take place unless there exists a legitimate cause for concern about violations of the right to health and other health-related human rights.
Dr. Pūras accepted all the Committee’s documentation including reports, books and videos, PowerPoint and verbal testimony, his Senior Human Rights Officer and Team Leader put them into record. Dr. Pūras also told the Ad Hoc Committee how he could support this effort within the framework of his mandate.
The report is now a published document with an assigned ISBN number. Therefore, it may be cited and quoted as a reference for many purposes including medical, scientific, legal, human rights, public health and economic analysis. For more details - see </span></span><a href="https://www.linkedin.com/pulse/addressing-systemic-obstacles-borreliosis-pandemic-jenna-luche-thayer/" target="_blank">https://www.linkedin.com/pulse/addressing-systemic-obstacles-borreliosis-pandemic-jenna-luche-thayer/</a> </span></span></div>
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<span style="background-color: white;"><span style="font-family: Verdana, sans-serif;"> (posting below for those who don't use linkedin.)</span></span></div>
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<u style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Addressing Systemic Obstacles in the Borreliosis Pandemic</u></h2>
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November 15, 2017 —contact jennaluche@gmail.com</h3>
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On November 10, 2017 global human rights expert Jenna Luché-Thayer gave a comprehensive presentation to over 700 medical and scientific professionals attending the International Lyme and Associated Diseases Society (ILADS) 18th Annual Scientific Conference in Boston [1].</h3>
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Luché-Thayer is the founder of the Ad Hoc Committee for Health Equity in ICD11 Borreliosis Codes. In this videoed presentation, Jenna explains how the Ad Hoc Committee is trying to address human rights abuses such as the obstruction to healthcare experienced by Lyme and relapsing fever borreliosis patients across the globe.</h3>
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Luché-Thayer provides compelling evidence as to how this disease has been politicized by the World Health Organization (WHO) and other key institutions responsible for public health and medical care. The entire presentation —<a href="https://www.youtube.com/watch?v=LLIO0r1mCcE" style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; color: #827be9; cursor: pointer; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: normal; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration-line: none; vertical-align: baseline; word-wrap: break-word;" target="_blank"><strong style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><u style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Addressing Systemic Obstacles in the Borreliosis Pandemic</u></strong></a>— is for available for free viewing <strong style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">on YouTube</strong>.</h3>
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The presentation also explains how the Ad Hoc Committee’s report, <u style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Updating ICD11 Borreliosis Diagnostic Codes: Edition One</u> [2], may be used by those concerned with the injustices associated with this pandemic.</h3>
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The report was accepted by WHO prior to the March 30, 2017 revisions deadline for international classification of diseases (ICD) codes. Also, as per WHO’s required rules and process for ICD revisions, each recommendation with supporting references was entered onto the WHO ICD Beta Platform. </h3>
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The <u style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Updating ICD11 Borreliosis Diagnostic Codes</u> report was also submitted to Dr. Dainius Pūras, the United Nations Human Rights Council’s Special Rapporteur for the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.</h3>
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The Ad Hoc Committee was then invited to meet with Dr. Pūras in his official capacity on June 7, 2017 —an event that does not take place unless there exists a legitimate cause for concern about violations of the right to health and other health-related human rights. Dr. Pūras accepted all the Committee’s documentation including reports, books and videos, PowerPoint and verbal testimony, his Senior Human Rights Officer and Team Leader put them into record. Dr. Pūras also told the Ad Hoc Committee how he could support this effort within the framework of his mandate.</h3>
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<a href="https://www.amazon.com/UPDATING-ICD11-Borreliosis-Diagnostic-Codes/dp/1978091796/ref=sr_1_1?ie=UTF8&qid=1510784455&sr=8-1&keywords=updating+icd11+borreliosis+diagnostic+codes" rel="nofollow noopener" style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; color: #827be9; cursor: pointer; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: normal; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration-line: none; vertical-align: baseline; word-wrap: break-word;" target="_blank"><strong style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">The report is now a published document with an assigned ISBN number</strong></a>. It may be cited and quoted as a reference for many purposes including medical, scientific, legal, human rights, public health and economic [3]. The following key information can be cited from the report:</h3>
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The record now shows 100s of peer-reviewed studies —written by nationally and internationally recognized scientists and medical researchers from across the globe— describing:</h3>
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Congenital Lyme disease, persistent infection, Borrelial lymphocytoma, Granuloma annulare, morphea, localized scleroderma, lichen sclerosis and atrophicus, Lyme meningitis, Lyme nephritis, Lyme hepatitis, Lyme myositis, Lyme aortic aneurysm, coronary artery aneurysm, late Lyme endocarditis, Lyme carditis, Late Lyme neuritis or neuropathy, Meningovascular and Neuroborreliosis – with cerebral infarcts, Intracranial aneurysm, Lyme Parkinsonism, Late Lyme meningoencephalitis or meningomyelo-encephalitis, Atrophic form of Lyme meningoencephalitis with dementia and subacute presenile dementia, Neuropsychiatric manifestations, late Lyme disease of liver and other viscera, late Lyme disease of kidney and ureter, late Lyme disease of Bronchus and lung and seronegative and Latent Lyme disease, unspecified.</h3>
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Furthermore, no medical condition was entered into record if it had less than three supporting peer-reviewed publications. The Committee members then gave verbal and additional written testimony as to how medical practitioners on the Committee had <u style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">collectively and effectively treated tens of thousands of patients with persistent and complicated LB with clinical practice guidelines that have meet internationally accepted standards</u>. </h3>
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These materials firmly establish the significant possibility that patients with persistent Lyme require biological medical care —<u style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">not as a matter of opinion, but as a matter of scientific fact</u>. Furthermore, treatment options for persistent Lyme —including extended and combination antimicrobial therapies— that have met internationally recognized standards for clinical guidelines are available, as are accredited educational programs on how to implement such therapies.</h3>
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The record also shows many different types of health human rights violations. These include how obstruction of access to treatment options from clinical practice guidelines that meet internationally accepted standards for guidelines violates the Availability, Accessibility, Acceptability, Quality (AAAQ) of Health Human Rights imperatives for "non-discriminatory" practices and medical ethics. The record also shows how LB patients who have received clinical diagnosis are routinely denied care should laboratory tests fail to confirm their clinical diagnosis. </h3>
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Many practices resulting from these codes are recognized as human rights violations. Furthermore, the codes are linked to policies recommending practices that:</h3>
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—for many patients, prevent proper diagnosis and obstruct access to treatment options that meet internationally accepted standards</h3>
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—promotes discrimination based on illness manifestations </h3>
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—misapplies somatic diagnosis [4] to deny medical care </h3>
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—obstructs treatments based on illness manifestations </h3>
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—promotes discrimination based on financial status </h3>
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—supports attacks on human rights defenders —including medical practitioners, scientists and researchers who act on behalf of this vulnerable patient group</h3>
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—restricts information regarding treatment options that meet internationally accepted standards</h3>
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—routinely excludes key stakeholders —such as medical practitioners, researchers, patients and caretakers who are concerned with persistent and complicated cases of LB —from decision-making venues … making these stakeholders invisible to policy makers, economists and other practitioners and researchers</h3>
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—permit sick children under treatments that meet internationally accepted standards be forcibly removed from their parents —and there are many cases where such parents are falsely accused of poisoning their children or Munchausen by Proxy </h3>
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—support alarming cases where euthanasia is encouraged over treatments that meet internationally accepted standards</h3>
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To summarize, the science and medical knowledge regarding persistent and complicated LB —from hundreds of peer reviewed publications written by nationally and internationally recognized experts— has been routinely ignored or suppressed. Furthermore, the human rights defenders of this patient group are routinely threatened and punished for fulfilling their Hippocratic oath to this marginalized patient community. Despite this institutionalized obstruction to care, tens of thousands of patients with persistent and complicated Lyme and relapsing fever borreliosis have regained quality of life, manage their illness and have become productive and contributing members of society by overcoming these obstructions and gaining access to extended treatments that meet internationally accepted standards for clinical guidelines.</h3>
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The widespread discrimination experienced by Lyme and relapsing fever patients has been systemic and institutionalized across ICD codes, national health policies and medical and insurance systems. Altogether, these factors have led to gross human rights violations that are on record with the United Nations Human Rights Council’s Special Rapporteur for the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.</h3>
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<strong style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> ###</strong></h3>
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[1] The full presentation is available for viewing on youtube: <a href="https://www.youtube.com/watch?v=LLIO0r1mCcE" style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; color: #827be9; cursor: pointer; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: normal; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration-line: none; vertical-align: baseline; word-wrap: break-word;" target="_blank"><strong style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">https://www.youtube.com/watch?v=LLIO0r1mCcE</strong></a> (titled: Jenna Luché-Thayer: Addressing Systemic Obstacles in the Borreliosis Pandemic)</h3>
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[2] <u style="border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Updating ICD11 Borreliosis Diagnostic Codes</u> Authors: Jenna Luche-Thayer, Holly Ahern, Dominick DellaSala, Sherrill Franklin, Leona Gilbert, Richard Horowitz, Kenneth Liegner, Clement Meseko, Mualla McManus, Judith Miklossy, Natasha Rudenko, Astrid Stuckelberger. Contributing researchers: Joseph Beaton, John Blakely, Phyllis Freeman, Kunal Garg, Huib Kraaijeveld, Vett Lloyd, Leena Merilainen. Cees Hamelink - Senior Advisor, Jeff Levy - editorial support, Angelica Johannson - organizational support. Publisher: CreateSpace Independent Publishing Platform (October 7, 2017). ISBN-10: 1978091796 and ISBN-13: 978-1978091795</h3>
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[3] The report is <a href="https://www.amazon.com/UPDATING-ICD11-Borreliosis-Diagnostic-Codes/dp/1978091796/ref=sr_1_1?ie=UTF8&qid=1510784455&sr=8-1&keywords=updating+icd11+borreliosis+diagnostic+codes" rel="nofollow noopener" style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; color: #827be9; cursor: pointer; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: normal; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration-line: none; vertical-align: baseline; word-wrap: break-word;" target="_blank"><strong style="background-attachment: initial; background-clip: initial; background-image: initial; background-origin: initial; background-position: initial; background-repeat: initial; background-size: initial; border: 0px; font-family: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">now available on Amazon</strong></a> and all proceeds support the voluntary work by the Committee.</h3>
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[4]Medically Unexplained Symptoms or MUS has been repudiated by the American Psychiatric Association (APA) and removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM). </h3>
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Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com0tag:blogger.com,1999:blog-3707770726760676731.post-51058928604889296642017-11-05T14:16:00.000+00:002017-11-06T09:12:21.907+00:00NICE DRAFT LYME DISEASE GUIDELINES SHAME UK MEDICINE<div dir="ltr" style="text-align: left;" trbidi="on">
<span style="font-family: "verdana" , sans-serif;"><b>CONCLUSION TO THE VIRAS STAKEHOLDER COMMENTS</b> </span><br />
<span style="font-family: "verdana" , sans-serif;"><br />In view of the extraordinary number of opportunities that these NICE (National Institute for Health and Care Exellence) guidelines provide for putting
doctors and patients at serious risk, it is essential for all interested parties to be aware that NICE
take no responsibility for any misleading information or dangerous advice included in their
guidelines. Here is a typical NICE Guidance disclaimer:</span><br />
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;"> “Health care providers need to use clinical judgement, knowledge and expertise when deciding
whether it is appropriate to apply guidances. The recommendations cited here are a guide and
may not be appropriate for use in all situations. The decision to adopt any of the
recommendations cited here must be made by the practitioners in light of individual patient
circumstances, the wishes of the patient, clinical expertise and resources. The National Clinical
Guideline Centre disclaims any responsibility for damages arising out of the use or non-use of this
guidance and the literature used in support of this guidance.”
(https://www.nice.org.uk/guidance/cg138/evidence/full-guideline-pdf-185142637) </span><br />
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;">Whilst NICE have discarded a wealth of research and evidence as unsuitable in preparing their
guidance, that same evidence may nevertheless stand-up in court.</span><br />
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;"><span style="color: red;"> Examples of foreseeable
harms to patients are: if and when the restrictive treatment recommendations fail to eradicate a
Lyme infection and a patient suffers injury as a result, or, if and when laboratory testing deprives
a patient of a necessary diagnosis and treatment, and they suffer injury as a result.</span> </span><br />
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;">Then the
evidence that has been ignored may receive a fair hearing in legal proceedings, especially as
much of this information comes from very experienced scientists and physicians. Harms to
patients and complaints against doctors are not just predictable, they are inevitable if doctors with
Lyme disease patients follow the advice as presented in the draft form. However, none of this is
any consolation to doctors who do not want to spend their time dealing with GMC complaints and
law suits, but who simply want to help their patients based on a balanced presentation of the
available pool of knowledge.</span><br />
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;"><span style="color: red;">VIRAS and others have provided ample evidence of foreseeable harms resulting from
misleading advice about Lyme disease. NICE may wash their hands of any responsibility
by claiming that individual doctors are responsible for their clinical decisions, but they can
and will be held to account for negligently misleading the public and government
agencies, discriminating against sick and disabled patients, and permitting their
procedures to be exploited by groups and individuals with competing interests.</span> </span><br />
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;">Doctors do not have to follow NICE guidelines but they must be able to justify their clinical
decisions. The USA Centers for Disease Control and Prevention (CDC) now estimate that they
have over 300,000 cases of Lyme disease per year. Some of the most experienced and
knowledgeable Lyme disease doctors and scientists in the USA have produced reliable and
trustworthy advice on the management of diverse aspects of Lyme disease. For doctors who
want a thorough understanding of Lyme disease medicine, including the limitations of current
18
knowledge, VIRAS recommends the authoritative resources listed here: </span><br />
<span style="font-family: "verdana" , sans-serif;"><a href="http://www.ilads.org/Lyme/treatment-guideline.php">http://www.ilads.org/Lyme/treatment-guideline.php</a></span><br />
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;">VIRAS reject the NICE draft guideline as unfit for purpose. It contains some downright dangerous
advice and too many contradictions to even form the basis of a semi-reasonable guideline. It is
biased, discriminatory and appears to be designed to serve undeclared agendas. It implies
certainty where there is none. Where it admits uncertainty it omits to provide balanced views to
allow doctor’s and patients to make informed choices and give informed consent as is required in
the practice of medicine in the UK. This makes the draft unethical. It evades awkward and
potentially embarrassing issues such as the inaccuracy of testing provided by the NHS, which it
misrepresents with false assurances. It evades the serious medical issues of chronic Lyme
disease, coinfections, misdiagnosis of Lyme as some other condition, and inadequate treatment.
The guideline is not quantitative or qualitative or a rational amalgam of both. It is bereft of
scientific discipline or basic humanistic and medical values.</span><br />
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;">NICE should have halted the process and rejected the task of producing a guideline when it
became apparent that the vast majority of research did not meet the threshold for inclusion.
Instead, it has produced a draft based on just a tiny and biased proportion of decades of
research. The draft guideline is irrelevant to 99% of UK Lyme patients who would be harmed by
its publication. The number and nature of the Research Recommendations clearly shows that not
enough is known to produce a guideline that could remotely approach the required standards for
NICE Guidance. These Research Recommendations relate to absolutely basic medical science
concerned with the diagnosis, treatment and management of Lyme disease. Without good data
to work with, or a balanced presentation of all the evidence available, the end product could only
ever be a self-contradictory and impractical mess. </span><br />
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="color: red; font-family: "verdana" , sans-serif;">Thousands of UK Lyme disease patients have been obliged to take matters into their own hands
due to the ignorance and incompetence of Public Health England. PHE (incorporating the HPA)
have actively obstructed the diagnosis and treatment of Lyme disease patients for decades. The
victims of this discrimination have been forced to either accept terrible illness which for many,
represents a life-sentence of loss and suffering, or to seek medical help elsewhere. Patients
spend their often meagre income and all their savings to get accurate tests and treatment that
have been denied to them by the NHS. </span><br />
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;">The outcome of the treatment that they are forced to pay for, may not always be the cure that
they sought. This is partly due to the incompetence that has delayed their diagnosis and
treatment for months, years or even decades. Yet for many, their treatment brings great relief.
Some of the appalling chronic symptoms improve or resolve completely. Physical and mental
functioning which could have been reduced to just a tiny percentage of their pre-Lyme infection
levels, are substantially improved and can be maintained with treatment. These patients KNOW
what PHE policies have done to them and are doing to others. They will recognise the PHE
official position on Lyme disease permeating the NICE draft guideline. They are not paranoid or
conspiracy-theorists, they know from their own lived experience that Lyme disease is a national
health threat that is being controlled by vested interests that disregard their Human Rights and
the fundamental tenets for the practice of medicine. It is in spite of PHE that many of these
patients have improved health, and such is the suffering that many have endured, they do not
want others to have a similar experience. With the finest motives that grace humanity, even
though their health and fitness may still be just a sad remnant of the energy they once enjoyed,
they give of that time and energy to help others who will otherwise be doomed by PHE to the
living hell of chronic Lyme disease. </span><br />
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;"><br /></span>
<span style="color: red;"><span style="font-family: "verdana" , sans-serif;">The draft guideline shames UK medicine and will bring the good names of the NHS and
NICE into disrepute. The danger to patients is obvious. This confused and confusing
guide will predictably harm patients and threaten the reputation and values of doctors who
place their trust in it</span>. </span><br />
<br />
<br />
<span style="font-family: "verdana" , sans-serif;">The above is the Conclusion, the Summary can be read in full from the VIRAS (<span style="background-color: white;"> </span></span><span style="background-color: white; color: #003399; font-family: "arial" , "helvetica" , sans-serif; font-weight: bold;">Vector-borne Infection - Research, Analysis, Strategy)</span><span style="background-color: white; color: #003399; font-family: "arial" , "helvetica" , sans-serif; font-weight: bold;"> </span><span style="font-family: "verdana" , sans-serif;">website.</span><br />
<span style="background-color: white;"> </span><br />
<span style="background-color: white;"><br /></span>
<span style="background-color: white;"><a href="http://counsellingme.com/VIRAS/NICE/VIRAS_stakeholder_comment_summary3.pdf" style="font-family: Arial, Helvetica, sans-serif;">Summary of VIRAS response to NICE Draft Guideline for Lyme Borreliosis</a><span style="font-family: "arial" , "helvetica" , sans-serif;"> available</span></span><br />
<span style="background-color: white;"><span style="font-family: "arial" , "helvetica" , sans-serif;"> </span></span><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="http://counsellingme.com/VIRAS/VIRAS.html" target="_blank">http://counsellingme.com/VIRAS/VIRAS.html </a></span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span>
<span style="font-family: "verdana" , sans-serif;">the Draft Nice Guidelines for Lyme Disease.</span><br />
<span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="https://www.nice.org.uk/guidance/indevelopment/gid-ng10007/consultation/html-content-2">https://www.nice.org.uk/guidance/indevelopment/gid-ng10007/consultation/html-content-2</a></span><br />
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Joannehttp://www.blogger.com/profile/12905137222286141548noreply@blogger.com3