Here at Galaxy Diagnostics, we are often asked “Why do symptoms for bartonellosis vary between patients so much?” and “How do I know that my symptoms are related to Bartonella species infection?”

The simple yet frustrating answer for patients and physicians alike is that chronic flea- and tick-borne illnesses are complex and typically do not follow a predictable course. Multiple body systems can be affected, including the brain and heart, resulting in a broad spectrum of symptoms.

Furthermore, the same patient can experience symptoms that affect different parts of the body throughout the course of the infection. The spectrum of symptoms often creates a unique web that is specific to each patient and difficult to untangle.

How can a single species, like Bartonella henselae, cause these harmful symptoms in one patient while another infected person appears to be healthy?

Emerging research on bartonellosis and Lyme borreliosis is increasingly showing the role of the host response in mediating the diverse clinical symptoms that patients present with. The host response is the way the infected individual’s immune system responds to cellular/tissue damage (pathology) caused by a pathogen. Some patients may have a more extreme immune response to the damage, resulting in a higher degree of inflammation and a related set of symptoms. Likewise, immune-deficient patients may experience more symptoms caused by the pathogen.

Factors that affect the host response to a pathogen include:

• Immune status (immunocompetent vs. immunocompromised)
• Genetic variances
• Previous and current immune exposures (pathogens, proteins, etc.)
• General health and well-being (stress, nutritional status, etc.)

For Bartonella henselae, the effect of host immune response was shown in extensive research conducted on HIV patients in the 1990s. Symptoms in immune-deficient patients may be atypical and unexpected. For example, researchers found that HIV patients infected with Bartonella henselae, or cat scratch disease, experienced bacillary angiomatosis and bacillary peliosis at a higher rate than immunocompetent patients.

The host response can continue to cause symptoms after a pathogen is gone. Recently, a study showed that arthritic symptoms persisted in mice infected with Borrelia burgdorferi. The researchers found that the mice developed an irregular immune response that resulted in T-cells targeting joint tissue even after the bacteria were eliminated. This aberrant immune response is like that seen in autoimmune diseases where the body is basically attacking itself.

Other recent research has suggested that measles infection can suppress the immune system for up to three years, leading to other illnesses. Meanwhile, parasitic worms that suppress the immune system may reduce heart disease in some communities. The immune system itself is extraordinarily complex, and identifying these influences is only the start of understanding how it is modulated by different exposures.

The web of influences on the host response is only just beginning to be understood, including the influence of flea and tick-borne pathogens in chronic symptoms. A better understanding of the host response, better genetic and biomarker tools to measure it, and better diagnostic tools to determine exposure and current infection of a wide variety of pathogens is necessary to overcome today’s frustrations and develop personalized treatments that will improve health.

References

Chaplin, D. D. (2010). Overview of the immune response. The Journal of Allergy and Clinical Immunology, 125(2, Suppl 2), S3-S23. doi:10.1016/j.jaci.2009.12.980 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2923430/

Resto-Ruiz, S. et al. (2003). The role of the host immune response in pathogenesis of  Bartonella henselae. DNA and Cell Biology, 22(6), 431-440. doi:10.1089/104454903767650694 https://www.liebertpub.com/doi/pdf/10.1089/104454903767650694

Lantos, P. M. et al. (2014). Detection of Bartonella species in the blood of veterinarians and veterinary technicians: A newly recognized occupational hazard? Vector-Borne and Zoonotic Diseases, 14(8), 563-570. doi:10.1089/vbz.2013.1512 https://www.liebertpub.com/doi/abs/10.1089/vbz.2013.1512

Carroll, L. (2018). Malfunctioning immune system may explain chronic Lyme symptoms. Today.com. Retrieved from: https://www.today.com/health/chronic-lyme-may-be-due-malfunctioning-immune-system-t122207

Huber, B. R. (2015). A deadly shadow: Measles may weaken immune system up to three years. Retrieved from: https://www.princeton.edu/news/2015/05/07/deadly-shadow-measles-may-weaken-immune-system-three-years

Gupta, S. (2019). Life lessons from the native tribe with the healthiest hearts in the world. CNN.com.Retrieved from: https://www.cnn.com/2019/04/19/health/bolivia-heart-disease-chasing-life-gupta/index.html

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**Comment**

I obviously missed this article when it was written in May.  I post it here because it brings up important points for consideration.

1. Is the Lyme patient coinfected with other pathogens? Research has shown that this issue of being coinfected is a reason for immune suppression, setting the patient up for a tougher case. Mainstream medicine still hasn’t grasped this fact. They are throwing the mono-therapy of doxycycline at this which is a joke when you stop and ponder it.  While doxy is a great front-line drug, it will not touch Babesia in 1,000 years – nor parasitic worms for instance.
2. Past pathogen exposure. Similarly to vaccines being able to reactivate latent infections, tick/insect bites are nature’s dirty needle and can also potentially activate latent infections be they bacterial or viral. Again, mainstream medicine has its head in the sand.
3. Chronically infected patients do not follow a predictable course. Mainstream medicine still believes that Bartonella (Cat Scratch Fever) is a simple disease that only affects those with compromised immune systems – specifically HIV.  They also believe that in most people it is easily cured.  My experience as a Lyme/MSIDS patient and advocate that it is even more persistent than Lyme disease – the pathogen that gets all the news coverage.
4. There is the issue of persistent symptoms.  While research has shown that host response is to blame for some patients, the issue of persistence of the organism still has not been fully embraced and accepted.  For a great read on this: https://madisonarealymesupportgroup.com/2019/02/25/medical-stalemate-what-causes-continuing-symptoms-after-lyme-treatment/  There are over 700-peer reviewed research articles showing persistence that somehow isn’t being reviewed by most doctors: Peer-Reviewed Evidence of Persistence of Lyme:MSIDS copy
5. The general health of the patient is important. This is true of all disease but particularly with tick-borne illness as this monster goes everywhere in the human body causing havoc.  I’ll never forget Dr. Burrascano’s words regarding Lyme/MSIDS patients, “Now is the time for pristine health habits.” Truer words were never spoken.