Infection of mice with Borrelia burgdorferi causes an inflammatory arthritis that peaks 3-4 wk postinfection and then spontaneously resolves. Although the recruitment of neutrophils is known to drive the development of arthritis, mechanisms of disease resolution remain unclear. Efficient clearance of apoptotic cells (AC) is likely an important component of arthritis resolution. In this article, we show the number of AC increases in the joints of B. burgdorferi-infected mice around day 21 postinfection and peaks around day 28. Injection of AC directly into the ankles of B. burgdorferi-infected mice limited ankle swelling but had no effect on spirochete clearance or arthritis severity scores. In vitro, addition of AC to bone marrow macrophage cultures decreased B. burgdorferi-induced TNF-α and KC and increased IL-10. In addition, phagocytosis of B. burgdorferi and neutrophil migration to LTB4 were inhibited by AC. Exogenous AC caused an increase in peroxisome proliferator-activated receptor-γ (PPAR-γ) expression both in vitro and in vivo during B. burgdorferi infection. The PPAR-γ agonist rosiglitazone elicited similar changes in macrophage cytokine production and neutrophil migration as exogenous AC. Addition of the PPAR-γ antagonist GW 9662 abrogated the effects of AC in vitro. Injection of rosiglitazone directly into the tibiotarsal joints of B. burgdorferi-infected mice decreased ankle swelling and immune cell recruitment, similar to the injection of AC.
These results suggest that clearance of AC plays a role in the resolution of inflammation during experimental Lyme arthritis through the activation of PPAR-γ. PPAR-γ agonists, such as rosiglitazone, may therefore be effective treatments for inducing arthritis resolution.
When cells recognize viruses and gene mutations, they may induce death to prevent the damage from spreading. In apoptosis the cell shrinks and sends out distress signals, which are answered by vacuum cleaners known as macrophages. The macrophages clean away the shrunken cells, leaving no trace.
Scientists are trying to learn how to modulate apoptosis, so that they can control which cells live and which undergo programmed cell death. Many diseases and disorders are linked with the life and death of cells such as AIDS & Parkinson’s. Decreased apoptosis can be a signal for lupus or cancer.
In the study above, they state that injecting the diabetic drug rosiglitazone (reduces blood glucose) into Bb infected mouse joints reduced swelling & immune cell recruitment similarly to injecting of apoptic cells.
Most interesting; however, is the admission that the injection of AC had no effect on spirochete clearance or arthritis severity scores.
So the question becomes once again, is getting rid of inflammation/swelling the sole issue for those of us “chronically/persistently” infected or is spirochete clearance important?
I predict that while rosigliazone might help with inflammation and pain (like so many other substances),spirochete clearance is still important.
This study begs the answer to what is causing persistent symptoms. I think it also important to suggest it may be a number of factors and it may vary from patient to patient.
If there’s one thing I’ve learned about Lyme/MSIDS, it’s that it is highly variable & complex.
ROBERT HERRIMAN WITH OUTBREAK NEWS INTERVIEWS GLA’S CHIEF SCIENTIFIC OFFICER TIMOTHY SELLATI, PH.D. TO DISCUSS LYME DISEASE, THE TICK-BORNE DISEASE WORKING GROUP, AND THE IDSA
Read the complete transcript below or listen to the podcast:
Approx. 15 Min.
Robert Herriman: Well hey everybody, this is Robert, and welcome to Outbreak News Interviews. Now the Federal Tick-Borne Disease Working Group recently released their first report to Congress about one year after the panel first convened. The Infectious Disease Society of America, or the IDSA, responded to the report in a letter that contained some criticisms of the report. So what is the Federal Tick-Borne Disease Working Group, what’s in the report, and what did the IDSA have to say? Well joining me to discuss these issues is Chief Scientific Officer for the Global Lyme Alliance, Timothy Sellati, Ph.D. Dr. Sellati, welcome to the show, sir.
Timothy Sellati: Thank you for having me.
Robert Herriman: You bet. So Dr. Sellati, let’s go ahead and start out with some basics ’cause some people may not be aware of this. What is the Federal Tick-Borne Disease Working Group, what’s their mission, and what’s the personnel composition of this group?
Timothy Sellati: So the Working Group was established as part of the Congress’s passage of the 21st Centuries Act, back in December 2016. The intent of that Act was to promote new healthcare initiatives for addressing array of public health issues, and one in particular was the advancement of research on tick-borne diseases. So with that as a backdrop, the US Department of Health and Human Services established the Federal Advisory Committee, the Tick-Borne Disease Working Group. So the Working Group is comprised of 14 voting members, there were seven public members and seven Federal members, and the composition of the Working Group was really drawn from a diverse group of professions. We had individuals that are world renounced research scientists, and physicians from top tier academic institutions and hospitals, subject matter experts from government agencies, as well as key stakeholders from the public sector including patients, and their advocates from several Lyme and other tick-borne disease nonprofit organizations.
Robert Herriman: Okay. So they recently released their first report, it’s a pretty hefty 108-page document. Dr. Sellati, what did you find good and important in the report?
Timothy Sellati: So I think some of the most important or key recommendations out of the report really related to epidemiology, and ecology, that was one of the subcommittees of the Working Group. And there, it was really driven home, the idea that Lyme disease surveillance criteria, which is a criteria that the CDC the Centers for Disease Control and Prevention, use for calculating the number of Lyme disease cases that occur annually. Those really should be used for surveillance purposes alone, and not for diagnostic purposes. The other important take home message from the prevention subcommittee was a focus on development of anti tick feeding vaccines, and really trying to work with key stakeholders to build trust via transparent mechanism to help examine and discuss the past Lyme disease vaccine activities, what some of the issues were with it, and the potential for adverse events so that that information coming from a number of different sources could help inform future vaccine development in Lyme disease. In terms of diagnosis, the real take home message was the importance of evaluating new technologies or approaches for the diagnosis of Lyme disease and other tick-borne diseases because of the inherent limitations with the current two-tier testing method. And the importance of including children in the process of diagnostic test validation as well, because children are particularly prone to the devastating consequences of dealing with Lyme disease, or other tick-borne diseases.
Timothy Sellati: In terms of treatment, I think conduct of additional clinical trials using appropriate target populations where gaps may exist. And there really, the glaring gap is with respect to patients, that experience, persistent symptoms and disability and diminished quality of life following the current standard of care, which is 10 to 28 days of antibiotics. So it’s really important to understand, this really came through as the overall gestalt of the report, that Lyme disease can be treated with antibiotics, but as many as 10% to 20% of infected individuals do not respond favorably to those antibiotics, so they go on to develop what we call Post Treatment Lyme Disease Syndrome, or in some circles, chronic Lyme disease. And so it’s really important to really address that gap in our understanding of how best to treat that patient population.
Timothy Sellati: And then the one last thing, and this was really a common theme that came out of all of the subcommittees’ reports, was the need to allocate increased funding for tick-borne diseases in the areas of research, treatment, and prevention, and have it really pegged to the burden of illness. So proportionally, there is much less federal funding to tackle tick-borne diseases than there are funding for other infectious diseases where the number of cases per year are considerably smaller.
Robert Herriman: Yeah. Now, were you 100% on board with everything in the report, or were there any issues that you had a problem with?
Timothy Sellati: I didn’t have any issues per se, with the report, as much as a concern about one of the recommendations. And this related to the protection of the rights of license and qualified clinicians to use individual clinical judgment to diagnose and treat patients in accordance with the needs and goals of each individual patient. I’m sort of reading that, verbatim almost, and while I don’t have any concerns about allowing licensed and qualified clinicians to care for their patients as they see fit, I also recognize that as a result of desperation on the part of some patients that have dealt with Lyme and other tick-borne diseases for years, if not decades, they are driven to seek out medical care from clinicians using treatment options that have not been carefully vetted by the scientific research establishment, or the medical research establishment. And so there’s a concern that there are some treatment options out there that really have not been proven to effectively treat the symptoms or the diseases that these desperate patients are dealing with.
Robert Herriman: Not too long after the release of the Working Group’s report, the IDSA sent a letter to DHHS Secretary Alex Azar, and it contained some criticisms of the report. You responded to the letter in a post on the Global Lyme Alliance website. Can you spend some time talking about that?
Timothy Sellati: Sure.
Some of the criticisms leveled by the IDSA that really caught my attention was that they had significant concerns with the Working Group’s lack of transparency, and minimal opportunities for meaningful public input. And I just didn’t understand the basis for that criticism, given that the Working Group was really comprised of so many different subject matter experts, and physicians that are treating patients, and the patients themselves, that I think the greater concern on the part of IDSA is that perhaps they didn’t have as much input into the report, or the content of the report, that came out of the Working Group’s extensive efforts.
Timothy Sellati: The IDSA also suggested that some of the recommendations of the working group would “cause significant harm to patients in public health,” and they really urged Alex Azar to ensure that the Federal government response to tick-borne disease’s fallacy rooted in the best available scientific evidence. And you know, part of the problem is in the controversy surrounding Lyme disease, is that the IDSA takes a strict parochial approach to considering Lyme disease, and the consequences of infection with bacteria that causes Lyme disease. From their perspective, they think Lyme disease, or promulgates this idea that Lyme disease is easily treated, and it’s easily diagnosed, and only very rarely does it result in lasting consequences of infection. But there is more and more well established scientific evidence in the main stream literature that argues against that very narrow understanding or narrative that IDSA wants to push forward.
Robert Herriman: Now, going to your first point, on the Working Group, is there any former or current IDSA members on that Working Group? I mean, do you know that?
Timothy Sellati: Yes, I believe there are.
Robert Herriman: Okay.
Timothy Sellati: I believe there are. But on the flip side, there are also, from what I understand, members of the ILADS organization as well. The composition of the subcommittees also was careful to include research scientists and physicians that really span the spectrum from IDSA on one of the end of the spectrum, to ILADS on the other. So I really do think that within the limited, within the capabilities of the Working Group, they were as intent as possible, in terms of hearing the voices of a wide variety of individuals. And again, to some extent, maybe IDSA would like to have had a larger bullhorn in terms of influencing the Working Group’s final report to the Congress.
Robert Herriman: So I just take it from your previous answer, that you don’t think most of the IDSA criticisms really hold a lot of water?
Timothy Sellati: No. No, I really don’t. And that’s what really spurred me to write this rebuttal in the first place. Again, I believe many of IDSA’s criticisms stem from the fact that the overall content of the report doesn’t necessarily fit into their mantra that Lyme disease is easy to diagnose, it’s easy to treat, and only very rarely results in lasting consequences of infection. So when you come into trying to solve a problem with that mindset, it limits how you approach trying to solve that problem.
Robert Herriman: Okay. Well, for the audience if you haven’t seen any of this, I will put up a link to Dr. Sellati’s rebuttal on the website when I publish the podcast, and I’ll also put up a link to the IDSA letter, and you can read it, and you can judge for yourselves. Dr. Sellati, any final thoughts on any of these issues?
Timothy Sellati: Yes, I’m glad you asked. So there is one final thought. As far as the report is concerned, I think there was a very important section in the report titled, “Looking Forward,” and in my opinion, I think one of the most important take home messages from that section was the need to develop and disseminate more comprehensive clinical education that highlights the diversity of symptoms that Lyme and other tick-borne disease patients might present with, expand the geography of infecting tics, and also the limitations of the current testing procedures. So I think if we do a better job of communicating to clinicians, and maybe even at the level of medical school students, the complexity of Lyme disease, and what some of the true limitations are in terms of prevention, diagnosis, and treatment, they will be better prepared to take care of the diversity of patients that they see during their practice.
Robert Herriman: Well very good. Well, I wanted to thank you Dr. Timothy Sellati for joining me to discuss these very important issues, I appreciate it, sir.
Borreliosis after sucking ticks is an acute problem in the world. People do not go to doctors after that often, which leads to the development of various complications. Thrombosis of veins of various localization can be one of them. Thrombosis of the portal vein represents a significant problem too with high morbidity and mortality. The risk factors for splanchnic vein thrombosis include infections, but its relationship with borreliosis has not been studied.
А 34-year-old man with chronic helicobacter-associated gastritis and gallstones was hospitalized due to development during the last 11 days of epigastric pain and fever to 38.7 °C after a picnic at the forest without a registered tick bite. The blood leukocytes were increased to 11.2*109/l, lymphocytes 70%, C-reactive protein 34.6 mg/l, procalcitonin 0.195 ng/ml. The multispiral computed tomography of the abdominal cavity revealed thrombosis of portal, lienalis and superior mesenteric veins. D-dimer was 1.98 mcg/ml, antithrombin III 75%. JACK2V617F, oncological, rheumatic, thrombophilia markers, blood and urine cultures were negative. A high concentration of anti-Borrelia burgdorferi IgM 62.2 U/ml and its increasing to 190 U/ml in dynamics was revealed at the immunofluorescence assay. Anti-Borrelia IgM to OspA, p31 and OspC, p25 were detected at the immunoblotting assay.
Anticoagulation, doxycycline, detoxification therapy reduced pain and normalized temperature and inflammation markers. Vein thrombosis was not detected at the control tomography after 2 weeks. Despite that the combination of thrombosis and borreliosis is rare, it is necessary to screen for Borrelia antigens in patients with splanchnic vein thrombosis and fever.
For PVT, doctors recommend anticoagulant drugs — blood thinners such as heparin. If PVT, as in this case, is caused by an infection, antibiotics will also be prescribed to cure the source of the problem.
Interestingly, heparin helps many MSIDS patients:
http://aac.asm.org/content/48/1/236.full.pdf Similarly with Bartonella, some respond miraculously to Heparin, which is a blood thinner. In the above link, heparin was found to inhibit Babesia growth. Horowitz also found it helps clear the parasites from the body.
Heparin helped my husband immensely. His blood looked like snot and continually clotted in catheters.
Interestingly, the authors state that vein thrombosis caused by borreliosis has not been studied, yet emphatically state that the combination of thrombosis and borreliosis is rare.
This is the bizarre disconnect patients live through.
In December of 2018, the Tick-Borne Disease Working Group released its first report to Congress regarding the epidemic of emerging disease. This article gives a basic rundown of relevant statements contained in the first of three TBDWG reports to Congress.
What is the Tick-Borne Disease Working Group?
The TBDWG is a fourteen-member panel of infectious disease professionals called together in light of the 21st Century Cures Act and organized by the Department of Health and Human Services. This group is tasked with reviewing the current science and treatment progress of the various tick-borne diseases and reporting their findings to Congress every two years in December. December 2018 saw the first report, there will be a second report in December 2020 followed by final recommendations at the end of 2022.
So what does this first report detail regarding Morgellons disease? Let’s dive in and find out!
Chronic Lyme Disease
At the start of the first TBDWG report it is stated,
“While most Lyme disease patients who are diagnosed and treated early can fully recover, 10 to 20% of patients suffer from persistent symptoms, which for some are chronic and disabling. Studies indicate that Lyme disease costs approximately $1.3 billion each year in direct medical costs alone in the United States.”
Sounds promising, but what about the insensitive testing methods? What does the report say about early diagnosis and why there are so many false negatives? Amazingly the report addresses these concerns directly, “Today, available diagnostic tests can be inaccurate and complex to interpret, especially during the earliest stage of infection when treatment is most effective. Unlike in other infectious disease settings, tests to directly measure the presence of the infecting organism, such as cultures or tissue biopsies, are not available for some tick-borne diseases such as Lyme disease. This leaves physicians without the tools needed to diagnose; and without an accurate diagnosis, it is challenging for physicians to provide early treatment.”
Wow! With that kind of admission about standard Lyme testing, you would expect similar honesty regarding other controversial aspects of Lyme disease. What about congenital transmission then, what does this report state about Lyme infecting unborn children?
Lyme Congenital Transmission
From the report, the sole instance of recognition appears on page 53 in the chapter titled “Treatment”. It states,
“Pregnancy: Transplacental infection of the human fetus has been recognized for relapsing fever borreliosis, as well as Lyme disease, babesiosis, and certain arthropodborne flaviviruses. Pregnancy poses particular challenges for treatment because few antimicrobials have been approved and are safe to use during pregnancy. Additional research into appropriate treatment options are needed.”
It’s right there in black and white and from the red, white and blue state of American Freedom and Democracy! Why then would the World Health Organization remove such an apparent consideration from its medical coding system?
But what about Morgellons specifically? What does this report elicit about those afflicted with this particular skin manifestation that’s been thoroughly associated with tick-borne disease?
What’s in the report for Morgellons?
Keyword analysis of the report reveals seventeen instances of the term “skin” speckled throughout. The first instance is regarding frequent skin lesions that occur early in the infectious process. It continues to state that with early treatment the better prognosis can be achieved. While that’s great and everything, what else does it say about skin lesions that may be particularly relevant?
Morgellons Disease
The next two instances of “skin” in the report occur regarding utilizing skin agents to deter ticks from attaching to the skin. The following six instances regard the characteristic erythema migrans bullseye rash and that relates to early diagnosis. This section is interesting in that it elaborates on the many kinds of erythema migrans that can occur and gives a visual presentation of each. Still, none of these erythema migrans look anything at all like Morgellons ulcerations.
The tenth and eleventh occurrence of the term “skin” in the first of three TBDWG reports to Congress are of interest as they describe Figure 10 in the report, “Skin Rashes of Tick-Borne Diseases”. Figure 10.a depicts Tularemia which is a Tick-Borne Infection (TBI) that produces lesions in the skin. The difference between Tularemia and Morgellons, however, is Tularemia does not produce collagenous fibers, which are the defining characteristic of Morgellons disease.
Tularemia Lesion
Occurrence twelve describes how skin rashes present early in dissemination and appears alongside a figure that demonstrates how the IgM response falls off over time, leaving a patient with primarily elevated IgG antibodies.
“Skin” appears for the thirteenth and fourteenth time in the report regarding the challenges of diagnosing skin rashes in individuals with darker skin tone. This section stresses the importance of TBI education in areas where Lyme is not considered endemic, as a lapse in diagnosis can result in severe patient complications.
The fifteenth and sixteenth use of the term “skin” appear alongside information regarding how the disease disseminates from the skin to other organs of the body in the sixth chapter which details treatment. This section is completely fascinating, eliciting how infected patients are more susceptible to re-infection and how mice vaccinated against influenza produced a suppressed immune response to the flu in light of their infection with Borrelia burgdorferi.
If Lyme disease can suppress the immune response for diseases other than itself, what else can it accomplish?
The final instance of the term “skin” in the TBDWG report to Congress is alongside recognition of NIAMS, the National Institute of Arthritis and Musculoskeletal and Skin Diseases. We went to the NIAMS website and was not at all surprised to produce a lack of search results for the term “Morgellons“.
The first TBDWG Report is surprising. It’s not at all littered with propaganda and falsehoods that plague our esteemed medical establishments. Besides not directly addressing Morgellons the report does reveal several controversial facts about Lyme disease that many in official health agencies currently disagree about. This is a refreshing move in what could be considered a positive direction.
This report did not try to appease the establishment, but at the same time, it doesn’t explore the full extent of the Lyme pandemic. The fact is the fourteen members of the TBDWG have two more reports to produce, and we know for certain many of them are aware of the significance Morgellons has relating to their efforts.
If a grade was to be applied to the first report it feels like this initial effort deserves a solid B+.
A Conversation With the Parasite Guy, Dr. Todd Watts
Cindy Kennedy, FNP, is joined by Dr. Todd Watts, a chiropractor and functional wellness practitioner from Idaho. Many know him as the “Parasite Guy,” but he also has extensive knowledge of functional blood chemistry, biochemistry and in helping those with chronic illness overcome their struggles to restore their health.
Dr. Watts is the co-founder of Microbe Formulas and CellCore Biosciences and loves to research to formulate products which will change the world.
Dr. Watts was the first to bring Mimosa Pudica seed to the general health market in the United States. He has an amazing health journey which has led him to be able to help others.
