Archive for the ‘research’ Category

Have We Finally Reached a Lyme Research Tipping Point?

https://www.lymedisease.org/lyme-research-tipping-point/

Sept. 16, 2021

If there were such a thing as an Olympic competition for Lyme research, I have a pretty good idea who would be on Team USA.

A recent paper entitled “Recent Progress in Lyme Disease and Remaining Challenges,” co-authored by 31 researchers from 19 separate institutions, reads like an all-star lineup of Lyme disease researchers.

The authors include many names familiar to the Lyme community including: Monica Embers, PhD, John Aucott, MD, Kim Lewis, PhD, Ed Breitschwerdt, DVM, DACVIM, Nicole Baumgarth, DVM, PhD, and Brian Fallon, MD.

The lead author, Jason Bobe MSc, is an associate professor in the genetics and genome science department at the Icahn School of Medicine at Mount Sinai in New York City.

Bobe is part of Mount Sinai’s Resilience Project. It seeks to discover why some people are more able than others to resist or recover from certain illnesses, including Lyme disease.

Recent advancements in Lyme disease

This paper does an excellent job of summarizing the advancements in Lyme and tick-borne diseases over the past five years. It also identifies gaps in knowledge, remaining challenges, the need for additional funding and further research.

The paper paints a comprehensive picture of what causes acute Lyme disease, including immune activation, dissemination, and inflammation.  In addition, it looks at newly discovered biological markers that may aid in the development of improved diagnostics.

Included is a detailed description of several potential causes of symptoms of Lyme disease that persist after standard treatment. The authors propose that the most salient hypotheses are “persistence of infection or antigenic debris, persistence of inappropriate immune activation and inflammation, or some combination of these.”

Topics covered in the publication includes the weakness of current standard Lyme disease diagnostics and a review of several emerging diagnostic assays. Included in the section on treatment is a review of recent drug discoveries and complementary therapies, including natural and botanical medicines.

Direct detection test for Lyme?

Another co-author, Brandon Jutras PhD, is an assistant professor of biochemistry in the Virginia Tech College of Agriculture and Life Sciences. His team is working to develop a new direct diagnostic test for acute Lyme disease.

In 2019, Jutras discovered that Borrelia burgdorferi sheds peptidoglycan, a mesh-like substance that forms the cell wall of the bacteria once it invades the human body. Although all bacteria have peptidoglycan, many do not shed it.

“Current Lyme disease diagnostics are indirect, meaning that the tests are detecting antibodies produced by the human in response to the infection, rather than detecting the bacteria itself,” said Jutras. “This method is prone to error and relies on the individual’s immune system, which can take weeks to make enough antibodies to detect, not to mention that everyone’s immune system is different.”

“We are trying to develop and critically test a procedure whereby we detect peptidoglycan, which is a unique piece of the bacterium that causes Lyme disease,” said Jutras. “The piece is a specific and abundant fragment that may act as a direct biomarker for an active infection and, in theory, be detectable within hours of transmission from an infected tick.”

Other Lyme research

Portions of the paper include research done by the authors. Some highlights include:

  1. Monica Embers showing Lyme persists after a standard course of antibiotics, Lyme spirochetes in multiple organs after antibiotics, and Lyme spirochetes in an autopsied brain (despite treatment).
  2. John Aucott, ongoing research as Director of the Johns Hopkins Lyme Disease Research Center, including examining why brain inflammation persists after Lyme disease treatment.
  3. Kim Lewis’ work on eradicating drug-tolerant infections as well as his new investigation into the gut microbiome as it pertains to persistent Lyme disease.
  4. Brain Fallon’s decades of research on neurological Lyme which will be continuing at Columbia University’s new Cohen Center for Health and Recovery from Tick-Borne Diseases.
  5. Nicole Baumgarth’s research into how Lyme spirochetes evade the immune system.
  6. Ed Breitschwerdt and Richard Maggi’s decades of work on developing treatment for Bartonella and other co-infections.

The authors also encourage collaborative efforts like that being done by co-author Liz Horn, PhD, the principal investigator at the Lyme Disease Biobank (LDB). The LDB was created by the Bay Area Lyme Foundation and has partnered with the National Disease Research Interchange as well as LymeDisease.org’s MyLymeData research project.

Need for federal funding

The authors highlight the urgent need for adequate federal funding to “support advancement in the scientific and clinical understanding of the disease, or to develop and evaluate innovative approaches for prevention, diagnosis, and treatment.”

The paper reads like a summary of all 14 of the previous Tick-borne Disease Working Group (TBDWG) sub-committee reports generated by the 2018 and 2020 working groups. If you’ve read any of the TBDWG sub-committee reports (some of them over 100+ pages long), you know this summary was a heavy lift.

Monica Embers was recently appointed to the 2021-2022 TBDWG. I hope this paper will be required reading for the 13 other members!

“It is very exciting to have the opportunity to shape future funding priorities regarding tick-borne disease research and response,” said Embers. “I’d like to see more of an emphasis on the neurological impacts of Lyme disease and a renewed commitment to improving how we diagnose and treat the disease.”

Outline

To summarize the entire paper would be difficult as it is over 80 pages long, with nearly 350 references, and swimming in deep science. If you are interested in a particular topic, I have provided an outline and a link to the paper below.

The topics included in this paper include:

  1. Introduction
  2. Clinical and Translational Medicine
    1. Diagnosis
      1. Exposure to Ticks
      2. Serological Testing
      3. Signs and Symptoms
      4. EM Lesion
      5. Direct Detection of Bb
      6. Emerging Diagnostics
    2. Treatment
      1. Drug Discovery and Preclinical Studies
      2. Complementary Therapies
    3. Well-Defined LD Patient Subgroups With Posttreatment Sequelae
      1. Antibiotic Refractory Lyme Arthritis
      2. PTLD
  3. Fundamental Knowledge
    1. Genomic Insights From Borreliaceae Lineages
    2. Proteomic Insights From Borreliaceae Lineages
    3. Transmission of Bb via Ixodes Spp. Vectors
    4. Pathogenesis
      1. Immune Activation and Inflammation in Untreated LD
      2. Inflammation and Immune Dysregulation Among Patients With Persistent LD
        1. CRP in Patients With Persistent Symptoms Following Treatment
        2. IFN-y and Antibiotic-Refractory Lyme arthritis patients
        3. CCL19 Among PTLD Patients
        4. IL-23 Among European PTLD Patients
        5. Autoantigens and Self-Reactivity In LA
    5. Persistence
      1. Persistent Antigenic Debris
      2. Persistent Infection
  4. Prevention
    1. Ecological Prevention
    2. Human Vaccine
    3. Field Building
      1. Biorepositories and Research Cohorts
        1. Lyme Disease Biobank
        2. Lyme Disease Research
        3. Long Island Outdoor Worker Cohort
      2. Data Repositories
        1. LymeMIND Commons
  5. Discussion
READ THE PAPER

Reference

Bobe JR, Jutras BL, Horn EJ, Embers ME, Bailey A, Moritz RL, Zhang Y, Soloski MJ, Ostfeld RS, Marconi RT, Aucott J, Ma’ayan A, Keesing F, Lewis K, Ben Mamoun C, Rebman AW, McClune ME, Breitschwerdt EB, Reddy PJ, Maggi R, Yang F, Nemser B, Ozcan A, Garner O, Di Carlo D, Ballard Z, Joung H-A, Garcia-Romeu A, Griffiths RR, Baumgarth N and Fallon BA (2021) Recent Progress in Lyme Disease and Remaining Challenges. Front. Med. 8:666554. doi: 10.3389/fmed.2021.666554

LymeSci is written by Lonnie Marcum, a Licensed Physical Therapist and mother of a daughter with Lyme. In 2019-2020, she served on a subcommittee of the federal Tick-Borne Disease Working Group. Follow her on Twitter: @LonnieRhea  Email her at: lmarcum@lymedisease.org.

___________________

**Comment**

I’m an optimistic person by nature; however, I have little hope for true change in Lyme-land.  All we have to do is look around at the continuing censorship, persecution, and real misinformation about COVID to see there are powerful forces at work that just don’t seem to step down despite protests, good scientific information, and facts.

Category:

Lyme, research

Do an Altered Gut Microbiota and an Associated Leaky Gut Affect COVID-19 Severity?

https://journals.asm.org/doi/10.1128/mbio.03022-20?

mBio

Volume 12, Number 1
23 February 2021
 
ABSTRACT
 
Coronavirus disease 2019 (COVID-19), which has been declared a pandemic, has exhibited a wide range of severity worldwide. Although this global variation is largely affected by socio-medical situations in each country, there is also high individual-level variation attributable to elderliness and certain underlying medical conditions, including high blood pressure, diabetes, and obesity. As both elderliness and the aforementioned chronic conditions are often associated with an altered gut microbiota, resulting in disrupted gut barrier integrity, and gut symptoms have consistently been associated with more severe illness in COVID-19 patients, it is possible that dysfunction of the gut as a whole influences COVID-19 severity. This article summarizes the accumulating evidence that supports the hypothesis that an altered gut microbiota and its associated leaky gut may contribute to the onset of gastrointestinal symptoms and occasionally to additional multiorgan complications that may lead to severe illness by allowing leakage of the causative coronavirus into the circulatory system.
 

For more: 

Category:

Gut Health, research, Viruses

Vaccine-Induced Thrombocytopenia With Severe Headache – Why Lyme/MSIDS Patients Should Care

https://www.nejm.org/doi/full/10.1056/NEJMc2112974?

Vaccine-Induced Thrombocytopenia with Severe Headache

To the Editor:

Vaccine-induced immune thrombotic thrombocytopenia (VITT), a serious adverse event after vaccination with ChAdOx1 nCoV-19 (AstraZeneca) or Ad26.COV2.S (Johnson & Johnson–Janssen), is caused by platelet factor 4 (PF4)–dependent, platelet-activating antibodies.1-3 High-dose immune globulins and anticoagulation are the main treatments.4,5 In this report, we present evidence that vaccine-induced thrombocytopenia (VIT) without associated cerebral venous sinus thrombosis (CVST) or other thromboses and with severe headache as the heraldic symptom may precede VITT (“pre-VITT syndrome”).

Eleven patients presented with severe headache in the absence of CVST 5 to 18 days after ChAdOx1 nCoV-19 vaccination.

  • All the patients had thrombocytopenia (low platelets in the blood which can cause hemorrhaging)
  • high d-dimer levels (a test to detect blood clots – a high level indicates clot formation and breakdown in the body)
  • high levels of anti–PF4–heparin IgG antibodies
  • during follow-up, intracranial hemorrhage occurred in three patients (Patients 1, 2, and 3), with radiologic evidence of new CVST in Patients 2 and 3 (Figure 1, and Table S1 in the Supplementary Appendix, available with the full text of this letter at NEJM.org).
  • Only two patients (Patients 2 and 4) were initially admitted with conditions that met the criteria for VITT; both patients had pulmonary embolism, and additional splanchnic vein thrombosis was present in Patient 2.

In Patient 2, anticoagulation treatment had been initiated several days earlier for pulmonary embolism (without diagnosis of VITT) but was stopped after the onset of headache, shortly before CVST developed.

  • In two patients (Patients 1 and 3), peripheral thromboses were eventually identified during follow-up.

Thrombotic complications did not develop in seven of the patients (Patients 5 through 11); all but one of these patients received high-dose immune globulin, glucocorticoids, or therapeutic-dose anticoagulation within 5 days after headache onset. In contrast, in all four patients with subsequent thrombosis (Patients 1 through 4), therapeutic-dose anticoagulation either was not started until 6 to 9 days after headache onset or was stopped prematurely before the development of CVST.

Although the combination of thrombocytopenia and severe headache due to CVST has been recognized as the typical presentation of VITT,1,2 the experience with these 11 patients suggests that VIT with severe headache, elevated d-dimer levels, and strongly positive results on anti–PF4–heparin IgG enzyme-linked immunosorbent assay may precede VITT.

Our findings have immediate implications for clinical practice: in this pre-VITT syndrome, severe headache may not develop as a symptom secondary to CVST but instead may precede CVST by several days, potentially in association with microthrombosis in smaller cortical veins.

Consequently, patients who present with severe headache 5 to 20 days after adenovirus vector vaccination against coronavirus disease 2019 should undergo immediate testing for thrombocytopenia and d-dimer levels and, if available, testing for anti–PF4–heparin IgG antibodies.

When these antibodies are present at high titers, patients are at imminent risk for CVST, and it is likely that this condition can be prevented with immediate treatment, such as with intravenous immune globulin. The decision to initiate therapeutic-dose anticoagulation is a difficult one; the risk of emerging thrombosis, including CVST, has to be balanced against the risk of intracranial hemorrhage on an individual basis (e.g., with consideration of platelet count and fibrinogen levels).

Farid Salih, M.D.
Charité-Universitätsmedizin Berlin, Berlin, Germany

Linda Schönborn, M.D.
Universitätsmedizin Greifswald, Greifswald, Germany

Siegfried Kohler, M.D., Christiana Franke, M.D., Martin Möckel, M.D., Thomas Dörner, M.D., Hans C. Bauknecht, M.D., Christian Pille, M.D., Jan A. Graw, M.D.
Charité-Universitätsmedizin Berlin, Berlin, Germany

Angelika Alonso, M.D.
University Hospital of Mannheim, Mannheim, Germany

Johann Pelz, M.D.
University Hospital of Leipzig, Leipzig, Germany

Hauke Schneider, M.D., Antonios Bayas, M.D., Monika Christ, M.D.
University Hospital of Augsburg, Augsburg, Germany

Joji B. Kuramatsu, M.D.
University Hospital of Erlangen, Erlangen, Germany

Thomas Thiele, M.D., Andreas Greinacher, M.D.
Universitätsmedizin Greifswald, Greifswald, Germany

Matthias Endres, M.D.
Charité-Universitätsmedizin Berlin, Berlin, Germany

Supported by Deutsche Forschungsgemeinschaft project number 374031971–TRR 240 (to Prof. Greinacher) and EXC-2049–390688087 NeuroCure under the German Excellence Strategy (to Prof. Endres) and by the Domagk-Programm of the Universitätsmedizin Greifswald (to Dr. Schönborn).

Disclosure forms provided by the authors are available with the full text of this letter at NEJM.org.

This letter was published on September 15, 2021, at NEJM.org.

Profs. Greinacher and Endres contributed equally to this letter.

___________________

**Comment**

Both Thrombocytopenia and severe headaches are common with Lyme/MSIDS patients.

Therapy for thrombocytopenia requires treatment or removal of the underlying infection, in addition to maintenance of platelet counts and hemostatic function.

Hopefully it’s clear that a Lyme/MSIDS patient getting a COVID shot could be diagnosed with thrombocytopenia that either already exists or worsens after the injection.  Treating the underlying infection is imperative but won’t be considered by mainstream medicine.

For more:

Go here for the latest VAERS data and the mounting list of adverse reactions and deaths.

Category:

Heart Issues, Inflammation, research, vaccines

New Study: Half of Hospitalized COVID Patients Have Mild Case, Are Asymptomatic, or in Hospital for Another Reason

https://thenewamerican.com/new-study-half-of-hospitalized-covid-patients-have-mild-case-are-asymptomatic-or-in-hospital-for-another-reason/

New Study: Half of Hospitalized COVID Patients Have Mild Case, Are Asymptomatic, or in Hospital for Another Reason

by R. Cort Kirkwood
New Study: Half of Hospitalized COVID Patients Have Mild Case, Are Asymptomatic, or in Hospital for Another Reason
Hispanolistic/E+/Getty Images

About three million people in the United States with the China Virus have been admitted to hospitals in the past year, data from the Centers for Disease Controls show.

Yet not all of those hospitalized with the virus were hospitalized because of the virus. Instead, the Atlantic reported on September 13, they went into the hospital for another reason, but tested positive after they were there.

That means the data on hospitalizations with the virus might not tell us what we think it does.

(See link for article)

_______________________
**Comment**
Once again, data is being twisted to provoke fear for a bigger agenda.

The important issue here is how the “virus” is affecting any given individual.

Due to vast testing being done at hospitals, they are recording incidental COVID cases that never would have been recorded otherwise. The past CDC director has admitted that hospitals have a monetary incentive to over count COVID deaths.  This has occurred in Wisconsin and in every state.  It’s notoriously been done in nursing homes.  Remember that even the CDC has withdrawn EUA for the PCR test as it can’t distinguish between COVID and the flu.  Further, the CDC stopped counting the flu to purposely pad COVID cases.

Important quotes:

Let’s read that again: About 50 percent of COVID-positive VA patients in the hospital were there for another reason or had a mild case of the disease.

Of vaccinated patients, 57 percent presented with mild or asymptomatic disease, and “unvaccinated patients have also been showing up with less severe symptoms, on average, than earlier in the pandemic,” the Atlantic reported:

While the authors want to give credit to the “vaccines”, historically it is known that viruses weaken over time.

The most logical conclusion is to refine the definition of hospitalization.

 “Those patients who are there with rather than from COVID don’t belong in the metric.”

I’m not downplaying the fact people can become very ill from COVID.  I was one such case.  What is despicable; however, is the fact our corrupt public health ‘authorities’ are censoring and denying cheap, effective, successful treatments that is killing thousands upon thousands as well as continues to push a narrative that our only hope is a fast-tracked, experimental gene therapy injection that is literally maiming and killing thousands more.

Category:

research, Viruses

Controversy Continues: “True Chronic Lyme Disease” Rather Than “Post-treatment Lyme Disease Syndrome”

Although written in 2018, it’s a perfect example how the debate continues on the issue of pathogen persistence due to thousands of patients who continue to have severe symptoms of Lyme/MSIDS despite years of treatment.  Similarly to the censorship and maligning of ivermectin, HCQ, and other effective treatments for COVID, doctors treating Lyme/MSIDS are afraid to treat patients long-term as the same bullying has occurred.

**********************

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6100330/

2018 Jul-Sep; 10(3): 170–171.
doi: 10.4103/jgid.jgid_152_17
PMCID: PMC6100330
PMID: 30166820

The Persistent Lyme Disease: “True Chronic Lyme Disease” rather than “Post-treatment Lyme Disease Syndrome”

Alexis Lacout, Mostafa El Hajjam,1 Pierre-Yves Marcy,2 and Christian Perronne3
Author information Copyright and License information Disclaimer
 

Sir,

A controversy continues regarding the reality of a chronic form of Lyme disease. Chronic Lyme disease can present as a “post-Lyme syndrome” explained by inflammatory and immunological phenomena, or as a genuine “chronic form” attributable to the persistence of the bacteria despite proper antibiotic therapy as per the current guidelines. The current guidelines however may not be so appropriate in the latter case.

The case referenced is of a 40-year-old patient, a hunting gard, regularly suffering from multiple tick bites. He began experiencing a lack of energy with diffuse palate of pains (cramps, stiffness, and neuropathic burning pain), tremor and fluctuating migrating arthralgia that evolved over a 3-month period. A first Lyme serology proved positive in Western blot. A second Lyme serology, performed a few months later, was negative but showed the presence of IgM antibodies below the threshold of of positivity: OspCBss(0,6), OspCBaf (0, 7), OspCBag (0, 5) and OspCBspp (0, 6).

A 21-day treatment of ceftriaxone (2 g/day) resulted in a spectacular improvement in his overall state of health. Yet, despite the improvement, there remained persistent bouts of moderate asthenia with episodes of arthralgia. Consequentially, two new antibiotic treatments were administered: ceftriaxone (2 g/day) for 15 days and doxycycline (100 mg twice a day) for 1 month. His symptoms disappeared almost completely. However, his symptoms gradually reappeared. A new approach with antibiotics was initiated: ceftriaxone (2 g/day for 1 month) followed by doxycycline (200 mg twice a day) associated with hydroxychloroquine 200 (once a day). Two months later, after a quick improvement, the patient exhibited no symptoms. Five months later, while the treatment was continued, the patient was still asymptomatic.

The clinical improvements and setbacks corresponding strictly to the administration and interruption of antibiotics, and the final remission are in favor of a chronic persistence of Borrelia. Interestingly, the persistence of Borrelia infection, despite a proper antibiotherapy, has been well described in literature.[] It would be due to the existence of the cystic shapes of Borrelia resisting to antibiotics and the creation of extracellular (matrices) biofilms protecting the bacteria.[] Bacteria that grow as a biofilms are indeed protected from killing by antibiotics.

In patients presenting with a chronic form, the interferon-gamma response is not followed by an increase in IL-4, thus suggesting both a persistent Th1 response and a deficiency in the Th2 response.[] Borreliosis may thus induce immunosuppression with a lack of humoral response and long-term immunity.[] False-negative serological results could be attributed to a deficiency of antibody production. As a matter of fact, Leeflang et al. reported a poor sensitivity of the enzyme immunoassay/immunoblot of 0.77 (95% confidence interval: 0.67–0.85) in the diagnosis of neuroborreliosis.[] A meta-analysis of test accuracy reported a sensitivity of only 59.5%, varying from 30.6%–86.2%.[] Antibiotic testing is necessary to reach Lyme disease final diagnosis, namely in patients presenting with negative tests and a suggestive clinical presentation.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

REFERENCES

  1. Miklossy J, Kasas S, Zurn AD, McCall S, Yu S, McGeer PL, et al. Persisting atypical and cystic forms of borrelia burgdorferi and local inflammation in lyme neuroborreliosis. J Neuroinflammation. 2008;5:40. [PMC free article] [PubMed] []
  2. Widhe M, Jarefors S, Ekerfelt C, Vrethem M, Bergstrom S, Forsberg P, et al. Borrelia-specific interferon-gamma and interleukin-4 secretion in cerebrospinal fluid and blood during lyme borreliosis in humans: Association with clinical outcome. J Infect Dis. 2004;189:1881–91. [PubMed] []
  3. Elsner RA, Hastey CJ, Olsen KJ, Baumgarth N. Suppression of long-lived humoral immunity following borrelia burgdorferi infection. PLoS Pathog. 2015;11:e1004976. [PMC free article] [PubMed] []
  4. Leeflang MM, Ang CW, Berkhout J, Bijlmer HA, Van Bortel W, Brandenburg AH, et al. The diagnostic accuracy of serological tests for lyme borreliosis in europe: A systematic review and meta-analysis. BMC Infect Dis. 2016;16:140. [PMC free article] [PubMed] []
  5. Cook MJ, Puri BK. Commercial test kits for detection of lyme borreliosis: A meta-analysis of test accuracy. Int J Gen Med. 2016;9:427–40. [PMC free article] [PubMed] []

Please see Microbiologist Tom Greer’s Important paper on “The Complexities of Lyme Disease”:

https://mail.google.com/mail/u/0/#inbox/FMfcgzGljlpcXbHDNVSpLsZWzfHRfWQV?projector=1&messagePartId=0.1

For more:

Similarly to what’s occurring with effective COVID treatments, treatments for Lyme/MSIDS have been attacked as well.

 

Category:

Lyme, research, Testing, Treatment