Archive for the ‘research’ Category

Immunity to COVID May Last Years

https://www.nytimes.com/2021/05/26/health/coronavirus-immunity-vaccines.html

Immunity to the Coronavirus May Persist for Years, Scientists Find

Important immune cells survive in the bone marrow of people who were infected with the virus or were inoculated against it, new research suggests.
The studies may soothe fears that immunity to the virus is transient, as is the case with coronaviruses that cause common colds.
Credit…Christopher Capozziello for The New York Times

By Apoorva Mandavilli

Immunity to the coronavirus lasts at least a year, possibly a lifetime, improving over time especially after vaccination, according to two new studies. The findings may help put to rest lingering fears that protection against the virus will be short-lived.

Together, the studies suggest that most people who have recovered from Covid-19 and who were later immunized will not need boosters. Vaccinated people who were never infected most likely will need the shots, however, as will a minority who were infected but did not produce a robust immune response.

Both reports looked at people who had been exposed to the coronavirus about a year earlier. Cells that retain a memory of the virus persist in the bone marrow and may churn out antibodies whenever needed, according to one of the studies, published on Monday in the journal Nature.

The other study, posted online at BioRxiv, a site for biology research, found that these so-called memory B cells continue to mature and strengthen for at least 12 months after the initial infection.

“The papers are consistent with the growing body of literature that suggests that immunity elicited by infection and vaccination for SARS-CoV-2 appears to be long-lived,” said Scott Hensley, an immunologist at the University of Pennsylvania who was not involved in the research.  (See link for article)

_____________________

**Comment**

A few points:

  • According to Dr. Peter McCullough as well as history, you can’t beat “natural” immunity. (Getting the virus naturally).  He also states you can not improve natural immunity with “vaccines”. Recently a Johns Hopkins professors states to “ignore the CDC” due to their refusal to recognize natural immunity from previous infection. The WHO also recently changed the definition of herd immunity to now only come from vaccines, essentially rewriting hundreds of years of scientific understanding.
  • There is ample evidence that those who have already had COVID should NOT get “vaccinated.” Dr. Hooman Noorchashm has repeatedly warned the FDA that “clear and present danger” exists for those who have had COVID-19 and subsequently get vaccinated due to viral antigens that remain in the body after a person is naturally infected; the immune response reactivated by the COVID-19 vaccine may trigger inflammation in tissues where the viral antigens exist. An international survey of 2,002 people found that people who had previously had COVID-19 experienced “significantly increased incidence and severity” of side effects after the COVID-19 vaccine
  • It’s important to remember that COVID injections are part of a grand experiment where final data is unknown. These are experimental, fast-tracked injections that have not undergone rigorous testing.
  • There are many reported deaths and severe adverse reactions after obtaining the injections.
  • There are many reported “break-through” cases of COVID after being fully “vaccinated,” demonstrating the injections do not stop you from becoming ill, or from dying. Public health ‘authorities’ are downplaying this, yet have counted at least 10,000 such cases. The true number is likely to be much higher. The CDC has even changed testing criteria for the “vaccinated” and is now only counting hospitalized cases, further lowering reported numbers.
  • They make a distinction that those who have not had COVID may need future booster shots.  The question begging to be asked is why get “vaccinated” at all when “natural” immunity is more complete?  Further, the Washington University study clearly demonstrates what has taken place in reality: the majority who get COVID have mild cases.
  • Also, falling antibody levels after infection is completely normal and does not signal waning immunity, because B cells remain in bone marrow, ready to mobilize when needed . A landmark 2007 study showed antibodies in theory, “could survive decades – perhaps well beyond the average life span – hinting at the long-term presence of memory B Cells.”
  • The same study found out of 19 patients, 15 had detectable memory B cells, but because FOUR didn’t they are suggesting “vaccination,” for all after infection. The immune system is complex. To suggest “vaccinating” the entire world based on the results of FOUR people is unfounded and reeks of bias.
  • The study found the number of memory B cells remained stable over time.
  • They make an example out of a Kentucky Senator (who happens to be a MD) who stated he would not get the COVID “vaccine” because he had already been infected and was immune. The authors state there is no such guarantee that this immunity will be powerful enough.  Imagine, again, someone stating this for Chicken Pox.  It isn’t done.  If COVID-19, which has never been completely purified and isolated, is more like the flu, then we need to have a serious discussion about the fact the flu vaccine, depending upon the year, has an effectiveness from 10%-43%.  The flu vaccine, similarly to the COVID shots, does not prevent the spread of the flu, does not reduce demands upon hospitals, does not reduce death, and increases risk of contracting non-flu respiratory illness by 65%. Source  The flu vaccine increases Coronavirus infection risk by 36%. Source
  • It’s obvious that the goal of this article is to push “vaccination” upon those who have already have COVID.   Even vaccine experts are giving stern warnings.  It’s interesting to note that only half of NIH employees have gotten the jab.

Important quote:

The experts all agreed that immunity is likely to play out very differently in people who have never had Covid-19. Fighting a live virus is different from responding to a single viral protein introduced by a vaccine.

Category:

research, vaccines, Viruses

Do You Really Need a Multivitamin?

https://vitalplan.com/blog/do-you-really-need-a-multivitamin?Do You REALLY Need a Multivitamin?

Do You REALLY Need a Multivitamin?

By Dr. Bill Rawls Posted 05-07-2021

I’ve been on the fence as to whether or not to take multivitamins for my whole life. Growing up in the 60s and 70s, there was always a bottle of multivitamins on the breakfast table. Every morning, each person at the table would take their turn. The basic “One A Day” was popular at the time, but chewable products were also making their debut. Flintstones were my favorite — they tasted like candy.

The idea of taking a multivitamin came with America’s shift toward processed food products in the mid-20 century. Fast food was a radical change from freshly prepared meals that had been the norm, but ready-made foods seemed to be a better fit for the fast pace of American life. Not only that, processed foods were specifically designed to appeal to our preferential tastes for carbohydrates and fats. I don’t think anyone thought that these new foods were nearly as nutritious as the freshly prepared foods people had been eating before, but that was okay; multivitamins were there to fill the void.

Both fast foods and multivitamins became the standard that is still with us today. Currently, half of all Americans and 70% of those over 65 take a multivitamin product.

The big question is: does taking a multivitamin really do anything?

white plastic bottle, tablets arranged into a question mark, blue background

Most average “once-daily” multivitamin products contain synthetic forms of vitamins and minerals. These aren’t the same as the forms of vitamins and minerals found in natural whole foods. When someone takes a standard multivitamin, the body has to expend energy to convert these synthetic substances into a form the body can actually use, which seems to defeat the whole purpose.

On top of that, numerous clinical studies failed to show a clear benefit of taking multivitamins for improving health or reducing the incidence of chronic illness and cancer. As recent as 2018, research published in the Journal of the American College of Cardiology reviewed data from 179 individual trials and concluded that multivitamin supplements did not help prevent or improve cardiovascular disease. Another study examined data from more than 30,000 people over six years. It likewise found that people who took multis and other nutrient supplements had about the same risk of dying as those who didn’t take a multivitamin.

That being said, some people still feel more comfortable taking multivitamins just for peace of mind. They believe by taking extra vitamins and minerals, their bases are covered if they don’t always eat healthily or are stressed.

And who isn’t stressed sometimes? Maybe when people are under stress or even as we age, we do need a little extra support.

At different points in my life, I’ve gone back and forth between taking and not taking multivitamins regularly. Growing up, I took them every day. After becoming an adult and shifting to a healthier diet, I felt that multivitamins weren’t as necessary, and I gave them up. Later in middle age, a health crisis precipitated by Lyme disease caused me to rethink a lot of things, including whether to take multivitamins.

two types of Homeopathic supplements on wooden spoon

I read opinions from experts who felt that the reason why studies consistently failed to show benefit was that they were all using unnatural synthetic forms of vitamins and minerals. They reasoned that if the natural forms of the vitamins, termed bioavailable, were used, the outcomes could have been different.

There’s no doubt that our body burns up a lot more vitamins and minerals when we’re stressed, and I was definitely stressed. Though I was particular about following a healthy diet, I wanted to give my body any advantage it could get. I again decided to take a multivitamin, but this time, not just any multivitamin off the grocery store shelf.

I found a top-quality product that exclusively provided bioavailable forms of essential vitamins and minerals and started taking it regularly. Did I notice any difference? Maybe a little. I certainly couldn’t say it was more than embracing a healthy diet, but it did give me peace of mind. Though I was confident that it wasn’t doing any harm with the doses I was using, it certainly wasn’t a total solution to my ongoing health issues either. Perhaps I needed more than just a multivitamin.

Nourishment vs. Protection

Multivitamin products and herbal products often get lumped together under the category of natural supplements, but they couldn’t be more different. They both have value, but that value is as different as apples and oranges.

To understand the difference, you have to think about the body as a complex collection of living cells. The body contains several trillion cells of about 200 different types. A person’s health is a reflection of the health of the cells that make up that person’s body. If a person’s cells are all healthy and all the cells in the body are functioning in harmony, then that person is the definition of good health.

To function properly, a cell must receive a steady supply of pure water, oxygen, and nutrients. Nutrients, including carbohydrates and fats to generate energy, amino acids to synthesize new proteins, and vitamins and minerals for enzymatic functions, must all be absorbed through the intestinal tract.

Everything that happens inside a cell is a function of enzymes. We need vitamins and minerals because they are key components of enzymes. To function properly, cells need an adequate supply of vitamins and minerals, but having more than the cell can use at one time doesn’t add any benefit. In fact, saturating a cell with excessive vitamins and minerals could even be harmful.

Healthy green salad with avocado, mangold leaves, red beans and cherry tomatoes. Vegan snack, vitamins, vegetarian food and diet concept

No doubt, the best source of vitamins and minerals is a healthy diet. Still, if a healthy diet isn’t consistent, logic would suggest that supplementing with essential vitamins and minerals could be beneficial. That being said, supplemental vitamins and minerals must be supplied in the form that the body can easily use — dumping unnatural synthetic forms of vitamins in the body is like putting cheap gas into your car; it works, but it’s not the best thing for the engine.

The key takeaway is that bioavailable vitamins and minerals are necessary for normal cellular functions and that greater quantities of vitamins and minerals are required when cells are stressed, but that vitamins and minerals alone do nothing to protect cells from being stressed.

This is where a group of plant chemicals, called phytochemicals, goes above and beyond the benefits offered by multivitamins. Plants produce a spectrum of different types of phytochemicals to protect cells against a wide range of physical, chemical, and biological (insects and microbes) stress factors. When we consume phytochemicals, either from foods or supplements, all those benefits are transferred. When our cells are protected from stress, they function better, burn out slower, and require less in the way of vitamins and minerals.

A few protective phytochemicals have become household words. Resveratrol, a phytochemical found in grapes and wine, is a potent antioxidant known for slowing aging. Resveratrol has also been found to protect mitochondria, the source of energy for cells. Less well known, pterostilbene is a phytochemical with similar properties found in blueberries. Phytochemicals called catechins, found in green tea, slow aging and prevent chronic illness by protecting cells from damaging antioxidants.

Though fruits and vegetables are an important source of protective phytochemicals, our food plants have been cultivated primarily to provide high yields of nutrients, especially carbohydrates. That has come at the expense of protective phytochemicals. This where the plants we define as herbs have a clear advantage.

Mushrooms growing on tree trunk, surrounded by greenery

Herbs are wild plants. Their value isn’t supplying nutrients. If you had to depend on eating herbs as a sole food source, you’d go hungry. Herbs, however, are an excellent source of protective phytochemicals — their true value is protecting cells. The wild plants defined as herbs are plants that humans have selectively been using for thousands of years for both culinary and medicinal purposes.

Adding Herbs for Organ and Cellular Protection

Adding herbs into your life provides a level of protection to your cells unmatched by any food source or multivitamin product. A good place to start is taking a few herbal ingredients along with your multivitamin. Some possible choices that provide exceptional protection for cells of the body against every type of possible stress include:

green leaves with white flowers

Trans-resveratrol from Japanese knotweed

Trans-resveratrol, the most bioavailable form of resveratrol, is well-known for offering cardiovascular support and antioxidant properties.

brown pine bark pieces

Pine Bark Extract

Potent antioxidants and other chemical compounds in Pine Bark Extract help the body maintain vascular tissue and support the integrity of blood vessels. PBE is also supportive to the immune system.

purple milk thistle flower

Milk Thistle Extract

Silymarin, the primary chemical component of milk thistle, offers potent support for the liver; it increases natural antioxidants found in liver cells. It is the most widely researched of all liver-related herbs and is well known for low toxicity and safety.

red hawthorn berries

Hawthorn Leaf Extract

Supports the cardiovascular system, blood flow to the heart, oxygen delivery to tissues, and healthy blood vessels.

purple powder

Maqui Berry

Maqui Berry is a Patagonian berry that is wild-harvested by the Mapuche people of Chile and Argentina. Their traditional Maqui Berry beverage is credited for contributing to their extraordinary strength and stamina.

orange flowers

Lutein & Zeaxanthin

These twin carotenoid compounds account for the yellow color in vegetables. They build up in the retina of the eye and maintain a healthy retina during normal exposure to sunlight. They also accumulate in the skin to support its health. Prevention Plus contains the same amount of these substances as compared to ocular supplements recommended by ophthalmologists.

Adding Herbs for Stress and Optimal Health

If you’re under stress or want to gain even more protection for your cells, consider adding on some herbs with adaptogenic properties. All herbal traditions recognize herbs with nonspecific properties that can be used daily to invigorate the body and promote longevity. In Traditional Chinese Medicine, they’re called tonics. In Ayurvedic medicine, the traditional medicine of India, they’re referred to as rasayanas. In the second half of the twentieth century, Western science began categorizing these and other herbs as adaptogens.

Herbs that fit the definition of adaptogen have been defined by science to:

  • Assist the body in resisting a wide range of physical, chemical, and biological stress factors.
  • Have nonspecific actions in the body that do not cause drug-like effects.
  • Are non-toxic and do not harm or disrupt normal functions in the body

collage of nine herb photos, mixture of leaves, mushrooms, powders, and bark

There are many herbs defined as adaptogens or herbs that complement adaptogens that can be taken daily to protect cells from stress and support optimal health. A few to consider are:

  • Rhodiola
  • Reishi
  • Cordyceps
  • Ashwagandha
  • Gotu kola
  • Turmeric
  • Japanese knotweed
  • Chinese skullcap
  • Shilajit

The Bottom Line

Your cells must have vitamins and minerals to function. A healthy diet is the best source, but admittedly, eating healthy all the time can be challenging. A multivitamin can help fill the void, but bioavailable forms are always the best choice. The limitation of multivitamins must be respected, however; multivitamins have little capacity to protect cells from stress and therefore shouldn’t be expected to reduce risks of chronic illness and cancer.

Herbs have a clear advantage for protecting cells against stress — the spectrum of phytochemicals in herbs protect cells against all types of stress. When cells aren’t stressed, they don’t have to work as hard, use fewer nutrients, and burn out slower.

Why not take both? Why not ensure your cells have a ready supply of bioavailable vitamins and minerals and protect your cells with herbal phytochemicals at the same time? Combining a daily herbal product with bioavailable vitamins and minerals may be the best of all possibilities!

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References
1. Jenkins, DJA et al. “Supplemental Vitamins and Minerals for CVD Prevention and Treatment.” J Am Coll Cardiol. 2018 Jun 5;71(22):2570-2584.
2. Chen, Fan et al. “Association Between Dietary Supplement Use, Nutrient Intake, and Mortality Among US Adults: A Cohort Study.” Ann Intern Med. 2019 May 7; 170(9): 604–613.
3. Harvard Health Publishing, Harvard Medical School. “Vitamins and your heart.” Healthbeat. Retrieved from https://www.health.harvard.edu/heart-health/vitamins-and-your-heart
4. Tapsell, Linda C. et al. “Foods, Nutrients, and Dietary Patterns: Interconnections and Implications for Dietary Guidelines.” Adv Nutr. 2016 May; 7(3): 445–454.
5. Diabetes Prevention Program Research Group. “Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin.” New England Journal of Medicine. 2002 Feb 7; 346(6): 393–403.
6. Dehghan, Mahshid et al. “Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study.” Lancet. 2017 Nov 4; 390(10107): 2050-2062
7. National Center of Complementary and Integrative Health. “Rhodiola.” Retrieved from https://nccih.nih.gov/health/rhodiola
8. Hewlings, Susan J. and Kalman, Douglas S. “Curcumin: A Review of Its’ Effects on Human Health.” Foods. 2017 Oct; 6(10): 92.
9. Ratan ZA, Youn SH, Kwak YS, et al. Adaptogenic effects of Panax ginseng on modulation of immune functions. J Ginseng Res. 2021;45(1):32-40. doi:10.1016/j.jgr.2020.09.004
10. Liao LY, He YF, Li L, et al. A preliminary review of studies on adaptogens: comparison of their bioactivity in TCM with that of ginseng-like herbs used worldwide. Chin Med. 2018;13:57. Published 2018 Nov 16. doi:10.1186/s13020-018-0214-9
11. Panossian AG, Efferth T, Shikov AN, et al. Evolution of the adaptogenic concept from traditional use to medical systems: Pharmacology of stress- and aging-related diseases. Med Res Rev. 2021;41(1):630-703. doi:10.1002/med.21743

Category:

diet and nutrition, Herbs, research, Supplements

Involuntary Body Movements Due to Lyme Disease Dismissed As Psychosomatic

https://danielcameronmd.com/involuntary-body-movements-lyme-disease/  Postcast Here

INVOLUNTARY BODY MOVEMENTS DUE TO LYME DISEASE DISMISSED AS PSYCHOSOMATIC

involuntary body movements lyme disease

Hello, and welcome to another Inside Lyme Podcast. I am your host Dr. Daniel Cameron. In this episode, I’ll be discussing a case involving a man in his 70’s who had an abrupt onset of involuntary body movements, including jerks in his left arm. The man was initially dismissed as having a functional disorder, when in fact, his involuntary body movements was due to Lyme disease.

By

Li and colleagues described this case, entitled “Lyme neuroborreliosis presenting as spinal myoclonus” in the journal BMJ Case Rep.. [1]

While visiting the Czech Republic, the man developed a large round erythematous rash on his left arm.  He also removed a tick from his thigh. Doctors prescribed amoxicillin and the rash resolved within 3 days.

Three weeks later, the man was evaluated at a clinic in Canada for radicular pain down his left arm. His symptoms progressed, which included involuntary body movements in multiple limbs.   “Within 1 week, these jerks progressed to his contralateral arm and bilateral legs as well as the trunk, consistent with propriospinal myoclonus,” the authors explain.

Propriospinal Myoclonus (PSM) is an extremely uncommon movement disorder characterized by myoclonic jerks, writes Verma and colleagues,2 adding that “PSM has sometimes been dismissed as psychogenic in some cases.”

Multiple Emergency Room Visits

The man, who presented to multiple emergency rooms, was given Pregabalin to treat his pain. Doctors diagnosed the patient with a functional disorder.

During this third visit to the emergency room, the man was finally diagnosed with Lyme disease. Laboratory tests were positive for Lyme disease by IgM EIA and Lyme IgM Western blot.

He subsequently tested positive for Borrelia afzelli. His spinal tap revealed an elevated protein with a lymphocytic pleocytosis.  His MRI showed abnormal patchy cauda equina nerve root enhancement and anterior spinal cord enhancement at C5–C6.

The patient was treated successfully for Lyme disease with 7 weeks of oral and intravenous antibiotics.

This is not the first case of propriospinal myoclonus. Propriospinal myoclonus was described in a 60-year-old woman following a tick bite and erythema migrans, the authors write. However, a spinal tap later revealed she was positive for Borrelia burgdorferi antibodies.

Editor’s note: This is a good example of a Lyme disease patient being dismissed as having a psychogenic or functional disorder instead of being recognized as involuntary body movements lyme disease.  The authors published a photo of the rash which was clearly a typical erythema migrans (EM) rash. The initial 3-day course of antibiotics would not be expected to be effective in treating Lyme disease.

The following questions are addressed in this episode:

  1. What is radicular pain?
  2. Can involuntary body movements be a symptom of Lyme disease?
  3. The patient was treated briefly for the rash. Your thoughts?
  4. What is propriospinal myoclonus?
  5. This movement disorder is often dismissed as a psychogenic illness?
  6. What is the significance of a diagnosis of psychogenic illness?
  7. The patient wasn’t diagnosed with Lyme disease until his 3rd ED visit?
  8. How do you interpret the laboratory tests?
  9. What are your thoughts about this patient’s treatment?

    Thanks for listening to another Inside Lyme Podcast. You can read more about these cases in my show notes and on my website @DanielCameronMD.com. As always, it is your likes, comments, reviews, and shares that help spread the word about Lyme disease. Until next time on Inside Lyme.

      Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

      Inside Lyme Podcast Series

      This Inside Lyme case series will be discussed on my Facebook and made available on podcast and YouTube.  As always, it is your likes, comments, and shares that help spread the word about this series and our work. If you can, please leave a review on iTunes or wherever else you get your podcasts.

      References:
      1. Li X, Kirschner A, Metrie M, Loeb M. Lyme neuroborreliosis presenting as spinal myoclonus. BMJ Case Rep. Dec 29 2019;12(12)doi:10.1136/bcr-2019-233162
      2. Verma R, Praharaj HN, Raut TP, Rai D. Propriospinal myoclonus: is it always psychogenic? BMJ Case Rep. Jul 29 2013;2013doi:10.1136/bcr-2013-009559

      _______________________

      **Comment**

      Another symptom that is frankly so bizarre that it’s hard to believe, until you’ve had it yourself.  

      Mainstream medicine needs to wake up.

      Category:

      Lyme, research

      Lyme Spirochetes in an Autopsied Brain Despite Treatment

      The following article is based off the study, posted here.

      https://www.lymedisease.org/lyme-spirochetes-autopsied-brain/

      LYME SCI: Lyme spirochetes in an autopsied brain (despite treatment)

      By Lonnie Marcum

      An important new study from Tulane University found Lyme bacteria in autopsied brain tissue of a woman who had been aggressively treated with antibiotics.

      “These findings underscore how persistent these spirochetes can be in spite of multiple rounds of antibiotics targeting them,” says Dr. Monica Embers, of Tulane.

      Dr. Embers’ team collaborated with Dr. Brian Fallon, of the Lyme and Tick-Borne Diseases Research Center at Columbia University Irving Medical Center.

      In their study, published in Frontiers in Neurology, the researchers performed an in-depth autopsy on the brain tissues of an elderly woman who had been previously treated for neurological Lyme disease.

      And guess what? They found intact Borrelia burgdorferi, the agent that causes Lyme disease, inside portions of the patient’s brain as well as DNA evidence in her spinal cord.

      Obviously, you can’t take brain samples from a living person. Therefore, autopsy samples, such as used in this study, can demonstrate that Borrelia can remain in human tissues even after extensive treatment with antibiotics. Such studies are essential in the effort to develop better diagnostics and treatment.

      Persistent Lyme

      Many academic researchers and physicians refer to the persistent symptoms of Lyme as post-treatment Lyme disease syndrome (PTLDS). But if you ask patients who are left disabled after being treated for Lyme, they will tell you it’s “chronic Lyme disease.”

      Along with the difficulty of obtaining a proper diagnosis, the treatment for Lyme is complicated by the fact that the standard antibiotic is most effective when administered early in the disease.

      Any delay in treatment allows the infection to spread throughout the body leading to a more severe chronic form of the disease. This chronic form of infection often necessitates stronger intravenous antibiotics, or longer-term antibiotics to clear infection. Even then, many patients remain ill.

      Researchers from Tulane and Columbia universities want to develop better methods to detect and treat Borrelia burgdorferi.

      Dr. Embers has been studying Lyme disease since 1998, mostly using animal models. Her early work demonstrated that at four months post-infection, neither a 28-day course of doxycycline nor a 90-day course of antibiotics (30 days IV Rocephin, followed by 60 days oral doxycycline) could eradicate Lyme disease. More recently, she found spirochetes in multiple organs after a 28-day course of doxycycline.

      History of the patient

      The new study focuses on a 69-year-old deceased woman who contracted Lyme disease at age 54. At the onset of her illness, she had a well-documented erythema migrans rash accompanied by severe headache, joint pain and a fever of 104º. Her standard two-tier tests for Lyme disease were positive on ELISA and both IgM and IgG Western blots.

      She was prescribed 10 days of doxycycline which resolved her initial symptoms. Two years later, the patient developed many chronic symptoms consistent with late-stage Lyme disease, as well as dementia.

      At age 60, the patient was treated with IV ceftriaxone for eight weeks, which led to 60% improvement in cognition and interpersonal engagement. Although oral amoxicillin was continued three times daily for the next six months, her symptoms gradually returned. Further antibiotic treatment with minocycline did not help. All the while her IgG Western blot for Lyme disease remained positive.

      Over time, the patient’s visual, mental and executive functions continued to deteriorate. At age 62, a cerebrospinal fluid (CSF) study demonstrated a positive Western blot. Unfortunately, a comparison of serum and CSF by a diagnostic ELISA was not performed at that time so she did not meet the full diagnostic criteria for neuroborreliosis.

      The authors suggest that the initial symptoms of the woman at age 54 (headache, high fever) indicate brain involvement at the time of the EM rash, consistent with a mild meningitis early in the disease process.

      Fifteen years after the initial diagnosis of Lyme disease, she experienced severe movement disorders, sleep disorder, paranoia and personality changes leading to a clinical diagnosis of dementia with Lewy bodies. Before she died at age 69, she decided to donate her brain to Columbia University for the study of the disease.

      What is dementia with Lewy bodies?

      Dementia is a general term referring to an impaired ability to remember, think or make decisions that interferes with one’s ability to perform normal activities of daily living.

      Symptoms can vary widely from person to person. People with dementia typically have problems with:

      • Memory
      • Attention
      • Communication
      • Reasoning, judgment, and problem solving
      • Visual perception beyond typical age-related changes in vision

      Lewy body dementia (LBD) is associated with abnormal deposits of a protein called alpha-synuclein in the brain. These deposits, called Lewy bodies, affect chemicals in the brain whose changes, in turn, can lead to problems with thinking, movement, behavior, and mood.

      In healthy people, alpha-synuclein plays a number of important roles in neurons (nerve cells) in the brain, especially at synapses, where brain cells communicate with each other. In LBD, alpha-synuclein forms into clumps inside neurons, starting in areas of the brain that control aspects of memory and movement. This process causes neurons to work less effectively and, eventually, to die.

      Neuroborreliosis

      Lyme disease can affect any organ or system of the body including the central nervous system (brain and spinal cord) and peripheral nervous system (nerves outside of the CNS). When Lyme infects the nervous system, it can result in Lyme neuroborreliosis.

      Lyme neuroborreliosis (LNB) can develop anywhere from a few days post infection to several months or even years later. Neuroborreliosis can be the primary and only manifestation in some patients with Lyme disease. Approximately 15% of patients with untreated Lyme disease will develop LNB.

      Neurological Lyme can affect many parts of the nervous system alone or in various combinations resulting in:

      • Lyme meningitis – inflammation of the membranes that cover the brain/spinal cord.
      • Lyme encephalitis – inflammation inside the brain
      • Lyme myelopathy – inflammation of the spinal cord
      • Lyme cranial neuritis – inflammation of the cranial nerves
      • Lyme neuropathy – inflammation of the peripheral nerves
      • Bannwarth’s syndrome – “terrible triad” of meningitis, cranial neuritis and painful neuropathy.

      Lyme encephalitis is a common manifestation in LNB patients who receive delayed or inadequate treatment for Lyme disease.

      Common symptoms of LNB include facial palsy, headache, stiff neck, vertigo (dizziness), cognitive dysfunction, memory or concentration problems, mood changes, sleep disturbances, or paresthesias (numbness and tingling.)

      The symptoms of LNB and dementia depend on which portions of the brain are affected as follows:

      • The cerebral cortex—controls many functions, including information processing, perception, thought, and language
      • The limbic cortex—plays a major role in emotions and behavior
      • The hippocampus—essential to forming new memories
      • The midbrain and basal ganglia—involved in movement
      • The brain stem—where all10 pairs of cranial nerves originate, also important in regulating sleep and maintaining alertness
      • Brain regions— important in recognizing smells (olfactory pathways), and hearing (auditory pathways)

      Some signs of LNB that overlap with signs of dementia may include:

      • Getting lost in a familiar neighborhood
      • Using unusual words to refer to familiar objects
      • Forgetting the name of a close family member or friend
      • Forgetting old memories
      • Not being able to complete tasks independently

      How Lyme persists

      Unlike typical bacteria, Borrelia has the ability to evade the immune system by propelling itself to different areas of the body, changing its outer surface proteins and shapeshifting—mechanisms that also help the bacteria resist standard antibiotics.

      Prior research has pointed to persistent infection as the cause of chronic Lyme disease including research by Fallon at Columbia University, Embers at Tulane University, Lewis at Northeastern University, Baumgarth at University of California, Davis, Zhang at Johns Hopkins University, Aucott at Johns Hopkins University, Novak at Harvard Medical School and many others.

      Multiple studies in both animals and humans over several decades have demonstrated both inflammation and persistence of Borrelia in the nervous system following doxycycline treatment.

      Using three highly sensitive methods of detection validated with nonhuman primate samples at Tulane National Primate Research Center, the research team concluded that at the donor’s time of death, her central nervous system still harbored intact spirochetes in spite of aggressive antibiotic therapy for Lyme disease at different times throughout her illness.

      The researchers employed the use of immunofluorescence staining to image the spirochetes, polymerase chain reaction or PCR to detect the presence of B. burgdorferi DNA, and RNAscope to determine whether the spirochetes were viable.

      The authors summarize the patient’s “initial good response to the IV ceftriaxone suggests a microbial infection was being treated, or that inflammation was dampened. The decline thereafter suggests either that persister Borrelia were present that are now known not to remit with standard antibiotic therapy, that an irreversible neurodegenerative process had been triggered by the prior B. burgdorferi infection, or that an unrelated neurodegenerative disorder was present at the same time as the presumed B. burgdorferi CNS infection.”

      Future directions

      Dr. Ember’s says the team plans to continue to investigate further tissues from other patients who have elected to donate. She hopes this study “brings more awareness to the ability of Borrelia to persist, even with extensive antibiotic therapy.”

      As far as treatment, Embers believes, “we need to find something that works at all phases of the infection from acute to chronic.” She says her team is currently “collaborating with several groups to identify better treatments, be it combination therapy, targeted therapy with small molecule inhibitors, or immune boosting. All of the above!”

      In light of this study, perhaps governing health agencies should reconsider the IDSA’s one-size-fits-all recommended treatment for Lyme disease. The growing body of evidence demonstrating Borrelia’s ability to survive a short course of of antibiotics, proves we need to move towards a more individualized approach to Lyme treatment.

      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.

      References

      Gadila SKG, Rosoklija G, Dwork AJ, Fallon BA and Embers ME (2021) Detecting Borrelia Spirochetes: A Case Study With Validation Among Autopsy Specimens. Front. Neurol. 12:628045. doi: 10.3389/fneur.2021.628045

      Personal communication with Monica Embers, PhD.

       

      Category:

      Lyme, research, Treatment

      Vector Biology: Connecting Human Health, Animal Health & the Environment

      Vector Biology: Connecting human health, animal

      health and the environment

      Mount Allison University

      Lyme Research Network

      Vett Lloyd, Chris Zinck, Samantha Bishop

      Vector-Biology-Connecting-human-health-animal-health-and-the-environment-Vett-Lloyd(1)   Slides Here 

      ________________________

      Important Findings:

      Donor 1
      ▪ Borrelia was detected by nPCR, FISH and protein was detected by immunohistology in biopsied thoracic artery tissue. It was not detected in the other cardiac tissues.
      ▪ Borrelia burgdorferi DNA present only at low abundance in connective tissue
      ▪ These results validate the clinical diagnosis of Lyme disease in this individual, US serology and tick exposure
      ▪ Limited detection is consistent with aggressive treatment, although Borrelia DNA was detected. Viability cannot be assessed by these methods.
      ▪ Round body more common than long/spriocheatal forms
      ▪ The individual is still well, active and healthy

      Donor 2
      ▪ Abundant Borrelia was detected by FISH in the pericardium
      ▪ Other tissues still to be tested
      ▪ These results are consistent with tick exposure and US WB but not Canadian serology
      ▪ Round body more common than long/spriocheatal forms
      ▪ Involvement of Borrelia infection in donor 2’s heart failure is an important question for the family and for all individuals living in endemic areas

      Significance

      ➢ This study demonstrates that Borrelia DNA can be detected in human tissues using molecular methods

      Category:

      Heart Issues, Lyme, research, Testing