Archive for the ‘research’ Category

Lyme Disease Patient With Permanent Tinnitus & Hearing Loss

https://danielcameronmd.com/lyme-disease-tinnitus-hearing-loss/  Podcast here

LYME DISEASE PATIENT WITH PERMANENT TINNITUS AND HEARING LOSS

lyme-disease-tinnitus

Hello, and welcome to another Inside Lyme Podcast. I am your host Dr. Daniel Cameron. I find that the best way to get to know Lyme disease is through reviewing actual cases. In this episode, I’ll be discussing a case involving a 46-year-old man with Lyme disease who developed permanent tinnitus and hearing loss.

By

Jozefowicz-Korczynska and colleagues first described this case in the journal Frontiers in Neurology in 2019.

A 46-year-old male farmer was hospitalized with a “sudden onset of tinnitus and hearing loss in the left ear, dizziness, severe balance instability, and gait ataxia,” the authors write.  (Gait ataxia consists of lack of voluntary coordination of muscle movements.)

Doctors initially suspected vestibular schwannoma, which is a benign tumor of the 8th nerve (also referred to as an acoustic nerve) that affects hearing and balance. But diagnostic testing was normal.

However, a Western blot test and spinal tap revealed the patient was positive for Lyme disease. He was treated with a 3-week course of oral doxycycline, but his dizziness and gait problems persisted.

The patient did not receive any additional oral or intravenous antibiotics. Instead, he was referred to a Balance Disorders Unit for vestibular evaluation.

“Upon his examination, the patient presented with severe gait disturbance and imbalance,” the authors write.

Audiology tests indicated the man had mild to moderate sensory-neural hearing loss in both ears.

He underwent vestibular rehabilitation therapy for 10 consecutive days which significantly improved his balance. But his hearing loss and tinnitus remained.

“Unfortunately, the antibiotic therapy was not successful in decreasing hearing loss or tinnitus, suggesting permanent damage to the hearing nerve and cochlea,” write the authors.

Another study by Logigian et al. from Tufts University of Medicine found that 4 out of 27 patients with chronic neurologic Lyme disease presented with hearing loss and tinnitus.2

Meanwhile, a study in Poland revealed that 162 out of 216 patients with tick-borne diseases had otolaryngological (ear, nose, throat) symptoms.

“The most common complaint was tinnitus (76.5%) accompanied by vertigo and dizziness (53.7%), headache (39%), and unilateral sensorineural hearing loss (16.7%).”3

The following questions are discussed in this episode:

  1. Initially, doctors suspected vestibular schwannoma. Can you explain this condition and why it was considered as a possible diagnosis?
  2. The patient was tested for Lyme disease. His symptoms were not typical for Lyme, so why was testing ordered?
  3. Would more than a three-week course of doxycycline have helped resolve the man’s tinnitus and hearing loss?
  4. How common is hearing loss, vertigo, tinnitus, and gait impairment in Lyme disease?
  5. What are other causes of tinnitus and hearing loss?
  6. Why was the patient referred to a balance disorder unit and was his treatment successful?
  7. There have been several cases of hearing loss reported in the literature. Can you discuss the Tufts University and Poland studies featured in one of your blogs?
    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. Jozefowicz-Korczynska M, Zamyslowska-Szmytke E, Piekarska A, Rosiak O. Vertigo and Severe Balance Instability as Symptoms of Lyme Disease-Literature Review and Case Report. Front Neurol. 2019 Nov 12;10:1172.
  2. Logigian EL, Kaplan RF, Steere AC. Chronic neurologic manifestations of Lyme disease. N Engl J Med. 1990;323(21):1438-1444.
  3. Sowula K, Skladzien J, Szaleniec J, Gawlik J. Otolaryngological symptoms in patients treated for tick-borne diseases. Otolaryngol Pol. 2018;72(1):30-34.

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For more:

Category:

Hearing Loss, Lyme, research

Pilot Study Finds Evidence of Bartonella in Schizophrenia Patients

https://news.ncsu.edu/2021/03/pilot-study-bartonella-schizophrenia-patients/

Pilot Study Finds Evidence of Bartonella Infection in Schizophrenia Patients

March 23, 2021
NC State gateway at sunset
FOR IMMEDIATE RELEASE
Tracey Peake

A pilot study from North Carolina State University and the University of North Carolina at Chapel Hill has found evidence of Bartonella infection in the blood of people with schizophrenia and schizoaffective disorder.

“Researchers have been looking at the connection between bacterial infection and neuropsychiatric disease for some time,” says Dr. Erin Lashnits, a former veterinary internist at NC State, current faculty member at the University of Wisconsin and first author of the study.

“Specifically, there has been research suggesting that cat ownership is associated with schizophrenia due to the zoonotic parasite Toxoplasma gondii, but to date there has been no conclusive evidence in support of a causative role for this parasite. So we decided to look at another cat-associated infectious agent, Bartonella, to see if there could be a connection.”

Bartonella are bacteria historically associated with cat-scratch disease, which until recently was thought to be solely a short-lived (or self-limiting) infection. Cats can become infected with Bartonella via exposure to fleas and potentially ticks, which are natural vectors of the bacteria. The cat is a host for at least three of the 40 known Bartonella species: Bartonella henselae, Bartonella clarridgeiae and Bartonella koehlerae.

“While there is emerging understanding of neuropsychiatric illnesses such as schizophrenia as disorders of brain networks, the question about the actual causes remains unanswered,” says corresponding author Flavio Frohlich, associate professor of psychiatry at the UNC School of Medicine. “It was an exciting opportunity for us in the UNC Department of Psychiatry to team up with the leading experts on Bartonella to pursue this innovative idea of a potential link to schizophrenia. To our knowledge, this is the very first work that examines a potential role of Bartonella in schizophrenia.”

The research team enrolled a group of 17 people with stable, medically managed schizophrenia or schizoaffective disorder, and a control group of 13 healthy adults, to test for evidence of Bartonella infection.

All participants filled out questionnaires on severity of symptoms and potential Bartonella exposure. Blood samples were taken from participants twice in a one-week period. The samples were cultured in a growth medium, and both cultured and whole blood samples underwent qPCR and droplet digital, or ddPCR testing, at seven-, 14- and 21-day intervals, to look for evidence of Bartonella organism-specific DNA. Blood samples were also tested for Bartonella species-specific antibodies.

Of the 17 patients with schizophrenia, 12 had Bartonella DNA in their blood, as compared to only one of 13 in the control group. According to the questionnaires, both patients and controls reported similar pet ownership and flea exposures.

“Bartonella ddPCR, a very new diagnostic technology, provides a more sensitive molecular test than we’ve previously had access to,” says Dr. Ed Breitschwerdt, Melanie S. Steele Distinguished Professor of Internal Medicine at NC State and study coauthor. “If we had not used ddPCR to test this cohort of individuals, we would not have found Bartonella DNA in any of the participants, either case or control.”

“It is important to remember that our study was by design not able to demonstrate a causal link between Bartonella infection and schizophrenia,” Frohlich says. “However, we believe this initial observational study strongly supports the need for follow-up research.”

The researchers plan to proceed with a larger study to see whether their preliminary results are borne out.

“Many of these patients have been undergoing care for years,” Breitschwerdt says. “What we’re starting to see is a pattern – Bartonella can persist for a long time. And for the subset of people who can’t eliminate the infection, the bacteria can cause chronic or progressive illness.”

The research appears in Vector Borne and Zoonotic Diseases and was supported in part by the National Institutes of Health (grants UL1TR002489 and T32OD011130). Ricardo Maggi and Julie Bradley of NC State, as well as L. Fredrik Jarskog of UNC-Chapel Hill, contributed to the work.

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Note to editors: The abstract of the paper follows.

“Schizophrenia and Bartonella spp. infection: a pilot case-control study”

DOI: 10.1089/vbz.2020.2729

Authors: Erin Lashnits, Ed Breitschwerdt, Ricardo Maggi, Julie Bradley, North Carolina State Univerity; L. Fredrik Jarskog, Flavio Frolich, University of North Carolina at Chapel Hill
Published: March 15, 2021 in Vector-Borne and Zoonotic Diseases

Abstract:
Recently, infections with emerging zoonotic bacteria of the genus Bartonella have been reported in association with a range of central nervous system (CNS) symptoms. Currently, it remains unknown if Bartonella spp. infection is associated with symptoms of schizophrenia/schizoaffective disorder (SCZ/SAD). The objective of this study was to determine if there is an association between Bartonella species infection and SCZ/SAD. A secondary objective was to determine if SCZ/SAD symptoms were more severe among participants with documented Bartonella spp. infection. Using a case–control study design, 17 cases and 13 controls were evaluated with a series of clinical and cognitive assessments. Blood samples were collected and tested for Bartonella spp. infection using serological, microbiological, and molecular techniques. People with SCZ/SAD were more likely than healthy volunteers to have Bartonella spp. DNA in their bloodstream, with 11 of 17 cases (65%) positive by Bartonella spp. droplet digital PCR (ddPCR). In comparison, only one healthy volunteer was Bartonella spp. ddPCR positive (8%, p = 0.0024). Based on serology, Bartonella spp. exposure was common among people with SCZ/SAD (12 of 17) as well as among healthy volunteers (12 of 13), with no significant difference between the groups ( p = 0.196). Within the case group of people with SCZ/SAD, there was no significant difference in SCZ/SAD severity scores between people with and without ddPCR evidence of Bartonella spp. infection. This pilot study provides preliminary evidence in support of future investigations that should examine a potential contribution of Bartonella spp. infection to SCZ/SAD.

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For more:

Category:

Bartonella, Psychological Aspects, research

Study of a Potential Test for Persistent Lyme Disease

https://flightpath.bio

FLIGHTPATH BIOSCIENCES’

Study of a Potential Test for Persistent Lyme Disease

Thanks to the enthusiastic response from the Lyme community, this study has met its current enrollment goal. Therefore, Flightpath Biosciences’ Study of a Potential Test for Persistent Lyme Disease will not be accepting any more applications at this time.

We’ll keep you posted as the project proceeds or if we reopen the study for further enrollment.

For questions related to this study, please contact: FlightpathLymeStudy@gmail.com

https://news.northeastern.edu/2020/09/29/intestinal-bacteria-could-give-doctors-an-objective-test-for-chronic-lyme-disease

Excerpt:

Fatigue, muscles aches, brain fog—are these symptoms of chronic Lyme disease, or merely side effects of the daily grind of human existence? It’s hard to tell. 

Chronic Lyme disease, also known as post-treatment Lyme disease syndrome or PTLDS, is incredibly hard to diagnose because symptoms vary greatly, and there is currently no biological test to detect the disease.

Now, Kim Lewis, University Distinguished Professor of biology and director of the Antimicrobial Discovery Center at Northeastern, has proposed a new way to objectively diagnose this elusive disease by analyzing the microbes in a patient’s gut. 

(Go to link for article)

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**Comment**

Lewis states there are about 800,000 people in America living with PTLDS.  I have written before about this confusing moniker that it means different things to different people.  For instance, microbiologist Holly Ahern states there are two groups of patients: those diagnosed and treated early and those diagnosed and treated late.  The PTLDS label only concerns the first group and only represents about 10-20% of people going on with persistent symptoms.  These low percentages are typically what researchers are referring to.  The label leaves out a much larger group (30-40%) that is diagnosed and treated late.  

This second group represents nearly all the patients I work with that never gets addressed by research because their cases are sticky, hard to define, and by nature don’t fit well into a research study design.

According to Lewis, people with PTLDS have an abundance of a type of bacteria called Blautia and a suppression of a type of bacteria called Bacteroides (which explains why Lyme/MSIDS patients suffer with inflammation, digestion, improper immune responses, depression and anxiety).

Unfortunately, this bacterial disregulation is also seen in many other diseases.

Flightpath is also working on making an oral form of the antibiotic azlollicin available, which has demonstrated in vivo efficacy in mice by significantly inhibiting the growth of drug-tolerant Borrelia burgdorferi (Bb) bacteria better than doxycycline (the standard of care), and reducing inflammation.

 

Category:

Gut Health, Inflammation, Lyme, research, Testing

Congenital Lyme: Opportunities for Research Support

Opportunities for Federal Funding and Research Support for Studies on Maternal-Fetal Transmission of Lyme Disease 03-21-2021

Lyme Disease and Pregnancy: State of the Science and Opportunities for Research Support

Join us for an interactive webinar
Thursday, April 29
5:00 – 6:30 pm EST

Register Here

While it is widely accepted that Lyme disease is spread by a tick bite, it is less well known that the agent of Lyme disease, Borrelia burgdorferi, can cross the placenta, both infecting, and causing harm to, unborn children.

CDC and NIH have recently acknowledged this crucial fact. Nevertheless, the dearth of published research on this topic has left patients, healthcare providers and caregivers to navigate a vast field of unknowns related to diagnosis, treatment and prevention.

In partnership with the National Institutes of Health to encourage new research in the field of tick-borne illness, this webinar will provide researchers the opportunity to learn about the application process and seek guidance from NIH program officers.

This is an extraordinary opportunity for established and early-stage investigators to build a foundation of research for a long-overlooked problem.

Agenda

  • Lyme Disease and Pregnancy: Why Research is Urgently Needed, Isabel Rose, Chair, Mothers Against Lyme
  • Epidemiology and Pathobiology of Lyme Disease: Implications for Research, Holly Ahern MS, MT(ASCP) Associate Professor of Microbiology, SUNY Adirondack
  • Maternal-Fetal Transmission of Lyme Disease: Research Gaps and Opportunities, Sue Faber, RN, BScN and President, LymeHope
  • NIH Research Opportunities for Maternal and Pediatric Infectious Diseases, NahidaChakhtoura, MD, Maternal and Pediatric Infectious Diseases Program Officer, National Institute of Child Health and Human Development (NICHD)
  • Advancing Research for Tickborne Diseases: Guidance and Resources for Investigators, Maliha Ilias, PhD, Lyme Disease Program Officer, National Institute of Allergy and Infectious Diseases (NIAID)
  • Q&A and Panel Discussion

Register for FREE to learn directly from the source how to apply and gain access to newly available funds ($29 million) that the Federal government has earmarked for research in the area of Lyme and tick-borne diseases.

Sponsored by Mothers Against Lyme and Project Lyme

For more information contact

Isabel.Rose@MothersAgainstLyme.org

Category:

Activism, Lyme, research

New Study Predicts Changing Lyme Disease Habitat Across the West Coast

https://www.eurekalert.org/pub_releases/2021-03/ttgr-nsp031621.php

NEWS RELEASE 

New study predicts changing Lyme disease habitat across the West Coast

Army of ‘citizen scientists’ collect more than 18,000 tick samples for analysis in study funded by Bay Area Lyme Foundation

THE TRANSLATIONAL GENOMICS RESEARCH INSTITUTE

FLAGSTAFF, Ariz. — March 16, 2021 — The findings of a recent analysis conducted by the Translational Genomics Research Institute (TGen), an affiliate of City of Hope, suggest that ecosystems suitable for harboring ticks that carry debilitating Lyme disease could be more widespread than previously thought in California, Oregon and Washington.

Bolstering the research were the efforts of an army of “citizen scientists” who collected and submitted 18,881 ticks over nearly three years through the Free Tick Testing Program created by the Bay Area Lyme Foundation, which funded the research, producing a wealth of data for scientists to analyze.

This new study builds on initial research led by the late Nate Nieto, Ph.D., at Northern Arizona University, and Daniel Salkeld, Ph.D., of Colorado State University.

This immense sample collection represented a multi-fold increase in the number of ticks that could be gathered by professional biologists conducting field surveys in far less time and at a fraction of the cost. This kind of citizen participation — which in the future could include smart-phone apps and photography — could become “a powerful tool” for tracking other animal- and insect-borne infectious diseases important for monitoring human and environmental health, according to study results published in the scientific journal PLOS ONE.

This study expands on previous work in California and is the first study to produce high resolution distributions of both actual and potential tick habitat in Oregon and Washington.

“This study is a great example of how citizen scientists can help — whether tracking climate change, fires, habitat changes or species distribution shifts — at a much finer scale than ever before,” said Tanner Porter, Ph.D., a TGen Research Associate and lead author of the study.

Specifically, Dr. Porter said the findings of this study could help raise awareness among physicians across the West, and throughout the nation, that tick-borne diseases are possible throughout a wider expanse than ever thought before.

Lyme disease is caused by a bacteria, Borrelia burgdorferi (sensu lato), which is carried by ticks, and in this study specifically, the western black-legged tick known as Ixodes pacificus. These ticks also carry pathogens associated with relapsing fever and anaplasmosis, which like Lyme disease can cause fever, headache, chills and muscle aches. Some patients with Lyme disease may experience a rash that may look like a red oval or bull’s-eye.

If not treated promptly, Lyme disease can progress to a debilitating stage, becoming difficult and sometimes impossible to cure. This may include inflammation of the heart and brain.

Lyme disease is the most common tickborne illness in the U.S., annually causing an estimated 500,000 infections, according to the CDC. However, even the most commonly-used diagnostic test for Lyme disease misses up to 70% of early stage cases. There is no treatment that works for all patients.

“We hope this study data encourages residents of California, Oregon and Washington to take precautions against ticks in the outdoors, and helps to ensure that local healthcare professionals will consider diagnoses of Lyme when patients present with symptoms,” said Linda Giampa, Executive Director of the Bay Area Lyme Foundation.

Citizen scientists were encouraged to mail in ticks collected off individuals’ bodies, pets and clothing. They noted the time and place where the ticks were discovered, and described activities involved, the surrounding environment, and in many cases specific GPS coordinates.

Field studies could take decades to produce the same amount of data, said Dr. Porter, adding, “this citizen science technique could allow for real-time distribution monitoring of ticks and other relevant species, an important consideration with emerging pathogens, changing land-use patterns, and climate change.”

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This study builds on TGen’s “One Health Collaborative,” an initiative that uses a holistic approach to monitor the health of humans, animals and the environment, according to David Engelthaler, Ph.D., head of TGen’s infectious disease studies.

The study — Predicting the current and future distribution of the western black-legged tick, Ixodes pacificus, across the Western US using citizen science collections — was published Jan. 5 In PLOS ONE.

About TGen, an affiliate of City of Hope

Translational Genomics Research Institute (TGen) is a Phoenix, Arizona-based nonprofit organization dedicated to conducting groundbreaking research with life-changing results. TGen is affiliated with City of Hope, a world-renowned independent research and treatment center for cancer, diabetes and other life-threatening diseases: CityofHope.org. This precision medicine affiliation enables both institutes to complement each other in research and patient care, with City of Hope providing a significant clinical setting to advance scientific discoveries made by TGen. TGen is focused on helping patients with neurological disorders, cancer, diabetes and infectious diseases through cutting-edge translational research (the process of rapidly moving research toward patient benefit). TGen physicians and scientists work to unravel the genetic components of both common and complex rare diseases in adults and children. Working with collaborators in the scientific and medical communities worldwide, TGen makes a substantial contribution to help our patients through efficiency and effectiveness of the translational process. For more information, visit: tgen.org. Follow TGen on Facebook, LinkedIn and Twitter @TGen.

Media Contact:

Steve Yozwiak
TGen Senior Science Writer
602-343-8704
syozwiak@tgen.org

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For more: 

Wisconsin’s citizen research effort:  The Tick App

Category:

research, Ticks