Archive for the ‘research’ Category

Five Herbal Medicines Potent Against Babesia Duncan in Test Tube

https://www.lymedisease.org/five-herbal-medicines-babesia/

Five herbal medicines potent against Babesia duncani in test tube

babesia duncani

Five herbal medicines had potent activity compared to commonly-used antibiotics in test tubes against Babesia duncani.

B. duncani is a malaria-like parasite carried by ticks which causes the disease babesiosis.

Published in the journal Frontiers in Cellular and Infection Microbiology, the laboratory study was funded in part by the Bay Area Lyme Foundation.

Collaborating researchers were from Johns Hopkins Bloomberg School of Public Health, California Center for Functional Medicine, and FOCUS Health Group, Naturopathic.

This research is particularly important because babesiosis is a significant emerging health risk, according to co-author Sunjya K. Schweig, MD.

“Due to limited therapeutics and a rise in treatment resistance, current treatment options for this disease are inadequate. Many patients rely on herbal therapies for which there is only anecdotal evidence of efficacy,” Schweig said.

“We hope this data offers inspiration to other researchers to further explore similar options for people living with persistent tick-borne diseases that do not respond to current treatments.”

Testing 46 herbs

Researchers tested a panel of 46 herbal medicine extracts against B. duncani compared to the commonly used medications quinine and clindamycin. Both are currently used to treat active babesiosis, a common co-infection with Lyme disease.

Plant extracts selected for the study included herbs or agents that are already in clinical use, have been previously used to manage the symptoms of patients who do not respond to standard Lyme antibiotic treatment, and have favorable safety profiles.

According to this study, the five herbal medicines that demonstrated inhibitory activity against B. duncani are:

  • Cryptolepis sanguinolenta
  • Artemisia annua (Sweet wormwood)
  • Scutellaria baicalensis (Chinese skullcap)
  • Alchornea cordifolia (African Christmas bush)
  • Polygonum cuspidatum (Japanese knotweed)
These compounds still need to be tested both in vitro and in animal models as well as in clinical trials.

While each of these botanical medicines are already in clinical use, it is important for future studies to evaluate them directly in patients using specific clinical treatment regimens, as each have the potential to produce side effects in patients, and should be taken only under the care of a clinician knowledgeable of their capabilities and toxicities.

The paper titled “Botanical medicines Cryptolepis sanguinolenta, Artemisia annua, Scutellaria baicalensis, Polygonum cuspidatum, and Alchornea cordifolia demonstrate inhibitory activity against Babesia duncani,” was authored by Yumin Zhang, Hector Alvarez-Manzo, Jacob Leone, ND, Sunjya Schweig, MD, and Ying Zhang, MD, PhD.

SOURCE OF PRESS RELEASE: Bay Area Lyme Foundation

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**Comment**

Paper found here:  https://www.frontiersin.org/articles/10.3389/fcimb.2021.624745/full

We must be careful when we read studies done in vitro, or a test tube.  Years back a similar study was done on Stevia and the shot heard round the world was that Stevia cured Lyme.  Obviously, if this were true we’d all be walking around healthier than cows in the field.  But, alas, we are not. Work has also been done on oregano, cinnamon and clove for Lyme.  (I’ve used each of these essential oils as well as stevia internally and never herxed or improved on them, and trust me when I say there’s nobody who wants these things to work more than I!)

I’m not saying these herbs won’t work at all.  I’ve tried them all except African Christmas bush, but to be honest, I didn’t herx on any of them and that was my marker for determining effectiveness. I realize I’m treading into muddy waters here as we are told that herxing isn’t required for effective treatment.  And then there’s the issue of whether you even herx with Babesia.  Since I had a hodgepodge of infections, treatment often hit numerous things simultaneously so it became nearly impossible to tease out what was doing what; however, I can tell you I herxed to high heaven on Babesia treatment  (I put my personal experience and treatment toward the end of the article).  I’m happy to report that after 1 solid year of treatment, both my husband and I are symptom-free.  I will add an ending note; however, that from the time we became infected my husband mysteriously became anemic and had strange blood cell counts and vessel size.  The problem at first it appeared to be low ferritin, which iron sucrose infusions helped with, but over time we found isn’t altogether the answer.  In short, I feel Babesia is behind this – but I may be wrong.

The interesting thing about any strain of Babesia is it isn’t bacteria – but protozoan. Antibiotics are not as effective for this.  Antimalarials have the best action upon Babesia, which thankfully do not hurt the gut like antibiotics used for Lyme.  While there is resistance to quinine due to a heavy reliance upon it for Malaria, another protozoan, there are numerous other options that appear to still be working.  I will add that from my reading another part of this drug resistance is not treating Babesia long enough, and in combination with other drugs. Please discuss this with your practitioner.  This is why many Lyme literate doctors use a drug cocktail (multiple drugs simultaneously). Also, from my discussions with practitioners, it’s important that once you start treating Babesia, stick with it for a solid 9 months to a year. Unfortunately, patients often jump from one thing to another attempting to find relief.  From experience, I can honestly say there isn’t much relief, if you are chronically infected.  You may have a good day or two or even maybe a week, but once the meds are switched, BAM! You feel like death on wheels again. Over time, symptoms disappear one by one.

I know this isn’t fun to read and may be downright depressing – but it’s important to remember this is a marathon not a sprint.  Patience truly is golden when it comes to treating tick-borne illness.  You need to be as tenacious as a Bull dog and as patient as a Basset Hound.

Word on the street is that Disulfiram, the new wonder-drug for Lyme (for some) also has action against Babesia.  (Study in link showing it works on malaria).  This is a very balanced article on DSM.

For more on Babesia treatment: https://madisonarealymesupportgroup.com/2016/01/16/babesia-treatment/

Category:

Babesia, Herbs, research, Treatment

25-Year-Old With Transverse Myelitis & Lyme

https://danielcameronmd.com/lyme-podcast-transverse-myelitis-lyme-disease/

LYME PODCAST: A 25-YEAR-OLD MAN WITH TRANSVERSE MYELITIS AND LYME DISEASE

A 25-year-old man with transverse myelitis and Lyme disease

I will be discussing a 25-year-old man with transverse myelitis and Lyme disease. “He showed gradual improvement in gait, motor and sensory functions of his lower extremities along with a resolution of neurogenic bowel.” wrote the authors. The authors added. “He continues to need intermittent self-catheterization for neurogenic bladder.”

By
 
 
Podcast:  https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5idXp6c3Byb3V0LmNvbS83NzIxNjAucnNz/episode/QnV6enNwcm91dC0zMDE1NDE4?sa=X&ved=0CAUQkfYCahcKEwjgy6vH3KPvAhUAAAAAHQAAAAAQAg

Dumic and colleague first discussed this case in the journal IDCases  in 2019.

“A previously healthy 25-year-old man presented with inability to urinate and frequent falls associated with bilateral lower extremity weakness and numbness.” wrote the authors.

Two weeks earlier, he described a red circumferential rash. His rash was approximately 10 cm in diameter, which is about 4 inch in diameter. The CDC only requires a 5 cm rash to diagnose Lyme disease criteria, which is about 2 inches.

He lived in Wisconsin, USA, with extensive exposure to ticks. He lived next to the woods, hiked, camped, and fished, and has two dogs. He had no recent history of a tick bite.

He also developed a mild, intermittent headache, mild neck stiffness, and thought he had a fever. Flu-like symptoms have commonly been reported in Lyme disease.

Did he get treated for Lyme disease? No.

The rash disappeared within a week without treatment. The erythema migrans rash of Lyme disease often clears without treatment.

His condition took a turn for the worse. “Five days prior to admission, he developed urinary retention as well as progressive numbness and weakness in his lower extremities.” wrote the authors. He was also not able to move his bowels.

His sensory deficit progressed from “left foot numbness to the upper thorax right below the nipple line anteriorly and below the shoulder blades posteriorly.” write the authors.

He began to fall due to the weakness of both legs and problems with his gait.

His physical examination revealed several findings. He had weakness of both legs, mild spasticity in both knees, increased reflexes in his legs, a diminished sensation in his legs, and a Babinski sign of the left foot.

A positive Babinski sign occurs when a doctor stimulates the bottom of the foot. The big toe bends up and back to the top of the foot, and the other toes fan out. This can mean there is some problem with the nervous system.

He had evidence suggestive of myelitis on an MRI “MRI of the cervical and thoracic spine revealed T2 signal hyperintensity in the central spinal cord gray matter at C5, C6 and T3 to T9 levels suggestive of myelitis.” write the authors. They use the term suggestive as a T2 signal hyperintensity can be from other causes. Myelitis refers to inflammation of the spinal cord.

He had strong evidence of an inflammatory process in his spinal fluid as measured by a pleocytosis in his spinal fluid. These are white cells in his spinal fluid. His antibody test for Lyme disease was negative.

His PCR for Lyme disease was positive. They were able to confirm PCR tests were positive for Lyme disease using a molecular detection test at the Mayo Medical Laboratories.

He was diagnosed and treated for acute transverse myelitis.

TRANSVERSE MYELITIS AND LYME DISEASE

The man’s motor, sensory, and autonomic dysfunction were typical of acute transverse myelitis. Autonomic dysfunction is a part of the nervous system that regulates internal organs such as the heart, stomach and intestines. The autonomic nervous system is composed of the Sympathetic and Parasympathetic system. It has also been called the fight-or-flight response. The man was unable to control his bowels and bladder.

OUTCOME

He was treated for Lyme disease with IV ceftriaxone. He also was treated with an intravenous antiviral medicine, Acyclovir, for two days until the spinal tap PCR was positive. Finally, he was treated with the steroid methylprednisolone 1 g IV daily for three days.

“He showed gradual improvement in gait, motor and sensory functions of his lower extremities along with a resolution of neurogenic bowel.” wrote the authors.

The authors added, “he continues to need intermittent self-catheterization for neurogenic bladder.”

This is not the first case of transverse myelitis and Lyme disease patients according to the authors. Their search revealed six other cases of neurologic Lyme disease associated with acute transverse myelitis.

What can we learn from this cases?

  1. Acute transverse myelitis can occur in Lyme disease.
  2. The spinal tap in Lyme disease can present with a high white count, also called pleocytosis, and still have a negative antibody test.
  3. A positive PCR test was able to confirm Lyme disease in this patient.
  4. The man’s acute transverse myelitis and Lyme disease improved with antibiotic treatment.

What questions does these cases raise?

  1. How often does transverse myelitis occur in Lyme disease?
  2. Would the man have been treated for Lyme disease if the PCR test at the Mayo had been negative?
  3. Would the man no longer need intermittent self-catheterization for neurogenic bladder if he were treated with more than a single one-month course of intravenous ceftriaxone?</li
  4. Were there other autonomic issues not described by the authors?</li
TREATING TICK-BORNE DISEASE IN MY PRACTICE

In my practice, each individual requires a careful assessment. That is why I order a broad range of blood tests for other illnesses in addition to tick-borne infections. I also arrange consultations with specialists as needed.

Many patients are complex, as highlighted in this Inside Lyme Podcast series.

We need more doctors with skills recognizing a tick-borne illness in an individual with acute transverse myelitis and Lyme disease. We hope that professionals evaluating individuals with acute transverse myelitis can use this case to remind them to look for tick-borne illnesses and treat accordingly.

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.  Sign up for our newsletter to keep up with our cases.

References:
  1. Dumic I, Vitorovic D, Spritzer S, Sviggum E, Patel J, Ramanan P. Acute transverse myelitis – A rare clinical manifestation of Lyme neuroborreliosis. IDCases. 2019;15:e00479.
  2. Kenney MJ, Ganta CK. Autonomic Nervous System and Immune System Interactions. Compr Physiol. 2014 July ; 4(3): 1177–1200.

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For more:

Category:

Inflammation, Lyme, research

Study Finds Half of Sampled Birds Have Competence for Lyme

https://onlinelibrary.wiley.com/doi/10.1111/geb.13256

RESEARCH PAPER

The macroecology and evolution of avian competence for Borrelia burgdorferi

First published: 21 January 2021
https://doi.org/10.1111/geb.13256
Read the full text

Abstract

Aim

Prediction of novel reservoirs of zoonotic pathogens would be improved by the identification of interspecific drivers of host competence (i.e., the ability to transmit pathogens to new hosts or vectors). Tick‐borne pathogens can provide a useful model system, because larvae become infected only when feeding on a competent host during their first blood meal. For tick‐borne diseases, competence has been studied best for Borrelia burgdorferi sensu lato (Bbsl), which causes Lyme borreliosis. Major reservoirs include several small mammal species, but birds might play an under‐recognized role in human risk given their ability to disperse infected ticks across large spatial scales. Here, we provide a global synthesis of the ecological and evolutionary factors that determine the ability of bird species to infect larval ticks with Bbsl.

Location

Global.

Time period

1983–2019.

Major taxa studied

Birds.

Methods

We compiled a dataset of Bbsl competence across 183 bird species and applied meta‐analysis, phylogenetic factorization and boosted regression trees to describe spatial and temporal patterns in competence, characterize its phylogenetic distribution across birds, reconstruct its evolution and evaluate the trait profiles associated with competent avian species.

Results

Half of the sampled bird species show evidence of competence for Bbsl. Competence displays moderate phylogenetic signal, has evolved multiple times across bird species and is pronounced in the genus Turdus. Trait‐based analyses distinguished competent birds with 80% accuracy and showed that such species have low baseline corticosterone, exist on both ends of the pace‐of‐life continuum, breed and winter at high latitudes and have broad migratory movements into their breeding range. We used these trait profiles to predict various likely but unsampled competent species, including novel concentrations of avian reservoirs within the Neotropics.

Main conclusion

Our results can generate new hypotheses for how birds contribute to the dynamics of tick‐borne pathogens and help to prioritize surveillance of likely but unsampled competent birds. Our findings also emphasize that birds display under‐recognized variation in their contributions to enzootic cycles of Bbsl and the broader need to consider competence in ecological and predictive studies of multi‐host pathogens.

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For more:  

Category:

Lyme, research, Ticks

Post-Treatment Lyme Disease as a Model for Persistent Symptoms in Lyme Disease

https://www.frontiersin.org/articles/10.3389/fmed.2020.00057/full

REVIEW ARTICLE
Front. Med., 25 February 2020 | https://doi.org/10.3389/fmed.2020.00057

Post-treatment Lyme Disease as a Model for Persistent Symptoms in Lyme Disease

Alison W. Rebman and John N. Aucott*
  • Lyme Disease Research Center, Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States

It has long been observed in clinical practice that a subset of patients with Lyme disease report a constellation of symptoms such as fatigue, cognitive difficulties, and musculoskeletal pain, which may last for a significant period of time. These symptoms, which can range from mild to severe, have been reported throughout the literature in both prospective and population-based studies in Lyme disease endemic regions. The etiology of these symptoms is unknown, however several illness-causing mechanisms have been hypothesized, including microbial persistence, host immune dysregulation through inflammatory or secondary autoimmune pathways, or altered neural networks, as in central sensitization. Evaluation and characterization of persistent symptoms in Lyme disease is complicated by potential independent, repeat exposures to B. burgdorferi, as well as the potential for co-morbid diseases with overlapping symptom profiles. Antibody testing for B. burgdorferi is an insensitive measure after treatment, and no other FDA-approved tests currently exist. As such, diagnosis presents a complex challenge for physicians, while the lived experience for patients is one marked by uncertainty and often illness invalidation. Currently, there are no FDA-approved pharmaceutical therapies, and the safety and efficacy of off-label and/or complementary therapies have not been well studied and are not agreed-upon within the medical community. Post-treatment Lyme disease represents a narrow, defined, mechanistically-neutral subset of this larger, more heterogeneous group of patients, and is a useful definition in research settings as an initial subgroup of study. The aim of this paper is to review the current literature on the diagnosis, etiology, risk factors, and treatment of patients with persistent symptoms in the context of Lyme disease. The meaning and relevance of existing patient subgroups will be discussed, as will future research priorities, including the need to develop illness biomarkers, elucidate the biologic mechanisms of disease, and drive improvements in therapeutic options.  (See link for article)

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**Comment**

When you read the entire thing you realize Aucott and Rebman elucidate the many groups of patients that have Lyme disease. While I appreciate the separation of groups for research purposes, it is this very slicing, dicing, and narrowly categorizing that has kept the sickest patients from ever being researched, diagnosed, and treated.  If you don’t test positive on a serology test that is inaccurate 70% of the time, or are in the highly variable group of 25-80% who have the EM rash, you simply don’t make the cut.  Sorry – “go home and be well.”  

And while these study authors clearly understand the complexity of PTLD (some might be chronically infected while others are dealing with an immune response, or both at once) trust me when I say other researchers don’t.  

In this day and age where it’s become abundantly clear the importance of touting the accepted narrative or else, hopefully we can all see that “chronic Lyme” is the ugly duckling nobody wants to touch with a 10-foot pole (unless you are an independent researcher with no purse-strings attached to the NIH).  

For more:

Category:

Lyme, research

Could Cytokine Storms Lead to Brain Fog in Lyme Disease Patients?

https://danielcameronmd.com/cytokine-brain-fog-lyme-disease/

COULD CYTOKINE STORMS LEAD TO BRAIN FOG IN LYME DISEASE PATIENTS?

brain-fog-lyme-disease

Lyme disease and COVID-19 patients often complain of having ‘brain fog.’ In a recent study, Remsik and colleagues suggest that brain fog reported by COVID-19 patients may be due to cytokines rather than an infection with the coronavirus SARS-CoV-2.

By

In their article, published in the journal Cancer Cell,¹ the authors explain, “One of the dozens of unusual symptoms that have emerged in COVID-19 patients is a condition that’s informally called ‘COVID brain’ or ‘brain fog.’ It’s characterized by confusion, headaches, and loss of short-term memory. In severe cases, it can lead to psychosis and even seizures.”

The authors expected to find evidence of COVID-19 infection in the cerebral spinal fluid (CSF) of 13 patients hospitalized with COVID-19. They did not.

Instead, Remsik and colleagues found an elevation of cytokines in the spinal fluid of their COVID-19 patients with brain fog. According to the authors, “These patients had persistent inflammation and high levels of cytokines in their cerebrospinal fluid, which explained the symptoms they were having.”

“These increased CSF cytokines are likely the result of both increased blood barrier permeability and local production by cells in the CNS,” the authors write.

Investigators have previously raised concerns that Lyme disease spirochetes could cross the blood-brain barrier leading to brain fog. In his article, Dr. Robert Bransfield raised concerns that persisting immune activation causes a cytokine storm in patients with chronic Lyme disease.²

Remsik et al. add support to the role of cytokines in patients with brain fog, leading to the question: Are cytokine storms associated with brain fog in Lyme disease patients?

Related Articles:

Disseminated Lyme disease more likely in those with weakened immune system

Persistent Lyme infection or inflammatory immune response?

Brain fog in COVID-19 and Lyme disease patients

References:
  1. Remsik J, Wilcox JA, Babady NE, et al. Inflammatory Leptomeningeal Cytokines Mediate COVID-19 Neurologic Symptoms in Cancer Patients. Cancer Cell. Feb 8 2021;39(2):276-283 e3. doi:10.1016/j.ccell.2021.01.007
  2. Bransfield RC. The psychoimmunology of lyme/tick-borne diseases and its association with neuropsychiatric symptoms. Open Neurol J. 2012;6:88-93. doi:10.2174/1874205X01206010088

Category:

Lyme, Psychological Aspects, research