Archive for the ‘research’ Category

A Vote Against Lyme Disease

https://now.tufts.edu/articles/vote-against-lyme-disease

A Vote Against Lyme Disease

Cast your ballot for the best new ideas in fighting a growing health problem
A deer tick lurking on a grass stem. Tufts students are competing to find the best new ideas for fighting the tick-borne illness Lyme disease.
Participants in the challenge have come up with some creative ways to keep deer ticks like this one from spreading illness. Photo: Shutterstock
By Julie Flaherty
January 9, 2020

In the video, Kobe the German Shepherd is getting his check-up at the veterinarian’s office. His owner says the dog is doing well, but she does mention,

“We’re starting to see a lot of ticks on him after his walks.”

After sharing some tips on keeping Kobe tick-free, the veterinarian adds:

“Do you think about doing tick checks on yourself?” It’s a good practice, the vet says, along with wearing insect repellant and treating clothes and shoes with the pesticide permethrin.

Dog owners already talk with vets about preventing ticks on their pets, so why not have vets share some info on protecting the rest of the family from tick bites?

The short video is one of four proposals that students developed as part of the Tufts Lyme Disease Challenge. The competition, the brainchild of Tufts trustee Hugh Roome, A74, F77, AG74, FG80, FG80, A11P, F15P, A18P, seeks to build on Tufts University’s long history of leadership in Lyme disease research. It draws on the broad scope of research at Tufts to develop novel approaches to preventing, diagnosing, treating and eradicating one of the fastest growing infectious diseases in the United States. Each year, an estimated 300,000 new cases are diagnosed.

Check out the video proposals and vote for your favorites. The top vote-getting team will receive $1,000.

The competition kicked off on November 1 with expert talks, panel discussions and brainstorming sessions to discuss what’s most needed in the fight against Lyme, from educational outreach to basic knowledge of the bacteria that causes the disease. Over 100 Tufts students, post-doctoral fellows, faculty and staff participated in the half-day event commented,

“It was great to have so much energy in the room and hear so many terrific ideas,” said Linden Hu, a Lyme disease researcher at Tufts University School of Medicine. “The goal now is to keep the momentum going and really have Tufts make a difference in eradicating Lyme disease.”

Since the event, smaller teams of students have worked with Lyme disease researchers at Tufts to develop their proposals. The four students from Cummings School of Veterinary Medicine at Tufts who submitted the Kobe video say that well visits with the vet could be a new way to spread education about Lyme Disease prevention.

In another video, a group of medical and biomedical engineering students propose a way to prevent tick bites from turning into disease. Lyme bacteria are amazingly cagey in their ability to avoid detection by the immune system. The students propose using nanoparticle infused therapeutics to boost a person’s immunity, essentially preventing the bacteria that cause Lyme Disease from starting a full-blown infection in the body.

The videos are impressive in their wide range of approaches. A group of biomedical engineering students suggest using the power of pheromones to create a tick-attracting trap; the first step would be enhancing tick pheromones so they last longer and can spread over a larger area.

The fourth video aims at one of the significant gaps in Lyme research: a thorough understanding of Borrelia, the bacteria that causes it. Borrelia is difficult to grow in a lab. One solution, the video offers, is to use a drug printing robot to make dozens of growth media with different combinations of nutrients, to quickly see which recipe is the best for culturing the bacteria.

You can vote once per email per day. Voting closes at midnight on February 24.

Julie Flaherty can be reached at julie.flaherty@tufts.edu.

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**Comment**

When you click onto the link called “Video Proposals,” you will be sent to a page where four videos explain the different research topics.

They include:

  • Vets Against Lyme: Combating Lyme Disease by harnessing the human animal bond

 

  • Team Diamond: Finding a growth media for borrelia & high throughput screening techniques  To me this appears very important because if researchers can’t culture Bb, nothing else really matters.

 

  • Team HMK: Nanoparticle and immunotherapy: Paradigm shifting Lyme treatments.  Please be aware that the researchers claim 70% of patients get the EM rash, which is untrue.  It varies from 25-80% and may even be lower than that. Research to date has required patients to test positive on antibody testing that misses over half of all cases and have the EM rash, despite many never getting the rash. They also only mention the Bull’s eye rash when many patients have a variety of rashes. They also push the PTLDS paradigm (post treatment Lyme disease syndrome) but at least present the two opposing viewpoints (hay-wire immune system vs. persistent infection)

 

  • Sour to Sweet: Tick prevention – using pheromone to attract ticks so they can be killed. I appreciate the presenter’s statement that ticks can fall out of trees.  This is denied by most authorities, yet patients commonly report becoming infected this way.

Category:

Activism, Lyme, research, Ticks

Severe Babesia Infection Leads to Exchange Transfusion

https://danielcameronmd.com/severe-babesia-infection-exchange-transfusion/

SEVERE BABESIA INFECTION LEADS TO EXCHANGE TRANSFUSION

Babesia infection, transfusion

Babesiosis is a parasitic disease transmitted primarily through the bite of an infected tick but it can also be spread through tainted blood transfusions or less frequently via organ transplantation or perinatally. The severity of Babesia can range from asymptomatic to life-threatening. In immunocompromised patients or in those who have contracted the disease through blood transfusions, a Babesia infection has a fatality rate of about 20%. [1,2]

By

Although the majority of Babesia cases are treated with antimicrobial agents, patients with severe cases may require an exchange transfusion (ET). In their article, “Repeat exchange transfusion for treatment of severe babesiosis,” Radcliffe and colleagues describe the case of a 73-year-old woman with an extreme case of a Babesia infection, who was immunocompromised. [3]

The woman ultimately required 2 exchange transfusions, along with prolonged anti-parasitic therapy to successfully treat the Babesia microti infection.

Approximately 1 month after camping in New Hampshire, the woman developed malaise, headaches, weakness, anorexia, and nausea, which lasted for 4 days. She did not recall having a tick bite.

The patient had a history of splenectomy, an autoimmune disorder, and immunosuppression therapy. “Her medical history was significant for longstanding rheumatoid arthritis treated with weekly etanercept and prior splenectomy for immune-mediated thrombocytopenia,” writes Radcliffe.

A blood smear revealed a parasitic burden of 43% and anemia with hemoglobin 9.2 mg/dL. “She was started on azithromycin and clindamycin and transferred to our hospital,” writes Radcliffe.

Case report: Severe Babesia in a 73-year-old woman resolves after 2 exchange transfusions. CLICK TO TWEETThe woman was admitted to the intensive care unit for hypotension. She initially needed fluids and vasopressors, as well as supplemental oxygen for a pulse oximetry of 88%.

Her treatment for the Babesia infection was changed to include: IV clindamycin, oral quinine sulfate, and oral doxycycline, as empiric treatment for possible co-infection with Lyme disease and/or anaplasmosis.

And on day 1, she received a red blood cell exchange transfusion of 12 units. This dropped the parasite load to 7.6%.

However, “despite a post-exchange drop in parasitemia to 7.6%, it rebounded to 11.4% on hospital day 5 accompanied by new onset high fevers and hypoxia,” explains Radcliffe.

On day 5, she received her second exchange transfer, which lowered parasitemia to 2.2%.

“She improved after a second exchange transfusion and ultimately resolved her infection after 12 weeks of anti-babesial antibiotics,” writes Radcliffe.

She underwent extended treatment for the Babesia infection, in part due to a parasitemia at day 9 of 1.7% and <1% at day 19.

“Antibiotics were discontinued as follows: atovaquone/proguanil at 61 days post-discharge, doxycycline at 72 days post-discharge, and azithromycin at 86 days post-discharge,” writes Radcliffe.

There are only 6 other cases in the literature documenting exchange transfusions in patients with Babesia. Unfortunately, one of those patients died.

“Our present case is instructive,” the authors explain, “because two ETs were necessary for cure despite a marked lowering of parasitemia after the first ET (81.5% reduction) and an extended anti-parasitic regimen…”

The authors conclude: “These cases highlight the need to remain vigilant when managing babesiosis in highly immunocompromised patients.”

Editor’s note: This patient’s case should serve as a reminder of the risk Babesia poses for immunocompromised patients with autoimmune disorders such as rheumatoid arthritis.

Related Articles:

Case series looks at the complexity of Babesia

Case report: Various clinical presentations of Babesia

Healthy people may be unaware they are infected with Babesia

References:
  1. Krause PJ. Human babesiosis. Int J Parasitol 2019;49(2):165–74.
  2. Krause PJ, Gewurz BE, Hill D, Marty FM, Vannier E, Foppa IM, et al. Persistent and
    relapsing babesiosis in immunocompromised patients. Clin Infect Dis 2008;46(3):370–6.
  3. Radcliffe C, Krause PJ, Grant M. Repeat exchange transfusion for treatment of severe babesiosis. Transfus Apher Sci. 2019 Sep 5. pii: S1473-0502(19)30189-2.

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**Comment**

According to Dr. Horowitz, Babesia is one of the most tenacious coinfections he treats and he recommends treating for 9 months to a year.  In my experience, with a lengthy, overlapping treatment using numerous antimicrobials, you can cure Babesia.  For treatment options:  https://madisonarealymesupportgroup.com/2016/01/16/babesia-treatment/  I include the treatment that was effective for us.

Authorities state that patients are more likely to get Babesia or Bartonella if they are immunocompromised.  What they aren’t considering is that having Lyme or other tick-borne illnesses CAUSES patients to be immunocompromised and sets them up to be targets for other pathogens that are either transmitted directly from a tick bite OR reactivates a latent infection that the immune system was able to keep in check until a trigger suppresses the immune system causing it to fail, allowing a activation of a latent infection.  Their heads are in the sand.

Category:

Babesia, research, Treatment

A Joint Effort: The Interplay Between the Innate and the Adaptive Immune System in Lyme Arthritis

https://www.ncbi.nlm.nih.gov/pubmed/31930745/

2020 Jan 13. doi: 10.1111/imr.12837. [Epub ahead of print]

A joint effort: The interplay between the innate and the adaptive immune system in Lyme arthritis.

Brouwer MAE1, van de Schoor FR1, Vrijmoeth HD1, Netea MG1,2, Joosten LAB1.

Abstract

Articular joints are a major target of Borrelia burgdorferi, the causative agent of Lyme arthritis. Despite antibiotic treatment, recurrent or persistent Lyme arthritis is observed in a significant number of patients. The host immune response plays a crucial role in this chronic arthritic joint complication of Borrelia infections. During the early stages of B. burgdorferi infection, a major hinder in generating a proper host immune response is the lack of induction of a strong adaptive immune response. This may lead to a delayed hyperinflammatory reaction later in the disease. Several mechanisms have been suggested that might be pivotal for the development of Lyme arthritis and will be highlighted in this review, from molecular mimicry of matrix metallopeptidases and glycosaminoglycans, to autoimmune responses to live bacteria, or remnants of Borrelia spirochetes in joints. Murine studies have suggested that the inflammatory responses are initiated by innate immune cells, but this does not exclude the involvement of the adaptive immune system in this dysregulated immune profile. Genetic predisposition, via human leukocyte antigen-DR isotype and microRNA expression, has been associated with the development of antibiotic-refractory Lyme arthritis. Yet the ultimate cause for (antibiotic-refractory) Lyme arthritis remains unknown. Complex processes of different immune cells and signaling cascades are involved in the development of Lyme arthritis. When these various mechanisms are fully been unraveled, new treatment strategies can be developed to target (antibiotic-refractory) Lyme arthritis more effectively.

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For more: Peer-Reviewed Evidence of Persistence of Lyme:MSIDS copy

https://madisonarealymesupportgroup.com/2019/02/22/why-mainstream-lyme-msids-research-remains-in-the-dark-ages/

Excerpt:

By combining the PTLDS group with the third group, there are 60% of patients ending up with chronic symptoms, a number that more closely matches my experience as a patient advocate (9).

THIS IS AN IMPORTANT POINT AS RESEARCHERS CONTINUE TO DOWNPLAY THE ASPECT OF PERSISTENT SYMPTOMS BY USING THE FALSELY SKEWED LOW PERCENTAGES.
  • Burrascano found Lyme disease has a 4-week cycle, where every 4 weeks patients experience a symptom flair. Burgdorfer found this in mice studies, and IGeneX found the same thing in urine antigen studies.Borrelia grow and are active, then become inactive.Four weeks later they activate.This has been shown recently in vitro. Think of Bb as a slow relapsing fever.This nuance is important because antibiotics only kill during the active phase.You need a minimum of a month to bracket a whole generation cycle.

 

  • When patients reach a plateau, he recommends cycling therapy where you discontinue antibiotics until symptoms return.Then, return to full treatment until symptoms are gone. He states that many patients become symptom free after 4 of these cycles.He also used this on himself with success.

In brief, all the research to date has used faulty study parameters.  Typically you must test positive on the 2-tiered testing and have the EM rash to even enter the study – leaving out a large patient population.  When you study the organism for any length of time at all you realize this is not your average bacteria.  Treatment must address this complexity.  The idea that 3 weeks of the mono therapy of doxycycline “curing” this is asinine. Also, little research has been done on concurrent infection.  Many researchers feel this is a rare event, yet in the real world many, many patients have far more than Lyme.  What little we know shows that concurrent infection is more severe and of a longer duration, yet these studies don’t ever touch this.

Current testing uses one species of borrelia when researchers are discovering a new species every year – which testing will never pick up.

Category:

Lyme, research

Dr. Rajadas: Disulfiram for Lyme Interviews

December 2019

Dr Jayakumar Rajadas First Interview with Disulfiram for Lyme Support Group

Dr. Rajadas Disulfiram for Lyme 2nd Interview Dec. 2019

Part 1 Introduction: https://youtu.be/Y0Ud42LRZp0

Part 2 Acetaldehyde: https://youtu.be/0XccN9U_2nk

Part 3 Delivery and Side Effects: https://youtu.be/YzsSUC2Pz38

Part 4 Dosages and Other Conditions: https://youtu.be/QSw861IMwwQ

Part 5 Research and Funding: https://youtu.be/16zHx8XK5fk

Link to the support group: https://www.facebook.com/groups/dsf4l…

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**Comment**

Again – please understand the risks:  https://madisonarealymesupportgroup.com/2019/10/15/disulfiram-psychosis-update/

For a great read on disulfiram:  https://madisonarealymesupportgroup.com/2019/11/19/if-disulfiram-is-the-cure-for-lyme-disease-should-it-be-prescribed-to-all-lyme-disease-patients/

 

 

 

Category:

Lyme, research, Treatment

One Health Trio: Dr. Breitschwerdt’s Three Publications About Vector-borne Pathogens and His Family

https://www.galaxydx.com/dr_breitschwerdt_family_publications_about_vector_borne_pathogens/

written on 

One Health Trio: Dr. Breitschwerdt’s Three Publications about Vector-borne Pathogens and His Family

As often happens in healthcare, specialists enter their field because of a personal experience with their specialty or because those personal experiences find them or those whom they love. The vector-borne disease researchers at Galaxy Diagnostics include people with these experiences. We are pleased to see One Health Month giving people the opportunity to tell their stories.

Dr. Breitschwerdt, co-founder of Galaxy Diagnostics, has published more than 380 peer-reviewed scientific manuscripts, many of which focus on various aspects of vector-borne infections or their transmission. Three publications tell One Health stories from his own family. They explain how vector-borne zoonotic pathogens have affected his father, his mother, and him.

In each of these cases, knowledge of the natural history of the vector-borne pathogen(s) was helpful in reaching a diagnosis. Two of the cases presented information that was on the edge of scientific knowledge at that time. Each case reflects the value of a One Health approach that brings together experts in human, veterinary and environmental medicine, all contributing their different perspectives on the life cycle and illnesses attributed to these pathogens.

At first, it may seem extraordinary that both of Dr. Breitschwerdt’s parents as well as he himself contracted vector-borne pathogens. However, there is no reason to believe the Breitschwerdt family has a particular genetic susceptibility to vector-borne diseases. Rather, Dr. Breitschwerdt grew up on his parents’ farm in central Maryland. They later sold that farm and moved to a farm on Maryland’s Eastern Shore. Meanwhile, Dr. Breitschwerdt lived on his own rural property in North Carolina. All of them had frequent contact with a variety of animals, their associated vectors and potential vector-borne pathogens. Thus, they had the same occupational exposure to vectors that many people with farming and veterinary jobs have on a daily basis.

They also happened to have the expertise of Dr. Breitschwerdt and the team at the Intracellular Pathogens Research Laboratory (IPRL) at the North Carolina State University College of Veterinary Medicine available to assist physicians in documenting the respective vector-borne infections.

2008-2009: Dr. Breitschwerdt’s Father’s Final Days

As often occurs with elderly family members, Dr. Breitschwerdt’s father’s declining health was imperceptible until the first few scary events that foreshadowed a crisis. He became a little forgetful and, more concerning, he fell twice at home. The crisis came when he fell down the stairs and broke his femur. Looking back, Dr. Breitschwerdt reports that he could clearly see the historical progression of events that led to this fall.

Despite somewhat unexplained complications, Mr. Breitschwerdt recovered from surgery, but next seemed to have a stroke before discharge from the hospital. He also had a slight fever and mild bilateral pleural effusion (fluid in his lungs), so he was evaluated for a variety of infectious causes. His blood, urine and cerebrospinal fluid (CSF) were tested for Borrelia burgdorferi, Rickettsia rickettsii, Bartonella henselae, Bartonella quintana and additional pathogens, but nothing was found.

Before he fell down the stairs, Mr. Breitschwerdt had been in the habit of capturing small rodents in his barn. When he captured groundhogs, he would transfer them in his car to a more suitable location for release. This activity had the potential to expose him to their fleas. He had a small circumscribed cutaneous lesion before he became sick that may have been one of these flea bites.

Dr. Breitschwerdt was provided samples of Mr. Breitschwerdt’s blood and CSF by his attending neurologist. When tested at the IPRL, both the blood and CSF samples were PCR-positive (a way of testing for DNA of a vector-borne pathogen) for the Bartonella genus, with DNA fragments similar to Bartonella volans, a species found in flying squirrels. The DNA sequence (like a DNA fingerprint found at a crime scene) was most similar to sequences found in small mammals such as groundhogs. Bartonella henselae DNA, the causative organism of cat scratch disease, was found in the CSF. And over the next few weeks, PCR tests were positive for Bartonella vinsonii subsp. berkhoffii, a species of Bartonella most commonly encountered in dogs. Based upon the timing of the serology results, it was possible this organism was transmitted during in-hospital blood transfusions to his father.

In retrospect, it is not possible to identify when or how exposure to each of these Bartonella species occurred or to define the symptoms that may have been attributable to them. This illness illustrates the complexity that can result when bartonellosis is not just infection with one species, but in this case likely infection with three different species, all potentially interacting.

After being treated with antibiotics and returning home, Mr. Breitschwerdt’s health stabilized. PCR testing did not find Bartonella DNA in his blood. Though Christmas was several months past, the family was able to open Christmas presents together. Unfortunately, his good health did not continue and despite starting antibiotics again, his condition deteriorated and he eventually chose to refuse medication. He died in hospice on May 2nd, 2008. Bartonella volans-like DNA was again amplified from blood specimens obtained shortly before his death.

2010: Dr. Breitschwerdt Infected with Rocky Mountain Spotted Fever

Adult female Lone star ticks (Amblyomma americanum) can be distinguished from other species by the distinct white dot on their back (Source: CDC.)

In May 2010, Dr. Breitschwerdt was bitten by a Lone Star tick in North Carolina. An experienced vector-borne disease researcher, he preserved the engorged tick in alcohol. Seven days later he became ill, and over the next few days he developed fever, body aches, headache, nausea and dizziness, along with a rash. A vector-borne disease was suspected and he was prescribed antibiotics and recovered.

Based upon testing in the IPRL, both the tick and his blood were positive for Rickettsia rickettsiiDNA. At the time, there was little evidence for the Lone Star tick as a vector of R. rickettsii. He later tested seropositive for R. rickettsii (Rocky Mountain Spotted Fever), thereby documenting seroconversion following tick transmission of the bacteria. The preservation of the tick and the use of high-quality laboratory practices was able to turn this personal happenstance into a milestone case study that was built upon by additional researchers to improve the epidemiological understanding of RMSF transmission. In subsequent laboratory studies at the Centers for Disease Control and Prevention, Dr. Michael Levin demonstrated that the Lone Star tick was a competent vector for the transmission of R. rickettsii in the laboratory.

2019: Dr. Breitschwerdt’s Mother’s Final Days

In 2005, Mrs. Breitschwerdt was treated for non-Hodgkin’s Lymphoma. During that time, Dr. Maggi (co-founder of Galaxy Diagnostics) tested her blood in the IPRL. Using PCR, he was able to identify Bartonella henselae in her blood. She had spent a lifetime around cats, dogs, farm animals and their associated fleas and ticks.

She was successfully treated for the lymphoma and was healthy until 2018, when she began to develop dementia. Then, her health suddenly got much worse over the course of two weeks. Dr. Breitschwerdt noticed that her blood values were similar to what he had observed in dogs infected with Ehrlichia canis. A close relative of that species, Ehrlichia chaffeensis, is more commonly the cause of ehrlichiosis in people. Dr. Breitschwerdt urged her doctors to test her for ehrlichiosis. Testing through the Mayo Clinic Diagnostic Laboratory confirmed the infection (ehrlichiosis). She was treated with antibiotics and her condition improved enough for her to be discharged to hospice care in the home of another of her sons. She died on August 4th, 2019.

_ _ _

A note from Dr. Breitschwerdt:

Groups throughout the world have worked together to raise awareness about One Health and to ultimately bring about this One Health Awareness Month. In particular, and clearly among many others, I want to recognize the work of the One Health Commission based in Research Triangle Park, NC.

The experiences of my parents and myself suggest that tick- and other vector-borne pathogens are of greater medical importance than is currently recognized. As I look back over my career, I’ve worked on collaborative One Health projects that have repeatedly documented the importance of these infections in animal and human patients, some decades old.

At the IPRL we’ve been able to identify novel, emerging and often overlooked vector-borne pathogens in individuals and families with a history of exposure. Due to the frequently nonspecific nature of these illnesses, these pathogens have caused symptoms that have been confused for a variety of other diseases.

My hope for One Health Awareness Month is that society and governmental funding agencies will embrace a One Health approach to protect animals, the environment, and the human race. As illustrated by the current coronavirus emergence occurring in China and extending to other parts of the world, including the United States, the health of one can be related to the health of many.

Additional References

Levin, M. L. et al. (2017). Vector competence of Amblyomma americanum (Acari: Ixodidae) for Rickettsia rickettsii. Ticks and Tick-borne Diseases, 8(4), 615-622. doi:10.1016/j.ttbdis.2017.04.006 https://www.sciencedirect.com/science/article/abs/pii/S1877959X16303004

Centers for Disease Control and Prevention. (2020). 2019 novel coronavirus, Wuhan, China: Situation summary. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2Fnovel-coronavirus-2019.html

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**Comment**

We owe Dr. Breitschwerdt a world of gratitude for his dogged persistence in researching Bartonella, a much bigger player in Lyme/MSIDS than the medical establishment is admitting to.  I’m thankful he’s taken bitter experiences his family has experienced and turned them into real life answers for thousands of patients.

For more:  https://madisonarealymesupportgroup.com/2016/01/03/bartonella-treatment/

https://madisonarealymesupportgroup.com/2019/04/24/human-bartonellosis-an-underappreciated-public-health-problem/

 

 

 

Category:

Bartonella, research