Archive for the ‘research’ Category

Suspected Insect and Arthropod Vectors for Bartonella Species – Galaxy

https://www.galaxydx.com/suspected-bartonella-vectors/

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Suspected Insect and Arthropod Vectors for Bartonella species

Vector-borne diseases like bartonellosis and Lyme borreliosis require the transfer of pathogens from a reservoir to humans by a “competent” vector.

A competent vector can acquire, carry, and pass on the living pathogen. The vector is generally an insect or arthropod that picks up the pathogen(s) while feeding from a reservoir species, such as deer or mice, and later infects an accidental host (a host that is not the usual reservoir) such as a human via a bite or excretions (feces).

Despite what may seem like an obvious cause and effect relationship, it can be very difficult to prove that a vector is competent. Some scientists have heroically proven vector competency by infecting themselves. You can read more about scientists who died as a result of making themselves their own Bartonella experiments here.

Because of the work of those scientists and others, we know that

  • Bartonella bacilliformis is transmitted by keds (biting flies)
  • Bartonella quintana is transmitted by body lice
  • Bartonella henselae is transmitted by fleas

After that the science becomes more uncertain.

The most controversial vector for Bartonella species is hard-bodied ticks of the genus Ixodes. PCR-based assays that detect fragments of DNA have shown that Bartonella bacteria can be found in their gut. However, the research on how viable bacteria are transmitted is still incomplete.

In one study of Ixodes ricinus collected in France, the authors were able to show that Bartonella henselae could be transmitted using an artificial feeding method. If one were to question whether this were adequate proof, the question would center around the fact that the transmission was observed in a controlled laboratory setting and not in nature.

Patients with Bartonella and other tick-borne infections sometimes recall a single tick bite that may have allowed for multiple pathogens to be transferred. Some scientists see this evidence as circumstantial as well and suggest more research is necessary before ticks are considered a competent vector for Bartonella.

Research and case studies have suggested additional arthropod vectors such as ants, mites, spiders, and more. They are not typically suspected in bartonellosis cases due to the very limited number of cases, but the potential is there. See below for some interesting cases:

  • Spiders
    • A family that lived in a house infested with woodlouse spiders became ill from Bartonella infections. Researchers suggested that the spiders were feeding on woodlice, which are also known as roly-polies or pill bugs but are actually land-dwelling crustaceans and not bugs at all. Woodlice have been shown to carry Bartonella species. Researchers suspected that the spiders fed on the infected woodlice and then transmitted the bacteria to the patients via bites.
  • Red ants
    • A man was hospitalized for encephalopathy due to a Bartonella henselae infection following red ant bites. While in the hospital, he experienced two episodes of cardiac arrest. He recovered after receiving systemic anticoagulatory medications and antimicrobials.
  • Triatomines or “Kissing bugs”
    • These biting insects are known to transmit the protozoa Trypanosoma cruzi, which causes Chagas disease. The authors of this paper discuss the role of the sand fly in transmitting Bartonella bacilliformis and suggest Bartonella species could be similarly transmitted in the saliva of other biting insects.
  • Mites
    • Some studies suggest various species of mites as possible vectors of Bartonella species. DNA from Bartonella quintana was incidentally discovered in Demodex mites of a patient with rosacea. Furthermore, mites found on tropical rats and bats showed evidence of carrying Bartonella species as well.

The development of novel molecular techniques like PCR and its variations have allowed researchers to detect Bartonella species in a wide range of insects, arthropods and crustaceans around the world.

Our ePCR technology is used by research partners around the world to better understand the One Health relationship between people, animals and the environment. Mapping the relationship between reservoirs, vectors and human and animal hosts is an important step in making prevention the best treatment.

References

Bradley, J. M. et al. (2014). Bartonella henselae infections in an owner and two Papillon dogs exposed to tropical rat mites (Ornithonyssus bacoti). Vector Borne and Zoonotic Diseases, 14(10), 703-709. doi:10.1089/vbz.2013.1492 https://www.ncbi.nlm.nih.gov/pubmed/25325313

Cotté, V. et al. (2008). Transmission of Bartonella henselae by Ixodes ricinus. Emerging Infectious Diseases, 14(7), 1074-1080. doi:10.3201/eid1407.071110 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600320/

do Amaral, R. B. et al. (2018). Molecular detection of Bartonella spp. and Rickettsia spp. In bat ectoparasites in Brazil. PLoS One, 13(6), e0198629. doi:10.1371/journal.pone.0198629 https://www.ncbi.nlm.nih.gov/pubmed/29870549

Guru, P. K. et al. (2018). A miraculous recovery: Bartonella henselae infection following a red ant bite. BMJ Case Reports, 2018, bcr-2017-222326. doi:10.1136/bcr-2017-222326 https://www.ncbi.nlm.nih.gov/pubmed/29728431?fbclid=IwAR0hoMRFwoz5jVPlepkpigJ6A0zuHWrRoRy4vhNIHxNPtEotjXwqrj6NRa4

Hofmeester, T. R. et al. (2018). Role of mustelids in the life-cycle of ixodid ticks and transmission cycles of four tick-borne pathogens. Parasites & Vectors, 11(1). doi:10.1186/s13071-018-3126-8 https://www.ncbi.nlm.nih.gov/pubmed/30458847

Mascarelli, P. E. et al. (2013). Bartonella henselae infection in a family experiencing neurological and neurocognitive abnormalities after woodlouse hunter spider bites. Parasites & Vectors, 6, 98. doi:10.1186/1756-3305-6-98 https://www.ncbi.nlm.nih.gov/pubmed/23587343

Murillo, N. et al. (2014). Bartonella Quintana detection in Demodex from erythematotelangiectatic rosacea patients. International Journal of Infectious Diseases, 29, 176-177. https://doi.org/10.1016/j.ijid.2014.07.021 https://www.ijidonline.com/article/S1201-9712(14)01606-3/fulltext

Viera, C. B. et al. (2018, November). Triatomines: Trypanosomatids, bacteria, and viruses potential vectors? Frontiers in Cellular and Infection Microbiology [Online]. doi:10.3389/fcimb.2018.00405 https://www.ncbi.nlm.nih.gov/pubmed/30505806

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**Comment**

One thing’s for sure – patients in Lyme-land OFTEN have Bartonella as well. Mainstream medicine/research doesn’t even contemplate or consider this well established fact and continues to treat this as a one-pathogen, one-drug disease when nothing could be further from the truth: https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/  This recent paper sums it up nicely:

“Our findings recognize that microbial infections in patients suffering from TBDs (tick borne diseases) do not follow the one microbe, one disease Germ Theory as 65% of the TBD patients produce immune responses to various microbes.”

For the first time, Garg et al. show a 85% probability for multiple infections including not only tick-borne pathogens but also opportunistic microbes such as EBV and other viruses.

And, according to this review, 83% of all commercial tests focus only on Lyme (borrelia), despite the fact we are infected with more than one microbe.  The review also states it takes 11 different visits to 11 different doctors, utilizing 11 different tests to be properly diagnosed.  https://www.news-medical.net/news/20181101/Tick-borne-disease-is-multiple-microbial-in-nature.aspx?

Thousands of patients are flying under the radar.

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

https://madisonarealymesupportgroup.com/2019/06/06/high-titers-of-bartonella-found-in-patients-with-musculoskeletal-complaints/

https://madisonarealymesupportgroup.com/2019/03/21/bartonella-sudden-onset-adolescent-schizophrenia-a-case-study/

https://madisonarealymesupportgroup.com/2018/05/07/fox-news-bartonella-is-the-new-lyme-disease/

https://madisonarealymesupportgroup.com/2018/03/15/risk-of-transmission-of-bartonella-via-blood-transfusion-chile/

https://madisonarealymesupportgroup.com/2019/05/09/bartonella-transmitted-to-children-at-birth-causing-chronic-infections/

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

Category:

Bartonella, research, Testing, Ticks, Transmission

When Lyme Kills

https://elemental.medium.com/when-lyme-kills

Illustration by Anuj Shrestha

When Lyme Kills

The extremely rare complication you should know about
Jun 24 2019

This story is part of “Tickpocalypse,” a multi-part special report.

Joseph Elone just felt tired at first, like he wasn’t sleeping well. Soon, however, Joseph developed cold symptoms — a cough, a sore throat, head and body aches, digestive problems, and a low-grade fever.

The doctor saw little reason for concern. Joseph likely had the flu, he said. He prescribed the standard regimen — rest, fluids, and the like — and suggested they give it time.

But a few days later, Joseph’s symptoms worsened. He was feeling light-headed and said he was sensitive to bright light. He returned to the same doctor, who ordered blood tests for strep throat, Lyme disease, and another tick-borne illness called anaplasmosis. The results were all negative.

It would take at least four months and several incorrect diagnoses to determine the cause of Joseph’s death, but ultimately, examinations revealed the presence of Lyme bacteria in several of his organs, including his heart.

(See link for entire article)

This story is part of “Tickpocalypse,” a multi-part special report.

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**Comment**

Well, if this isn’t heartbreaking, I don’t know what is.

There are numerous points that should be mentioned:

  1. The media, researchers, and doctors need to refrain from the word “RARE” on pretty much anything regarding tick-borne illness. Notice out of one side of his mouth, the author states the same year Elone died, the CDC released a report of three other deaths related to Lyme, “which led to further inquiries that uncovered numerous additional instances in New York state…leading experts to wonder if Lyme deaths might actually be more common than previously thought.”  Then, out of the other side of his mouth he announces with certainty that it’s rare. This is illogical and undermines the seriousness of this. All I can say is Zika was handled very differently.
  2. Please take note that spirochetes riddled his body. They were all over. How many dead bodies have to pile up before the CDC/IDSA/NIH believe Lyme is serious and that those with persistent symptoms just might be chronically infected, with spirochetes riddling our bodies? Instead, we have bone-heads saying we have MUS (medically unexplained symptoms), which essentially means he believes we are psychosomatic:  https://madisonarealymesupportgroup.com/2019/06/11/dr-eugene-shapiro-medically-unexplained-symptoms/  Video of Shapiro stating he believes our symptoms are completely unrelated to Lyme, i.e. – MUS. He also states the parents weren’t happy with his findings….gee, I wonder why?
  3. Again, regarding only 20% of patients being in the PTLDS group: https://madisonarealymesupportgroup.com/2019/02/25/medical-stalemate-what-causes-continuing-symptoms-after-lyme-treatment/, microbiologist Holly Ahern states that number is incorrect and only includes those patients diagnosed and treated early. When you add the 10-20% in this category with the 30-40% NOT diagnosed and treated, you get a whopping potential 60% of ALL patients who go on to develop chronic/persistent symptoms.  This is HUGE and downplayed. Little to no research exists on this patient group and yet they are in the majority.
  4. If you want to take a peek at the number of people DYING from Lyme: http://whatislyme.com/rip-lyme-friends-memorial/  Collected by Lyme patient and advocate Lisa Hilton, she’s also made a chart and listing of Lyme deaths: http://whatislyme.com/is-lyme-disease-fatal/, based upon 219 Lyme deaths.  
Is that still considered rare?

 

 

Category:

Activism, Heart Issues, Lyme, research, Ticks

Babesiosis Could Be More Common in Sweden Than Previously Thought

https://www.ncbi.nlm.nih.gov/pubmed/31265116/

2019 Jun 28;116. pii: FL4D.

Babesiosis could be more common in Sweden than previously thought

[Article in Swedish]
Svensson J1, Lazarevic V2, Bläckberg J3, Olsson M4, Persson K1.

Abstract

Babesia is a malaria-like, intraerythrocytic parasite with more than 100 different species. It is a zoonosis and some of the species are transmitted to humans by ticks and also as a possible transfusion-transmitted infection. In Sweden the disease has been well known in veterinary medicine for a long time, but only a few but severe cases have been published in humans during the last decades. Common symptoms from human Babesia infections (babesiosis) are fever, chills and myalgia and they vary from subclinical to potentially fatal among those with risk factors such as immunosuppression and splenectomy. In the U.S. more than 2,000 cases of babesiosis are found yearly and it is one of the most frequent fatal infections following blood transfusion. A study from southern Sweden has recently revealed a seroprevalence of 16% of Babesia antibodies among Borrelia-infected persons. These results indicate that there is a need to broaden awareness of Babesia in Sweden.

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**Comment**

This abstract underplays the prevalence of Babesia. Not sure why they state it is a possible transfusion-transmitted infection when the Red Cross recently came out with a test to screen Babesia for blood.  It’s an obvious problem:

https://madisonarealymesupportgroup.com/2019/07/11/characteristics-of-transfusion-transmitted-babesia-microti-american-red-cross-2010-2017/

Here’s an even earlier article going transfusion-transmission:  https://madisonarealymesupportgroup.com/2016/12/15/blood-screening-for-babesia/  of those confirmed to be positive, 20% were PCR-positive, with 13% antibody-negative.

Here we have babies contracting it from blood:  https://madisonarealymesupportgroup.com/2017/09/27/premature-infants-develop-babesia-via-blood-transfusion

Here we have people contracting Babesia from transfusions, even in non-endemic areas.  https://madisonarealymesupportgroup.com/2017/08/08/transfusion-transmitted-babesiosis-in-nonendemic-areas/   Excerpt:

“Asymptomatic individuals with Babesia infection are able to donate blood in the United States because of the lack of specific blood donation testing. Blood products collected in Babesia-endemic areas are distributed nationally; thus, clinicians in nonendemic states may fail to include babesiosis in the differential diagnosis of a patient who had a recent transfusion history and a fever of unknown origin.”  

In the abstract, those with Lyme also had a seroprevalence of 16% of Babesia antibodies. In this study,  https://madisonarealymesupportgroup.com/2016/11/19/seroprevalence-of-babesia-in-individuals-with-ld/  it was nearly 29%. To me this demonstrates those with Lyme are at risk for Babesia and other pathogens.

To date, little work has been done on concurrent infections, and has been underplayed for decades.

The most important, recent work demonstrating multiple pathogen involvement:  https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/  This shows Lyme patients are at risk for not only other tick borne illnesses but opportunistic infections as well.  This is what we experience and see in the real world of Lymeland.

I don’t think mainstream medicine has a clue how important concurrent infection is.

http://www.nejm.org/doi/full/10.1056/NEJM199807163390304  When left untreated, silent babesial infection may persist for months or even years. Although treatment with clindamycin and quinine reduces the duration of parasitemia, infection may still persist and recrudesce and side effects are common. Improved treatments are needed.

Dr. Krause published in the New England Journal of Medicine that when a patient has Lyme and Babesia, Lyme is found three-times more frequently in the blood, proving Babesia suppresses the immune system.  http://danielcameronmd.com/babesia-and-lyme-its-worse-than-you-think/

https://madisonarealymesupportgroup.com/2017/06/28/concurrent-babesiosis-and-lyme-in-patient/   Dr. Horowitz warns that due to this immune suppression,patients with Rheumatoid Arthritis or Lupus and are on immunosuppressant drugs, if they have Babesia, could get much worse. The strain, B. divergens, causes a higher mortality rate and more severe symptoms, and if left untreated, this strain can develop into shock-like symptoms with pulmonary edema and renal failure.

More on Babesia:  https://madisonarealymesupportgroup.com/2016/01/16/babesia-treatment/  Dr. Horowitz, a nationally recognized LLMD, states Babesia is one of the most tenacious coinfections he sees in his patients and that treatment often takes 9 months to a year, particularly with those also infected with Lyme disease (borrelia).  Treatment options for you to discuss with your practitioner in this link.  

 

 

 

 

 

Category:

Babesia, Lyme, research

Characteristics of Transfusion-Transmitted Babesia Microti, American Red Cross 2010-2017

https://www.ncbi.nlm.nih.gov/pubmed/31250463/

2019 Jun 27. doi: 10.1111/trf.15425. [Epub ahead of print]

Characteristics of transfusion-transmitted Babesia microti, American Red Cross 2010-2017.

Tonnetti L1, Townsend RL1, Dodd RY1, Stramer SL1.

Abstract

BACKGROUND:

Babesia microti, a red blood cell (RBC) parasite transmitted naturally to vertebrate hosts by ixodid ticks, is endemic to the northeastern and upper midwestern United States, with the geographic range of infected ticks expanding. B. microti is a blood safety issue with >200 transfusion-transmissions reported.

METHODS:

The American Red Cross’s Hemovigilance program investigated hospital-reported transfusion-transmitted babesiosis (TTB) cases. Follow-up samples from involved donors were tested for B. microti antibodies and parasite DNA, the latter by real-time polymerase chain reaction (PCR). Test-positive donors were permanently deferred from future donations.

RESULTS:

B. microti-positive donors were implicated in 77 of 143 suspect TTB cases investigated from 2010 through 2017. In four cases, two positive donors were identified for a total of 81 positive donors. In three cases, a RBC unit was split and components transfused multiple times to the same pediatric recipient. RBCs were the transmitting product in all cases. At follow-up, all involved donors were antibody positive; 25 donors were also PCR positive. Positive donations were collected throughout the year, peaking in the summer. Most donors (78) were resident of, or traveled to (2), an endemic state. One donor resided in a non-endemic state without relevant travel history. One fatality listed babesia as a contributing factor. No implicated donation was screened by an investigational protocol.

CONCLUSIONS:

Babesiosis remains a blood safety issue. Prior to FDA-licensed screening test availability and final FDA Guidance, blood collectors in endemic states investigationally tested none, a portion, or all collections. Future expanded testing will reduce the frequency of TTB cases.

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**Comment**

This clearly shows there were more than 200 Babesia transfusion-transmissions reported. It also shows you don’t have to reside in an endemic area or travel to an endemic area to get it. The article also clearly points out that the geographic range of ticks is expanding, which means the pathogens they carry will as well.

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

Babesia, as well as Lyme is under reported. Research hardly exists on those with both. We desperately need to know what concurrent infection is doing to patients. It only makes logical sense that their cases are more severe and of greater duration, yet mainstream research and medicine doesn’t blink at this issue:

Going back to 1998, it was known that when a patient has Lyme and Babesia, Lyme is found three-times more frequently in the blood, causing greater symptoms, disease severity, and duration of illness:  https://reference.medscape.com/medline/abstract/8637139

What happens when a patient has Lyme, Babesia, and Bartonella and maybe a few viruses thrown in for good measure?  Nobody’s studied this, yet it is common scenario in Lyme-land:  https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/

Category:

Babesia, research, Testing, Ticks

Chronic Inflammation Removes Motivation By Reducing Dopamine in the Brain

https://www.news-medical.net/news/20190605/Chronic-inflammation-removes-motivation-by-reducing-dopamine-in-the-brain.aspx

Chronic inflammation removes motivation by reducing dopamine in the brain

June 5, 2109

Written by Dr. Liji Thomas

Why do we feel listless when we are recovering from an illness? The answer is, apparently, that low-grade chronic inflammation interferes with the dopaminergic signaling system in the brain that motivates us to do things.

This was reported in a new paper published in the journal Trends in Cognitive Sciences.

The research carried out at Emory University explains the links between the reduced release of dopamine in the brain, the motivation to do things, and the presence of an inflammatory reaction in the body. It also presents the possibility that this is part of the body’s effort to optimize its energy expenditure during such inflammatory episodes, citing evidence gathered during their study.

The authors also published an experimental framework based on computational tools, devised to test the theory.

The underlying hypothesis is that the body needs more energy to heal a wound or overcome an infection, for instance, both of which are associated with low-grade inflammation. To ensure that energy is available, the brain uses an adaptive technique to reduce the natural drive to perform other tasks which could potentially drain away the energy needed for healing. This is essentially a recalibration of the specialized reward neurons in the motivation center of the brain, so that ordinary tasks no longer feel like they’re worth doing.

According to the new study, the mechanism of this recalibration is immune-mediated disruption of the dopamine pathway, reducing dopamine release.

The computational technique published by the scientists is designed to allow experimental measurements of the extent to which low-grade inflammation affects the amount of energy available, and the decision to do something based on the effort needed. This could allow us to better understand why and how chronic inflammatory states cause a lack of motivation in other disease conditions as well, including schizophrenia and depression.

Andrew Miller, co-author of the study, says,

“If our theory is correct, then it could have a tremendous impact on treating cases of depression and other behavioral disorders that may be driven by inflammation. It would open up opportunities for the development of therapies that target energy utilization by immune cells, which would be something completely new in our field.”

It is already known that immune cells release cellular signaling molecules called cytokines, which affect the functioning of the dopamine-releasing neurons in the area of the brain called the mesolimbic system. This area enhances our willingness to work hard for the sake of a reward.

Dopamine

Image Copyright: Meletios, Image ID: 71648629 via shutterstock.com
Recently, it was discovered that immune cells also enjoy a unique capability to shift between various metabolic states, unlike other cells. This could affect cytokine release patterns in such a way as to signal the brain to conserve available energy for the use of the immune system.
These facts were the foundation of the new hypothesis, which explains it in terms of evolutionary adaptation. In the hypothetical early environment, the immune system, faced with abundant microbial and predatory challenges, needed tremendous amounts of energy. It therefore had its own mechanism to signal other body systems, via the mesolimbic dopamine system, to control the use of energy resources during periods when the organism was undergoing severe or sudden stress.
Modern life is relatively soft and less challenging. With less physical activity, low-grade inflammation is chiefly due to factors such as obesity, chronic stress, metabolic syndrome, aging and other lifestyle illnesses. This could mistakenly cause the mesolimbic dopamine neurons to produce less dopamine. Lower dopamine levels in turn decrease the motivation for work, by reducing the perception of reward while increasing the perception of effort involved. This ultimately conserves energy for use by the immune system.
Previous studies by Miller as well as other scientists have shown that a high level of immune functioning in association with low levels of dopamine and reduced motivation characterizes some cases of schizophrenia, depression and certain other mental health conditions.
The scientists do not think these disorders are caused by the low-grade inflammation, but that some people who have these illnesses are hypersensitive to immune cytokines. This could in turn cause them to lose motivation for daily living.
The scientists are currently performing a clinical trial on people with depression, to test the theory using the computational framework.

 

Source: Treadway M. T. et al., (2019). Can’t or Won’t? Immunometabolic Constraints on Dopaminergic Drive. Trends in Cognitive Sciences. https://doi.org/10.1016/j.tics.2019.03.003

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**Comment**
Interestingly,
2017 May;3(3). doi: 10.15761/JSIN.1000163. Epub 2017 May 11.

Lyme and Dopaminergic Function: Hypothesizing Reduced Reward Deficiency Symptomatology by Regulating Dopamine Transmission.

Blum K1,2,3,4,5,6,7, Modestino EJ8, Febo M1, Steinberg B8, McLaughlin T9, Fried L2, Baron D5, Siwicki D7, Badgaiyan RD6.

Abstract

The principal vector of Lyme disease in the United States is Ixodes scapularis: black legged or deer ticks. There is increased evidence that those infected may be plagued by anxiety or depression as well. Researchers have identified transcripts coding for two putative cytosolic sulfotransferases in these ticks, which recognized phenolic monoamines as their substrates. It is hypothesized that protracted Lyme disease sequelae may be due to impairment of dopaminergic function of the brain reward circuitry. The subsequent recombinant proteins exhibited sulfotransferase function against two neurotransmitters: dopamine and octopamine. This, in itself, can reduce dopamine function leading to many Reward Deficiency Syndrome behaviors, including depression and possibly, anxiety. In fact, it was shown that activity of Ixosc Sult 1 and Sult 2 in the Ixodid tick salivary glands might contain inactivation of the salivation signal through sulfonation of either dopamine or octopamine. This infraction results in a number of clinically observed mood changes, such as anxiety and depression. In fact, there are common symptoms observed for both Parkinson and Lyme diseases. The importance of understanding the mechanistic and neurobiological effects of Lyme on the central nervous system (CNS) provides the basis for pro-dopamine regulation as a treatment. WC 195.

Great article on dopamine:  https://suzycohen.com/articles/depression_low_dopamine/ Excerpt:

Dopamine deficiency will cause you to wake up sluggish in the morning, usually with brain fog, but you might feel happier and suddenly more enthusiastic with a “hit” of some sort, perhaps a cup of coffee.  Low dopamine (as opposed to low serotonin) causes a different kind of depression, one that is hallmarked by a lack of pleasure.

 

 

 

 

Category:

Inflammation, Lyme, Psychological Aspects, research