Archive for the ‘research’ Category

Acute Onset Confusion in Elderly Man – Had Bb

Neuroborreliosis and acute encephalopathy: The use of CXCL13 as a biomarker in CNS manifestations of Lyme borreliosis

Karrasch M, Fingerle V, Boden K, Darr A, Baier M, Straube E, Nenadic I.
Ticks and Tick-borne Diseases, online first, 2017 Dec 11.

https://doi.org/10.1016/j.ttbdis.2017.12.008https://doi.org/10.1016/j.ttbdis.2017.12.008

Abstract

We report the case of an 80-year-old patient with acute onset confusion initially suspected to reflect delirium in incipient Alzheimer’s disease.

Cerebrospinal fluid tests revealed an unusually severe form of neuroborreliosis, which resolved following antibiotic treatment. This was mirrored in the measurement of CXCL13, which is suggested as a complementary biomarker.

Clinical implications for screening, differential diagnosis and treatment are discussed.

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For more:

https://madisonarealymesupportgroup.com/2017/06/10/the-coming-pandemic-of-lyme-dementia/

https://madisonarealymesupportgroup.com/2017/01/18/a-bug-for-alzheimers/

https://madisonarealymesupportgroup.com/2016/06/09/alzheimers-byproduct-of-infection/

https://madisonarealymesupportgroup.com/2016/11/17/antibiotics-and-alzheimers/

https://madisonarealymesupportgroup.com/2016/06/03/borrelia-hiding-in-worms-causing-chronic-brain-diseases/

https://madisonarealymesupportgroup.com/2017/10/03/treat-the-infection-psychiatric-symptoms-get-better/

https://madisonarealymesupportgroup.com/2017/11/01/lyme-mental-illness-dr-jane-marke/

https://madisonarealymesupportgroup.com/2017/06/04/minocycline-for-ms-and-much-more/

 

Bb Infected Ticks in Iowa

Range Expansion and Increasing Borrelia burgdorferi Infection of the Tick Ixodes scapularis (Acari: Ixodidae) in Iowa, 1990-2013.

Oliver JD, Bennett SW, Beati L, Bartholomay LC.
Journal of Medical Entomology. 2017 Nov 7;54(6):1727-1734.

https://doi.org/10.1093/jme/tjx121

Abstract

A passive surveillance program monitored ticks submitted by the public in Iowa from 1990–2013. Submitted ticks were identified to species and life stage, and Ixodes scapularis Say nymphs and adults were tested for the presence of Borrelia burgdorferi.

An average of 2.6 of Iowa’s 99 counties submitted first reports of I. scapularis per year over the surveillance period, indicating expansion of this tick species across the state. The proportion of vector ticks infected by B. burgdorferi increased over time between 1998 and 2013.

In 2013, 23.5% of nymphal and adult I. scapularis were infected with B. burgdorferi, the highest proportion of any year. Active surveillance was performed at selected sites from 2007–2009. Ixodes scapularis nymphs collected at these sites were tested for the presence of B. burgdorferi, Anaplasma phagocytophilum, and spotted fever group Rickettsia spp. (likely representing Rickettsia buchneri).

Nymphs tested were 17.3% positive for B. burgdorferi, 28.9% for A. phagocytophilum, and 67.3% for Rickettsia spp. The results of these surveillance programs indicate an increasing risk of disease transmission by I. scapularis in Iowa.

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For more:  https://madisonarealymesupportgroup.com/2017/08/17/of-birds-and-ticks/

https://madisonarealymesupportgroup.com/2017/12/03/biologists-at-sf-state-dig-into-ticks-and-ld/

https://madisonarealymesupportgroup.com/2017/10/06/remembering-dr-masters-the-rebel-for-lyme-patients-who-took-on-the-cdc-single-handedly/  “Go here: http://steveclarknd.com/wp-content/uploads/2013/11/The-Confounding-Debate-Over-Lyme-Disease-in-the-South-DiscoverMagazine.com_.pdf for a great article on how Andrew Spielman’s tick maps ruled Lyme Land like the iron curtain, and frankly still do, dictating where Lyme is and is not. https://madisonarealymesupportgroup.com/2017/08/24/canine-maps-better-than-the-cdcs-in-predicting-lyme-disease/ (nothing’s changed)”

 

 

 

 

TBRF in Texan Dogs – Yep: Despite Poor Tests it’s There

Serological detection of Tick-Borne Relapsing Fever in Texan domestic dogs

Esteve-Gasent MD, Snell CB, Adetunji SA, Piccione J.
/PLoS One/. 2017 Dec 12;12(12):e0189786. eCollection 2017.

https://doi.org/10.1371/journal.pone.0189786

Abstract

Tick-Borne Relapsing Fever (TBRF) is caused by spirochetes in the genus
/Borrelia/. Very limited information exists on the incidence of this
disease in humans and domestic dogs in the United States. The main
objective of this study is to evaluate exposure of dogs to /Borrelia
turicatae/, a causative agent of TBRF, in Texas.

To this end, 878 canine serum samples were submitted to Texas A&M
Veterinary Medical Diagnostic Laboratory from October 2011 to September
2012 for suspected tick-borne illnesses. The recombinant Borrelial
antigen glycerophosphodiester phosphodiesterase (GlpQ) was expressed,
purified, and used as a diagnostic antigen in both ELISA assays and
Immunoblot analysis. Unfortunately, due to significant background
reaction, the use of GlpQ as a diagnostic marker in the ELISA assay was
not effective in discriminating dogs exposed to /B/. /turicatae/.
Nevertheless, immunoblot assays showed that 17 out of 853 samples tested
were considered to be seropositive, which constitutes 1.99% of all Texas
samples tested in this study.

The majority of positive samples were from central and southern Texas.
Exposure to TBRF spirochetes may be seasonal, with 70.59% (12 out of 17)
of the cases detected between June and December. In addition, 2 out of
the 17 sero-reactive cases (11.76%) showed reactivity to both /B/.
/burgdorferi/ (causative agent of Lyme disease) and /B/. /turicatae/ (a
causative agent of TBRF).

This is the first report of TBRF sero-prevalence in companion animals in
an endemic area. Our findings further indicate that /B/. /turicatae/ is
maintained in domestic canids in Texas in regions where human disease
also occurs, suggesting that domestic dogs could serve as sentinels for
this disease.

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**Comment**

I predict much more to come.  Texan Lyme/MSIDS patients – we stand with you.

For a must-read important history about the South’s fight to be recognized as having tick borne illness:  https://madisonarealymesupportgroup.com/2017/10/06/remembering-dr-masters-the-rebel-for-lyme-patients-who-took-on-the-cdc-single-handedly/

People in the South are commonly denied treatment:  https://madisonarealymesupportgroup.com/2016/09/24/arkansas-kids-denied-lyme-treatment/

https://madisonarealymesupportgroup.com/2017/10/24/no-lyme-in-oklahoma-yeah-right/

And Texans have had enough of the denial and are taking action:  https://madisonarealymesupportgroup.com/2017/11/15/lyme-patients-file-lawsuit-against-idsa-and-insurers-over-treatment-denials/

“Remember the Alamo!”

https://madisonarealymesupportgroup.com/2017/03/09/remember-vicki-logan/

 

Duke Studying Alternatives to Antibiotics for Lyme

https://corporate.dukehealth.org/news-listing/lyme-study-uses-drug-discovery-methods-have-fueled-cancer-breakthroughs

Lyme Study Uses Drug Discovery Methods That Have Fueled Cancer Breakthroughs

Labs at Duke and other academic centers collaborate to identify alternatives to antibiotics

Published December 13, 2017 

Ticks can spread the bacterium that causes Lyme disease

DURHAM, N.C. – Antibiotics are currently the only treatments available for Lyme disease and other tick-borne illnesses, but researchers at Duke Health are working to expand the medical toolkit by identifying vulnerable areas of disease-causing bacteria that could lead to innovative therapies.

The research project, which recently received a $3.8 million grant from the Steven & Alexandra Cohen Foundation, relies on drug discovery methods that have proven successful in identifying treatments for cancer and viral diseases.

“Our goal is to find alternatives to antibiotics to treat Lyme disease, which is caused by the Borrelia burgdorferi bacterium, and illnesses that arise from the Bartonella pathogen,” said Neil Spector, M.D., the Sandra Coates Associate Professor Breast Cancer Research at Duke Cancer Institute and the study’s co-principal investigator.

“We’re hoping to move from isolating targets to identifying potential drugs to testing in animal models within three years – so a very aggressive timeline,” said Spector, who was a Lyme patient himself and nearly died from complications of disease. “Our goal is to identify drugs that will target the Achilles’ heel of these pathogens while sparing the normal gut microbiome.”

Spector and co-principal investigator Timothy Haystead, Ph.D., professor in the department of Pharmacology and Cancer Biology at Duke, are collaborating with scientists at Johns Hopkins School of Medicine and Tulane Medical Center to perform distinct functions of the study.

The Duke team will use technology Haystead’s lab has pioneered for cancer drug discovery, which will identify protein targets for the development of a completely new class of molecularly targeted therapies for Borrelia burgdorferi and Bartonella.

The team at Duke will then screen thousands of new compounds to identify those that target the desired proteins. The new compounds identified at Duke will then be tested at Johns Hopkins in a high-throughput assay to evaluate their effects on the viability of Borrelia burgdorferi and Bartonella.

The most promising drug candidates will then be sent to Tulane, where researchers will determine their efficacy in animal models of Bartonella illnesses and Lyme diseases, including in primates.

The Spector and Haystead labs have already identified more than 20 bacterial proteins that represent attractive targets for drug development. The protein targets are selected in part for their specificity to Borrelia burgdorferi, which would reduce the risk of adverse side effects such as the destruction of normal, healthy gut flora.

Duke researchers have begun screening a library of thousands of compounds looking for potential drugs that target a specific Borrelia burgdorferi protein that plays a key role in promoting the survival of the bacteria.

The research project represents a new exploration for Spector, a leading cancer researcher who was instrumental in the development of lapatinib, the first oral inhibitor of the HER2/neu cancer promoting protein approved by the FDA for the treatment of a subset of breast cancers. Spector’s interest in Lyme disease research stems from his personal experience with the infection, which he battled for years without a clear diagnosis. After suffering near-fatal heart failure, he underwent a heart transplant in 2009.

Spector said many features of cancer are also true of Lyme. For example, how and where tumors spread is not random. Similarly, Lyme affects different people in different ways, and Spector asserts that there are likely biological factors at play.

“I think there’s a way to capitalize on the lessons we’ve learned in cancer biology and basic research over the past 20 years and apply them to Lyme research,” Spector said. “We don’t have to reinvent the wheel.”

Contact

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Live Bb Found – Months After Doxy

https://www.news-medical.net/news/20171214/Study-Living-Lyme-disease-bacteria-found-months-after-antibiotic-treatment.aspx

Study: Living Lyme disease bacteria found months after antibiotic treatment

Bay Area Lyme Foundation, a leading sponsor of Lyme disease research in the US, today announced results of two papers published in the peer-reviewed journals PLOS ONE http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0189071 and American Journal of Pathology, that seem to support claims of lingering symptoms reported by many patients who have already received antibiotic treatment for the disease.

Based on a single, extensive study of Lyme disease designed by Tulane University researchers, the study employed multiple methods to evaluate the presence of Borrelia burgdorferi spirochetes, the bacteria that cause Lyme disease, before and after antibiotic treatment in primates. The study also measured the antibody immune response to the bacteria both pre- and post- treatment, as this is how current diagnostics typically evaluate Lyme disease in humans.

The data show that living B. burgdorferi spirochetes were found in ticks that fed upon the primates and in multiple organs after treatment with 28 days of oral doxycycline. The results also indicated that the immune response to the bacteria varied widely in both treated and untreated subjects.

“It is apparent from these data that B. burgdorferi bacteria, which have had time to adapt to their host, have the ability to escape immune recognition, tolerate the antibiotic doxycycline and invade vital organs such as the brain and heart,” said lead author Monica Embers, PhD, assistant professor of microbiology and immunology at Tulane University School of Medicine.

“In this study, we were able to observe the existence of microscopic disease and low numbers of bacteria, which would be difficult to ‘see’ in humans but could possibly be the cause of the variable and nonspecific symptoms that are characteristic of post-treatment Lyme disease syndrome. Although current antibiotic regimens may cure most patients who are treated early, if the infection is allowed to progress, the 28-day treatment may be insufficient, based on these findings,” Embers said.

The findings also demonstrated:

  • All subjects treated with antibiotics were found to have some level of infection 7 – 12 months post treatment.
  • Despite testing negative by antibody tests for Lyme disease, two of 10 subjects were still infected with Lyme bacteria in heart and bladder.
  • Lyme bacteria which persist are still viable.

To better elucidate previous animal studies demonstrating that some B. burgdorferi bacteria survive antibiotics, the study explored Lyme disease infection in rhesus macaque primates treated with antibiotics and a control group who were also infected but not treated. This species has been shown to demonstrate a progression of Lyme disease most similar to humans, particularly related to erythema migrans, carditis, arthritis, and neuropathy of the peripheral and central nervous systems.

“Clearly, some medical practices governing diagnosis and treatment of Lyme disease should be reconsidered in light of this study. This study shows that we must reevaluate the current paradigm of antibody response tests for diagnosis and move away from the one size fits all approach to Lyme treatment,” said

In the study, ticks carrying B. burgdorferi spirochetes fed on ten primates. Four months post infection, half of the primates (five) received the antibiotic doxycycline orally for 28 days at a proportional dose to that used in human treatment. Five subjects were treated with placebo and all ten were evaluated by more than five different diagnostic methods to characterize any remaining infection. The researchers used several important techniques, including xenodiagnoses, to determine if the spirochete bacteria persisted.

The results show:

  • Few subjects displayed a rash. Although all subjects were infected, only one of the 10 displayed a rash with central clearing, the classical “bulls-eye” rash. The subject that developed this rash, interestingly, never mounted an immune response to five borrelia antigens throughout the study period, prior to and following treatment.
  • Organs may be infected even if antibody tests are negative. One subject which tested negative for B. burgdorferi by skin biopsy cultures, PCR and in vivo cultures, was found to have B. burgdorferi infecting the heart. Another untreated subject, who was ultimately shown to have residual Lyme bacteria in the bladder, showed a decrease in immune response over the course of infection, with a negative xenodiagnosis test in the late stage, which would signal that the animal self-cured.
  • Intact spirochetes were found in three of five treated and four of five untreated subjects based on xenodiagnosis results 12 months after the tick bite.
  • Immune responses to B. burgdorferi varied greatly post-treatment, with one subject’s antibody levels dropping to pre-bite levels for three antigens while another subject experienced elevated antibodies for the same antigens throughout the study period. This is significant because it demonstrates that subjects infected with the same strain of B. burgdorferi may have different immune responses to the same antigen. And, because humans, like primates, are genetically diverse, it underscores that testing antibody responses may be inherently unreliable as a singular diagnostic modality for Lyme disease.
  • Widespread and variable microscopic disease was observed in all infected subjects, despite antibiotic treatment. Compared to uninfected subjects of the same age, infected subjects in this study (treated and untreated) demonstrated Inflammation in and around the heart, in skeletal muscles, joints, and the protective sheath that covers the brain, and near peripheral nerves.
  • Rare, but intact B. burgdorferi spirochetes were found in the tissues of both the treated and untreated subjects. In two subjects treated with doxycycline, multiple Lyme bacteria were observed in the brain tissue. Others organs in which the spirochetes were observed included the heart, joints, bladder, skeletal muscle and adjacent to peripheral nerves.
    Source:
    http://tulane.edu/

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For more:  https://madisonarealymesupportgroup.com/2017/11/03/lyme-bug-stronger-than-antibiotics-in-animals-and-test-tubes-now-study-people/

https://madisonarealymesupportgroup.com/2015/09/19/proof-of-borrelia-persistence/

https://madisonarealymesupportgroup.com/2017/08/18/drexel-prof-lyme-persists/

https://madisonarealymesupportgroup.com/2017/12/02/scottish-doctor-gives-insight-on-lyme-msids/   “If you look at major medical microbiology and infectious disease textbooks, they state that after 4 weeks you can’t find the Lyme bacteria anymore. Therefore Lyme is then categorised as ‘post infectious’. But I get back to the point I’ve made before: if you can’t culture it, you cannot know anything about its viability. You do not have a organism specific test (culture or PCR), that guides your ‘test of cure’. How do you say that a bacteria is killed, when you couldn’t grow and measure it in the first place?”  “One of the rules of infectious diseases medicine is that once you stop treatment and the patient stays better, they are cured. When they get worse, the infection has returned and they have relapse of infection and need repeat treatment. My ID colleagues live by that rule with most other infections, but not with Lyme.”