Lyme Wars – Part 3

http://www.nbcnewyork.com/on-air/as-seen-on/Lyme-Wars-Part-III-How-Science-Could-Overcome-Lyme_New-York-453167163.html  (Click on link for news video)

Erica Byfield reports on a Johns Hopkins University research center dedicated to curing the tick-borne illness. This is the third in our five-part series on Lyme disease and the debate over the controversial diagnosis of chronic Lyme.

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**Comment**

Christine Heidt of the University of Alberta has written a clear treatise on the issue of the persistence of Lyme (borrelia) TheCaseforthePersistenceofLymeDiseaseAfterAntibioticTherapy

In a study published over 20 years ago, it was reported that “Antibiotic therapy with penicillin, doxycycline, and ceftriaxone has proven to be effective for the treatment of Lyme borreliosis. In some patients, however, it was noticed that borreliae can survive in the tissues in spite of seemingly adequate therapy.”(14) Interestingly, recent studies support this same conclusion. Additionally, researchers have observed that either of the two antibiotics that were administered in the IDSA studies were found to initiate the transformation of the LD spirochete into treatment resistant persister cells and other bacterial forms.(5,6,9,10,11,12,13,14,15,16) Ironically, the four clinical trials meant to support the IDSA’s PTLDS model actually serve to support this recent research, which in turn supports ILADS assertion of reversion to persistent bacteremia causing ongoing symptoms, rather than the IDSA’s expert opinion that the infection has been eradicated and residual symptoms remain indefinitely….

A recent research article co-authored by, Dr Paul Auwaerter (President-elect of the IDSA), entitled “Drug Combinations against Borrelia burgdorferi Persisters In Vitro: Eradication Achieved by Using Daptomycin, Cefoperazone and Doxycycline” suggests that perhaps even the IDSA’s own members are not fully convinced of the IDSA’s version of chronic Lyme disease.(10) While Auwaerter asserts that the cause of PTLDS is unknown, he admits that “findings that suggest the continued presence of B. burgdorferi in some form indicate that current Lyme disease treatment may not sufficiently eliminate B. burgdorferi persisters or that the immune system fails to clear persisting organisms or bacterial debris, which may be the underlying cause for those who suffer from unresolved Lyme disease symptoms.”

Prior to this publication, Dr Auwaerter co-authored a publication with IDSA LD Guidelines members entitled “ Antiscience and ethical concerns associated with advocacy of Lyme disease” where he and the other authors attempt to discredit any research that does not support the IDSA’s PTLDS theories, with statements such as “Some activists portray Lyme disease, a geographically limited tick-borne infection, as a disease that is insidious, ubiquitous, difficult to diagnose, and almost incurable; they also propose that the disease causes mainly non-specific symptoms that can be treated only with long-term antibiotics and other unorthodox and unvalidated treatments. Similar to other antiscience groups, these advocates have created a pseudoscientific and alternative selection of practitioners, research, and publications and have coordinated public protests, accused opponents of both corruption and conspiracy, and spurred legislative efforts to subvert evidence-based medicine and peer-reviewed science.”(21)  

The truth is that over 50% of the IDSA’s guidelines are based on “expert opinion” rather than “evidence-based medicine” as their publication suggests. A further 31% of the IDSA guidelines are based on observational studies. Only a meagre 29% of the IDSA Guidelines fit into “evidence-based medicine”.(22,23,24,25,27) Importantly, the IDSA’s own research supports these very findings.(22) Furthermore, various IDSA members that co-authored the “Antiscience and ethical concerns” publication(21) were also involved with the creation of the Lyme Guidelines although they, themselves hold competing interests. Some members hold patents for LD products, some own shares in companies that have vested interests with the diagnosis and treatment of LD and some act as “expert witnesses in malpractice litigation” against any Dr that dares to question their “expert opinion”.(22,26) Rather than sharing information and learning from others, the IDSA continues to belittle, publicly attack and/or attempt to jail any Dr or researcher that does not endorse their Lyme disease Guidelines and policies.(22) 

Animal studies have also shown detectable borrelia DNA:  Straubinger’s dog study (persist & reactivate).pages

B. burgdorferi disseminates through tissue by migration following tick inoculation, produces episodes of acute arthritis, and establishes persistent infection. The spirochete survives antibiotic treatment and disease can be reactivated in immunosuppressed animals.

http://archives.republicans.foreignaffairs.house.gov/112/HHRG-112-FA16-WState-BartholdS-20120717.pdf  by Stephen W. Barthold, DVM, PhD

It’s been demonstrated in dogs, mice, and monkeys that non cultivable spirochetes persist following antibiotic treatment.  So, researchers have been able to detect borrelia DNA but they have not been able to culture it from tissues.  This has led many researchers to conclude that after treatment with antibiotics, spirochetes are viable but not infectious.

http://www.hoajonline.com/infectdis/2052-5958/1/2

Stricker and Johnson state that the Embers et al. monkey study provides animal evidence for persistent infection when three quarters failed antibiotic treatment and had persistent infection showing up in tissues at necropsy using PCR.  It’s also important to note that “small numbers of intact spirochetes were recovered by xenodiagnosis from treated monkeys.”  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256191/

What this means is researchers put ticks void of infection upon the monkeys after treatment.  After a blood meal they removed the ticks and found spirochetes in them proving there were still spirochetes in the treated monkeys.

This has been done in humans too:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952603/

Dr. Betty Maloney states that the positive xenodiagnostic test in a persistently ill post-treatment subject is highly significant evidence of persistence infection; however, she feels the authors went to great lengths to discount the significance and only questioned whether the recovered DNA was just dead remnants that happened to be in the tick bite site, or due to patient noncompliance with previous therapy, inadequate blood levels of antibiotics, or re-infection.  https://www.lymedisease.org/TheLymeTimes-V26-3/index.html#25/z  The authors concluded there was insufficient evidence.

To read Dr. Horowitz’s comment about episode 3 on his FB page:  https://www.facebook.com/drrichardhorowitz/posts/1524119334343526 He too lists studies as well as the fact treating physicians have found antibiotics to significantly help improve the quality of life of patients and that recent peer-reviewed studies have shown borrelia can persist like TB and leprosy due to biofilms and dormant forms.

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

https://madisonarealymesupportgroup.com/2016/12/21/dr-zhang-on-persisters/

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

https://madisonarealymesupportgroup.com/2017/08/25/sleeper-cells-the-stringent-response-and-persistence-in-the-borreliella-burgdorferi-enzootic-cycle/

And so the circle goes round and round without end.  The IDSA states none of this proves infection.  We ALL want to know why folks are still sick.

And the IDSA wants to have us believe Lyme disease is simple.  Really?