Archive for the ‘research’ Category

Ocular Bartonellosis

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5318637/
J Trop Med. 2017; 2017: 7946123.
Published online 2017 Feb 7. doi:  10.1155/2017/7946123
PMCID: PMC5318637

Clinical Profile and Visual Outcome of Ocular Bartonellosis in Malaysia
Chai Lee Tan, Lai Chan Fhun,  Evelyn Li Min Tai, Nor Hasnida Abdul Gani, Julieana Muhammed, Tengku Norina Tuan Jaafar, Liza Sharmini Ahmad Tajudin, and Wan-Hazabbah Wan Hitam 

Abstract

Background. Ocular bartonellosis can present in various ways, with variable visual outcome. There is limited data on ocular bartonellosis in Malaysia. Objective. We aim to describe the clinical presentation and visual outcome of ocular bartonellosis in Malaysia. Materials and Methods. This was a retrospective review of patients treated for ocular bartonellosis in two ophthalmology centers in Malaysia between January 2013 and December 2015. The diagnosis was based on clinical features, supported by a positive Bartonella spp. serology. Results. Of the 19 patients in our series, females were predominant (63.2%). The mean age was 29.3 years. The majority (63.2%) had unilateral involvement. Five patients (26.3%) had a history of contact with cats. Neuroretinitis was the most common presentation (62.5%). Azithromycin was the antibiotic of choice (42.1%). Concurrent systemic corticosteroids were used in approximately 60% of cases. The presenting visual acuity was worse than 6/18 in approximately 60% of eyes; on final review, 76.9% of eyes had a visual acuity better than 6/18. Conclusion. Ocular bartonellosis tends to present with neuroretinitis. Azithromycin is a viable option for treatment. Systemic corticosteroids may be considered in those with poor visual acuity on presentation.

In the results section we learn that 19 patients with ocular bartonellosis were followed from 3-68 weeks. Neuroretinitis is an inflammation of the neural retina and optic nerve which can be caused by viruses, autoimmune disease, or bacteria including: syphilis, Rocky Mountain Spotted Fever, toxoplasmosis, toxocariasis, histoplasmosis, leptospirosis, and Lyme Disease. Tuberculosis and Tularemia can also present similarly. The most common ocular complaint was blurred vision with around 60% reporting headaches as their initial symptom.

We also learn that the treatment of choice was Azithromycin followed by Doxycyline, ciprofloxacin, ceftazidime, and cotrimoxazole, with 60% receiving systemic corticosteroid therapy. The discussion section states that the treatment of Bartonellosis is still controversial and that they had to resort of isolated case reports for information.

http://webeye.ophth.uiowa.edu/eyeforum/cases/36-CatScratchBartonella.htm In this case study a 44 year old woman had non-specific blurriness of vision in her left eye. After they went through about every other possibility, they asked about pets at which she showed multiple cat scratches on her arms.

Laboratory results showed:
*White blood cell count: 18,200 with left shift (12,194 segmented neutrophils and 3276 bands)
*Bartonella Henselae IgG 1:1024 (strongly positive)

According to this study, a literature review suggested that a one month course of doxycycline or erythromycin (with or without rifampin) is adequate to treat the organism and hasten recovery. They chose a one month course of doxycycline 100 mg twice daily. The patient returned for follow-up appointments one and two months after this initial diagnosis. Vision improved to 20/60 in the affected eye, improving visual fields, decreased optic disc edema, and resolving sub-retinal fluid.

The case study also states that diagnosis officially requires 3 out of 4 criteria:
• Lymphadenopathy in the absence of other reason (can be missed because it is not present yet or subclinical)
• Positive Bartonella H. titer or skin test
• Known cat contact, preferably with pustule or papule at the site
• Lymph node biopsy with bacilli present, necrosis

They admit this woman met only 2 of the criteria. They also state it is well documented patients will almost always get better on their own but that hundreds of reports give various treatment regimens including doxycycline, erythromycin, rifampin, azithromycin, ciprofloxacin, later addition of steroid drop, and many others.

The unfortunate thing about both of these reports is they make Bartonellosis out to be a benign pathogen, which for Lyme/MSIDS patients couldn’t be further from the truth.

As to the criteria to diagnose:

Thankfully, this woman didn’t present with swollen lymph nodes so they had to find a reason and state it was either subclinical or hadn’t presented yet.

*Hardly anyone I know with Bartonella has swollen lymph nodes.

*The testing for Lyme and every coinfection, including Bartonella, is abysmal.

*They emphasize the cat’s role but don’t even mention ticks, mites, biting flies, other arachnids, sand flies, mosquitoes, fleas and flea feces, the human body louse, potentially from needles and syringes in the drug addicted, as well as bites and scratches from other reservoir hosts.

*As to node biopsy, even this NIH study shows a lack of specificity and lack of typical micro abscesses in almost half of the cases and may mimic other lymphadenopathies.
https://www.ncbi.nlm.nih.gov/pubmed/26551620

*https://wwwnc.cdc.gov/eid/article/22/3/15-0269_article This CDC article states that Bartonella spp. may be the cause of unclear and undiagnosed chronic illness in humans previously bitten by ticks.

*They also fail to mention there are 15 species and counting of Bartonella known to infect humans and that Dr. Ricardo Maggi states, “This case reinforces the hypothesis that any Bartonella species can cause human infection.”
http://townsendletter.com/July2015/bartonellosis0715_3.html  Besides the cat (including bobcats, mountain lions, and other large cats), rats, dogs, rabbits, deer, cattle, small woodland animals, rodents, coyotes, foxes, and elk were found to harbor Bart.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88941/ The question really should be, “What doesn’t carry Bartonella?”

https://madisonarealymesupportgroup.com/2016/01/03/bartonella-treatment/  Here, Dr. Mozayeni states about 60% of Lyme patients tested positive for Bartonella and that it is one of the major coinfections. This link also has treatments, explanation of Bartonella including what it does and how it can present, along with a link for a checklist you can print out and take to your doctor to discuss.

I appreciate Dr. Breitschwert’s and Dorsey Kordick’s comment in the concluding remarks,

“Not too long ago, many were taught during microbiology courses (or medical school training) that blood is generally a sterile medium. Increasingly, this assertion must be qualified with regard to Bartonella spp. as well as other intracellular pathogens that have coevolved with humans and animals to persist in circulating blood cells such as erythrocytes or macrophages for months to years and perhaps longer.”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88941/

I wish more researchers were this transparent, then perhaps patients would be taken more seriously.   And, don’t kid yourself, Bartonella is a formidable foe to the immunocompromised.

Category:

Bartonella, Lyme, mosquitoes, research, Ticks, Transmission, Treatment

Study Shows Probiotic Helps Depression in Mice

Published on Feb 10, 2017

Researchers at the University of Virginia School of Medicine have reversed depression symptoms in mice by feeding them Lactobacillus, a probiotic bacteria found in some yogurts. Further, the researchers have determined exactly how the bacteria affect mood, providing a concrete link between the health of the gut microbiome and mental health.

Based on their findings, they suspect their discovery will hold true in people and are planning to confirm theirs findings in depressed patients.

“The big hope of this kind of research is that we won’t need to bother with complex drugs and side effects when we can just play with the microbiome,” explained researcher Alban Gaultier, PhD. “It would be magical just to change your diet, to change the bacteria you take, to fix your health – and your mood.”

Lyme/MSIDS patients often have depression and are required to take many medications to effectively deal with numerous Tick Born Infections.  Adding anti-depressants and other medications can yield nasty side-effects.  This mouse study is promising in that taking probiotics do not have the downsides of prescription anti-depressants.  Not only that, these good-guy bacteria help line the gut to prevent or lessen leaky gut syndrome.

https://news.virginia.edu/content/uva-reverses-depression-symptoms-mice-using-probiotics  Evidently, the researchers found that the lower the level of Lactobacillus in the gut, the higher the level of kynurenine, a blood metabolite, which drives depression symptoms.  Mouse behavior was directly correlated to Lactobacillus levels.

Study here:  http://www.nature.com/articles/srep43859

Microbiota alteration is associated with the development of stress-induced despair behavior
Ioana A. Marin, Jennifer E. Goertz, Tiantian Ren, Stephen S. Rich, Suna Onengut-Gumuscu, Emily Farber, Martin Wu, Christopher C. Overall, Jonathan Kipnis & Alban Gaultier

Abstract
Depressive disorders often run in families, which, in addition to the genetic component, may point to the microbiome as a causative agent. Here, we employed a combination of behavioral, molecular and computational techniques to test the role of the microbiota in mediating despair behavior. In chronically stressed mice displaying despair behavior, we found that the microbiota composition and the metabolic signature dramatically change. Specifically, we observed reduced Lactobacillus and increased circulating kynurenine levels as the most prominent changes in stressed mice. Restoring intestinal Lactobacillus levels was sufficient to improve the metabolic alterations and behavioral abnormalities. Mechanistically, we identified that Lactobacillus-derived reactive oxygen species may suppress host kynurenine metabolism, by inhibiting the expression of the metabolizing enzyme, IDO1, in the intestine. Moreover, maintaining elevated kynurenine levels during Lactobacillus supplementation diminished the treatment benefits. Collectively, our data provide a mechanistic scenario for how a microbiota player (Lactobacillus) may contribute to regulating metabolism and resilience during stress.

 

 

Category:

diet and nutrition, Psychological Aspects, research

Gulf War Illness, Vaccines, MSIDS, & Brain Damage

http://www.usatoday.com/story/news/nation/2013/03/20/research-ties-gulf-war-illness-to-brain-damage/1982817/  There is now physical proof that Gulf War Illness is caused by damage to the brain.  http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0058493  

Gulf War Illness affects more than 250,000 vets and causes black-outs, cysts on scalp, inability to concentrate, chronic headaches, liver damage, Tourette’s syndrome, chronic fatigue, lesions on the brain, heart and lungs, skin rashes, thyroid cancer, paralysis of the stomach, respiratory problems, vertigo, autoimmune disorders, liver damage, chronic fatigue, allergies, pain, and more.

 

Until now most cannot get benefits or treatment, and to add insult to injury vets are accused of faking it or suffering from post traumatic stress.  James Baraniuk, senior author and professor of medicine at Georgetown University Medical Center, regarding doctors, states,

“If it doesn’t fall within their small world of known diseases, then the patient is nuts.”

Using fMRI (functional MRI) machines, researchers saw anomalies in the bundle of nerve fibers that interpret pain signals in the brain in 31 Gulf War veterans. The research appears to correlate with previous research on Gulf War Illness, including a major study showing problems in involuntary function, as well as a study showing as many as 100,000 troops may have been doused with Sarin gas when the U.S. Air Force bombed a munitions factory during the war.

The good news about a fMRI (functional MRI) is it allows doctors to diagnose Gulf War Illness quickly, and while most hospitals are equipped with MRI equipment they may need to install fMRI software and be trained to use it.

Researchers suspect environmental factors such as Sarin gas, ACHL-inhibitors found in nerve agents, anti-nerve-agent pills, pesticides, and vaccines, particularly the Anthrax Vaccine which is a 6-shot regimen adjuvanted by aluminum hydroxide, and squalene.

The military calls Gulf War Syndrome an emotional ailment. Refusing the vaccine has ended in dishonorable discharge, fines, and prison. Malcom Hopper M.D. Emeritus Professor of Medicinal Chemistry at a University in Britain, and the chief advisor to the Gulf War Veterans in the UK states that those who have received the vaccine have horrific pain in their sexual organs such as burning semen syndrome. The number of infants born without eye sockets has sky-rocketed following Executive Order 13139. Over 1,000,000 military personnel have adverse side effects to the Anthrax Vaccine (RAC-GWVI Government report 2008). Today 35,000 new soldiers receive the Anthrax Vaccine each month (RAC-GWVI Government Report 2014).   https://madisonarealymesupportgroup.com/2017/03/25/vaccines-revealed-6-please-share-with-all-military-members/

Baraniuk states the research is important because it shows that Gulf War Illness is NOT psychological.  He also states:

“If 30% of Congress got sick, or 30% of Manhattan got sick, there would have been an outcry.” Also, “The guys who were robust and leading the charge on this 10 years ago are now using canes.”

Many military members also suffer from Lyme/MSIDS, including Mycoplasma.  

https://madisonarealymesupportgroup.com/2017/03/21/military-veterans-suicide-and-lymemsids/

https://www.ncbi.nlm.nih.gov/m/pubmed/15694687/  Owen DC. Med Hypothesis.  2005.

Abstract

Symptoms of Gulf War Syndrome and chronic Lyme disease are very similar. Lyme disease is a condition which can be difficult to diagnose since one of the main features of the condition, the erythema migrans rash, may be absent or overlooked and serological testing for Lyme disease may be falsely negative. Symptoms of Lyme disease may not became apparent until years after exposure to the causative organism. Military personnel during training in the field are at risk of tick bites and it may be that those who developed Gulf War Syndrome entered the conflict with latent Lyme disease. There has been no systematic examination of Gulf War Syndrome sufferers for chronic Lyme disease and it is hypothesized that chronic Lyme disease has been overlooked as a cause of Gulf War Syndrome. To address this it is suggested that sufferers of Gulf War Syndrome or similar illnesses should be examined by physicians who have experience diagnosing and treating large numbers of patients with Lyme disease.

https://madisonarealymesupportgroup.com/2015/08/12/connecting-dots-mycoplasma/

 

 

Category:

Activism, Lyme, Mycoplasma, research, vaccines

LymeSeq – New Lyme/MSIDS Test Explained

http://www.azpbs.org/arizonahorizon/play.php?vidId=10327

Arizona PBS

Airdate: March 21, 2017

Lyme Disease is spread by ticks and can be difficult to diagnose because symptoms mimic other illnesses. The group Focus on Lyme is funding research at the Translational Genomics Research Institute in Phoenix to increase the speed and accuracy of Lyme Disease diagnosis with a test called LymeSeq.

Tammy Crawford, the executive director of Focus on Lyme, explains the new test.

Listen to interview in link above.

Category:

Babesia, Bartonella, Lyme, Mycoplasma, research, Rickettsia, Testing

Sulfa Drugs Against Stationary Phase Bb in Vitro

http://www.mdpi.com/2079-6382/6/1/10

Jie Feng, Shuo Zhang, Wanliang Shi and Ying Zhang *
Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
Academic Editor: Christopher C. Butler
Received: 19 January 2017 / Revised: 7 March 2017 / Accepted: 14 March 2017 / Published: 22 March 2017

Abstract

Lyme disease is a most common vector-borne disease in the US. Although the majority of Lyme patients can be cured with the standard two- to four-week antibiotic treatment, at least 10%–20% of patients continue to suffer from prolonged post-treatment Lyme disease syndrome (PTLDS). While the cause for this is unclear, one possibility is that persisting organisms are not killed by current Lyme antibiotics.

In our previous studies, we screened an FDA drug library and an NCI compound library on B. burgdorferi and found some drug hits including sulfa drugs as having good activity against B. burgdorferi stationary phase cells. In this study, we evaluated the relative activity of three commonly used sulfa drugs, sulfamethoxazole (Smx), dapsone (Dps), sulfachlorpyridazine (Scp), and also trimethoprim (Tmp), and assessed their combinations with the commonly prescribed Lyme antibiotics for activities against B. burgdorferi stationary phase cells.

Using the same molarity concentration, dapsone, sulfachlorpyridazine and trimethoprim showed very similar activity against stationary phase B. burgdorferi enriched in persisters; however, sulfamethoxazole was the least active drug among the three sulfa drugs tested. Interestingly, contrary to other bacterial systems, Tmp did not show synergy in drug combinations with the three sulfa drugs at their clinically relevant serum concentrations against B. burgdorferi.

We found that sulfa drugs combined with other antibiotics were more active than their respective single drugs and that four-drug combinations were more active than three-drug combinations. Four-drug combinations dapsone + minocycline + cefuroxime + azithromycin and dapsone + minocycline + cefuroxime + rifampin showed the best activity against stationary phase B. burgdorferi in these sulfa drug combinations.

However, these four-sulfa-drug–containing combinations still had considerably less activity against B. burgdorferi stationary phase cells than the Daptomycin + cefuroxime + doxycycline used as a positive control which completely eradicated B. burgdorferi stationary phase cells. Future studies are needed to evaluate and optimize the sulfa drug combinations in vitro and also in animal models.

Category:

Lyme, research, Treatment