Please see the letter below addressed to Dr. Lochhead of Mass General Hospital after he responded to a second letter I sent asking additional questions about the following Lyme disease study: MicroRNA expression shows inflammatory dysregulation and tumor-like proliferative responses in joints of patients with post-infectious Lyme arthritis http://onlinelibrary.wiley.com/doi/10.1002/art.40039/abstract Letter to Dr. Lochhead of Mass General Hospital ________________________________________ From: "Carl Tuttle" To: "Robert B. Lochhead" Cc: "richard bucala" , ASTEERE@mgh.harvard.edu Sent: Wednesday, February 1, 2017 9:25:20 AM Subject: Re: MicroRNA expression shows inflammatory dysregulation and tumor-like proliferative responses in joints of patients with post-infectious Lyme arthritis. On Jan 30, 2017 Dr. Lochhead wrote: “This is a complex disease, and we are dedicating our careers as scientists and physicians to help patients suffering from the Lyme disease epidemic. We ask for your patience and support as we carry on our work.” Dear Dr. Lochhead, It was once believed that rifampin was curative in treating Brucellosis but when symptoms returned doxycycline was added to the mix and when that too failed a third antibiotic, streptomycin was added to the current treatment regimen. [1] [2] In 1985 the worldwide incidence of leprosy was 6,000,000. Last year, it was 800,000. The only thing that changed was the addition of rifampin to dapsone in the treatment of the disease. Rifampin was added to dapsone because the M leprae were becoming resistant and it was a new antibiotic at that time. Treatments for multidrug-resistant tuberculosis have been introduced (bedaquiline and delamanid) with more in the pipeline. [3] A new treatment for recurrent Clostridium difficile was recently studied (bezlotoxumab) for reducing the risk of a repeat infection. [4] In contrast, oral amoxicillin or doxycycline remains the treatment of choice for treating Lyme disease for over thirty years regardless if debilitating symptoms return. Dr. Allen Steere knew that these antibiotics were not effective for all patients [5] (see attachment) but there has been no change in treatment or research to find more effective ways to eradicate the infection in all stages of disease. Your studies are looking into treatment for the Lyme patient who failed the recommended 30yr old treatment protocol after damage has already been done and you ask for patience as you carry on your work? At what point in time do we recognize that we are dealing with an antibiotic resistant/tolerant superbug and focus our research on finding new antimicrobials for this life-altering/life-threatening disease? Steere and his thirty year bias against persistent infection are toxic to the advancement of science as more of the population becomes severely disabled from persistent Lyme disease. The focus has been to discredit the sick and disabled along with the clinicians attempting to help these people as we observed in the Lancet article in which Steere coauthored: Antiscience and ethical concerns associated with advocacy of Lyme disease http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(11)70034-2/abstract?rss=yes Your research at Mass General Hospital may or may not help a very small percentage of patients with rheumatologic complications from Lyme disease but it won’t end the suffering of hundreds of thousands perhaps millions worldwide from this growing 21st Century plague. The advancement in the treatment of Lyme disease will come from researchers who recognize that the groupthink mentality spearheaded by Steere and his colleagues is the most shameful affair in medical history. Good luck with your work and career Dr. Lochhead. Sincerely, -Carl Tuttle REFERENCES ________________________________________ [1] Chronic Brucellosis and Persistence of Brucella melitensis DNA https://www.ncbi.nlm.nih.gov/pubmed/?term=Chronic+Brucellosis+and+Persistence+of+Brucella+melitensis+DNA After acute brucellosis infection, symptoms persist in a minority of patients for more than 1 year. Such patients are defined as having chronic brucellosis. Since no objective laboratory methods exist to confirm the presence of chronic disease, these patients suffer delays in both diagnosis and treatment. [2] Administration of a triple versus a standard double antimicrobial regimen for human brucellosis more efficiently eliminates bacterial DNA load. https://www.ncbi.nlm.nih.gov/pubmed/25246401 The doxycycline-streptomycin-rifampin regimen eliminates Brucella DNA more efficiently than doxycycline-streptomycin, which may result in superior long-term clearance of Brucella. [3] Global Introduction of New Multidrug-Resistant Tuberculosis Drugs—Balancing Regulation with Urgent Patient Needs https://wwwnc.cdc.gov/eid/article/22/3/15-1228_article [4] New C.diff treatment reduces recurrent infections by 40% https://www.sciencedaily.com/releases/2017/01/170126081724.htm [5] Lyme arthritis: an epidemic of oligoarticular arthritis in children and adults in three connecticut communities. Steere AC, Malawista SE, Snydman DR, Shope RE, Andiman WA, Ross MR, Steele FM. Excerpt: "The best treatment for this illness is not clear. Some physicians have reported that penicillin or tetracycline results in disappearance of the skin lesion (41,42), but others find antibiotics ineffective. Four of the patients with expanding skin lesions received penicillin but still developed arthritis." 2nd Response from Dr. Lochhead: ________________________________________ From: "Robert B. Lochhead" To: "Carl Tuttle" Sent: Monday, January 30, 2017 10:35:46 AM Subject: RE: MicroRNA expression shows inflammatory dysregulation and tumor-like proliferative responses in joints of patients with post-infectious Lyme arthritis. Dear Mr. Tuttle, Thank you for your continued interest in my research. Your questions highlight the importance of finding effective solutions for patients with Lyme disease for whom the current antibiotic regimen is not working. This is a complex disease, and we are dedicating our careers as scientists and physicians to help patients suffering from the Lyme disease epidemic. We ask for your patience and support as we carry on our work. Regards, Robert Lochhead, Ph.D.