The study below reveals what the late stage Lyme community has been experiencing for decades. Late stage Lyme is incurable using the one-size-fits-all IDSA treatment guideline.
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------- Original Message ----------
From: CARL TUTTLE <runagain@comcast.net>
To: afauci@niaid.nih.gov, brett.giroir@hhs.gov, tickbornedisease@hhs.gov
Cc: (96 Undisclosed recipients)
Date: April 5, 2019 at 9:30 AM
Subject: Stationary Phase Persister/Biofilm Microcolony of Borrelia burgdorferi Causes More Severe Disease
To the Tick Borne Disease Working Group;
Finally a study that recognizes late stage chronic Lyme disease that does not respond whatsoever to a single antibiotic treatment regime and required three different antibiotics to clear the infection: daptomycin+doxycycline+ceftriaxone
So much for the one-size-fits-all IDSA treatment guideline intended to limit treatment to the horribly sick Lyme patient......
* Stationary Phase Persister/Biofilm Microcolony of Borrelia burgdorferi Causes More Severe Disease in a Mouse Model of Lyme Arthritis: Implications for Understanding Persistence, Post-Treatment Lyme Disease Syndrome (PTLDS), and Treatment Failure*
Jie Feng, Tingting Li, Rebecca Yee, Yuting Yuan, Chunxiang Bai, Menghua Cai, Wanliang Shi, Monica Embers, Cory Brayton, Harumi Saeki, Kathleen Gabrielson, Ying Zhang
/Discovery Medicine/, online first March 28, 2019, Volume 27, Number
148, March 2019.
or http://tinyurl.com/y4ahku6q
Abstract
Although most patients with Lyme disease can be cured with a 2-4 week antibiotic therapy, about 10-20% of patients continue to suffer prolonged persistent symptoms, a condition called post-treatment Lyme disease syndrome (PTLDS). The cause for PTLDS is unclear and hotly debated. /B. burgdorferi /develops morphological variants under stress conditions but their significance is not clear.
Here we isolated the biofilm-like microcolony (MC) and planktonic (spirochetal form and round body) (SP) variant forms from the stationary phase culture and showed that the MC and SP were not only more tolerant to the current Lyme antibiotics but also caused more severe arthritis in mice than the log phase spirochete form (LOG).
We propose to divide the persistent Lyme disease into two categories:
(1) early development of persistent disease from inoculation with persister/biofilm at the beginning of infection introduced by tick bites, or Type I persistent disease (i.e., PTLDS); and
(2) late development of persistent disease due to initial infection not being diagnosed or treated in time such that the infection develops into late persistent disease, or Type II persistent disease. Importantly, we show that the murine infection caused by LOG could be eradicated by ceftriaxone whereas the persistent infection established with MC could not be eradicated by doxycycline (Doxy), ceftriaxone (CefT), or vancomycin (Van), or Doxy+CefT or Van+CefT, but could only be eradicated by the persister drug combination daptomycin+doxycycline+ceftriaxone.
Our studies demonstrate that varying levels of persistence and
pathologies of Borrelia infection can be established with heterogeneous inocula with different morphologies and have different treatment responses. These observations may have broad implications for
understanding pathogenesis and treatment of not only persistent Lyme
disease but also other persistent infections in general and call for
treatment of persistent infections with persister drug combination
regimens that are more effective than the current often single-antibiotic monotherapy treatment.
*Free, full text*: http://tinyurl.com/y4ahku6q
Carl Tuttle
Lyme Endemic Hudson, NH