A new study of Rhesus Monkeys clearly shows that Borrelia burgdorferi persists following long term antibiotic treatment. There are three reasons this study stands out:
Macaques were used, not mice. It's more expensize and kinda sad, but it's a better animal host.
Treatment was longterm and multiple antibiotics were used, ceftriaxone (4 weeks) and doxycycline (8 weeks)
Persistence was detected using xenodiagnosis using nimphal ticks and PCR/Fluorescence
This type of study is exactly the kind of research that needs to be done to bring more attention to the persistant nature of Borrelia burgdorferi. Followup research will need to show that the Bb is pathogenic. Signs of heart inflammation were found during the autopsies.
The paper was published on PLoS One so it can be accessed by everyone at: Link to Paper
A new spending bill that funds the Centers for Disease Control is calling for a greater focus on Lyme disease, a request by U.S. Congressman Frank Wolf (R-10th).
The inside story is that Time for Lyme, Inc. lobbied for the language to be included in the appropriations bill. See the lobbying report here (Lobbying Disclosure).
Within CDC, the National Center for Emerging and Zoonotic Infectious Diseases would receive $253.919 million, up $1.476 million, or 0.6%. Conferees urged CDC to expand efforts to develop improved diagnostic tools and tests for Lyme disease, study the feasibility of developing a national reporting system on Lyme disease, and expand public and physician education efforts to prevent Lyme and tick-borne diseases.
Wolf pushed for the language in the bill and has been a long-time advocate for victims of Lyme.
A fully preserved body of a European man was found on top of an icy mountain in Austria in 1991. The "Iceman" is one of a handful of humans to have their entire genetic code sequenced. During the genetic autopsy there was an incredible finding:
"Perhaps most surprising, researchers found the genetic footprint of bacteria known as Borrelia burgdorferi, in his DNA—making the Iceman the earliest known human infected by the bug that causes Lyme disease."
This incredible piece of news was buried deep in the article from National Geographic:
I think you'll enjoy the full article. Early human life is fascinating to me, like how the Iceman had brown hair, brown eyes, and was lactose intolerant.
Other than mummies, the Iceman is the oldest preserved human. The finding of Borrelia burgdorferi means that Lyme disease is the oldest known human pathogen! Holy cow!! Geneticists believe that the modern form of Borrelia diverged 10,000 years ago from its most common predecessor. In bacterial terms, 10,000 years is an incredibly long time. Some conspiracy theorists believe that Lyme disease was engineered but I think these new findings are more mysterious and more plausible. Lyme disease is caused by an ancient pathogen that has survived the ages. It will take all of modern human ingenuity to rid the earth of the plague.
Abbott’s Ibis Biosciences today introduced a new molecular assay to detect a wide variety of vector-borne microorganisms, including those known to cause Lyme Disease, Rocky Mountain Spotted Fever, Babesiosis, Ehrlichiosis and Anaplasmosis. Vector-borne pathogens are microorganisms that are typically transmitted by arthropods such as ticks, mosquitoes or fleas.
The PLEX-ID™ Vector-borne test, which is intended for non-diagnostic use, has been designed to support bioresearch, environmental surveillance, and other activities central to the detection and identification of vector-borne pathogens.
"The PLEX-ID Vector-borne test is a single broad-range molecular assay that can detect a wide array of microorganisms and mixtures of microorganisms in a single specimen," said Mark Eshoo, Ph.D., director, New Technology Development, Ibis Biosciences. "The test can identify protozoa, bacteria, and nematodes, in a wide range of specimen types, including ticks, fleas, blood or tissue."
Dr. Eshoo led a study in which vector-borne disease surveillance researchers in New York and Connecticut collected 299 blacklegged ticks. The ticks were analyzed using the Ibis technology for a wide range of vector-borne microorganisms. Results showed that two-thirds of the ticks were infected with B. burgdorferi, the agent of Lyme disease, and a third of these positive ticks contained other tick-borne co-infections such as Babesia microti or Anaplasma phagocytophilum. The research demonstrated that the Ibis technology can detect and identify B. burgdorferi as well as co-infection in ticks with other vector-borne pathogens quicker than traditional lab methods.
About the
Currently intended for non-diagnostic use, PLEX-ID is the only high-throughput technology that offers rapid and broad identification, detailed genotyping and characterization, and recognition of emerging organisms. The system employs a combination of molecular technologies, including polymerase chain reaction (PCR) for gene amplification and mass spectrometry analysis to rapidly characterize known and unknown organisms. It is designed to address a significant unmet need by providing test results in less than eight hours instead of three or more days required with blood and tissue culture-based methods.
PLEX-ID is designed to identify a broad range of bacteria, viruses, fungi, certain parasites, and also provide information about drug resistance, virulence, and strain type. Anticipated public health and biodefense applications include epidemiologic research and identification of emerging or previously unknown agents. In addition, the system is being used for forensic characterization of human samples.
In 2009, PLEX-ID was recognized by both The Scientist and the Wall Street Journal as a top scientific innovation of the year. The Scientist honored the system because it can detect and characterize a broad range of microorganisms in any given sample. Since its development in 2005, PLEX-ID technology has been deployed in sites around the United States, including the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration.
The 2011 LDA/Columbia Lyme Conference schedule has been released. The conference will be held Oct 1-2, 2011 in Philadelphia. The speakers are top-notch and the topics timely. I'm specifically interested in the Keynote about Biofilms and talks about Cycli-di-GMP, California genotypes, and epileptic seizures. I am also interested to hear John Aucott of Johns Hopkins give a talk about new research he has been conducting.
Keynote Speaker: J. William Costerton, PhD The Role of Biofilms in Chronic Bacterial Infections
Eva Sapi, PhD Killing Borrelia: An impossible job?
Thomas Angel, PhD Lyme disease reflected in the cerebrospinal fluid proteome
Richard Marconi, PhD Cyclic-di-GMP controls critical processes required for completion of the enzootic cycle of the Lyme disease spirochetes
Chris Earnhart, MD Lyme disease vaccine: an update on recent progress
Robert S. Lane, PhD Diversity of Borrelia burgdorferi s.l. genospecies and genotypes in California, and Implications for human infection.
M. Karen Newell Rogers, PhD A New Model of Intervention for Lyme Disease by Targeting Chronic Inflammation and Selective Aspects of Immune Activation:
Robert Yolken, MD Infections and Human Neuropsychiatric Diseases
Josep Dalmau, MD, PhD Clinical spectrum and cellular mechanisms of autoimmunity to NMDA and other synaptic receptors
John Aucott, MD Early microbiologic and immunologic events in Lyme disease
Reinhard K. Straubinger, PhD Canine and equine Lyme borreliosis – The animals’ perspective of the disease.
Benjamin J. Luft, MD Diagnostics: update on protein arrays and new Lyme assays
Brian Fallon, MD What is Chronic Lyme Disease? Models and evidence
Andrew W. Walter, MD Update on Ehrlichiosis and Hemophagocytic Lymphohistiocytosis in Children
Andrea Gaito, MD Clinical Evaluation and treatment of Lyme Arthritis; An autoimmune perspective
Ingeborg Dziedzic, MD What everyone should know about Eyes & Lyme Disease
Vijay Thadani, MD Epilepsy update: distinguishing Epileptic from Non-epileptic seizures
Steve Bock, MD Complementary and Integrative Medical approaches to Chronic Tick-borne Disease
Elizabeth Maloney, MD The treatment of Lyme disease - a critical review of the literature – lessons, gaps, and future research needs
Unforntunately, I won't be able to attend and encourage anyone who is to live-blog the conference. These are the scientists that are advancing Lyme disease research. Nobody is getting rich doing this and I appreciate the dedication of everyones who works in this field.
In the past, the LDA conference would be followed by the ILADS conference. That is not the case anymore. The ILADS conference is later in October in Toronto for 2011.
The journal, Clinical Infectious Diseases, has published a supplement packet (Feb 2011) making an argument for the need for a new Lyme Disease vaccine. The supplement contains 5 articles.
The supplement lays out a convincing argument that we still need a Lyme vaccine despite the "fiasco" of the past. It also highlights the vaccine research at Baxter and Stony Brook.
The lackluster advancements for new therapies and diagnostics for Lyme Disease is a continuing disappointment. However, the profit motive for a Lyme vaccine is more apparent to business than a therapy or diagnostic. By learning from the past failures, a new vaccine could be marketed and become a real success.
My new requirements for a vaccine based on lessons learned:
The vaccine should be available to children, better yet, required in endemic areas
The vaccine should be applicable to European strains
Strong recommendations from the CDC and FDA are requirements
Promote to health providers not the public
Clinical studies need to look for genetic links to adverse reactions, possibly pairing the vaccine with a companion diagnostic to eliminate risky sub-populations
Although Lyme disease has not yet permeated the national milieu, the numbers speak for themselves. Here are the CDC numbers for "Notifiable diseases" that were reported in 2008. Lyme disease is right behind AIDS and within several years will surpass AIDS in the US, if it hasn't already.
The Lyme and Tick-borne Diseases Research Center at Columbia University Medical Center was established in April 30, 2007 in a joint collaboration between Columbia University, Time for Lyme, Inc. (a volunteer not-for-profit activist organization), and the LDA. The center has some very worthwhile goals which include:
Comparing Laboratory Test Accuracy
Specimen Bank (blood/CSF from PLDS patients AND cerebral tissue from deceased)
Second Opinions
Evaluating SPECT Brain scans as a diagnostic tool
Establishing a neuro-cognitive profile for Lyme disease
Neurimaging studies
Biomarker research as a diagnostic tool
Training Fellowships(2 Post doc positions and 2 summer MD internships)
Collecting cerebral tissues is a great idea! I would suggest expanding the specimen bank to include other tissue types, urine, skin punch, and fat. The establishment of a dedicated center at a major research university is a huge accomplishment. I encourage you to learn more about the center by reading their website at http://www.columbia-lyme.org
The Interview:
On July 16th, Dr. Brian Fallon, Lyme Center Director and Dr. Carolyn Britton, Associate Professor of Clinical Neurology at Columbia Medical Center appeared on the WNYC Leonard Lopate program entitled "Please Explain - Lyme Disease". In this informative program, they discussed the basics of Lyme disease and highlighted issues regarding symptoms, treatment, diagnosis and prevention. You can listen to the broadcast on the WNYC website or listen now.
"The Current", a radio program broadcast in Canada and Sirius, recently interviewed several Lyme specialists. Canadian Doctor Maureen McShane contracted Lyme Disease and a went through an aggressive treatment regimen and now has devoted her practice to Lyme Disease. She suffered a great deal and has strong opinions about co-infections and Chronic Lyme Disease. What she experienced is normally called late-stage Lyme disease, the dangers are debilitating symptoms, misdiagnoses, and a potentially fatal outcome. When patients experience non-resolution of symptoms after treatment the accepted term for the disease state is "Post Treatment Lyme Disease Syndrome" or PLDS.
Although each Lyme patients story is unique, Doctor McShane's story struck me as quintessential. Listen to how she describes symptoms for late-stage neurological Lyme.
(The interviews start after the over-population teaser)
The second interview is of Nick Ogden, another Canadian doctor who works for the Public Health Department. The best information from this interview is that Lyme Disease is now a reportable disease in Canada. He wants to somehow warn the public of the rising threat of Lyme Disease but not create an unwarranted scare. The belief that both are possible is doublethink. In today's desensitized society, it's not possible to penetrate the public's consciousness without the application of fear tactics, large sums of money, or celebrity endorsements.
New videos made by the cast of the hit show "Vampire Diaries" effectively warn people of the dangers of ticks.
"Ticks and Tick-borne Diseases" is a new scientific journal published by Elsevier GmbH. The journal comes out quarterly and is already in its second issue. The journal focuses on tick biology, tick ecology, tick-borne pathogens, and tick-borne diseases of animals and humans. The first issue contained 1 Editorial, 2 Mini Reviews, 6 Regular Papers, 1 Short Communication, and 1 Obituary.
I quickly reviewed the articles and found them very interesting. A paper titled, "A spatially-explicit model of acarological risk of exposure to Borrelia burgdorferi-infected Ixodes pacificus nymphs in northwestern California based on woodland type, temperature, and water vapor" looked interesting due to the large number of nymphs tested in California. The paper states, "In total, 4.9%(264) of 5431 I. pacificus nymphs tested for the presence of B. burgdorferi were infected." That is a lot of nymphs to capture, extract and test individually. The infection rate is similar to other recent studies where Northern California ticks were tested. First author on the paper was Rebecca J. Eisen and last author was Robert Lane, the tick ecologist from UC Berkeley.
Three new grant opportunities totalling $800k are available through the CDC to improve upon the two-tier diagnostic regime for Lyme Disease and to study Post-Treatment Lyme Disease Syndrome (PLDS). Each are small steps in the right direction. Put your applications in by April 14th!
The PLDS grant is an R01 type grant. Typically R01's may be followed up by 4 more years of funding, so the opportunity is larger than it seems. Often this initial work can lead to larger opportunities but to have a shot at the R01 you must already have done some interesting work into PLDS or have an applicable semi-developed technology.
I wish the amounts of the grants were higher but don't look a gift horse in the mouth.
