Borrelia – In the Lymelight

March 8, 2013

Joel (Snowathlete) continues his series on zoonotic pathogens with a thorough examination of Borellia and Lyme disease – and their possible relevance for ME/CFS patients.

Borrelia

Borrelia spirochete
by Tina Carvalho, University of Hawaii at Manoa

Borrelia is the bacterium that causes borreliosis. It is a microscopic spiral-shaped parasite. There are many different species of Borrelia, some of which cause Lyme borreliosis, otherwise known as Lyme disease.

Borrelia is a zoonotic pathogen transmitted via a vector, usually a tick. There is evidence that other arthropods such as fleas, biting flies, mites and spiders also carry it, but so far there is only limited – mainly anecdotal – evidence of transmission to humans by non-tick arthropods.

Transmission from ticks appears to be the most common and important method of transmission, perhaps because ticks have a salivary protein called Salp15 which the Borrelia attaches to and which is thought to have immunosuppressive effects [1].  Following transmission, Borrelia can travel through the body quite rapidly, including into the central nervous system [2, 3].

How common is it?

Borreliosis, including Lyme and Lyme-like diseases, is one of the most prevalent infectious diseases in the world. In the USA it is the most commonly-reported vector-borne disease and the sixth most common disease nationally. It is more prevalent in the northeast and upper Midwest of the US; in Massachusetts, only hepatitis and HIV-AIDS are more common, despite under-reporting.

deer ticks in a row

Deer Ticks (Ixodes scapularis)
Photo by Sandy__R

In the past there has been a view that tick-borne infections, particularly Borrelia, are only common in the US and that other parts of the world don’t have a problem. This is simply not the case, with the UK, mainland Europe and Asia/Oceania also affected. The disease is the same, the ticks (and often the species of Borrelia) are different.

The existence of Lyme disease in Australia is controversial. The government has strict border controls to stop foreign insects and pathogens from entering the country, and the government have been reluctant to accept that there is a local problem, claiming that Borrelia infection occurs outside the country when people travel abroad. Most Lyme organizations in Australia dispute this and so does some of the medical literature [4].

Different strains

In North America, the predominant strain that causes Lyme disease is Borrelia burgdorferi. This strain also occurs in Europe and Asia, though B. garinii and B. afzelii are more common in these areas. Many other strains are known to infect humans and cause disease, some being suspected of causing Lyme, or Lyme-like illness. In particular, two other strains; B. spielmanii and B. bavariensis (both closely related to B. burgdorferi) are now widely acknowledged to cause Lyme disease.

Some strains have only been confirmed to cause borreliosis in the last few years, but have possibly been doing so for much longer [5].

Co-infections

Those diagnosed with Lyme disease often have co-infections, usually transmitted by the same tick that gave them Borrelia, and these co-infections can complicate disease and treatment. Some of the more common co-infections are Babesia, Rickettsia, Ehrlichia and Bartonella, and they can be serious in their own right. It is common for ticks to transmit multiple pathogens in one bite. Some of these other pathogens will be discussed in detail in future articles in the zoonotics series.

Symptoms

Borrelia colony

Borrelia spirochete agglomeration into colony-like masses.
Image courtesy of BioMed Central.

When you peruse a list of symptoms caused by Lyme disease or other borreliosis, you can’t help but notice that most of the symptoms in the list are the same, or similar, to those belonging to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and fibromyalgia.

As with ME/CFS the disease tends to get worse over time with new symptoms developing. A quick Google search will return many pages with information on symptoms. As most readers will be familiar with the majority of these symptoms already, I won’t try to list them here. Instead, I will focus on those symptoms that are usually distinguishable from ME/CFS, though not everyone with Lyme disease will have these symptoms.

  • Lyme can cause paralysis of facial muscles, sometimes called Bell’s palsy. It tends to be on only one side of the face and often is not permanent.
  • Meningitis may also develop from Lyme, or from other forms of borreliosis, and is another symptom which is not as common in ME/CFS.
  • Atrophy of the skin may occur, especially with treatment as the Borrelia rise to the peripheral circulation to avoid antibiotic contact.

Having any of the above may signal that you have Lyme rather than ME/CFS, though not having them doesn’t necessarily rule out Lyme.

The other species of Borrelia that cause non-Lyme borreliosis tend to produce milder symptoms, the main presentation being relapsing fever or short-term virus-like illness, but some strains such as B. miyamotoi can, in some cases, cause severe disease [5].

Borrelia’s effect on the immune system and its ability to change form

Borrelia cyst

Borrelia cysti, covered by a thick membrane masking the contents of the cyst.
Image courtesy of BioMed Central.

Borrelia is reported to spread quickly to the central nervous system [2, 3] where it is harder to touch, and it is thought that the longer you’ve had it, the harder it is to get antibiotics to these places to kill it.

Genetically speaking, Borrelia is a very advanced bacterium [6]. It is pleomorphic, which means that it can change form from a spirochete to a cell-wall-deficient L-form [25] which is thought to be a mechanism of defense and antibiotic resistance [7, 8]. There is also evidence that Borrelia is able to create biofilm [9] which is thought to provide resistance to antibiotics and immune cells.

Borrelia is the only bacterium with 21 plasmids (B. burgdorferi), which gives it a diverse arsenal. Plasmids are pieces of DNA separate from the chromosomal nucleus of the cell, and they express surface-proteins that are essential to the bacteria’s pathogenicity [10].

Ötzi the Iceman

The remains of Ötzi the Iceman, a deceased human discovered in the Alps in 1991, were found to be infected with Borrelia burgdorferi [11, 12], showing that the bacteria has been infecting humans for at least 5300 years.

Nevertheless, there is some suggestion that Lyme disease has become more pathogenic recently as cases have increased so much in the last 50 years. This may in fact be down to improved recognition and reporting, but there is another theory that it is related to changes in the environment that have favored ticks.

Another interesting view is that Lyme may cause autoimmunity [13,14,15], which is interesting because autoimmune diseases appear to have been on the increase in the modern age as well, and some people believe ME/CFS to be an autoimmune disease (see my previous article here). Perhaps it is possible that Borrelia may be a trigger for ME/CFS autoimmunity?

How is it tested?

Otzi the Iceman

Otzi the Iceman – not your typical Lyme disease sufferer

You’d think that as they managed to detect Borrelia in Ötzi, a guy who’s been dead for more than five millennia, it should be a simple matter to detect it in living patients in the here and now, but it isn’t, and as a result the testing of Lyme disease is controversial. There are many who believe that Lyme tests often produce false-negatives, though some disagree about this, and then there is the question of false-positives too… So who is right?

A recent argument for the reliability of tests (at least with established infections) is made by John J Halperin et al [16]. However, there are those in the Lyme community that disagree with the science behind many of the conclusions in this article, and they may be right on some points. A key fact, I think, is that the Centers for Disease Control and Prevention (CDC) still says that Lyme diagnosis should not be based solely on test results, which does support the view that the tests are not reliable enough.

Questions aside over the reliability of the approved tests, there is evidence that those who are immunocompromised are more likely to turn up false-negatives for Lyme as the FDA approved tests look for antibodies. The problem is that those with a compromised immune system may not produce antibodies properly [17]. This could therefore be relevant for those of us with ME/CFS because of the evidence of immune dysfunction.

The FDA approved tests

The FDA currently recommends a two-step test process using two different types of test. If the patient is positive or equivocal in the first test then the second test is carried out. If either test is negative then the tests indicate that the patient does not have Lyme disease.

The first test is an enzyme-linked immunoassay (ELISA), which looks for antibodies against Borrelia in the blood. The second test is known as a western blot and looks for immunoglobulin M (IgM) and/or immunoglobulin G (IgG) antibodies.

The results of the approved western blot tests are themselves contentious, as the results that are returned have to be interpreted and the CDC seems to be quite conservative about what constitutes a positive result. Therefore, some people believe that some results that the CDC would deem negative should in fact be read as positive.

Non-approved tests

There are several non-approved tests, some using blood, some using other fluids, some looking for DNA, others for antibodies or antigens. But what is consistent is that they all cost money and because they are not FDA approved you may question their reliability, and even if you don’t, your doctor probably will. Some of the alternative tests on the market have at least been formally assessed and so you may find such published papers [18] useful in making your own judgment on the value of such tests.

Rather than trying to make such a judgment for you or trying to produce an exhaustive list, instead I am just going to mention some of the more commonly recommended tests, though I personally have no experience with any of these tests myself.

Infectolabs in Germany are often suggested, and seem to find a number of people positive who had previously tested negative using the FDA approved tests. Another lab often recommended is IgeneX in the US which also offers a variety of different tests for Borrelia.

Chronic Lyme

Chronic Lyme (or ‘post treatment Lyme disease syndrome’ as the CDC prefers to call it) is controversial. At the heart of it are two opposing organizations and the only thing they have in common is the letters they share in their acronyms. Although it may sound like the title of a bad B movie, a paper titled “Lyme disease: the next decade” [19] does a good job of explaining the differences between these two groups, but I will briefly summarize it here:

Representing the dark-side in our little B movie, we have the Infectious Diseases Society of America (IDSA) who essentially state that chronic Lyme doesn’t exist and have tried to limit treatment of the condition. Representing the light-side you have the International Lyme and Associated Diseases Society (ILADS – remember: the one with the L in the acronym is on the light-side) who speak up for the many thousands of people who have difficulty recovering from Lyme, even after treatment.

This study [20], which supports the views of the IDSA, claims that chronic Lyme doesn’t exist. Nevertheless, the evidence to the contrary is not insignificant, and there has even been litigation against the IDSA alleging conflicts of interest that may have influenced their position on chronic Lyme.

The thing is, it’s all too easy to dismiss an illness like this, isn’t it? That is, unless you’re the guy suffering from it, in which case you know all too well how real it is.

Whatever the reason – unidentified infection, bacterial remnants, autoimmunity, irreversible damage – I believe these people are sick, and just like ME/CFS, the illness is not given the attention it deserves.

How is Lyme disease treated?

lone star tick

lone-star tick (Amblyomma americanum)
by Elizabeth Nicodemus

Unsurprisingly, treatment is controversial too, with some believing that longer and stronger treatment is needed, especially in long established illness.

One of the important factors here is that Borrelia is known to replicate slowly, often only once or twice in 24 hours, whereas a bacterium such as staphylococcus (mentioned in my first article on zoonotics) would replicate around 70 times in 24 hours. This is important because many antibiotics target the cell wall of bacteria when they are dividing.

Antibiotics are bactericidal (they kill bacteria) or bacteriostatic (they inhibit replication), so bacteriostatic antibiotics given in short courses may not reduce Borrelia infection very much. Bactericidal antibiotics are probably better against Borrelia, but still the argument is made that low dose and short-course treatments are insufficient to kill most of the infection. This leads to some experts stating that long-term antibiotic treatment is required to control or eradicate Borrelia.

Those that are immunosuppressed by another illness can have more difficulty eradicating Borrelia and so it seems reasonable to suspect that anyone with both Borrelia and ME/CFS would have difficulty with treatment. Additionally, someone with Lyme may be more susceptible to ME/CFS and probably other illnesses, due to the immune impact of Lyme.

Different antibiotic treatments may be given to target Borrelia in its various guises and stages of illness. The treatment of choice is usually doxycycline, but other antibiotics including penicillin, amoxicillin and cefuroxime axetil are also commonly prescribed. In more stubborn cases cefotaxime or ceftriaxone may be given intravenously. Treatment in pregnancy is usually with erythromycin.

As well as ceftriaxone, minocycline or metronidazole may be used where infection of the brain is suspected as it crosses the blood-brain barrier. Additionally, there is evidence that metronidazole may be more effective against Borrelia in its cyst form [21].

What has this to do with ME/CFS?

Some people think that ME/CFS is actually undiagnosed Lyme. There is some limited evidence for that, such as a study from Poland which found that 50 percent of patients diagnosed with borreliosis or tickborne encephalitis could be identified as having CFS, concluding: “The findings suggest that the chronic fatigue syndrome is frequent among patients with a history of borreliosis.” [22]. This illustrates that tickborne zoonotics may be implicated in ME/CFS. Alternatively, it could be argued that this is just a result of the two illnesses presenting with similar symptomology.

Another study looked at gender differences and found that women were significantly more likely to develop chronic Lyme compared to men [23]. This is interesting, given the higher ratio of women to men with ME/CFS. Of course, correlation does not constitute evidence, and the finding may support other conclusions, such as the higher degree of women with autoimmune diseases.

A recent study provides evidence which suggests the two diseases are distinct by demonstrating that the cerebrospinal fluid was different in the two conditions [24].

As you can imagine, both sides continue to argue over whether the two illnesses are the same, related, or completely separate. I’m not sure there is enough evidence either way yet, but what is certain is that some people with ME/CFS do later turn out to have Lyme disease. In the last two months on the Phoenix Rising forum I have noticed at least three recent posts (Jan-Feb 2013) from ME/CFS sufferers who have been tested for Lyme and come up positive.

Then you have to bear in mind that Lyme is caused by several different species of Borrelia, as explained above, and several other species are suspected of causing Lyme. Each comes with its own flavor of Lyme disease, where symptoms differ slightly. Additionally, as stated earlier, some people infected with Borrelia don’t get Lyme disease but get other borreliosis illnesses, some of which come with overlapping symptoms to ME/CFS, or which may be present as co-infections.

And importantly, if the illnesses are distinct, then there is still no rule that says you can’t have ME/CFS and Lyme disease at the same time.

Not all species of Borrelia are tested for, and probably not all are even discovered yet, as most have only been discovered in the last two decades. Indeed, the Australian government agree that another pathogen infecting Australian ticks, either a novel Borrelia or some other zoonotic, may be the cause of Lyme-like disease in the country, so there is still room for a greater number of people to have Lyme, borreliosis, or some other tick-borne pathogen as the cause of their ME/CFS, or at least as a co-infection.

Whereas there is some scope for ME/CFS to turn out to be caused by Borrelia, I don’t think anyone can reasonably make that kind of claim yet. For the moment it is categorized as a different illness.  Nevertheless, I think the similarities are quite intriguing and at the very least some people labeled as having ME/CFS do have Lyme either instead of, or as well as, ME/CFS. I think it is good, therefore, that some ME/CFS doctors do test for it, and adjust their treatment protocols accordingly. Lerner, De Meirleir, probably one or two others, but it does appear that some ME/CFS doctors overlook it.

What should I do then? Get tested?

With the symptoms being similar and with the knowledge that some people with a diagnosis of ME/CFS do later test positive for Lyme, it has to be said that there is a case for getting tested. Most of us would probably bite your Borrelia-infested arm off if we could swap from an illness of unknown etiology to one of proven etiology, with some prospect of treatment.

The level of testing you go to is of course a different topic and there are no easy answers on how far you should pursue it, but it would seem prudent to at least have the standard FDA approved tests, and if you live in a region where Lyme is endemic, or you think you have some other reason to suspect that you might have been bitten, then you may want to explore test options further.

Joel was diagnosed with ME/CFS in 2009 but struggled with the illness for some time prior to this. He loves to write, and hopes to regain enough health to return to the career he loved and have his work published. 

OTHER ARTICLES BY THIS WRITER:

REFERENCES:

  1. Joppe W.R. Hovius, et al. Tick–host–pathogen interactions in Lyme borreliosis. 2007.
  2. Steer AC, et al. The Emergence of Lyme disease. 2004.
  3. Pachner AR, et al. Lyme neuroborreliosis: infection, immunity, and inflammation. 2007.
  4. Mayne PJ. Emerging incidence of Lyme borreliosis, babesiosis, bartonellosis, and granulocytic ehrlichiosis in Australia. 2011.
  5. Platonov AE, et al. Humans infected with relapsing fever spirochete Borrelia miyamotoi , Russia. 2011.
  6. Frazer, et al. Genomic sequence of a Lyme disease spirochaete, Borrelia burgdorferi. 1997.
  7. Elizabeth Fuller, et al. β-Lactam Resistance in Staphylococcus aureus Cells That Do Not Require a Cell Wall for Integrity. 2005.
  8. A Kersten, et al. Effects of penicillin, ceftriaxone, and doxycycline on morphology of Borrelia burgdorferi. 1995.
  9. Sapi E, et al. Characterization of Biofilm Formation by Borrelia burgdorferi In Vitro. 2012.
  10. Chan K, et al. Detection of established virulence genes and plasmids to differentiate Borrelia burgdorferi strains. 2012.
  11. Iceman Autopsy – National Geographic. 2011.
  12. Kean WF. The musculoskeletal abnormalities of the Similaun Iceman (“ÖTZI”): clues to chronic pain and possible treatments. 2013.
  13. Aberer E, et al. Molecular mimicry and Lyme borreliosis: a shared antigenic determinant between Borrelia burgdorferi and human tissue. 1989.
  14. Elizabeth S. Raveche, et al. Evidence of Borrelia Autoimmunity-Induced Component of Lyme Carditis and Arthritis. 2005.
  15. A M Ercolini, et al. The role of infections in autoimmune disease. 2009.
  16. John J Halperin et al. Common Misconceptions About Lyme Disease. 14 January 2013.
  17. van Dop WA, et al. Seronegative lyme neuroborreliosis in a patient using rituximab. 2013.
  18. Volker von Baehr et al. The Lymphocyte Transformation Test for Borrelia Detects Active Lyme Borreliosis and Verifies Effective Antibiotic Treatment. 2012.
  19. Raphael B Stricker, et al. Lyme disease: the next decade. 2011.
  20. Henry M Feder, Jr., et al. A Critical Appraisal of “Chronic Lyme Disease”. 2007.
  21. Brorson O et al. An in vitro study of the susceptibility of mobile and cystic forms of Borrelia burgdorferi to metronidazole. 1999.
  22. Gustaw K. Chronic fatigue syndrome following tick-borne diseases. 2003.
  23. Wormser GP, et al. Implications fo gender in chronic Lyme disease. 2009.
  24. Steven E Schutzer, et al. Distinct Cerebrospinal Fluid Proteomes Differentiate Post-Treatment Lyme Disease from Chronic Fatigue Syndrome. 2011.
  25. Mursic VP, et al. Formation and cultivation of Borrelia burgdorferi spheroplast-L-form variants. 1996.

IMAGES
Figures B and H originally published by BioMed Central. Journal of Neuroinflammation. Judith Miklossy, et al. 25 Sep 2008. Persisting atypical and cystic forms of Borrelia burgdorferi and local inflammation in Lyme neuroborreliosis.
B. Dark field microscopy of Borrelia burgdorferi showing the usual spiral form of spirochetes and their agglomeration into colony-like masses.
H. Cystic form of Borrelia burgdoferi spirochetes, entirely covered by a thickened membrane masking the contents of the cyst.

FURTHER READING:

  1. A History of Cell Wall Deficient Bacteria: A Selection of Researchers Who Have Worked with the L-form.
  2. Vaccination against Lyme disease: past, present, and future. 2013.
  3. FDA recorded webinar on Lyme disease diagnostic research. 2012.

 

 

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123 comments

{ 123 comments… read them below or add one }

merylg September 20, 2013 at 8:48 pm
merylg September 26, 2013 at 1:46 am

http://lymelesslivemore.com/dr-klin…5be037af53de793f9bbd9fdfe7eff73abc070270495f6

merylg December 1, 2013 at 11:31 pm

Attention!!! Anyone interested in the future of research into Lyme-like disease in Australia?

You may enjoy some light holiday reading!

http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-lyme-disease.htm

Comments on the 'Scoping Study' are sought before 31st Jan 2014.

merylg December 9, 2013 at 6:39 am

Pour yourself a tea, grab lunch, and listen to this great 40min PODCast on Lyme Disease in Australia. Interviews with The Chief Medical Officer of Australia, multiple doctors and patients.

http://www.tickvectors.com/lyme-a-four-letter-word.html

atoska December 9, 2013 at 1:46 pm

Thanks @merylg for sharing the podcast! Very interesting! Are you diagnosed with lyme?

merylg February 15, 2014 at 1:54 am
roxie60 February 15, 2014 at 1:13 pm

http://www.ncbi.nlm.nih.gov/pubmed/17578772

Clin Infect Dis. 2007 Jul 15;45(2):149-57. Epub 2007 Jun 5.
Counterpoint: long-term antibiotic therapy improves persistent symptoms associated with lyme disease.
Stricker RB.
Author information

Abstract
BACKGROUND:
Controversy exists regarding the diagnosis and treatment of Lyme disease. Patients with persistent symptoms after standard (2-4-week) antibiotic therapy for this tickborne illness have been denied further antibiotic treatment as a result of the perception that long-term infection with the Lyme spirochete, Borrelia burgdorferi, and associated tickborne pathogens is rare or nonexistent.

METHODS:
I review the pathophysiology of B. burgdorferi infection and the peer-reviewed literature on diagnostic Lyme disease testing, standard treatment results, and coinfection with tickborne agents, such as Babesia, Anaplasma, Ehrlichia, and Bartonella species. I also examine uncontrolled and controlled trials of prolonged antibiotic therapy in patients with persistent symptoms of Lyme disease.

RESULTS:
The complex "stealth" pathology of B. burgdorferi allows the spirochete to invade diverse tissues, elude the immune response, and establish long-term infection. Commercial testing for Lyme disease is highly specific but relatively insensitive, especially during the later stages of disease. Numerous studies have documented the failure of standard antibiotic therapy in patients with Lyme disease. Previous uncontrolled trials and recent placebo-controlled trials suggest that prolonged antibiotic therapy (duration, >4 weeks) may be beneficial for patients with persistent Lyme disease symptoms. Tickborne coinfections may increase the severity and duration of infection with B. burgdorferi.

CONCLUSIONS:
Prolonged antibiotic therapy may be useful and justifiable in patients with persistent symptoms of Lyme disease and coinfection with tickborne agents.

roxie60 February 15, 2014 at 1:19 pm

http://www.ncbi.nlm.nih.gov/pubmed/19140878

Scand J Immunol. 2009 Jan;69(1):64-9. doi: 10.1111/j.1365-3083.2008.02191.x.
Complement split products c3a and c4a in chronic lyme disease.
Stricker RB, Savely VR, Motanya NC, Giclas PC.
Author information

Abstract
Complement split products C3a and C4a are reportedly elevated in patients with acute Lyme disease. We have now examined these immunologic markers in patients with chronic Lyme disease compared to appropriate disease controls. The study population consisted of 29 healthy controls, 445 patients with chronic Lyme disease, 11 patients with systemic lupus erythematosus (SLE) and six patients with AIDS. The Lyme disease patients were divided according to predominant musculoskeletal symptoms (324 patients) or predominant neurologic symptoms (121 patients). C3a and C4a levels were measured by radioimmunoassay. All patients with chronic Lyme disease and AIDS had normal C3a levels compared to controls, whereas patients with SLE had significantly increased levels of this marker. Patients with predominant musculoskeletal symptoms of Lyme disease and AIDS patients had significantly increased levels of C4a compared to either controls, patients with predominant neurologic symptoms of Lyme disease or SLE patients. Response to antibiotic therapy in chronic Lyme disease was associated with a significant decrease in the C4a level, whereas lack of response was associated with a significant increase in this marker. In contrast, AIDS patients had persistently increased C4a levels despite antiretroviral therapy. Lyme patients with positive single-photon emission computed tomographic (SPECT) scans had significantly lower C4a levels compared to Lyme patients with normal SPECT scan results. Patients with predominant musculoskeletal symptoms of Lyme disease have normal C3a and increased C4a levels. This pattern differs from the increase in both markers seen in acute Lyme disease, and C4a changes correlate with the response to therapy in chronic Lyme disease. C4a appears to be a valuable immunologic marker in patients with persistent symptoms of Lyme disease.

PMID:
19140878
[PubMed - indexed for MEDLINE]

roxie60 February 15, 2014 at 1:21 pm

Anyone with Lyme have these C3a and C4a tests? Did the results lie up with the above study? Where does one get a C3a and C4a test and are they reliable (woth the time and money)?

roxie60 February 15, 2014 at 1:26 pm

At least someone is trying to find screening tests…this is for CFS but I'm also looking for a similar study for lyme and other bacterial infections impact on B, T and NK cells as a potential marker simile to CD57. This is also a relatively new study, 2013, so maybe we can expect more o the CFS and Lyme screening options. I wish CD57 NK had been included in this study.

http://www.ncbi.nlm.nih.gov/pubmed/23514202

J Transl Med. 2013 Mar 20;11:68. doi: 10.1186/1479-5876-11-68.
Screening NK-, B- and T-cell phenotype and function in patients suffering from Chronic Fatigue Syndrome.
Curriu M, Carrillo J, Massanella M, Rigau J, Alegre J, Puig J, Garcia-Quintana AM, Castro-Marrero J, Negredo E, Clotet B, Cabrera C, Blanco J.
Author information
Abstract
BACKGROUND:
Chronic Fatigue Syndrome (CFS) is a debilitating neuro-immune disorder of unknown etiology diagnosed by an array of clinical manifestations. Although several immunological abnormalities have been described in CFS, their heterogeneity has limited diagnostic applicability.

METHODS:
Immunological features of CFS were screened in 22 CFS diagnosed individuals fulfilling Fukuda criteria and 30 control healthy individuals. Peripheral blood T, B and NK cell function and phenotype were analyzed by flow cytometry in both groups.

RESULTS:
CFS diagnosed individuals showed similar absolute numbers of T, B and NK cells, with minor differences in the percentage of CD4+ and CD8+ T cells. B cells showed similar subset frequencies and proliferative responses between groups. Conversely, significant differences were observed in T cell subsets. CFS individuals showed increased levels of T regulatory cells (CD25+/FOXP3+) CD4 T cells, and lower proliferative responses in vitro and in vivo. Moreover, CD8 T cells from the CFS group showed significantly lower activation and frequency of effector memory cells. No clear signs of T-cell immunosenescence were observed. NK cells from CFS individuals displayed higher expression of NKp46 and CD69 but lower expression of CD25 in all NK subsets defined. Overall, T cell and NK cell features clearly clustered CFS individuals.

CONCLUSIONS:
Our findings suggest that alterations in T-cell phenotype and proliferative response along with the specific signature of NK cell phenotype may be useful to identify CFS individuals. The striking down modulation of T cell mediated immunity may help to understand intercurrent viral infections in CFS.

roxie60 February 15, 2014 at 1:45 pm

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108755/

Great article, takes IDSA to task for their blatant conflict of interest and the other issues many of us have learned the hard way like 'abysmal clincal testing'.

Here is the abstact posted at NIH for this article:
http://www.ncbi.nlm.nih.gov/pubmed/21694904

Infect Drug Resist. 2011;4:1-9. doi: 10.2147/IDR.S15653. Epub 2011 Jan 7.
Lyme disease: the next decade.
Stricker RB, Johnson L.
Author information
Abstract

Although Lyme disease remains a controversial illness, recent events have created an unprecedented opportunity to make progress against this serious tick-borne infection. Evidence presented during the legally mandated review of the restrictive Lyme guidelines of the Infectious Diseases Society of America (IDSA) has confirmed the potential for persistent infection with the Lyme spirochete, Borrelia burgdorferi, as well as the complicating role of tick-borne coinfections such as Babesia, Anaplasma, Ehrlichia, and Bartonella species associated with failure of short-course antibiotic therapy. Furthermore, renewed interest in the role of cell wall-deficient (CWD) forms in chronic bacterial infection and progress in understanding the molecular mechanisms of biofilms has focused attention on these processes in chronic Lyme disease. Recognition of the importance of CWD forms and biofilms in persistent B. burgdorferi infection should stimulate pharmaceutical research into new antimicrobial agents that target these mechanisms of chronic infection with the Lyme spirochete. Concurrent clinical implementation of proteomic screening offers a chance to correct significant deficiencies in Lyme testing. Advances in these areas have the potential to revolutionize the diagnosis and treatment of Lyme disease in the coming decade.

KEYWORDS:
Borrelia burgdorferi, L-forms, Lyme disease, biofilms, cysts, proteomics

Ema February 15, 2014 at 2:00 pm


roxie60

Anyone with Lyme have these C3a and C4a tests?

Yes

roxie60

Did the results lie up with the above study?

Not for me

roxie60

Where does one get a C3a and C4a test and are they reliable (woth the time and money)?

I had mine drawn at Quest and sent to National Jewish Hospital for testing.

My insurance covered it so I can't comment about the money. I did it with other testing so I can't comment about the time. But it didn't answer any questions for me.

That said, I have a LOT going on other than simply Lyme. I can't say what would happen in someone who *only* had Lyme (though I actually think that would be pretty darn rare!).

roxie60 February 15, 2014 at 2:07 pm

This abstract sounds interesting but I cant find the article or study it is associated with…..anyone find if there is more to this than just the abstract?
http://www.ncbi.nlm.nih.gov/pubmed/16498239

Chemotherapy. 2006;52(2):53-9. Epub 2006 Feb 22.
Lyme disease: the quest for magic bullets.
Stricker RB, Lautin A, Burrascano JJ.
Author information
Abstract

Lyme disease represents a growing public health threat. Recent molecular and genetic studies have confirmed that Borrelia burgdorferi, the spirochetal agent of Lyme disease, is one of the most complex bacteria known to man. Affinity for multiple cell types and the presence of non-replicating forms of B. burgdorferi have contributed to persistent infection and failure of simple antibiotic regimens. The controversial clinical science of Lyme disease has impeded reliable diagnosis and effective treatment of this protean illness. Two major clinical hurdles are the absence of a therapeutic endpoint in treating Lyme disease and the presence of tick-borne coinfections that may complicate the course of the illness. New strategies for the diagnosis, treatment and prevention of Lyme disease are urgently needed.

Copyright 2006 S. Karger AG, Basel.

PMID:
16498239
[PubMed - indexed for MEDLINE]

roxie60 February 15, 2014 at 2:15 pm

Another one on the treatment of Lyme b.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003502/?report=classic

some of the abx amounts seem kinda low to me????

roxie60 February 15, 2014 at 2:32 pm

For those who have not had a reason lately to get angry over the IDSA and their self centered panel of quacks here is the 'new' guidelines (which look a lot like the old guidelines) for doctors who treat patients with Lyme. BTW these so called 'new' guidelines were a result of litigation against IDSA and their Lyme guidelines.

http://www.ncbi.nlm.nih.gov/pubmed/17029130

Ema February 15, 2014 at 2:49 pm


roxie60

Another one on the treatment of Lyme b.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003502/?report=classic

some of the abx amounts seem kinda low to me????

Just a little…;)

roxie60 February 15, 2014 at 2:54 pm

:p;):cat::lol:

roxie60 February 15, 2014 at 8:46 pm

Although we all know there are mental and emotional aspects to having this disease/illness/infection this article is mostly acceptable to me but there was one statement that nearly started a BART rage…..can you find the sentence that got my BART going???? :mad: Other than the one statement I find the article refreshing somewhat. Hint: it's towards the bottom.

http://www.mentalhealthandillness.com/tnaold.html

roxie60 February 18, 2014 at 4:36 pm


anniekim
GcMAF Australia

Annie
i emailed this question to the CEO of infectolabs. maybe he will answer for you?

GcMAF

Gcmaf Australia, that's really kind of you to email this question to the CEO of infectolabs. I hope he answers as I will be very interested to hear his reply. Many thanks

So would I as I am considering getting the Bb ELISPOT and Ehrlichia and Chlamydophila test done there. It is a lot of money just not sure if I shoudl do that or just do IGenex again since I have just fiished a 6 weeks round of antibiotics.

roxie60 February 18, 2014 at 4:38 pm

Sorry guys, I did not realiz my earlier posts were going here, I though I was just adding to someone's thread. Hope I didn't derail this important blog.

roxie60 February 18, 2014 at 4:43 pm

Thank you so much Joel for writing this. You did a good job explaining the expereince we have trying to pin down what is wrong with us and how controversial Lyme is on so many levels. I thought I got treated poorly when CFS was considered my diagnosis now with the possibility of Lyme it is even more of a nightmare expereince. I did not think that was possible.

snowathlete February 18, 2014 at 4:57 pm


roxie60

Sorry guys, I did not realiz my earlier posts were going here, I though I was just adding to someone's thread. Hope I didn't derail this important blog.

I don't mind it going here, personally. There is nowhere better for it at present.

roxie60

Thank you so much Joel for writing this. You did a good job explaining the expereince we have trying to pin down what is wrong with us and how controversial Lyme is on so many levels. I thought I got treated poorly when CFS was considered my diagnosis now with the possibility of Lyme it is even more of a nightmare expereince. I did not think that was possible.

Thanks, and you're welcome. My experience of Lyme so far is that people get it more than ME/CFS but not by much. The public understand what it is a bit more, and some doctors seem to take it seriously, compared to ME/CFS at least, but then some others do not. It's certainly inadequate on many levels either way you look at it. I'd like to write more about Lyme, but I'm too sick. :ill:

roxie60 February 18, 2014 at 5:08 pm

I look forward to you feeling better and sharing your thoughts about lyme when you are better.

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