Ceftriaxone Pulse Dosing Fails to Eradicate Biofilm-Like Bb Persisters

Topics with information and discussion about published studies related to Lyme disease and other tick-borne diseases.
duncan
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Re: Ceftriaxone Pulse Dosing Fails to Eradicate Biofilm-Like Bb Persisters

Post by duncan » Sat 3 Dec 2016 17:42

This discussion is not about me, but I will indulge you, Henry, but I hope not at the expense of this thread.

I am currently: ELISA positive; WB IgG positive in accordance with CDC requirements, ie, five or more of their stipulated bands; and C6 positive.

I was also at one time documented IgM positive. I also have had a clinically evaluated and diagnosed EM.

Can't get much clearer than that.

Henry
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Re: Ceftriaxone Pulse Dosing Fails to Eradicate Biofilm-Like Bb Persisters

Post by Henry » Sat 3 Dec 2016 19:45

Duncan: Good. Since I assume you were given recommended antibiotic therapy, the next issue is whether you are actively infected or such serological data indicates past exposure. I assume you were given a second round of antibiotic therapy, in the event that this might be a re-infection? Immunity to Lyme disease is very short lived. There are reports of individuals being re-infected as many as 7 times.

duncan
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Re: Ceftriaxone Pulse Dosing Fails to Eradicate Biofilm-Like Bb Persisters

Post by duncan » Sat 3 Dec 2016 20:20

Which cannot be done. Forget about culturing. PCR is a joke - indeed even the IDSA notes its low yield.

So, how do you go about proving abx therapy has failed? It's devilishly difficult to do with the outrageously high bar organizations like the IDSA have set even just to get acknowledged with Lyme in the first place. If someone manages to achieve a diagnosis, what happens if they decline a band or two, and no longer satisfy the 2T - as you well know, they will be pronounced as cured, regardless of symptoms. Regardless of symptoms. And all those poor people who cannot muster the proper immunological response...what do they do?

What about people like me, though? People whose immune results mirrors symptoms despite the mechanizations of Bb, and despite the inadequacies of current metrics. Here's a thought: Does the patient fit the serologic criteria for late stage Lyme, and is he/she still symptomatic? If the answer to both these questions is Yes, then the patient is likely refractory to conventional treatment, and is still infected. This is pretty straightforward.

See, the thing is, I can PROVE I've been infected. That's easy. But according to rules I did not make, I am STILL infected. No one - no one - can prove Borrelia has been eradicated in me, and this is a statement made in full appreciation of how Lyme is identified, diagnosed and confirmed in the first place. This is following all the "rules" and "guidelines". Even the pattern of my serological results is highly suggestive of active infection. TRYING to prove I am no longer infected runs the risk as appearing as a transparent circle-the-wagons maneuver in a vain attempt to silence someone who is a walking-talking proof that conventional abx can fail.

If IDSA-recommended therapy can fail me, it can fail anyone.

This thread is about another study - from Johns Hopkins no less - which helps explain why.

Henry
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Re: Ceftriaxone Pulse Dosing Fails to Eradicate Biofilm-Like Bb Persisters

Post by Henry » Sat 3 Dec 2016 21:27

There are now at least 5 separate clinical studies showing that extended antibiotic therapy is of no benefit for the treatment of PTLDS. Furthermore, in all of these studies, there is no evidence for the existence of "persisters" in such patients and all were PCR negative when such an examination was made. Clearly, the answer is to treat such patients symptomatically or to look for other causes of their symptoms. The later should not be minimized; I know of two patients who after many months of antibiotic therapy that was not beneficial, discovered that they had a thyroid deficiency. Once that was discovered and the patient treated properly, they recovers almost miraculously. Other, who had chronic knee or hip problems, had osteoarthritis and responded quite well after knee or hip replacement replacement. By the way, what sort of chronic symptoms do you have?

duncan
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Re: Ceftriaxone Pulse Dosing Fails to Eradicate Biofilm-Like Bb Persisters

Post by duncan » Sat 3 Dec 2016 21:30

Apples and oranges, Henry. I'm not talking about some manufactured syndrome. I'm talking late stage Lyme. I also am familiar with those studies, and imo they have so many holes in them they'd sink if ever forced to float on their own merits.

Henry
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Re: Ceftriaxone Pulse Dosing Fails to Eradicate Biofilm-Like Bb Persisters

Post by Henry » Sat 3 Dec 2016 22:04

Your wrong. Five different, independently conducted studies all coming to the SAME conclusion. If 5 more studies were done -- with different antibiotics-- they would result in the same conclusions. Now, tell me about the symptoms of your late stage Lyme disease. In the U.S., this usually involves arthritic-type symptoms, involving the large joints.

duncan
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Re: Ceftriaxone Pulse Dosing Fails to Eradicate Biofilm-Like Bb Persisters

Post by duncan » Sat 3 Dec 2016 22:17

Bull. You are describing Steere's disease. As for the studies, you need to be looking at more variables than just the abx - duration of treatment, for example.

I suspect in the US the principal manifestations of late stage Borreliosis are neurological.

I am talking real-world here, Henry. Not some manual written by a bunch of theorists in a not-so-ivory tower who are burdened by dogma, and mired in legacy and/or patent concerns.

nnecker
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Re: Ceftriaxone Pulse Dosing Fails to Eradicate Biofilm-Like Bb Persisters

Post by nnecker » Sat 3 Dec 2016 23:01

Duncan,do you have proof that you have an active Lyme infection,yes or no?If yes, what is it?

Henry
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Re: Ceftriaxone Pulse Dosing Fails to Eradicate Biofilm-Like Bb Persisters

Post by Henry » Sun 4 Dec 2016 15:25

You are just plain wrong, Duncan. Within the species Borrelia, Borrelia garnii is the the most neurotropic and with Borrelia azfeldii being a distant second. These species are common in Europe, not the U.S.That is why neuroborreliosis is more common in Europe and relatively infrequent in the U.S. where Borrelia burgdorferi is the predominant species. Thus, in the U.S., the symptoms of late Lyme disease are mainly arthritic. There is LOTS of data to support that.

Although it is common to treat those few cases of early Lyme disease with neurological symptoms that do occur with ceftriaxone, i.v., several comparative studies have been conducted in Europe showing that oral doxycycline is just as effective as i.v. doxycycline in treating such patients. There is abundant evidence showing that oral doxycycline crosses the blood-brain barrier and thus can access the CNS. Furthermore, doxycycline can also penetrate cells, even though Borrelia are not intracellular and, when found (in vivo), are confined mainly to matrix tissue.

Alan Steer is a rheumatologist by training and receives much of his grant support from the Arthritis Institute at the NIH. One should not be surprised that his research on Lyme disease is focused primarily on arthritis phenomens, i.e., joint inflammation. The studies referred to above were done by other clinical investigators, most of whom are neurologist by training. Their findings have been published in several prestigious peer-reviewed journals and have been frequently cited -- and indeed confirmed-- by others. These are the scientists who have actually done clinical and basic research, not just theorists. That's the real [/b]world, Duncan .Your biased views reflect your ignorance of these facts. Do you really believe so many outstanding and experienced investigators can all be wrong? And what are your credentials to defend your views? Only a person with no support for his erroneous views would minimize the outstanding work of others.

The "principle manifestations of late stage Lyme disease" are clearly defined in a separate section of the IDSA guidelines. You ought to examine that section since it provides answers to the issues that you raise repeatedly.

By the way, I fail to understand how recommended treatment with a generic drug (doxycycline) for 3-4 weeks duration -- at a cost of about $40-- would create patent concerns or result in financial enrichment. That's absurd.

duncan
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Re: Ceftriaxone Pulse Dosing Fails to Eradicate Biofilm-Like Bb Persisters

Post by duncan » Sun 4 Dec 2016 15:41

Wow.

You really are cozy with that nifty little handbook, aren't you, Henry? :)

I'm not buying what you're selling. And that handbook needs updating.

Henry, somewhere in the IDSA Guidelines there is a line - and I am paraphrasing from memory here, so excuse me if I'm off a bit - that basically says that in all the combined experience of the authors, they'd diagnosed less than 10 cases of Lyme encephalopathy in the previous five years (or something to that effect)

I think a difference between me and you is that you would interpret that statement the way I think the authors likely meant it, i.e., there just aren't that many cases of Lyme encephalopathy in the US. But I would suggest a different interpretation: The tools and methods of looking aren't adequate yet.

All this supports the need for research such as this study out of Johns Hopkins represents. We need more research in diagnostics - for both early and late stages. And we need more research into treatments that encompass ALL - including the 10-20% or so who may be falling through the cracks.

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