Invincible borrelia?

[hv808ct]

Among Lyme activists, these are some of the evolving reasons for treatment failures:

1. Treatment was too short
2. Co-infections
3. Physical seclusion (e.g., intracellular, which Bb doesn’t do)
4. Toxins (which Bb doesn’t produce)
5. Morphological changes (i.e., round bodies)
6. Antigenic variation of surface proteins
7. Antibiotic resistance (not seen in Bb)
8. Immunosuppression by Bb products
9. Biofilms
10. Persister cells following antibiotic treatment

Did I forget any? Of course, most bacterial and parasitic pathogens employ one or more of the above strategies, and yet remain susceptible to antimicrobial drugs and adaptive immune responses.

[X-member]

General outcomes after discontinuation of treatment

http://www.lymeneteurope.org/forum/view ... f=6&t=3581

Dr Marie Kroun, Denmark, a quote:

3: Quickly relapse with gradually increasing symptom levels after discontinuation of antibiotics, ie. patient. "bombed back" to pre-treatment levels within approx. 3 months, there are typically the same good effects of retreatment with antibiotics; mixed infection (s) / additive factors (Immune suppression? Hormonal disturbances? Something else?) Must be suspected; poor prognosis without treatment!

[X-member]

From the Swedish guidelines.

https://lakemedelsverket.se/upload/hals ... A4rken.pdf

A google translated quote, professor Dag Nyman:

At relapse, it is not shown that an acquired resistance would have evolved, why change of medication would not be necessary. A primary resistance to certain antibiotics, however, is possible, which is why a change of class of drugs can be endorsed at relapse.

Edit to add, one more translated quote from professor Dag Nyman:

intracellular localization

[X-member]

Center for vector-borne infections, Uppsala, Sweden.

I asked (by e-mail):

What treatment do you give in treatment failure or relapse?

Professor Björn Olsen (at CVI) replied (by e-mail):

We usually give Doxyferm or in some cases Rocephalin.

This means that treatment failures and relapses occur in Sweden and are treated with abx.

[Henry]

These "relapses" don't necessarily mean that one has a persistent infection that "re-emerges" because of insufficient antibiotic therapy, or when antibiotic therapy has been terminated prematurely. There is much evidence to indicate that antibiotics have many pharmacological properties. If you don't believe me, just do a PubMed search on "pharmacological and antiinflammatory effects of antibiotics" or "antiinflammatory effects of tetracyclines" and several references will emerge. In this context, the well-known anti-inflammatory effects of tetracyclines is a good example. If their beneficial effects in certain patients is due largely to reducing the inflammation of a painful arthritic knee joint, obviously once antibiotic therapy is discontinued, of course the inflammation and pain (relapse) will return. One does not need to invoke the unproven possibility of a persistent infection to explain such a phenomenon; this is a classic pharmacological phenomenon. Likewise, ceftriaxone -- the antibiotic that is often given intravenously to alleviate the neurological symptoms associated with Lyme disease has been reported to have neuroprotective effects; such neuroprotective effects are now being studied in clinical trials to see if they might be of value in treating patients with MS. If you don't believe this, do a PubMed search for "neuroprotective effects of ceftriaxone" and you will find several publication in that regard.

[X-member]

From Sweden (for Henry):

Doxycycline-mediated effects on persistent symptoms and systemic cytokine responses post-neuroborreliosis: a randomized, prospective, cross-over study

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3507907/

A quote:

All 15 patients finished the study. No doxycycline-mediated improvement of post-treatment symptoms or quality of life was observed. Nor could any doxycycline-mediated changes in systemic cytokine responses be detected. The study was completed without any serious adverse events.

[X-member]

Sven Bergström, Sweden

http://www.lymeneteurope.org/forum/view ... =11&t=5323

Professor Sven Bergström, a quote:

His research includes studying the role of migratory birds in moving infected ticks across broad geographical regions, characterizing pathogenic mechanisms, and how quiescent bacteria infections can be reactivated by subsequent infections with other pathogens including parasites.

[X-member]

hv808ct wrote:

Toxins (which Bb doesn’t produce)

Professor Dag Nyman (again):

http://www.bimelix.ax/sites/www.bimelix ... j_2010.pdf

A google translated quote:

Herxheimer reaction is a general reaction to toxin release starting about 8 hours after the first dose of antibiotics.

[X-member]

But if hv808ct try to say that no more treatment studies need to be done on cases that have no signs of an (still) active borrelia infection, I agree!

We need some good treatment studies on cases that actually have signs of an (still) active borrelia infection, instead.

[Henry]

X-member: In all 5 of the published clinical studies on the benefit of extended antibiotic therapy for the treatment of post-treatment Lyme disease symptoms, the investigators could find NO evidence for the existence of a persistent infection prior to treatment. None. In most instances, the existence of a persistent infection in such patients is ASSUMED, not demonstrated to be the case. The question is, in the absence of DIRECT EVIDENCE to support the existence of a persistent infection, is one justified to continue to treat with antibiotics for prolonged periods of time? Given the fact that some antibiotics have antiinflammatory and other pharmacological effects, might other drugs be more appropriate, safer, and perhaps more effective?