0 Review Of The 2011 Lyme and Tick-Borne Diseases National Conference

In October 2011, a national conference on Lyme and tick-borne diseases was held in Philadelphia by Columbia University and the Lyme Disease Association.

Here is a brief overview of the topics presented:

• Dr. J. William Costerton’s riveting talk on “The Role of Biofilms in Chronic Bacterial Infections” reviewed the history of the discovery of biofilms, demonstrating that these biofilms enable micro-organisms to resist host defenses and antibiotics, enabling infections to become chronic.
• Dr. Eva Sapi’s talk on “Killing Borrelia – an impossible job?” addressed various mechanisms associated with Borrelia burgdorferi that may help it to survive despite antibiotic treatment.
• Dr. Jason A. Carlyon’s talk focused on Anaplasma phagocytophilum, the agent of human granulocytic anaplasmosis (HGA). This emerging tick-borne pathogen demonstrates stealth trickery, enabling it to avoid and even subvert immune cells.
• Dr. Richard Marconi’s talk on “C-Di-GMP” described research demonstrating that the cyclic nucleotide, c-di-GMP, plays a critical role in regulating several important cellular processes.
• Dr. Chris Earnhart’s talk described work developing a novel next-generation Lyme disease vaccine based on outer surface protein C. Osp C is expressed by all Bb species and strains and is expressed in the human host for several weeks before being down-regulated.
• Dr. Robert S. Lane gave a brief overview of his research team's long-term studies of the ecology and epidemiology of Lyme disease in California, and then summarized some exciting recent findings regarding the genospecies and genotypes of Borrelia burgdorferi s. l. that infect the western black-legged tick and humans in this region.
• Dr. Karen Newell Rogers presented a talk about novel ways to target chronic inflammation and chronic immune activation among patients with chronic Lyme disease. The primary controversy with Lyme disease has been whether the disease is the result of long-lasting bacterial infection or whether long-term symptoms result from a post-infectious, uncontrolled autoimmune response.
• Dr. Robert Yolken’s talk on “Infections and Human Neuropsychiatric Diseases” focused on the Stanley Center’s work at Hopkins which has examined infectious triggers of psychosis.
• Dr. Josep Dalmau’s talk on “The Clinical Spectrum and Cellular Mechanisms of Autoimmunity in NMDA and other synaptic receptors”. His pioneering work studying anti-NMDA receptor encephalitis shows how an immune response triggered by a tumor (e.g., ovarian teratoma) or perhaps an infectious process, results in antibodies that can attack critical receptors and synaptic proteins in the Central Nervous System involved in memory, behavior, cognition, and psychosis.
• Dr. John Aucott’s talk on “Early Lyme disease” reported from the SLICE prospective cohort and his Maryland studies.
• Dr. Reinhard K. Straubinger's talk on “Canine and Equine Lyme Borreliosis” focused on Lyme borreliosis in animals, especially in dogs and horses.
• Dr. James Moeller presented a talk on “Immunologic aspects of neuropsychiatric illness: Lyme disease as model”.
• Dr. Brian Fallon presented a talk on “Models of Chronic Lyme Disease”. The talk started with a review of the terms that refer to chronic symptoms and recommendations on how the the IDSA’s definition of Post-treatment Lyme Syndrome could be improved. This talk reviewed the evidence regarding models of persistent infection and/or persistent immune activation.
• Dr. Andrew Walter reported on Ehrlichiosis and Hemophagocytic Lymphohistiocytosis (HLH) in cases of children diagnosed in Delaware.
• Dr. Andrea Gaito provided an update on the clinical evaluation and treatment of Lyme Arthritis from an autoimmune perspective. Lyme arthritis occurs in sixty percent of patients with untreated Lyme disease.
• Dr. Ingeborg Dziedzic presented an interesting (and at times entertaining) overview of how Lyme disease impacts the eye, emphasizing that the eye is in part like the skin and in part like the brain.
• Dr. Vijay Thadani presented an overview of seizures and non-epileptic seizures, showing videos of both. Brain infections such as Lyme disease can lead to the development of epilepsy.
  
• Dr. Steve Bock addressed complementary and integrative medicine approaches to the treatment of chronic Lyme disease.
• Dr. Elizabeth Maloney addressed studies of antibiotic treatment of Lyme disease, providing a thoughtful and critical review of the literature to identify lessons, gaps, and future research needs.

READ MORE - Full Presentation Information Here:
2011 Lyme and Tick Borne-Diseases National Conference Summary Report

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2 Article: Anaplasmosis Plus Lyme Disease In Dogs = Sick As Dogs

The West Salem Veterinary Clinic reposted part of an August 2011 article on its site in the La Crosse Tribune in Wisconsin recently.

The original article is found here:
http://westsalemvetclinic.vetstreet.com/blog/ticks

Here are two paragraphs I want share with all dog lovers out there:

Anaplasmosis phagocytophilum, previously known as Ehrlichia equi, is very prevalent in this area. It is spread by the same ticks as Lyme Disease and it can be a co-infection (both infections occurring at the same time) with Lyme Disease. Experts at IDEXX Laboratories, the manufacturers of the IDEXX SNAP® 4DX™ test, maintain that when a dog contracts Lyme disease or anaplasmosis alone, its immune system is more likely to suppress disease. However, a dog with both infections at once is more likely to become sick. IDEXX created the 4DX test to test for Heartworm, Lyme, Anaplasmosis, and Ehrlichia canis (another tick-borne disease that is not as prevalent in this area.)

If your dog shows any of the previously listed symptoms, he or she should be examined and tested. If your dog is positive for anaplasmosis, he or she should have a complete blood cell count performed to further evaluate for active disease. If your dog lives in this area, he or she should be on tick control year-round, screened with the 4DX test annually and vaccinated for Lyme Disease. Visiting dogs from other areas need tick control and screening as well. You cannot catch these diseases directly from your dog, but you are exposed to the same ticks in the environment as your dog, so be sure to use tick repellent on yourself and check for ticks on yourself as well as on your dog on a daily basis.

Now, my question is, how much more severe is the course of infection in humans who are infected by both Borrelia burgdorferi and Anaplasmosis phagocytophilum?


How do humans differ from dogs in this infectious disease model?

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0 Article: Equine Borreliosis

Came across this article on equine Borreliosis, "The State of Lyme Disease".

If you are a horse owner, it's important to know the common symptoms of equine Lyme disease: shifting leg lameness, myalgia (muscle pain), dermal hypersensitivity, behavior changes, weight loss, uveitis, and neurological signs.

Sounds similar to the symptoms that people get with Lyme disease.

An interesting point to be made in this article is about the value of retesting in horses:

"It is also difficult to determine response to treatment with serological testing, because B. burgdorferi antibody levels are known to persist for years in humans and are also apparently long-lived in horses. Retesting is suggested four to six months after treatment to see if there is a decrease in serological values. This retesting can be questionable in determining response to treatment because horses are likely to be exposed and possibly reinfected post-treatment if living in areas of high tick density."

So, is the implication here that a decrease in values on a blood test is sign of progress against the disease?

It's true that if the horse is exposed and reinfected post-treatment in an endemic area that having shown a long-lived antibody response from a previous infection makes a new test result less useful. At the same time, a horse could have been reinfected, so then one has to look at a clinical diagnosis based on symptoms for a diagnosis. This is another thing which is similar for people with Lyme disease.

Having a more solid direct detection test which could distinguish between an active infection and past infection would be excellent. What does it take to create a test like this for Lyme disease?

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5 Abstract: A tick mannose-binding lectin inhibitor interferes with the vertebrate complement cascade

A tick mannose-binding lectin inhibitor interferes with the vertebrate complement cascade to enhance transmission of the lyme disease agent. Schuijt TJ, Coumou J, Narasimhan S, Dai J, Deponte K, Wouters D, Brouwer M, Oei A, Roelofs JJ, van Dam AP, van der Poll T, Van't Veer C, Hovius JW, Fikrig E. Cell Host Microbe. 2011 Aug 18;10(2):136-46.

Source: http://www.ncbi.nlm.nih.gov/pubmed/21843870?dopt=Abstract

Comments:

It occurs to me that a lot of the concern from the Lyme patient community over the use of vaccines could be eliminated if R & D shied away from human vaccine development.

Mice and other animals in the woods could ingest oral vaccines which could prevent the transmission of Borrelia burgdorferi to reservoir hosts on which ticks feed. Not only that, but this could have an extended effect of helping pets, too.

I think creating oral vaccines to block transmission of Bb to animals and pets is a good idea.

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7 Tracking Lyme Disease in Dogs May Help Protect Humans: MedlinePlus

For the study,  a team led by Dr. Paul Mead, a CDC medical epidemiologist, used data from 46 states on human and canine Lyme disease prevalence.

Comparing the data, Mead's team found that when 1 percent or less of the dogs tested positive for Lyme disease, the risk of people becoming infected was low. However, when more than 5 percent of the dogs were infected, the risk to people was high.


Read More Here: Tracking Lyme Disease in Dogs May Help Protect Humans: MedlinePlus


Comment:

This is the kind of low cost surveillance data I think should have been collected all along - and let the vets do the data collection and reporting. I think it makes sense to use dogs to determine potential risk to humans because dogs roam around more and get in the tall grass - they go where the ticks are whereas people try to stay away from them. I consider a dog another potential piece of dragging white flannel flag.

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