Lyme disease, science, and society: Camp Other

Friday, October 28, 2011

6 ILADS 2011 Conference

I was kinda expecting that at some point, this sign would show up on my feed:


No Burrascano. Missed part of Maloney. Horowitz was also MIA. Only got to see part of Jones, as I'd already taken a coffee break.

Maybe tomorrow will be better if I can haul myself out of bed early on a Saturday... If.

More on this event in the future - especially if there is more to see.


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Tuesday, October 25, 2011

0 Stony Brook Young Investigators Series On Lyme Disease

Ixodus ticks that carry B.burgdorferi.
Photo Credit: http://www.freewebs.com/
lymeandautism/GF-596-4ticks_cm.jpg
Stony Brook University has an online journal of science called The Young Investigators where students from the school write an in-depth article with citations on different topics.

Nadya Peresleni, Editor in Chief of the journal and undergraduate class of 2011, wrote a report on Lyme disease that I think is pretty good - it's detailed, touches upon the controversy over treatment in a matter-of-fact manner, describes the immunological and inflammatory aspects of the infection, and leaves some ideas about areas to target for future treatment options.

I found this paragraph to be of interest, and there is much more in the article that is good to read:
"Along with Dr. Benach's work, the laboratory of Professor Martha B. Furie has published on the role of interferon-gamma (IFN-γ), a cell-signaling molecule of the immune system, in the endothelial tissue of a genetically engineered mouse model that was infected with B. burgdorferi. 
"IFN-γ is like a molecular switch that turns on chronic inflammation," explained Dr. Furie. When the bacteria disseminate throughout the body after the tick bite, they activate the endothelium and begin the inflammatory process by attracting T lymphocytes that secrete IFN-γ [22]. The inflammation was found to be due, in large part, to a synergistic effect of B. burgdorferi and IFN-γ, which together activate the transcription of a series of genes in endothelial cells. These genes encode chemokines, or chemoattractants, specific for T lymphocytes. 
Interestingly, there seemed to be selection for those T lymphocytes that secreted more IFN-γ, and the result was a positive feedback loop that generated more and more IFN-γ, leading to a state of chronic inflammation in the tissue. The damage to human tissues is likely caused by the body's reaction to the bacteria, not the bacteria themselves [22]."

Yes, but the question remains as to whether the damage left behind is causing symptoms - or if the inflammation is caused by bacteria which are still viable is part of the problem... Or both.

This article mentions persistent infection and offers citations to examples - and it also mentions the above kind of mechanism for producing symptoms.

Check out the entire article here: http://www.younginvestigators.com/article-lyme-disease-overview.php


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0 News: New Molecular Test Could Detect Early Lyme Disease

The Guardian has written about a new molecular test using nanoparticles which was developed by Alessandra Luchini, of George Mason University, to initially detect cancers. The new test is being used in clinical trials to detect early Lyme disease - even if there is no rash present in the infected patient.

Excerpt that will be of interest to readers:
"Q: In years to come, is this something that could be available in hospitals? 
That's the hope we have. The first clinical trial is on the detection of Lyme disease. A fraction of patients get a skin rash but for those without the rash it is very difficult to diagnose. So with the particles we are able to capture the antigens that come from the spirochaete that is the causative agent of Lyme disease. If we see in the urine a piece of the bacteria of the spirochaete, we are sure that the patient has Lyme disease. We are gathering all the evidence and then we will need to go first for FDA approval before it is available in clinics. 
Q: How much earlier will you be able to detect Lyme disease? 
Lyme disease has a window of two to three weeks before seroconversion [production of antibodies in the host blood, indicating infection]. With our tests, we're able to detect it before seroconversion, because we're not looking for the antibodies, we just look for the spirochaete. I would say here, yes, by weeks, and earlier diagnosis would be beneficial for the prognosis."
Comment: One thing this does make me wonder about is how similar this test is to Temple Douglas' hydrogel nanoparticle test for early detection of Lyme disease. Maybe it's time to do a compare and contrast of patent application content?

MORE here at the link: http://www.guardian.co.uk/technology/2011/oct/23/bright-idea-nanoparticle-trap-cancer

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0 News: Antibiotic Shortages Affect Patients

This just in from the Internal Medicine website: Antimicrobial Shortages Affect Patient Quality.

For those who are treating tickborne illnesses, this excerpt may be particularly of importance to you:

"The drugs reported most frequently to be unavailable or in short supply include the intravenous formulation of trimethoprim/sulfamethoxazole (Bactrim), amikacin (Amikin), aztreonam (Azactam), foscarnet (Foscavir), and penicillin G."

Other drugs are listed as well, of which the shortage will affect many people this flu season as one of them is Tamiflu.

(Now would be a good time for more startups to invest in not only antibiotic drug development, but phage therapy as well.)

MORE on how patients have been affected and why this is happening can be found at the link: http://www.internalmedicinenews.com/newsletter/conference-coverage/singleview40841/id-docs-antimicrobial-shortages-threaten-patient-care-quality/802aeb528c.html

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Thursday, October 20, 2011

0 Where Have All The Sane Lyme Patients Gone?

Here is an exchange I've seen elsewhere on the internet, names removed to place more focus on the content:

Do you think that morgellons stuff is a joke? Or lida mattman saying that Lyme can be transmitted by doorknobs and pens? Or that every sample she's ever seen shows Lyme?

No, those who put forth these theories are not joking. And no, I do NOT believe these things. And YES, I think they are damaging.

there are minions ready to believe anything.

This is true --patients who remain ill and find themselves fighting mainstream treatment guidelines have become angry and confused, and almost anything sometimes seems possible to them. They lack the scientific/medical background to distinguish.

Sober? Maybe. Not when they insist that mcsweegan is poisioning their well water though. I've heard some crazy stuff.

This is an old story. Let's move on. The baton has passed.

More sober and savvy than most people who have ever posted here? Sure. But that is like saying that they see and hear better than Helen Keller.

Many times people work behind the scenes because of forums like sci.med, which have gotten issues so knotted and confused.

I know some people with Lyme who aren't extremists. But they're few and far between.

Define extremist: In some circles, simply believing the cure didn't take after 28 days doxy is considered extreme. I find that if I talk to people logically and rationally they can respond in kind. Most people I have met in Lyme are turned off by the outrageous antics of the most notorious protagonists here, and I will not name the names. I don't know who you have met --but those I speak to, while sometimes empathetic, are NOT marching in line with a RICO lawsuit.

I've seen more than one "llmd" and waited in their waiting rooms with other lyme patients and heard them start talking or started talking with them. They're "informed" but don't seem to distinguish between what is good information and what isn't.

They are very confused by the situation --but the confusion starts with what medicine has handed down to them, not with the patients. If you create an artifactual disease that people don't have, then the patients who don't fit your model might be accused of factitious illness. It's a very frustrating situation for patients. The psychopathology starts with medicine, and patients are caught up and then labelled pathological, themselves. It is one of those Freudian boxes --the patients find there is no way out.

I don't see a lot of rationality anywhere.

It's hard to be rational in the face of an irrational situation that predated your involvement.

I don't think that two wrongs make a right and that rigid academic experts views are "balanced" by the views here.

Of course I do not believe this --I am simply saying that extremism begets extremism. I hold to my view that the dysfunction in Lyme was kicked off by biomedicine and not by patients.

It is just as easy to conclude that both are wrong and that maybe the "truth" is somewhere in between. Or nowhere in between but somewhere else entirely.

You must resolve dysfunction before you attempt to learn the truth.

I think you're glossing over things. Let's say you reject what the  academics say. Why does that mean that you have to buy into what Lida Mattman says?

I don't buy into what Mattman says. And nor do I reject academic research --some of what the academics say is right-on. But some of them have misused their craft and trampled the scientific method (perhaps unwittingly) in the process creating an unduly restrictive disease definition, discarding or twisting data, and spawning an untenable, dysfunctional situation out in the field. Most patients who appear dysfunctional once they get to Lyme were perfectly functional before --it is the scene and the situation --the disturbing dissonance between patient experience and medical paradigm-- that is at fault.

Rejecting the false negatives on elisa or western blot doesn't mean accepting a specific Lyme speciality lab's test results does it?

we don't need to keep debating this --of course not.

Have Lyme patients made things better?

Sadly things have not gotten better, but worse, IMO.

So you didn't answer the question. Where have all the sane Lyme patients gone?  Where is the forum, in real life or on the internet where I can find them? Where do they dominate? Where is rationality revered over reactionary radicalism?

I have met many MANY sane Lyme disease patients. I am sorry you have not. They are everywhere.

Lyme patients are fully to blame for how they've responded to the medical establishment.

Lyme patients are between a rock and a hard place --they have been dismantled, dismissed, and made fun of; they have been misdiagnosed for so long they develop chronic illness when they could have been totally cured. Lyme patients are angry. But they have not often strategized well in the past, I'll grant you that.

It's been a very bad confluence of situations and personalities all around, I'm afraid. It is, in short, a disaster: But if you don't look to what has transpired in medicine and science to stanch out the dysfunction, you will be spinning your wheels to the end of time. Should Lyme patients do a better job of achieving this? Yes of course.



And another comment from a Chronic Lyme Disease patient seen elsewhere, from someone who reminds me of LymeEngima (but was not identified as such):

"I have Chronic Lyme and I hated the movie “Under Our Skin”.  All it did was try and instill panic in people who are already sick and vulnerable to making desperate choices.  [...]
The IDSA Guidelines scare me. The doctors who treat Lyme scare me. The treatments scare me and the fear and anger around the whole subject scares me. Nothing about Lyme resembles even handed scientific principles and more closely resemble hysteria."

Comments such as this are rare to come by online. Few Lyme disease patients have said anything negative about UOS or admitted that everything about Lyme disease scares them.



These comments are a prelude to my own post about why and how dealing with Lyme disease drives me crazy, so I put them here for review and discussion.

Any thoughts from those of you reading along?

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Tuesday, October 18, 2011

0 Abstract: European neuroborreliosis: neuropsychological findings 30 months post-treatment.

European neuroborreliosis: neuropsychological findings 30 months post-treatment.
Eikeland, R., Ljøstad, U, Mygland, Å., Herlofson, K., Løhaugen, G. C.
European Journal of Neurology.1468-1331.
http://dx.doi.org/10.1111/j.1468-1331.2011.03563.x

Background:  The aim of this study was to compare neuropsychological (NP) functioning in patients with Lyme neuroborreliosis (LNB) 30 months after treatment to matched controls.

Methods:  We tested 50 patients with LNB and 50 controls with the trail-making test (TMT), Stroop test, digit symbol test, and California Verbal Learning test (CVLT). A global NP sumscore was calculated to express the number of low scores on 23 NP subtasks.

Results:  Mean scores were lower amongst LNB-treated patients than amongst controls on tasks assessing attention/executive functions: (Stroop test 4: 77.6 vs. 67.0, P = 0.015), response/processing speed (TMT 5: 23.4 vs. 19.2, P = 0.004), visual memory (digit symbol recall: 6.6 vs. 7.2, P = 0.038), and verbal memory (CVLT list B: 4.68 vs. 5.50, P = 0.003). The proportion of patients and controls with NP sumscores within one SD from the mean in the control group (defined as normal) and between one and two SD (defined as deficit) were similar, but more LNB-treated patients than controls had a sumscore more than two SD from the mean (defined as impairment) (8 vs. 1, P = 0.014). Conclusions: As a group, LNB-treated patients scored lower on four NP subtasks assessing processing speed, visual and verbal memory, and executive/attention functions, as compared to matched controls. The distribution of NP dysfunctions indicates that most LNB-treated patients perform comparable to controls, whilst a small subgroup have a debilitating long-term course with cognitive problems.



Questions to consider:


1) If one did a protein study of the CSF between those in the small subgroup having a debilitating long-term course with cognitive problems and the rest of the neuroborreliosis group, would differences be found between samples?

2) What was the difference in scoring in this most affected subgroup compared to the other patients who had neuroborreliosis?

3) Is there research which uses the same methods and compares pre- and post-treatment neuroborreliosis patients?


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The Camp Other Song Of The Month


Why is this posted? Just for fun!

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