Re: Lyme disease info and anti-TNF meds

December 29, 2008

> fyi thought many on this list might find this of interest. lyme can

> minaifest in many ways so if you are diagnosed with RA should test for

> lyme. see below for info on what using anti-TNF therapy can do to lyme

> bacteria. i'm quite certain they contribute to proliferation of all

> bacteria since they disarm the immune system.

>

> *Research Op-Ed and Commentaries*

>

> In this section, key articles are summarized and commentary is

> provided. This section also serves as an opportunity for specific

> topics to be reviewed in detail. Contributions to this section by

> scientists, researchers, and/or physicians are welcome and will be

> reviewed for inclusion by members of our Center Research Staff and by

> members of the Center's Scientific Advisory Board with expertise

> specific to the commentary or review.

>

> *Persistence of Borrelia burgdorferi in mice after antibiotic therapy.*

>

> Two studies have recently been published which reveal that Bb may

> persist in the mouse despite antibiotic therapy. These studies

> support much earlier work by Straubinger et al in the dog model (1997)

> and Bockenstedt et al (2002) in the mouse model. Bockenstedt et al

> (2002) showed that Bb persistence can occur after antibiotic treatment

> and that these spirochetes could be acquired by ticks (xenodiagnosis)

> but that the infected^ ticks could not transmit infection to naïve

> hosts -- suggesting that the spirochetes were attenuated in that they

> had become non-infectious. Straubinger et al (1997) had shown that

> even after 30 days of antibiotic treatment, Bb spirochetes could be

> demonstrated in 3/12 dogs by culture, and DNA could be demonstrated by

> PCR in 9/12 dogs long after treatment.

>

> More recently, Hodzic et al from UC in California reported in

> Antimicrob Agents Chemother. (2008;52(5):1728-36) a study which

> examined the effectiveness of antibiotic treatment using ceftriaxone

> or saline for 1 month. Mice were treated either early in the

> infection (3 weeks) or later (4 months). Tissues were tested by

> immunohistochemistry, PCR, culture, transplantation of allografts, and

> xenodiagnosis at 1 and 3 months after treatment. Tissues from the

> mice treated with antibiotics were culture negative, but tissues from

> some of the mice remained PCR positive and intact antigen-positive

> organisms with spirochetal morphology were visualized in collagen-rich

> tissues. Xenodiagnosis demonstrated that uninfected larval ticks

> after feeding on the antibiotic-treated mice were able to acquire

> spirochetes (confirmed by PCR) and then transmit these spirochetes to

> naïve SCID mice which became PCR positive but culture negative. This

> study therefore demonstrated that antibiotic treatment in the mouse

> model does not result in eradication of the Bb spirochetes and that

> some of these spirochetes were infectious, although attenuated in

> activity.

>

> Yrjanainen et al from Univ of Turku in Finland reported in _J

> Infectious Disease_ (2007; 195(10):1489-96) a study which examined

> whether anti-tumor necrosis factor-alpha would have a beneficial

> effect on Bb-infected mice. C3H/He mice were infected with B. garinii

> A218 or B. burgdorferi sensu stricto N40. In study 1 (with B. garinii)

> and in study 2 (with Bb SSN40), 2 weeks after infection, 10 mice were

> treated with ceftriaxone only for 5 days and 10 mice were treated with

> anti-TNF-alpha only. In another group of 10 mice, anti-TNF was added

> simultaneous to the ceftriaxone at 2 weeks after infection while in

> another group of 10 mice anti-TNF was added at 6 weeks after infection

> (ie, 4 weeks after ceftriaxone). Finally, a fifth group of mice was

> treated with saline as a sham treatment. For the group that received

> ceftriaxone only, no samples were positive by culture or by PCR at 2

> weeks after infection. However, among those mice treated with

> anti-TNF-alpha either at 2 weeks or 6 weeks after infection,

> spirochetes grew from one-third of the mice. Contrary to earlier

> findings by Bockenstedt et al (2002) in which the spirochetes detected

> after antibiotic treatment were attenuated in activity, the recovered

> spirochetes in this study did not appear to be attenuated, as

> ceftriaxone sensitivity rates, plasmid profiles, and virulence rates

> were similar to those of bacteria used to infect the mice. This study

> demonstrated that a portion of B. burgdorferi-infected mice still have

> live spirochetes in their body, which are activated by anti-TNF-alpha

> treatment.

>

> *Commentary*. These two studies demonstrate that Bb spirochetes can

> persist in the mouse after ceftriaxone therapy. The Finish study was

> remarkable in that culture and PCR were negative after ceftriaxone

> but, after additional treatment with anti-TNF-alpha, viable

> spirochetes were recovered. TNF is a pro-inflammatory cytokine which,

> when blocked, typically results in a reduction in clinical

> inflammation; for this reason, such treatment is used for patients

> with rheumatoid arthritis. To the surprise of the authors, viable

> spirochetes were recovered in these PCR- and culture-negative mice

> after TNF blocking treatment was given. Also interesting is that

> anti-TNF treatment did not result in the expected finding of a

> reduction of joint swelling.

>

> The Finnish study was the first study to demonstrate that

> immunomodulatory treatment of animals infected with Bb could convert

> them from culture negative to culture positive. The California study

> was remarkable in that only tick-feeding was capable of extracting

> infectious but non-replicating attenuated spirochetes; without having

> done that step of xenodiagnosis and then transferring the tick to feed

> on naïve SCID mice, the authors' conclusion would have been that

> infectious spirochetes do not persist in the mouse model as culture

> was negative. The authors further concluded that negative culture

> and PCR can not be relied upon as markers of treatment success.

>

> We do not know the extent to which these findings can be translated to

> the human situation. Nevertheless, the activation of infectious

> spirochetes after anti-TNF therapy in mice should alert clinicians to

> the possibility that anti-cytokine therapy may result in a similarly

> increased risk of activating latent infection among patients with a

> history of treated Lyme disease. At this point, we do not know

> whether attenuated spirochetes are capable of inducing

> illness-symptoms in mice or humans; while it is possible that

> spirochetal mRNA may be producing surface lipoproteins that stimulate

> systemic symptoms, this hypothesis needs to be tested in the next

> phase of this important research.

>

> *BAFallon, MD*

>

> *from http://www.columbia-lyme.org/research/keyarticles.html*

>

> Happy Holidays!

>

> Jim M.

> President

> CANADIAN LYME DISEASE FOUNDATION

> A Federally-registered Charitable Organization

> www.canlyme.com <http://www.canlyme.com>

>

> PLEASE NOTE:

> Nothing contained in this document is to be considered as medical advice.

> Please consult your doctor for medical advice.

>

December 30, 2008

Can anyone translate the below into something short/sweet/understandable/the

bottom line? I have no idea what anti-TNF therapy is and my brain is not

working well enough today to comprehend the below.

I have Lymes’ (and was diagnosed with RA) and was on Minocin for just under

three years. I’ve toyed with the idea of MMS and Marshall Protocol;

actually did the Schardt protocol; feel pretty great; now the below has me

worrying. El

_____

From: rheumatic [mailto:rheumatic ] On Behalf

Of Sauve

Sent: Tuesday, December 30, 2008 1:54 AM

rheumatic

Subject: rheumatic Re: Lyme disease info and anti-TNF meds