Lyme Highlights from 2013, Part One: Research Highlights

I had my lyme diagnosis for most of 2013, though I've had lyme for almost 4 years.  I didn't read a whole lot about lyme before being diagnosed, having focused more on the diseases I was previously diagnosed with.  Filling in the blanks on lyme isn't easy during any year, and I don't have other years to compare to.  So I can't say that this was a crazier year than most for catching up, but I can say it sure feels like a lot has happened in a year.  This is not by any means a recap, but it is a collection of some of the highlights for me as I worked through my first year with the right diagnosis.

Research Highlights

There was more research available from previous years than I expected once I started to dig.  Even browsing lyme sites was fruitful, as lyme advocates are refreshingly science-focused as a group (see lymedisease.org's page regarding evidence based health care for a great example of this).  Many lyme patients appear to me to ask very sound questions and approach the questions sytematically.

I believe this is one of the primary reasons why a review of the pseudoscience they are answered with is such an insulting endeavor.  It is not just the unsupported conclusions IDSA, CDC, and uninformed physicians are drawing (or the nasty way so many choose to present them) that is so insulting, as much as it is the lack of willingness (or ability?) to ask or answer the right questions, or to at least use all available science to answer the alternate questions they are distracting themselves with.


---end rant----

There are too many good studies from the year to sort through well enough to rank them.  So, though we need better science, this also should highlight that we also need better use of the science already available.  So here are five of my favorites, not in ranked order.

#1  Pathologist Alan MacDonald's work on Biofilms



This article on his findings includes discussion of obstacles to getting hard science on lyme disease published. I've found his videos extremely enlightening and informative as well.

#2 Nanotubes could help detect lyme disease earlier

This is still in the research phase and my not necessarily overcome timing and interpretation obstacles that complicate current tests.  But, per the article linked above:

Currently used blood tests catch Lyme disease in later stages, because they detect an infected person's antibodies in response to Lyme bacteria. The new test directly identifies the Lyme bacteria proteins, known as antigens because they are the actual substances that trigger the immune response.....However, Fahmy cautioned that full diagnosis depends on other factors. These include the eventual production of antibodies to the disease.

#3 The Real Lyme Numbers

This one, and all of it's possible ramifications/motivations leads to a whole other topic of its own.  Articles are numerous that summarize the study that lead to the lead/release of the more realistic infection rates of 300,000 Americans per year.  This blog post summarizes the misgivings some advocates had (even prior to the later announcement of a new lyme vaccine, largely validating their skepticism).  I recall a good blog post on lymedisease.org on this topic (maybe under Policy Wonk?).

#4 Bartonella transmission from tick to host

Lack of acknowledgement or knowledge of coinfections (on the part of both patients and physicians) is a major obstacle to effective lyme treatement.   This is the type of "best available science" I would expect to see referenced (not just peripherally refuted) by CDC and state health departments, as discussed in the blog link above, which summarizes and links to the study:

This study is very important to patients with Lyme disease because it confirms that the transmission of bartonella from ticks may produce Bartonelleosis.  Note that this contradicts the guidelines of the Infectious Diseases Society of America on Lyme disease, which provide: “Bartonella DNA has been found in some Ixodes species, but there is no convincing evidence that Bartonella infections can be transmitted to humans by a tick bite.”  This points to another example of how the IDSA Lyme guidelines–which were written in 2006 before this study was published–are now outdated. 

#5 "Evaluation of in-vitro antibiotic susceptibility of different morphological forms of Borrelia burgdorferi"

No need to expand on the following excerpt from the blog linked to above, which again summarizes the study well:

The most important result of the research was the development of a new culture technique that dramatically increases the growth of Borrelia burgdorferi (Bb), the corkscrew-shaped bacteria (spirochete) that causes Lyme disease, making it easier to detect persistence of the bacteria. The new culture technique is also better able to grow the cyst form of the bacteria that is thought to be metabolically dormant... 

The ability to easily culture the cyst form as well as the spirochete form of the bacteria permitted the researchers to determine the effect of various antibiotics on each form of the bacteria.  Some antibiotics decreased the number of spirochetes but increased the number of cysts, while other antibiotics reduced both spirochetes and cysts, but at different rates.   

Finally, the researchers were able to develop biofilm colonies of the Lyme bacteria.  These colonies are made up of bacterial clusters coated in slime, and they have been shown to promote persistent infection in other diseases. The effectiveness of antibiotics for Bb in biofilm colonies was greatly reduced, with viable organisms detected in 70-85% of the biofilm colonies. 

2013 brought some really great published findings, though I haven't seen most of the work cited yet by CDC or 'anti-lyme' factions, even in articles or materials published well after these studies came out.  In other sciences, professionals in government agencies are required to demonstrate their use/consideration of the best available science when analyzing an issue or proposal, or making a decision.  Documentation of this step wouldn't be feasible to require in every publication, but it would be a necessary first step toward adequate patient care to require it to occur and to be documented somewhere by the agencies making decisions or affirming protocols for patient care.

Additional topics with interesting findings either released or widely discussed this year include, but are not limited to: an essential factor for lyme transmission, Lyme and Alheimer's,the role of fence lizards in lyme transmission reduction, species of ticks that transmit lyme to humans, strains of lyme that infect humans, and how long it takes to kill a tick in a clothes dryer.  Several of which, plus several more, can be found on the lymedisease.org blog, "Hard Science on Lyme" which is where I'm often able to find articles on studies I know I've read about but can't re-find later (including some of the top 5, above, which were otherwise much harder to find than I expected).  A University of Florida study identifying two additional non-black-legged tick species that can transmit lyme to humans was one of the most meaningful studies I read this year, but when I finally track that study down again, it'll warrant another post of its own.

I"ll never have time to read as much as I want to, which in a way is OK, as knowledge on this topic can be exhausting to carry around with you.  Though not as exhausting as this disease, so here's to a year of catching up on all the articles I wanted to read----and will be able to re-find through the tireless work of groups like lymedisease.org.