Door: Jie Feng
Uit: Discovery Medicine
28 Maart 2019
http://www.discoverymedicine.com/Jie-Fe ... use-model/
Abstract
Although most patients with lyme disease can be cured with a 2-4 week antibiotic therapy, about 10-20% of patients continue to suffer prolonged persistent symptoms,
a condition called post-treatment lyme disease syndrome ( PTLDS) The cause for PTLDS is unclear and holly debated.
B. burgdorferi develops morphological variants under stress conditions but their significanse is not clear.
Here we isolated the biofilm-like microcolony (MC ) and planktonic ( spirochetal form and round body) variant forms from the stationary phase culture and showed that the MC and SP
were not only more tolerant to the current antibiotics but also caused more severe arthritis in mice than the LOG
phase spirochete form ( LOG )
We propose to divide the persistent lyme disease into two categories:
1- early development of persistent disease from inoculation with persister/biofilm at the beginning of
infection introduced by tick bites, or Type 1 persistent disease ( i.e., PTLDS), and
2- late development of persistent disease due to initial infection not being diagnosed or treated in time such that the
infection develops into late persistent disease, or Type persitent disease, importantly, we show that
the murine infection caused by LOG could be eradicated by ceftriaxone wheras the persistent infection established with MC could not be eradicated by doxycycline, ceftriaxone, or vancomycin, or doxy+Cef or Van+Cef
But could only be eradicated by persister drug combination daptomycyn+doxycycline+ceftriaxone.
Our studies demonstrate that varying levels of
persistence and athologies of Borrelia infection can be established with heterogeneous inocula with
different morphologies and have different treatment responses.
These observations may have broad implications for understanding pathogenesis and treatment of nog only persistent lyme disease
but also other persistent infections in general and call for studies to evaluate if treatment of persistent infections with persister drug combination regiments is more effective than the current mostly single antibiotic monotherapy
De studie van Johns Hopkins universiteit zou kunnen leiden tot een meer effectievere manier van behandelen voor mensen met persisterende borreliose symptomen
https://www.lymedisease.org/lymesci-jhu ... tent-lyme/