my homepage blog, I posted a summary of the scary world we live in that
consists of toxins and ticks. Thankfully, there are some action steps we can
take to mitigate some of the burden on our body from our chemical soup environment.
even scarier for some is the fact that adversarial critters seem to be
spreading and taking over our previous serene outdoors. Between the recent Zika
virus scare and the identification of a new Borellia
species discovered, it seems that going outside could become a health risk!
regards to addressing Lyme (Borellia
burgdoferi), there are several controversies including:
- The existence of chronic Lyme and its difficultly in accurate
diagnosis (Lyme has been called the great imitator)
- The efficacy, sensitivity, and reliability of current conventional
- Best treatments- length, duration, antibiotic selection
- Treatment of its coinfections
to the downfalls of the various conventional tests not being very sensitive,
there has been much research into more accurate assessment. Interestingly, this month
there are already two promising ones!
first study for Lyme testing was based on genomic sequencing of peripheral
blood mononuclear cells (PBMCs, a type of immune cell). This was done in order
to investigate the transcriptomes (RNA sequence) of 29 patients with acute Lyme
disease from the time of diagnosis to 6 months’ post-treatment compared to 13
Science Daily reports:
“In an effort to find better ways of
diagnosing the disease, and discovering molecular pathways that might explain
how Lyme disease could cause long-term symptoms, researchers used a
next-generation sequencing technique, called RNA-seq, to investigate the
transcriptome — the genes that are being turned on — in peripheral blood
are several neat things about this new test. One is its ability to test the
response of the infection via genetic analysis on the immune cells. Second, the
authors also took into account various aspects of the immune response (acute
verse chronic) that other tests may miss. Third, the study results demonstrated
that Lyme and other critters had the potential to sustain transcriptome
changes, which supports long-term changes in the body. Finally, the researchers
also compared the gene expression signature of Lyme disease to other infections
and chronic diseases.
The authors summary states:
is the most common tick-borne infection in the United States, and some patients
report lingering symptoms lasting months to years despite antibiotic treatment.
To better understand the role of the human host response in acute Lyme disease
and the development of post-treatment symptoms, we conducted the first
longitudinal gene expression (transcriptome) study of patients enrolled at the
time of diagnosis and followed up for up to 6 months after treatment.
Importantly, we found that the gene expression signature of early Lyme disease
is distinct from that of other acute infectious diseases and persists for at
least 3 weeks following infection. This study also uncovered multiple
previously undescribed pathways and genes that may be useful in the future as
human host biomarkers for diagnosis and that constitute potential targets for
the development of new therapies.
important to note that this study was small and needs to be replicated, but it
may provide clues for better detection.
exciting test this month holds promise for diagnosing acute Lyme disease
through detection of a lipoprotein of B. burgdoferi. As mentioned in my homepage blog, Borrellia has many ways to trick the
immune system, so finding a marker that is apparent early on in the disease spectrum is exciting. I was
not able to maintain the full article, but the abstract states:
The Borrelia burgdorferi spirochete is
the causative agent of Lyme disease, the most common tick-borne disease in the
United States. The low abundance of bacterial proteins in human serum during
infection imposes a challenge for early proteomic detection of Lyme disease. To
address this challenge, we propose to detect membrane proteins released from
bacteria due to disruption of their plasma membrane triggered by the innate
immune system. These membrane proteins can be separated from the bulk of serum
proteins by high-speed centrifugation causing substantial sample enrichment
prior to targeted protein quantification using multiple reaction monitoring
mass spectrometry. This new approach was first applied to detection of B. burgdorferi membrane proteins
supplemented in human serum. Our results indicated that detection of B. burgdorferi membrane proteins,
which are ≈107 lower in abundance than major serum proteins, is
feasible. Therefore, quantitative analysis was also carried out for serum
samples from three patients with acute Lyme disease. We were able to
demonstrate the detection of ospA, the major B. burgdorferi lipoprotein at the level of 4.0 fmol of ospA/mg
of serum protein. The results confirm the concept and suggest that the proposed
approach can be expanded to detect other bacterial infections in humans,
particularly where existing diagnostics are unreliable.
Person, Don’t Just Kill the Critter
think it’s important to remember that to fully address any chronic issue, you
have to address the whole person, not just “kill the critter.” Getting rid of the buggers may take off
some stress on the immune response, but the long-term implications on the
microbiome and other imbalances created by the infection will remain. As I
mentioned previously, I like to look at the whole picture based on the individual.
This includes assessing:
•Inflammation and oxidative stress
•Genetic variations as needed (such as SNPs related
to MTHFR, DRD2, DRD4, COMT, CBS, serotonin transporters (5HTT),)
•Nutritional status and capacity for assimilation
•Dietary triggers and deficiencies (including iron
•Mitochondrial dysfunctions and imbalances
•Stress & cortisol levels
•The microbiome balance
•Environmental toxicants, especially mold!
•Blood sugar levels
•Other stealth infections
•Childhood adversity and its impact on the immune and
•Emotional tone and spirituality
•Brain trauma history
•Nervous system stressors
•Hyper or hypo-activity in a brain region
- …and more! (Get
link references here)
labs and symptoms will tell me where to start with my client and not all of these are done at
once! See, as a naturopathic and functional medicine doctor, the diagnosis of
Lyme and knowing how it interacts with the body is important. However, knowing
how to treat the person with Lyme, that’s the art of medicine.
for Disease Control and Prevention (CDC). Zika Virus. February 12, 2016.
for Disease Control and Prevention (CDC). Areas with Zika. February 9, 2016.
R. New Lyme Disease Bacteria Discovered in Upper Midwest: CDC. Health Day.
February 9, 2016.
Bouquet et al. Longitudinal
Transcriptome Analysis Reveals a Sustained Differential Gene Expression
Signature in Patients Treated for Acute Lyme Disease. mBio, February
of California, San Francisco (UCSF). Gene signature could lead to a new way of
diagnosing Lyme Disease. ScienceDaily, 12 February 2016.
SF, et al. Quantification of Borrelia burgdorferi Membrane Proteins in Human Serum:
A New Concept for Detection of Bacterial Infection. Analytical
Chemistry, 2015; 87 (22): 11383.
Institute of Standards and Technology (NIST). New experimental test detects
signs of Lyme disease near time of infection: In proof-of-concept study, new
method detects Lyme bacteria before standard blood test. ScienceDaily. 12