What is a Lyme disease “persister”?
Mounting evidence that shows Borrelia (Lyme disease) to remain active and continue to cause painful and debilitating symptoms even after antibiotic treatment has been given the name PTLDS or Post Treatment Lyme Disease Syndrome in a strange determination to avoid the term “Chronic Lyme Disease.”
So Lyme disease “persisters” are Borrelia that persist after treatment – yet another way to describe chronic Lyme disease without having to admit to the existence of such a condition.
Whether CLD, PTLDS or “Persisters” – a new study published in Emerging Microbes Through a team funded by Johns Hopkins University and headed by Dr. Jie Feng has drawn solid attention from the doctors on the front lines of treating Lyme disease.
This curious turn of events is a marvelous victory for those of us who suffer from persistent Borrelia, chronic Lyme disease or PTLDS (whatever you want to call it.) Instead of being thrown out of the Hospital, there is emerging hope that we may be treated as a serious patient with a serious condition who needs more antibiotics NOT less.
The idea in this study is that certain antibiotics very effectively destroy the early active part of the infection, while other antibiotics address the persistent form of the infection (we hope).
From the study:
“Findings that suggest the continued presence of B. burgdorferi in some form indicate that current Lyme disease treatment may not sufficiently eliminate B. burgdorferi persisters or that the immune system fails to clear persisting organisms or bacterial debris, which may be the underlying cause for those who suffer from unresolved Lyme disease symptoms. These factors may also be responsible for antibiotic-refractory arthritis, as suggested in a murine model in which spirochetal antigens appeared to persist around cartilage. To date, there is no effective antibiotic treatment or preventative strategy for those who suffer from persistent symptoms after contracting Lyme disease.”
“The problem of persistent B. burgdorferi infection has been difficult to study for several reasons, including difficulty culturing the persisting organisms after antibiotic treatment; inability of the current antibiotics, doxycycline and amoxicillin, to kill the persister organisms, as demonstrated in various animal models; and a lack of antibiotics that are effective against B. burgdorferi persisters. While concern remains whether PTLDS is due to persisting organisms, identification of antibiotics that have activity against B. burgdorferi persisters we feel should prompt testing of some antibiotic combinations that could impact either persisters if they exist or presence of antigenic debris, and by whatever mechanisms, study whether such an approach may lead to improved clinical outcomes in Lyme disease including Lyme arthritis or patients with PTLDS.”
After I sent this study to my internist, he promptly added 1000 mg of Cefuroxime to the 2000 mg of penicillin I have been taking for 18 months and I immediately herxed for two days experiencing pain in places that have not hurt in years, as well as severe pain in places that have been constantly painful for many, many years. Afterwards I felt better than ever.
Perhaps these researchers are really on to something.
Certainly we can all agree that the infections are complex, bacterial and viral, with much remaining to discover.
However we will have to agree to disagree on semantics. Does it really matter if some doctors refuse to “believe” in chronic Lyme disease but can wholeheartedly believe in “Persistent Lyme disease”? I don’t care as long as diagnosis and treatment are a top priority to stop the death and suffering.
Read the entire study here: http://www.nature.com/emi/journal/v3/n7/full/emi201453a.html
Emerging Microbes & Infections (2014) 3, e49; doi:10.1038/emi.2014.53
Published online 2 July 2014