True Story Behind the Rocky Road to Publication Regarding Evidence of Borrelia Biofilms

True Story Behind the Rocky Road to Publication Regarding Evidence of Borrelia Biofilms

“The Rest of the Story About Getting Evidence Regarding Biofilms of Borrelia Accepted for Publication:”

Written by Alan MacDonald MD; July 24,2013

In the original release of the movie “UNDER OUR SKIN” my parting remarks are about the exciting future of Biofilms of Borrelia.

At the time of filming, we already had the proof in hand, but we had to have a credible published medical paper to be included in the movie.

We also had to get it past an Editor in Chief of a Journal with good academic standing in the world of medical publishing for general credibility.

We knew that we would not succeed with the Journal of Infectious Disease or Clinical Microbiology and infectious Disease or with the newsletter to the membership of the IDSA due to IDSA bias.

Then finally, in November 2012, we got our big break with the milestone publication that we had long awaited of the PLOS ONE article onIn Vitro Biofilms of Borrelia burgdorferi.”

We had long since discussed in video interviews, six years earlier (in the year 2006) which thankfully was able to appear in “Under Our Skin” that Lyme biofilms would be the next “Big Thing.”

It took 6 years of tedious and politically gut wrenching work to get that article into a Prestige journal, PLOS ONE.

The acceptance for the article to be published was, like some births, not an easy delivery.

The original manuscript reviews required mandatory revisions – non-negotiable revisions.

The most onerous of these was the directive by the editorial staff to REMOVE Any and All language from the manuscript which connected the significance of Borrelia biofilms to human medicine, human disease, and/or to Lyme disease specifically.  This included specifically the attitude toward the proper treatment of Lyme disease and related Borrelia infections as a result of the evidence of Borrelia biofilms.

These demands were acceded to in the article in order to get it published.

Why would PhD reviewers be at all interested in MD treatment-type information? They are usually focused on the legitimacy of the science NOT the specifics of potential treatments.

We solved the mystery which fits perfectly with existing politics.

None of the 3 reviewers were IDSA aligned persons.

All of the article reviewers, (from best that we could determine,) were European Microbiologists with special life experience in biofilm biology of other non-borrelia microbes.

What most people don’t know (because the general public only hear about dental biofilms) is that in the study of biofilms,  the infectious type are ALWAYS a marker of CHRONIC INFECTION.

Of course chronic Lyme borreliosis was then, and was in 2006, and is today in 2013, a much disputed entity.

Allowing biofilms of Borrelia to attain academic respectability, with the publication of the Sapi et al In Vitro Borrelia biofilm article, the conceptual link by a microscopic structure (biofilm of borrelia community) overturned all of the objections to the impossibility of chronic borreliosis as a validated entity.

In other words it gave tangible evidence to the frustrating questions about why antibiotics wasn’t curing Lyme disease, and how borreliosis becomes chronic in so many cases.

So , did we ask a good question, as the Nobel laureate Izzy Singer once challenged?


And so, the next “good question” was, BAre there borrelia biofilms in living organisms or are Borrelia biofilms just a test tube curiosity?” (the immediate reaction by sceptics.)

Two weeks after the PLOS ONE publication of the Sapi biofilm In vitro Paper, came the announcement from the Sapi Group at the University of New Haven, Connecticut that Borrelia biofilms were detected under the microscope in a human skin biopsy from a European patient with cutaneous borreliosis.

So Dr. Sapi’s research group started to look into the tick gut, to see if Borrelia biofilms appear in the living tick, as a measure to maintain the Borrelia through a period of starvation, before it bites its next human victim.

This work has also been paradigm shifting.

Now to look ahead to the paradigm shifts yet to come.

I have announced that the PLAQUES of Alzheimer’s disease are biofilm communities.

The obvious question arises, “How do we attack and remove these infectious biofilms?”

This is another tough question.

Biofilms are fortress-like communities which are from their very inception designed to survive all manner of attack, including high dose long term antibiotic therapies  – even through IV lines surgically sewn into the veins of sick patients who require long term and large quantities of antibiotic therapy.

So antibiotic therapy is not a panacea for eliminating Lyme disease and/or biofilms of any microbe.  But, just before Dr. Bill Costerton passed away from Pancreatic cancer in 2012, he recorded a video interview on You Tube. In that interview he discussed many things about biofilm biology.

Dr. Costerton, as the author of many peer reviewed articles on biofilms of many species of microbes, was ideally situated to editorialize about “ALL THINGS BIOFILM.”

One of the last topics which he introduced at the end of the video was the concept that ultrasound energy , correctly administered to test tube biofilm communities actually breaks up the protective covering that hides the infection, and opens up the heretofore “stealth” bacteria to the action of antibiotics, which can then get to the microbes and kill them.

So there is more than a “vague new direction” for killing biofilm infections. Dr. Costerton has built us an 8 lane highway.

More about this later.

So, I had made the promise in Under Our Skin that biofilms would be the “Next Great Thing”, and that promise has been kept.

But watch for the great things that will accrue to Lyme borreliosis patients because of basement laboratory investigations conducted by determined researchers who will build on these discoveries.

Best to you, as always,

Alan MacDonald MD
July 24,2013

PS: This week the Lancet Infectious Disease Journal 2013: 13:(8) :719-724 has a manuscript which discusses Streptococcus Gallolyticus and Cancer. Strep Gallolyticus actually helps form biofilm and is highly associated with setting up the communities on the surface of malignant tumors and premalignant tumors in the human colon.

Some of these biofilm communities send off “showers” of the Strep Gallo biofilm community into the bloodstream, and some of these microbial “emboli” infect the human cardiac valves causing Bacterial endocarditis of the Strep Gallo Type (Formerly Strep Bovis endocarditis) Endocarditis is, and always has been, a BIOFILM infection of the human heart valves.

So this timely news in the world of infectious disease brings further evidence regarding biofilm in Borrelia – the biofilm – always chronic – infections.

Think about it…

More Resources:

View Dr. MacDonald’s new website:

Alan MacDonald, PhD; The Biology of Lyme Disease: An Expert’s Perspective:

Evi Sapi, PhD on Biofilm Discovery in Lyme Disease:

Dr. Bill Costerton on Diagnosing and Treating Biofilms:

Dr. Randy Wolcott on Molecular Validation of Biofilm Infection:

Dr. Bonnie Bassler on “Quorum Sensing” Bacteria Communicating in a cell and/or in a Biofilm:

Edited by Jenna Smith on August 2, 2013

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3 Responses to True Story Behind the Rocky Road to Publication Regarding Evidence of Borrelia Biofilms

  1. Carin says:

    Hi Alan, I’m personally really excited about the “new” future for Biofilms of Borrelia. Please keep us updated on the news and what researchers who will build on these discoveries actually find out. Thanks.

  2. Don Mau says:

    Dear Dr. MacDonald;

    Thank you for your youtube videos , they helped my understanding. What do you think about the angiogenic tumors that Bartonella produces, do you think these also pose the problem of sequestering pathogens as biofilms do?

    “Bartonella are the only bacteria able to produce angiogenic tumors in humans, very much like the Agrobacterium species that produce tumors in plants”

    “Bartonella Species Bacteremia in Two Patients with Epithelioid Hemangioendothelioma”

    “Infectious Angiogenesis”

    Thank you
    Don Mau

  3. don mau says:

    It’s not the biofilms that is the problem. It is the ability of Bartonella to produce angiogenic tumors and Bartonellas ability for horizontal Gene transfer.

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