A Systematic Review of Borrelia burgdorferi Morphologic Variants Does Not Support a Role in Chronic Lyme Disease

From: “Carl Tuttle” <runagain@comcast.net>
To: “Clinical Infectious Diseases” <cid@tufts.edu>
Cc: cid3@tufts.edu, CID-editor@tufts.edu, “sherwood gorbach” <sherwood.gorbach@tufts.edu>, “michael barza” <michael.barza@tufts.edu>, scosgro1@jhmi.edu, asteere@partners.org, kstrle@partners.org,ethics@harvard.edu,

“David Linsky” <David.Linsky@mahouse.gov>, “Dick Blumenthal” <Dick_Blumenthal@blumenthal.senate.gov>

To: “Clinical Infectious Diseases” <cid@tufts.edu>

Sent: Sunday, December 15, 2013 11:26:22 PM

Subject: Re: CID MS 73416

Dear Dr Gorbach,

Here is yet another example of junk science published in Clinical Infectious Diseases aimed at denying the existence of persistent infection.

A Systematic Review of Borrelia burgdorferi Morphologic Variants Does Not Support a Role in Chronic Lyme Disease

http://cid.oxfordjournals.org/content/early/2013/12/12/cid.cit810.abstract

Conclusion from the “Three Amigos” abstract: (Lantos, Auwaerter and Wormser)

Conclusions.”In the context of the broader medical literature it is not currently possible to ascribe a pathogenic role to morphologic variants of  B. burgdorferi in either typical manifestations of Lyme disease or in other chronic disease states that are often labeled chronic Lyme disease. There is no clinical literature to justify specific treatment of B. burgdorferi morphologic variants.”

Studies on the Cystic Form of Borrelia burgdorferi Mechanisms of Persistence

http://www.samento.com.ec/sciencelib/4lyme/studiesoncyst.pdf

Effects of Penicillin, Ceftriaxone, and Doxycycline on Morphology of Borrelia burgdorferi

Date of Publication: May, 1995

Source: Antimicrobial Agents & Chemotherapy, 39(5):1127-33

Authors: Kersten A; Poitschek C; Rauch S; Aberer E.

Institution: Department of Dermatology, University of Vienna, AustriaAbstract

Antibiotic therapy with penicillin, doxycycline, and ceftriaxone has proven to be effective for the treatment of Lyme borreliosis. In some patients, however, it was noticed that borreliae can survival in the tissues in spite of seemingly adequate therapy. For a better understanding of this phenomenon, we investigated the different modes of degeneration of Borrelia burgdorferi suspensions during a 96-h exposure to various antibiotics. By dark-field microscopy and ultrastructural investigations,increasing blebbing and the gradual formation of granular and cystic structures could be followed during the exposure time. Although antibiotic concentrations at the MIC at which 90% of organisms are inhibited after 72 h were 80% or even greater, motile organisms were still present after incubation with penicillin and doxycycline but not after incubation with ceftriaxone. By transmission electron microscopy, intact spirochetal parts, mostly situated in cysts, were seen up to 96 h after exposure with all three antibiotics tested. According to experiences from studies with other spirochetes it is suggested that encysted borreliae, granules, and the remaining blebs might be responsible for the ongoing antigenic stimulus leading to complaints of chronic Lyme borreliosis.

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Quotation From The Full-Text Article

“Morphologically intact borrelia parts seen after 4 days of incubation with antibiotics, however, may also persist in humans during antibiotic treatment. …granules and encysted

B. burgdorferi should be investigated further in view of their long-term persistence in infected tissues and their contribution to the pathogenesis of Lyme borreliosis.” (p.1132)

Carl Tuttle

Website: New Hampshire Lyme Misdiagnosis