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About 300,000 people a year are infected with Lyme disease through tick bites, and for up to 20 percent of them the condition persists after a course of antibiotics. But just in time for tick season, Johns Hopkins University researchers are now onto a promising treatment for those sufferers.
It would be the first specific treatment for those who contend with such symptoms as fatigue, muscle and joint aches, and brain fog, sometimes severe. It also would be a major step for researchers who long struggled to even prove those symptoms were related to Lyme — partly because Lyme bacteria was no longer detected in blood tests after the initial treatment.
Most cases of Lyme disease are resolved with a course of doxycycline, amoxicillin or cefuroxime, for two to four weeks.
Researchers from the Hopkins Bloomberg School of Public Health have had success in mice with a three-drug combination — daptomycin, doxycycline and ceftriaxone — to treat what is now called post-treatment Lyme disease syndrome. The new study was published in the March 28 journal Discovery Medicine.
The idea is that there is slow-growing variant of Lyme bacteria, Borrelia burgdorferi, which persists and causes these sometimes severe arthritis-like symptoms. The “persister” bacteria were found to be immune to the standard single-antibiotic treatment.
Researchers believe certain conditions cause these bacteria to switch from their normal fast-growth mode to variants with little or no growth.
Past studies also have suggested these variants can be killed with the right drugs.
The next step for the three-drug combination will be testing it in people.
“There is a lot of excitement in the field, because we now have not only a plausible explanation but also a potential solution for patients who suffer from persistent Lyme disease symptoms despite standard single-antibiotic treatment,” said Dr. Ying Zhang, the study’s senior author and a professor in the Bloomberg School’s department of molecular microbiology and immunology.
Zhang said the idea of drug combinations may translate to treatments for other infectious diseases caused by such persister bacteria.
Good information, many thanks!It's possible better testing doesn't exist for those reasons, but I think the nature of borrelia burgdorferi makes them very hard to detect. They can live outside of the bloodstream, so they won't necessarily be present in a blood draw, and they can suppress and hide from the immune system, which means antibodies aren't a reliable test either. Until recently, many Lyme doctors would start a course of antibiotics based on symptoms and then retest after a month or so. Their hope was that the immune system would detect the dead borrelia burgdorferi and produce antibodies, which would then result in a positive test. At that point, they would know to continue with treatment.
Newer tests are being developed, which focus on metabolomics. Development of a metabolic biosignature for detection of early Lyme disease. - PubMed - NCBI There's also more doctors and scientists coming around to the idea that the initial course of antibiotics may not be effective in all people.
As tick season begins, researchers find promising treatment for Lyme-related disease
Lyme doctors are already aware of the multi-drug approach against persisters, but still, the right choice of antibiotics is highly disputed, and some of them come with significant drawbacks. Co-infections complicate things even further, as they often need to be treated as well. More research is obviously needed. It would behoove insurance companies to get on board. The right treatment could prevent chronic cases, and cure cases that have become chronic. The alternative is misdiagnosis and wasted money on ineffective treatment.