Link: http://www.scielo.br/pdf/bjmbr/v40n4/6497.pdf 

Excerpt:

An emerging clinical entity that reproduces clinical manifestations
similar to those observed in Lyme disease (LD) has been recently
under discussion in Brazil. Due to etiological and laboratory particularities
it is named LD-like syndrome or LD imitator syndrome. The
condition is considered to be a zoonosis transmitted by ticks of the
genus Amblyomma, possibly caused by interaction of multiple fastidious
microorganisms originating a protean clinical picture, including
neurological, osteoarticular and erythema migrans-like lesions. 

Excerpt:

Using cryo-electron tomography, we observed closely associated Borrelia cells. Some of these showed a single outer membrane surrounding two longitudinally arranged cytoplasmic cylinders. We also observed fusion of two cytoplasmic cylinders and differences in the surface layer density of fused spirochetes. These processes could play a role in the interaction of Borrelia species with the host’s immune system.

Excerpt:

Background

Skin erythemas of unknown origin are a frequent reason for consulting the general practitioner or dermatologist.

Case presentation

Here we report a case of an erythema resembling the erythema migrans manifestation of Lyme disease, but with atypical symptoms like persistent pruritus. The patient had no history of a recent tick-bite but displayed a positive serology for an advanced stage of Lyme borreliosis, which stood in contrast to the clinical manifestation of erythema migrans as a symptom of early Lyme disease. Three skin swabs and soil samples, collected in the area where the patient possibly acquired the infection, were examined by bacterial and fungal culture methods. Microorganisms were identified by using 16S rRNA gene sequencing and bioinformatics. The patient and soil isolates were compared by employing RAPD analysis. The serum samples of the patient were examined by immunoblotting. Arthrobacter mysorens, a soil bacterium, was isolated from the collected skin and soil samples. The identity of both isolates was determined by molecular fingerprinting methods. A.mysorens was proven to be causative for the erythema by direct isolation from the affected skin and a positive serology, thus explaining the atypical appearance of the erythema compared to erythema migrans caused by Borrelia infection.

Conclusions

Infections with A.mysorens might be underreported and microbiological diagnostic techniques should be applied in cases of patients with unclear erythemas, resembling erythema migrans, without a history of tick bites.

Excerpt:

Borrelia burgdorferi spirochetes cause Lyme disease, which can result in
severe clinical symptoms such as multiple joint inflammation and
neurological disorders. IFN-gamma and IL-17 have been suggested to play an
important role in the host defense against Borrelia, and in the
immunopathology of Lyme disease.
The caspase-1-dependent cytokine IL-1beta has been linked to the generation
of IL-17-producing T cells, whereas caspase-1-mediated IL-18 is crucial for
IFN-gamma production. In this study, we show by using knockout mice the role
of inflammasome-activated caspase-1 in the regulation of cytokine responses
by B.
burgdorferi. Caspase-1-deficient cells showed significantly less IFN-gamma
and
IL-17 production after Borrelia stimulation. A lack of IL-1beta was
responsible for the defective IL-17 production, whereas IL-18 was crucial
for the IFN-gamma production. Caspase-1-dependent IL-33 played no role in
the Borrelia-induced production of IL-1beta, IFN-gamma or IL-17. 
In conclusion, we describe for the
first time the role of the inflammasome-dependent caspase-1 activation of
cytokines in the regulation of IL-17 production induced by Borrelia spp. As
IL-17 has been implicated in the pathogenesis of chronic Lyme disease, these
data suggest that caspase-1 targeting may represent a new immunomodulatory
strategy for the treatment of complications of late stage Lyme disease.
Copyright (c) 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Excerpt:

In October 2010, I attended the ILADS 2010 Annual event.  The event was packed.  Almost 400 people attended in person and over 1,000 people watched on the live webcast.  It is exciting to see so many people taking an interest in this controversial area of medicine.  The event was full of great information and people working hard to help us all find answers.

In this blog entry, I will share a few of the key takeaways that I learned at the event.  The slides from the event are available for purchase here for a very reasonable $40.  The DVDs (Friday’s sessions) and CDs of the presentations can be obtained from ZenWorks Productions.  Thus, I am not going to attempt to repeat information that is available elsewhere, but I will focus on some of the key things that caught my attention.

• The 2011 ILADS event will be in Toronto, Canada – October 28-30, 2011

• Dr. Richard Horowitz proposed that Chronic Lyme is really MCIDS – MultipleChronic Infectious Disease Syndrome

• Biofilm treatment may be with EDTA or a Banderol/Samento combination.  There may be a strong antigen release with biofilm treatment which may make it a good candidate for pulsed therapy

• Dr. Steve Harris mentioned that yeast may cannibalize dying Borrelia and that yeast is not always the result of antibiotic therapy alone.  He suggested up to 100 billion probiotic organisms daily.  In terms of diet, he said, “If it’s white, it ain’t right”

• Minocycline may have longer toxic effects than doxycycline but has better CNS penetration.  Mino also has less sun sensitivity than doxy.  That said, Dr. Joe Burrascano commented that the effectiveness of minocycline may be regional as he never observed it working well in his patients

Excerpt:

Tick-borne pathogens such as Lyme borreliosis spirochaetes,
Anaplasma phagocytophilum, Rickettsia spp. and Babesia spp. cause
a great variety of diseases in animals and humans. Although their
importance with respect to emerging human diseases is increasing,
many issues about their ecology are still unclear. In spring
2007, 191 Ixodes ricinus (Acari: Ixodidae) ticks were collected
from 99 birds of 11 species on a bird conservation island in the
Baltic Sea in order to test them for Borrelia spp., A.
phagocytophilum, Rickettsia spp. and Babesia spp. infections.
Identification of the pathogens was performed by polymerase chain
reaction (PCR), restriction fragment length polymorphism and
sequence analysis. The majority of birds with ticks testing
positive were European robins and thrushes. Borrelia DNA was
detected in 14.1%, A. phagocytophilum in 2.6%, rickettsiae in
7.3% and Babesia spp. in 4.7% of the ticks. Co-infections with
different pathogens occurred in six ticks (3.1%). The fact that
11 ticks (five larvae, six nymphs) were infected with Borrelia
afzelii suggests that birds may, contrary to current opinion,
serve as reservoir hosts for this species. Among rickettsial
infections, we identified Rickettsia monacensis and Rickettsia
helvetica. As we detected five Rickettsia spp.
positive larvae and two birds carried more than one infected
tick, transmission of those pathogens from birds to ticks appears
possible.

Excerpt:

Tick-borne pathogens such as Lyme borreliosis spirochaetes,
Anaplasma phagocytophilum, Rickettsia spp. and Babesia spp. cause
a great variety of diseases in animals and humans. Although their
importance with respect to emerging human diseases is increasing,
many issues about their ecology are still unclear. In spring
2007, 191 Ixodes ricinus (Acari: Ixodidae) ticks were collected
from 99 birds of 11 species on a bird conservation island in the
Baltic Sea in order to test them for Borrelia spp., A.
phagocytophilum, Rickettsia spp. and Babesia spp. infections.
Identification of the pathogens was performed by polymerase chain
reaction (PCR), restriction fragment length polymorphism and
sequence analysis. The majority of birds with ticks testing
positive were European robins and thrushes. Borrelia DNA was
detected in 14.1%, A. phagocytophilum in 2.6%, rickettsiae in
7.3% and Babesia spp. in 4.7% of the ticks. Co-infections with
different pathogens occurred in six ticks (3.1%). The fact that
11 ticks (five larvae, six nymphs) were infected with Borrelia
afzelii suggests that birds may, contrary to current opinion,
serve as reservoir hosts for this species. Among rickettsial
infections, we identified Rickettsia monacensis and Rickettsia
helvetica. As we detected five Rickettsia spp.
positive larvae and two birds carried more than one infected
tick, transmission of those pathogens from birds to ticks appears
possible.

Excerpt:

Members of the genus Borrelia are among the most common
infectious agents causing tick-borne disease in humans worldwide.
Here, we developed a Light Upon
eXtension(TM) (LUX) real-time PCR assay that can detect and
quantify Borrelia species in ticks that have fed on humans, and
we applied the assay to 399 such ticks. Borrelia PCR-positive
ticks were identified to species by sequencing the products of
conventional PCR performed using Borrelia group-specific primers.
There was a 19% prevalence of Borrelia spp. in the detached
ticks, and the number of spirochetes per Borrelia PCR-positive
tick ranged from 2.0 x 10(2) to
4.9 x 10(5) with a median of 7.8 x 10(3) spirochetes. Adult ticks
had a significantly larger number of spirochetes with a median of
8.4 x 10(4) compared to the median of nymphs 4.4 x 10(4). Adult
ticks also exhibited higher prevalence of Borrelia (33%) compared
to nymphs (14%). Among the identified species, Borrelia afzelii
was found to predominate (61%), followed by B. garinii (23%), B.
valaisiana (13%), B. burgdorferi sensu stricto (1%), B.
lusitaniae (1%), and B. miyamotoi-like (1%). Also, 3% of the
ticks were co-infected with multiple strains of B. afzelii.
Notably, this is the first report of B.
lusitaniae being detected in ticks in Sweden. 

Excerpt:

IDSA knows that chronic Lyme exists

The IDSA is aware that chronic Lyme exists. We know this because
members of the 2000 and 2006 Lyme disease guideline panels wrote, in
research articles and patents, that chronic Lyme exists.

Evidence about the existence of chronic Lyme borreliosis has increased
since the 2006 LD guidelines were published.

Scientists in California recently reported that not only can Bb persist
in mice despite treatment with ceftriaxone, but the Borrelia can also
infect other ticks and mice. (1) This study buttresses previous
studies that showed that Borrelia can persist in mice (2, 3), dogs (4,
5, 6), and ponies (7).

Studies have also shown that Bb can persist despite antibiotic
treatment in the following human cells, tissues, organs, and body
fluids:

* Fibroblasts (8; Mark Klempner, an IDSA LD guideline panel member in
2006, is an author of this study)