artur737
04.11.05, 06:09
The LDA and ILADS conferences, Philadelphia, October 2005 –
A presentation for Lyme Disease Action by Dr. David Owen.
Below is a summary of the conferences subdivided into the areas of science, medicine and politics. The order within the sections reflects the order in which presentations were given.
The science
The conference began with Sven Bergstrom PhD who has many years of experience in the Borrelia field. His work has focussed on Borrelia in Africa where the problem of relapsing fever (RF) occurs, a disease caused by Borrelia species. There are many analogies with Lyme disease which itself is relapsing in nature. It was interesting to note that the problem of relapsing fever is eclipsed by malaria in Africa. The two often co-exist (up to 10% by PCR) but little attention is given to the RF if malaria is present. Mechanisms of immune evasion in RF were discussed and there is strong evidence that RF may persist for long periods: It is not just an acute disease as we have been lead to believe.
Steven Norris PhD has been working on factors which allow Borrelia to survive in the host for long periods. Although Borrelia is fully sequenced the function of most of its proteins is not known. It is apparent some genes are needed for survival in ticks and others in mammals. Many interact with the immune system in complex ways. Add on the diversity of the Borrelia genome and it is clear that the work to be done here will keep scientists busy for a very long time indeed and we will continue to be bewildered by the complexity of it all.
Dr. Klaus-Peter Hunfeld presented data relating to the sensitivity of Borrelia burgdorferi in vitro. Although variable degrees of sensitivity do occur there is no evidence of increased resistance after exposure to antibiotics in vitro. Comment - Classical resistance is mediated by enzyme induction and it is reassuring to note that this does not seem to occur in Borrelia. The reason for this may be that Borrelia simply does not need to use this strategy for survival – it has so many others it uses!
Terry Schultze PhD talked on the ways in which tick populations can be controlled. Biological control remains a dream but locally populations can be controlled with acaricides using various strategies. Correct timing of applications is crucial and varies with location.
The US military appears to be taking Lyme very seriously. Pat Smith, President of the LDA (Lyme Disease Association), told conference that the military may soon have access to portable equipment developed in US Army CHPPM which is based on PCR testing and enables them to determine whether a particular tick carries Borrelia or any of its co-infections. This will allow targeted treatment of bitten soldiers to be given on the spot. Comment - I wonder with prompt treatment how much future morbidity could be prevented?
Dr. Joshua Zimmerberg presented work on the culturing of Borrelia. Failure to culture Borrelia is perhaps the main reason that Borrelia has escaped attention for so long. There is hope that the culturing which takes place in gently rotating chambers will aid research into Borrelia.
In the ILADS meeting Jyotsna Shah PhD told us about testing as carried out in the Igenex lab. Igenex is the world leader in TBDs. The lab recognises the arbitrary restriction on Western Blot testing imposed by CDC criteria. The result is that more patients with Lyme disease receive benefit when Igenex is used. Testing should not be relied upon for LD diagnosis but to some degree we are all guilty of placing too much reliance on technology in medical practice.
Testing for LD is improving and Bernard Raxlen MD told the conference about promising findings using the new peptide based Elisa test. When this is used more cases will be picked up especially if the test is applied to co-infection resultant antibodies as well.
Alan Macdonald MD presented his work on Alzheimer’s dementia and Borrelia. He first publicised work in this field in the early 80s but he was widely criticised and actually driven out of practice. Borrelia DNA is being found by Dr. Macdonald in Alzheimer brains and this supports his earlier morphological work. Comment - I hope that this time his work will be received without prejudice.
Garth Nicolson PhD has spent many years working in the field of Chronic Fatigue Syndrome (CFS) like diseases and has highlighted the importance of Mycoplasma in the past. Mycoplasma can be found in ticks and is another co-infection for Lyme. Prof. Nicolson presented data relating to NTFactor, a commercially available nutritional supplement which may help some patients with persistent fatigue.
