Research from Dr. Zhang’s lab at JH shatters numerous company iconic beliefs about Lyme therapies.
We perceive that Lyme disease, or rather the causative organism, Borrelia burdorferi, is very unaccommodating eradicate. In vitro (in a proof tube) it took a combination of 3 antibiotics to consummate the task. Doxycycline was a order. The other drugs are either unavailable or prohibitively requiring great outlay, (cefoperazone and daptomycin).
Persistent viability of the spirochete relates to its adroitness to form round body forms and other pleomorphic variants and to from aggregates of spirochetes protected by a muccopolysaccharide covering. Rather that the provisions: L forms, cyst forms and biofilm colonies, Dr. Zhang simplifies: in that place are two groups,rapidly dividing forms (spirochetes) and standing forms (persisters).
Cocktails of drugs are needed to root out the organism. At this point we perceive little about the synergy of uncertain combinations.
First off, this is not of the present day, but Lyme does not form L-forms. L forms are bacterial lacking a small room wall, like mycoplasma. Alternatively, some gram negative bacteria, treated with antibiotics give out their cells walls transforming into L forms. L forms cannot live on outside the milieu of the intracellular cytoplasm of the host cells. Lyme spirochetes are encased in a dual membrane, not a solitary abode; squalid wall. Although the bacteria may be in actual possession of an intracellular location they are originally extracellular. Cell wall drugs work because the Lyme spirochetes have something like each internal skeleton comprised of cell wall essential, peptidoglycans. Lyme does not form truthful cysts. The terms round body shape and pleomorphic variants is more precise.
I don’t like the bound cyst busters (always reminds me of sprite busters). It may be easier to give Lyme as a dichotomy of spirochetes and persisters.
I am vile that I have bored you in such a manner far. The rest may be of greater advantage.
Doxycycline remains the first line then it comes to treating spirochete forms. Doxy has in ~ degree impact on stationary forms. You even now knew this.
Flagyl is not a “cyst buster.” It does not carry off stationary forms any better than doxycycline. ( you to all appearance did not know this) This furthermore true for amoxicillin. Ceftin does gain the ability to kill both active and stationary forms of Lyme. Rifampin does not give a death-blow to. Lyme by itself but confers persister killing furniture to doxycycline and amoxicillin.
I was secure that Tindamax must kill stationary forms. It works in the same state well in the clinical setting. So I asked Dr. Zhang and he responded. Unpublished facts show that Tindamax is ineffective in preparation for stationary form of Lyme, perhaps slenderly better than Flagyl. How could I subsist so wrong?
Then there is a extended list of drugs that kill Lyme upper hand than currently used drugs, at smallest in a test tube. Two drugs stand thoroughly: Diflucan and Artemisinin.
Why do Flagyl and Tindamax work so well? These drugs have prime penetration into tissues and into the brain. Perhaps this property and synergy elucidate clinical effectiveness. Tindamax (one of my favorites) is known to rectify in bodily fluids and tissues extremely well.
Doctors regard added Flagyl and Tindamax to Omnicef and Ceftin – for decades, because they are “sac busters.” These doctors had inapposite the whole time. It was to the end of time the other way around.
Ceftin refuse a highly touted Lyme drug. It is afore~ to be the only second generation cephalosporin that penetrates the blood brain barricade. Omnicef is a third generation cephalosporin, like Rocephin. All third part generation drugs can pass through the BBB. Early studies cited in the literature proved that Ceftin was effective in treating timely Lyme patients with EM rash. It was not studied for late state Lyme disease, heterogeneous doxycycline.
All cephalosporins do a reduced job of getting into the brain. They simply penetrate the brain when there is agile inflammation in the meninges (lining surrounding the brain). Oral drugs like Ceftin and Omnicef obtain poor uptake into the brain in patients through chronic Lyme encephalopathy. Tindamax and Flagyl may not slaughter persisters better than the others but they penetrate hard to reach places including the brain.
Amoxicillin, what one. like Ceftin/Omnicef does not carry off persisters but amoxicillin has slightly improvement penetration into the brain/central of the nerves system. I have found it besides effective in most patients.
Then we are left through the question: how do we despatch Lyme persisters in the brain?
IV Rocephin, by adequate brain penetration does have anti-persister properties. Perhaps IV Ceftin (cefuroxime) Zinacef, works more valuable – worth a try.
Obvioiusly we can’t mandate IV antibiotics for everybody.
Rifampin trials the BBB well and should boost the anti-persister effectiveness of drugs of that kind as doxycycline. I have found this clinically to have ~ing the case.
Test tube results to not ever translate into clinical results. Sulfa drugs slay persister and penetrate well into the brain; clinical efficacy in my practice has been lacking.
What approximately Diflucan? penetrates well into the brain and kills persisters. Role in Lyme to subsist determined.
Artemisinin? This drug has a abruptly half-life. This is why a derived combined with a longer acting active element (Coartem) has greater efficacy for malaria/babesiosis. Artemisinin has honest brain penetration. It has activity in contact with Lyme persisters. Clinical use for Lyme unexplored.
We had a lot of elemental part wrong but new doors have been opened in the manner that the search for the best passage to treat Lyme goes on.
I perceive Snuffy isn’t a young journalist, and he should have existence have more integrity than to race with something so ludicrous during a GOP battle for, but he is, after all, a of the people operative.