Research from Dr. Zhang’s lab at JH shatters numerous company iconic beliefs about Lyme therapies.
We be sure that Lyme disease, or rather the causal organism, Borrelia burdorferi, is very herculean eradicate. In vitro (in a exhibition tube) it took a combination of 3 antibiotics to complete the task. Doxycycline was a injunction. The other drugs are either unavailable or prohibitively costly, (cefoperazone and daptomycin).
Persistent viability of the spirochete relates to its ingenuity to form round body forms and other pleomorphic variants and to from aggregates of spirochetes protected ~ means of a muccopolysaccharide covering. Rather that the stipulations: L forms, cyst forms and biofilm colonies, Dr. Zhang simplifies: in that place are two groups,rapidly dividing forms (spirochetes) and at a stand forms (persisters).
Cocktails of drugs are needed to eradicate the organism. At this point we comprehend little about the synergy of various combinations.
First off, this is not recent, but Lyme does not form L-forms. L forms are bacterial lacking a solitary abode; squalid wall, like mycoplasma. Alternatively, some gram negative bacteria, treated with antibiotics throw off their cells walls transforming into L forms. L forms cannot live longer than outside the milieu of the intracellular cytoplasm of the entertainer cells. Lyme spirochetes are encased in a dual membrane, not a organic unit wall. Although the bacteria may be obliged an intracellular location they are in the first place extracellular. Cell wall drugs work for the Lyme spirochetes have something like every internal skeleton comprised of cell wall vital, peptidoglycans. Lyme does not form pure cysts. The terms round body mould and pleomorphic variants is more close.
I don’t like the style cyst busters (always reminds me of apparition busters). It may be easier to be attentive to Lyme as a dichotomy of spirochetes and persisters.
I am contemptible that I have bored you in the same manner far. The rest may be of greater portion.
Doxycycline remains the first line at what time it comes to treating spirochete forms. Doxy has ~t any impact on stationary forms. You before that time knew this.
Flagyl is not a “pouch buster.” It does not give one his quietus stationary forms any better than doxycycline. ( you probably did not know this) This in like manner true for amoxicillin. Ceftin does be delivered of the ability to kill both effectual and stationary forms of Lyme. Rifampin does not slaughter Lyme by itself but confers persister killing furniture to doxycycline and amoxicillin.
I was sure that Tindamax must kill stationary forms. It works so well in the clinical setting. So I asked Dr. Zhang and he responded. Unpublished data show that Tindamax is ineffective off stationary form of Lyme, perhaps scornfully better than Flagyl. How could I be so wrong?
Then there is a lingering list of drugs that kill Lyme more fully than currently used drugs, at smallest in a test tube. Two drugs stand gone ~: Diflucan and Artemisinin.
Why do Flagyl and Tindamax labor so well? These drugs have worthy penetration into tissues and into the brain. Perhaps this property and synergy reduce to law clinical effectiveness. Tindamax (one of my favorites) is known to reduce by evaporation in bodily fluids and tissues extremely well.
Doctors acquire added Flagyl and Tindamax to Omnicef and Ceftin – according to decades, because they are “cyst busters.” These doctors had trespass the whole time. It was unceasingly the other way around.
Ceftin remainder a highly touted Lyme drug. It is said to be the only second people of the same age cephalosporin that penetrates the blood brain obstacle. Omnicef is a third generation cephalosporin, like Rocephin. All third generation drugs can pass through the BBB. Early studies cited in the literary productions proved that Ceftin was effective in treating timely Lyme patients with EM rash. It was not closely examined for late state Lyme disease, dissimilar doxycycline.
All cephalosporins do a hard up job of getting into the brain. They merely penetrate the brain when there is notable inflammation in the meninges (lining surrounding the brain). Oral drugs like Ceftin and Omnicef be obliged poor uptake into the brain in patients through chronic Lyme encephalopathy. Tindamax and Flagyl may not kill persisters better than the others if it be not that they penetrate hard to reach places including the brain.
Amoxicillin, that like Ceftin/Omnicef does not kill persisters but amoxicillin has slightly more intimate. see various meanings of good penetration into the brain/central nervy system. I have found it besides effective in most patients.
Then we are left with the question: how do we carry off Lyme persisters in the brain?
IV Rocephin, by adequate brain penetration does have anti-persister properties. Perhaps IV Ceftin (cefuroxime) Zinacef, works victory – worth a try.
Obvioiusly we can’t carry on IV antibiotics for everybody.
Rifampin vexations the BBB well and should boost the anti-persister effectiveness of drugs such as doxycycline. I have found this clinically to exist the case.
Test tube results to not evermore translate into clinical results. Sulfa drugs despatch persister and penetrate well into the brain; clinical efficacy in my practice has been lacking.
What all over Diflucan? penetrates well into the brain and kills persisters. Role in Lyme to have existence determined.
Artemisinin? This drug has a brief half-life. This is why a derivative combined with a longer acting actor (Coartem) has greater efficacy for malaria/babesiosis. Artemisinin has promising brain penetration. It has activity in preparation for Lyme persisters. Clinical use for Lyme unnoted.
We had a lot of fill with dressing wrong but new doors have been opened in the same proportion that the search for the best manner to treat Lyme goes on.
So frequent people are conscious about their measure but not everyone ought to cast to pills for help.