Cure Lyme Disease Forever

Lyme Strategies

This latest updated text, in digital eBook form and available for immediate download, has been expanded nearly eightfold over the original guide of 2004 in terms of the exact, step-by-step lue-print and essential information designed to maximize this protocol. Just some of the valuable information contained in this 193-page guide includes: How to do the protocol, including the exact, specific method or procedure that is critical to its success. Schedule chart, measurements guide, tips and recommendations. The basic elements of the protocol are actually five, not just salt and vitamin C what these are and why Understanding what a Jarisch-Herxheimer reaction (or Herx) is. Particular djunct items found to be extremely helpful and particular items for special issues. A Technical Section detailing why the protocol works (posited mechanisms), including scientific citations and and studies. The right salt versus wrong salt and why. the low-salt, no-salt myth and scientific truth. the historical, medicinal use of natural salt. Did you know salt was used to treat syphilis, caused by Lyme's bacterial cousin, in the 1800s? Why Vitamin C and what does it do? The protocol and specific body considerations (heart, adrenals, etc.) Key Characteristics of the Lyme bacterium (Borrelia burgdorferi), including nearly 20 extraordinary mechanisms and features it uses to elude the immune and proliferate in the body

Lyme Strategies Summary


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Contents: 193 Pages EBook
Author: M. Fett
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Answers To Case 23 Lyme Disease

Summary A young man presents with a peripheral facial nerve palsy occurring in the setting of a febrile illness associated with arthralgias, myalgias, neck stiffness, and an erythematous annular plaque at his waistline. He recently went on a camping trip, but he shows no specific tick or other arthropod exposure. The rash is consistent with erythema migrans, the distinctive lesion of early Lyme disease, and all of the clinical features are consistent with that disease. Most likely diagnosis Lyme disease, probably early disseminated stage. Most appropriate next step Lumbar puncture to evaluate for meningitis and look for antibody production against Borrelia burgdorferi.

Approach To Suspected Lyme Disease

The evaluation of the patient who presents with fever and a rash is a very common problem that often frustrates and confuses beginning clinicians, partly because of their unfamiliarity with many typical rash patterns, and partly because the rash may be an incidental nonspecific finding (as in miliaria or heat rash), may be a sign of serious, even fatal illness (as in the purpuric rash of meningococcemia), or may be the pathognomonic finding that yields the diagnosis, as in the case of the erythema migrans rash of Lyme disease. Table 23-1 lists some important clinical features of systemic febrile syndromes associated with rash. Lyme disease is diagnosed by the clinical presentation of the patient and can be verified by serologic tests at the earliest 6 weeks after the initial infection thus, the patient's history is the key to the diagnosis. Lyme disease can present in three different stages early localized (stage 1), early disseminated (stage 2), and late disease (stage 3). The early...

Chromosome Topology and Number

Bacteria generally have a single, double-stranded circular DNA chromosome. However, a number of bacterial species have a linear chromosome (5,11). The first linear bacterial chromosome identified was that of Borrelia burgdorferi (12). A number of Streptomyces species, including S. lividans 66 (13), S. coelicolor A3 (14), and S. aver-mitilis (15), also have a linear chromosome. It is likely that the Streptomyces linear chromosome evolved from an ancestral circular chromosome (11).

Infectious Vasculitis

A number of bacteria and fungi that infect the nervous system often produce an acute inflammatory, necrotizing, or chronic granulomatous vasculitis of the cerebral blood vessels. Spirochetes may infect the blood vessels Treponema pallidum in neurosyphilis and Borrelia burgdorferi in Lyme disease. HIV-associated vasculitis is prone to cause ischemic episodes in both adults and children. Vasculitis of the large cerebral arteries accounts for the hemiplegia that develops contralaterally to a facial or ocular herpes zoster infection. Post varicella vasculopathy is a potential risk for stroke in children.

Plasmids Structure Size Topology and Evolutionary Role

Plasmids are extrachromosomal genetic elements of diverse sizes ranging from a few kilo basepairs to more than 400 kb. The most common structure of plasmids is a double-stranded circular DNA molecule. However, linear plasmids are found in all species of the Borrelia genus and in many species of Streptomyces (65). Linear plasmids have also been isolated from Rhodococcus fascians (66), Nocardia opaca (67), and Clavibacter michiganensis subsp. Sepedonicus (68).

Other Bacterial Infections

Keeping the skin covered and use of insect repellants are effective to prevent tick bites and tick removal shortly after attachment (within 24 h) will prevent infection. In most manifestations of the disease, Borrelia burgdorferi responds to amoxicillin or doxycycline orally for up to 21 days but when the central nervous system is invaded large doses of cefotaxime should be given i.v. for 14 days.

Treatment Of Primary Cutaneous Bcell Lymphoma

PCBCLs are characterized by a favorable prognosis with a tendency to remain localized to a limited area of the skin and a low risk of extracutaneous spread. Compared to cutaneous T-cell lymphoma (CTCL), experience with treatment of PCBCL is more limited and focuses on follicle center cell lymphoma (FCCL). The optimum treatment for marginal zone lymphoma (MZL) immunocytoma (IC), large B-cell lymphoma of the leg (LBCL of the leg), and the provisional entities remains controversial. Traditional treatment approaches, including surgical excision, local radiation, and or chemotherapy, are most commonly used, but relapses occur frequently. Antibiotics may be used as a first-line treatment of Borrelia burgdor-feri-associated primary cutaneous B-cell lymphoma.56 Biologic therapies, such as interferon alpha and ritux-imab, a chimeric monoclonal antibody directed against

Clinical Use of Tetracycline Antibiotics and Currently Used Drugs

Cious against aerobic and anaerobic Grampositive and Gram-negative bacteria. They are generally orally administered and have found extensive use in the treatment of infectious diseases and continue to be widely used, but are now being supplanted by other agents such as the quinolones. Nonetheless, the tetracyclines remain first-line drugs in the treatment of infections caused by pathogens of the family Rickettsiae (causative agents of Rocky Mountain spotted fever, typhus, Q fever, ehrlichiosis), Chlamydia pneumoniae, Mycoplasma pneumoniae, Chlamydia trachomatis, Borrelia burgdorferi (Lyme disease), members of the genus Brucella that cause brucellosis, Calymmatobacterium granulomatis (granuloma inguinale), Vibrio cholera (cholera), and

Activities of bacteria

Unfortunately, many bacteria are pathogenic that is, they cause human disease. Such diseases as tuberculosis, gonorrhea, syphilis, scarlet fever, food poisoning, Lyme disease, plague, tetanus, typhoid fever, and most pneumonias are due to bacteria. In many cases, the bacteria produce powerful toxins that interfere with normal body functions and bring about disease. The botulism (food poisoning) and tetanus toxins are examples. In other cases, bacteria grow aggressively in the tissues (for example, tuberculosis and typhoid fever), destroying them and thereby causing disease.

Comparing the Leptospiral Genomes

The genome of L. borgpetersenii serovar Hardjobovis strain L550 comprises two circular chromosomes of 3,614,446 bases and 317,336 bases, with an overall guanine and cytosine (G+C) content of 41.3 . The density of CDS sequences across the genome is 80.3 , with an average gene size of 931 bases. In total 3111 and 292 CDS features were annotated on chromosome 1 and chromosome 2, respectively. The L. borgpetersenii genome is smaller than the L. interrogans genomes (Table 2) and codes for proportionally fewer genes. The G+C content is higher than that found for L. interrogans, consistent with previous estimates of G+C content (3). The relatively lower density of coding regions found in Leptospira compared with Escherichia coli may be related to the fluidity of the arrangement of genes on the genome. Consistent with this viewpoint, the gene layout found in the sequenced Borrelia genomes is conserved and the density of coding regions is around 95 (10). Also likely to contribute to genome...

Regulation of Gene Expression

Leptospira appears to use a number of known strategies to tailor expression patterns to the diverse environments normally encountered by this bacterium. Like the other spirochetes, Leptospira appears to have both Sigma-54 (LA2404, LIC11545, SPN1246) and Sigma-70 (LA2232, LIC11701, and SPN1385) transcription initiation factors. Sigma-70 is essential for the regulation of transcription during exponential growth (15). Specialized sigma factors, such as the extracytoplasmic function (ECF) sigma factors, which respond to specific environmental signals, are not found in the Borrelia genomes, whereas there are one and two examples in the T. pallidum and T. denticola genomes, respectively. By contrast, each of the leptospiral genomes has 11 ECF sigma factors. Notably, these factors are not encoded exclusively on chromosome 1. In other bacteria these factors are normally cotranscribed with an antisigma regulatory factor that is normally located in the inner membrane (16). It is not surprising,...

Protein Secretion Systems

Based on similarity, Leptospira has a Sec translocase that resembles that of E. coli. This complex is responsible for the translocation of both inner membrane and extra-cytoplasmic proteins (19). The processing of the extracytoplasmic proteins occurs via the signal peptidases. Orthologs of Lgt, Lnt, and LspA (signal peptidase II) are present, indicating that Leptospira processes lipoproteins using a mechanism similar to other Gram-negative bacteria, although the specificity of the signal recognition sequence is different (20). In addition, proteins related to LolA, LolC, and LolD are present and are probably involved in the transport and incorporation of lipoproteins into the outer membrane. The signal directing, newly translocated lipoproteins to the outer membrane is encoded by the second amino acid of the mature lipoprotein again, this signal differs from that found for Gram-negative bacteria (20). Two LepB-related proteins are encoded on each of the sequenced genomes indicating a...

Identification of Tularemic Antigens Recognized by Sera Collected from Naturally Infected Individuals

Serological proteome analysis, based on a combination of 2-DE and immuno-blotting with sera from infected individuals, is a suitable approach for the detection of immunoreactive antigens. In our study, first, the sera collected from 44 patients with tularemia were examined by 1-DE immunoblotting against whole-cell lysates. Sera from 20 healthy blood donors served as controls and the reaction with 16 sera from Lyme disease patients was tested as well, because both borrelio-sis and tularemia are tick-borne diseases. Then the sera reacting with the characteristic profile of tularemic antigens were selected and analyzed by 2-DE immunoblotting. Figure 16.14 shows all 25 identified immunoreactive antigens together with information about the specificity of their immunorecognition. The names of identified spots with their further characteristics are listed in Table 16.1. The 14 antigens provided a highly specific reaction only with human sera collected from patients suffering from tularemia....

Chlamydia trachomatis Immunoproteome

The above described approach, in which 2-DE is combined with immunoblot-ting with patient sera, is now widely used to identify immunogenic proteins in different pathogens. For example, some studies have been performed to investigate immunorelevant Borrelia garinii antigens in patients affected by Lyme disease 28 , to identify possible vaccine candidates in infections of Staphylococcus aureus, using pooled sera from different patients 29 or for mapping immunoreactive antigens in Francisella tularensis 30 . (See Chapter 16 for reference maps and comparative analysis of F. tularensis.) A number of studies have been performed to investigate the antigenicity of Helicobacter pylori, some using 2-DE and immunoblotting with a pooled sera from patients 31, 32 , others using sera from individual patients to evaluate the frequency of the antigens during different gastroduodenal pathologies 33, 34 , or analyzing only the proteins present on the cell surface 35 . Other humoral immune responses to...

Disease transmission

Such as babesiosis and human granulocytic ehrlichiosis, have been transmitted by blood, and others such as Lyme disease have that potential (Cable and Leiby, 2003). Some common infectious agents, such as cytomegalovirus and parvovirus B19, are readily transmitted by blood, and though often innocuous may be devastating for particularly vulnerable patients such as pregnant women, premature infants and immuno-suppressed patients. Most blood components are not tested for these agents. Perhaps the greatest worry in the developed world is the silent emergence of some new agent, like HIV in the 1980s, for which recognition (and therefore testing) may be delayed for years while asymptomatic carriers donating blood spread infection through the blood supply. The most recent example involves emergence of the West Nile virus, an agent that infected thousands of blood donors, resulted in transfusion-transmitted disease, and presented a sudden, unexpected and significant threat to the US blood...

Viral findings

Such as human T cell leukaemia virus type 2 (HTLV-2) and the spumaviruses Borrelia burgdoferi and Borna disease virus. As it is difficult to measure directly the presence of a virus, most of these studies have relied on the presence of elevated antibodies in the body. Antibodies are assumed to reflect the body's immune response to the presence of a viral or bacterial infection. Although some studies have reported elevated levels of viral antibodies in groups of CFS patients the results are inconsistent and there is often considerable overlap between CFS patients and controls (Ablashi 1994 Hotchin et al. 1989 Kawai and Kawai 1992 Landay et al 1991 Levy 1994 MacDonald et al 1996).

Diagnostic Testing

Using DNA probes and PCR, scientists are now able to detect the DNA associated with HIV (and AIDS). This has yielded a direct test for AIDS that is preferred over the AIDS antibody test. Lyme disease and genetic diseases such as cystic fibrosis, muscular dystrophy, Huntington's disease, and fragile X syndrome can be identified by DNA probes. (Cystic fibrosis is a respiratory disease in which mucus clogs the respiratory passageways and makes breathing difficult muscular dystrophy is a disorder of the nervous system in which destruction of nerve fibers leads to erratic muscular activity Huntington's disease is a disease of the nervous system accompanied by erratic movements and nervous degeneration and fragile X syndrome is a disease of the X chromosome accompanied by a form of mental retardation.)

TLR2 TLR6 and TLR1

TLR2 recognizes compounds from many microorganisms, including peptidoglycan (PGN) and lipoteichoic acid from Gram-positive bacteria (e.g., Staphylococcus aureus or Bacillus subtilis), and lipoproteins from Gram-negative bacteria (e.g., Borrelia burgdorferi, Treponema pallidum, and Mycoplasma fermentans) (29-34). These ligands for TLR2 were confirmed by several studies. Lipoproteins or PGN were found to induce NF-kB activation in human embryonic kidney 293 cells or Chinese hamster macrophages transfected with TLR2. Furthermore, only anti-TLR2 antibody or a mutant TLR2 (TLR2-P681H, with inhibitory activity) were found to block TNF-a production induced by lipoprotein or whole Mycobacterium tuberculosis in human peripheral blood mononuclear cells or RAW264.7 macrophages. Akira's group also confirmed that macrophages form TLR2 knockout mice are hyposensitive to PGN derived from S. aureus (30,35). Other possible ligands of TLR2 are lipoarabinomannan from Mycobacteria (e.g., M. tuberculosis)...

Bacterial Infections

Infection is the most common cause of neurological complications in CLL patients, most of which are caused by nonbacterial pathogens (55). Bacterial meningitis is most likely to be caused by S. pneumoniae or L. monocytogenes. The latter infection has been associated with fludarabine therapy, especially when given with prednisone (47). Septicemia occurs predominantly in patients with moderate to severe neutropenia, and the most common pathogens are Pseudomonas aeruginosa, E. coli, Klebsiella species, and S. aureus, the latter organism also causing skin and soft tissue infections (40). Interestingly, low-grade malignant lymphocytic infiltrates of the skin have been associated with chronic Borrelia burgdorferi skin lesions (56). Some early studies reported an association between CLL and tuberculosis. A few cases of atypical mycobacterial infection have been reported in patients receiving purine analog therapy.

Concluding Remarks

The remarkable feature of the relationship between Leptospira and the other spirochetes is the near absence of a relationship. Although there are fundamental features that have been conserved among the sequenced spirochetes, such as the endoflagella and the systems for protein translocation, the systems used for nutrient acquisition and metabolism have virtually no similarities. However, these differences are probably related to the apparent extensive genome reduction that T. pallidum and Borrelia have undergone. 8. Fraser, C. M., Casjens, S., Huang, W. M., et al. (1997) Genomic sequence of a Lyme disease spirochaete, Borrelia burgdorferi. Nature 390, 580-586. 10. Glockner, G., Lehmann, R., Romualdi, A., et al. (2004) Comparative analysis of the Borrelia garinii genome. Nucleic Acids Res. 32, 6038-6046.

Endocarditis Cases

When serum was tested with complement fixation test to Chlamydia group antigen, the titer was 1 1280. When the sera were investigated using MIF over a period of 121 days, the C. pneumoniae-specific IgG antibody titer had decreased from 1 256 to 1 128, and the specific C. pneumoniae IgM antibody titer had declined from 1 128 at 60 days to 0 at 121 days. The sera had no specific antibodies to C. trachomatis or to nine different strains of C. psittaci.


Tetracyclines are active against nearly all Gram-positive and Gram-negative pathogenic bacteria, but increasing bacterial resistance and low innate activity limit their clinical use. They remain drugs of first choice for infection with chlamydiae (psittacosis, trachoma, pelvic inflammatory disease, lymphogranuloma venereum), mycoplasma (pneumonia), rickettsiae (Q fever, typhus), Vibrio cholerae (cholera) and borreliae (Lyme disease, relapsing fever) (for use in acne, see p. 313). Their most common other uses are as second line therapy of minor skin and soft tissue infections especially in (3-lactam allergic patients surprisingly, many MRS A strains currently remain susceptible to tetracyclines in the UK.