Talk:Lyme disease

Antibiotics for long term symptoms

A new high quality RCT does not find support [1] Doc James (talk · contribs · email) 12:01, 31 March 2016 (UTC)

CDC / NIOSH reference here [2] Brock-brac (talk) 20:45, 15 July 2016 (UTC)

It seems bias to reference that source so early on in the article “In those who develop persistent symptoms, long-term antibiotic therapy has not been found to be useful.”. There is obviously a lot of controversy around treatment for Lyme, but this is only one side of the argument. I have lyme disease, and long-term antibiotic therapy has significantly helped me. Alexmb1993 (talk) 17:06, 16 September 2016 (UTC)

Update external link for NAIAD

In the External Links section, the link out to the NAIAD page on Lyme disease is broken. Please change it to https://www.niaid.nih.gov/diseases-conditions/lyme-disease Pipitone (talk) 21:10, 24 September 2016 (UTC)

 Done I just removed the link, as it is used as a ref, per WP:ELNO Jytdog (talk) 21:36, 24 September 2016 (UTC)

new SciAm article: "Long-Forgotten Research Unearths New Mystery about Lyme Disease"

"Discovery sparks questions about factors that may make ailment harder to cure or lead to misdiagnosis By Charles Piller, STAT on October 13, 2016"

https://www.scientificamerican.com/article/long-forgotten-research-unearths-new-mystery-about-lyme-disease/#

Just thought I'd post this here so that you folks who have the background & interest can extract from it what you think worthwhile to add to this page (or the Lyme Disease Controversy page).

Phantom in ca (talk) 02:04, 17 October 2016 (UTC)

Diagnosis: does it refer mostly to B. burgdorferi?

This is the last phrase of the 3rd paragraph: "As all people with later-stage infection will have a positive antibody test, simple blood tests can exclude Lyme disease as a possible cause of a person's symptoms.[91]"

Also, in the next subsection on "Laboratory testing": "Several forms of laboratory testing for Lyme disease are available, some of which have not been adequately validated. The most widely used tests are serologies, which measure levels of specific antibodies in a patient's blood. These tests may be negative in early infection as the body may not have produced a significant quantity of antibodies, but they are considered a reliable aid in the diagnosis of later stages of Lyme disease.[92] Serologic tests for Lyme disease are of limited use in people lacking objective signs of Lyme disease because of false positive results and cost.[93]"

1) The first quote is contradicted in the subsection "Laboratory testing"; serologic tests do not give sure results.

2) This is the main issue I have here: references [91] and [92] mention the bacteria B. burgdorferi, not the other types of Borrelia. Then I ask, can one blood test work for all Borrelia bacteria? From what I read lately, this is not the case and it may be one of the reasons why blood tests fail in many cases in Europe - the tests are designed for B. burgdorferi and they may fail to recognize other types of Borrelia. I read this in an issue of Science&Vie, a French science popularizing journal, so not a definite reference on the subject (but a pretty good one in its category).

I think some mentions to the specific type of bacteria the tests address should be inserted, but I'm out of my field of expertise with this.Ferred (talk) 15:40, 29 October 2016 (UTC)

Persistence

Needs ref that supports

"Persistence

The National Institutes of Health have supported research into bacterial resistance which has demonstrated persistence after antibiotic therapy in several animal models, including mice and primates. However, it was not possible to culture these bacteria and it is not known if they are infectious, or if they contribute to symptom persistence post-treatment. "

Doc James (talk · contribs · email) 20:23, 11 November 2016 (UTC)

The existing cite is not only dead, an archived version I found fails to verify the claim - no mention of persisters or culture. (It does say: "In patients who have non-specific symptoms after being treated for Lyme disease, and no evidence of active infection (patients with PLDS), studies have shown that more antibiotic therapy is not helpful and can be dangerous.")

Separately, "Kim Lewis, director of the antimicrobial discovery center at Northeastern University, and his colleagues grew B. burgdorferi in the laboratory, treated them with various antibiotics and found that whereas most of the bacteria died within the first day, a small percentage—called persister cells—managed to survive the drug onslaught." The research has been reproduced too - per https://www.scientificamerican.com/article/lyme-disease-may-linger-for-1-in-5-because-of-persisters/--Elvey^(t•c) 20:29, 11 November 2016 (UTC)

Update: I found a new URL for the apparent source: https://www.niaid.nih.gov/diseases-conditions/chronic-lyme-disease. (Wow, some folks at the NIH are too ignorant to not break URLs gratuitously during a reorg. Makes me wonder how often they fuck up complicated medical science.) It has an additional paragraph that shows the text is somewhat verifiable... it has one RS behind it.

However, the claim remains dubious. If the persisters don't really persist, why are researchers searching for cocktails to kill them : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4876775/ and many more. paper says: "Although the cause for post-treatment Lyme disease syndrome (PTLDS) is unclear, one possibility is the presence of bacterial persisters not effectively cleared by the current Lyme antibiotics." That's well put. I propose this replace the second sentence: ♦Current mainstream research thinking is that <quote>. That would justify removing the tag, IMO.

(Skimmed http://www.akademiai.com/doi/pdf/10.1556/1886.2015.00049 ; looks like some very through, high quality research. CC, positive and negative controls, detailed methods description... BUT, I don't see any indication that the biofilms were isolated from patients with PTLDS. Claims: "Culture negativity of biofilms from different patho-gens is one of the cornerstone concepts for the behavior of true biofilms [50, 51] as it was shown in biofilms in culture-negative orthopedic and endocardiatic biofilm infections [51, 52] and therefore cannot be used to dismiss the idea that Borrelia can make biofilm in vivo."). Alternative proposal: ♠we could present this view and the one in the current second sentence. --Elvey^(t•c) 22:04, 11 November 2016 (UTC)

Any secondary sources that discuss this? Have trimmed the primary source and moved it to a section on research. Doc James (talk · contribs · email) 17:08, 12 November 2016 (UTC)

I think that made a mess of it, because persisters and resistant mutants are not the same thing, User:Doc James. --Elvey^(t•c) 08:14, 15 November 2016 (UTC)