This diary by leema focuses on the organism, Borrelia burgdorferi (Bb), the spirochete that causes Lyme disease in humans and many animals.
For an introduction to Lyme disease see Welcome To Lyme Disease Awareness Month.
Spirochete Overview:
Spirochetes are a type of bacteria. Some spirochetes cause illnesses and some don’t. Some are found in humans and some aren’t. They are very slender and long and often look like corkscrews or spirals when viewed microscopically. They are difficult to see under a standard light microscope, so dark field microscopy must be used to view them. Spirochetes are also very difficult to grow in culture and some cannot be cultivated at all. Some spirochetes inhabit water environments, while others are parasites of arthropods (such as ticks and lice) as well as warm-blooded animals like us. Spirochetes that cause diseases include Borrelia burgdorferi (Bb), the agent of Lyme disease, Treponema pallidum, the cause of syphilis, and Leptospira interrogans, the agent of leptospirosis.
May is Lyme Disease Awareness Month
Lyme is the most prevalent vector-borne disease and one of the fastest spreading diseases throughout the United States, and the subjects of diagnosis and treatment of Lyme are politically-charged.
This series of diaries is designed to provide information to the Daily Kos community both for Lyme disease prevention and for those Kossacks living with Lyme. Because the disease is often missed by physicians, these diaries may assist an individual or two in pursuing testing which might otherwise have been missed.
The Lyme Disease Awareness series is eclectic, including personal statements, informational pieces about the science of Lyme, and calls to action for community and political advocacy.
We hope you'll all join us all month in learning about this rampant disease and the medical/financial/political morass in which Lyme patients find themselves.
Whether or not you are a member of this group, it appears you will need to FOLLOW in order to have the diaries show up in your stream. We invite you to join and follow us.
Borrelia burgdorferi (Bb); the amazing and elusive cause of Lyme disease:
Borrelia burgdorferi viewed with fluorescent antibody stain
Borreliosis (commonly known as Lyme disease) is just another version of the battle that was lost due to a missing nail or two. In this case the nail is our lack of knowledge about the bacteria that causes Lyme disease, and the consequent lack of sensitive (definitive) tests. All those missing nails mean that Lyme disease remains under-diagnosed, misdiagnosed and undertreated. (1)
It is clear that the proper study of borreliosis is borrelia, but the more one learns about this elusive and fascinating spirochete, the more one comes to realize that said study is easier said than done. Bb is a complex organism and it causes an equally complex disease process. Neither are well understood and much remains to be learned.
Authorities have called Bb both anaerobic (cannot live in the presence of oxygen) and microaerophilic (can tolerate very small amounts of oxygen). But however Bb is classified, it all boils down to the fact that Bb does not survive well in the presence of oxygen. This fact might explain the die off responses (increase of symptoms) that often occur in infected individuals following a change in oxygen permeation to their bodies. (Airplane flights, physical activities).
Bb avoids being studied. Biopsy and culture are the two main methods of direct detection and viewing. The most successful biopsy sites have been: near the leading edge of a rash in humans; from a mouse ear or from the walls of the mouse bladder. Culture, however, is so difficult that it is rarely undertaken in the clinical setting.
• Culture of Bb requires a very specialized culture medium. (BSK)
• Bb has a long doubling (reproductive) time compared to most other
bacteria. (12-24 hours vs. 20-30 minutes for others) Note that a slow
dividing time in bacteria usually translates into the need for MUCH longer
treatment times, as with the treatment of TB.
• The organism is very fastidious and is apt to change its form to a non spiral
state (Cyst or L form) at the least provocation (even at times in the special
BSK culture medium); whereupon it is usually thought to have vanished or
died by the unsuspecting lab tech. Note that in its cyst form it is no longer
replicating and so is no longer susceptible to most antibiotics.
Bb avoids being captured and killed by both our immune systems and antibiotics in a number of novel ways.
• Above all else it is pleomorphic…a shape shifter! We see it most easily in its
spiral, reproductive form as in the picture above, but when it is in an
inhospitable environment it hunkers down and becomes just a blob (cyst or
L form)…safe from antibiotics and safe from our immune system…although still
thought to be very provocative to our immune system.
• Unlike most other bacteria it is an equal opportunity organism; it can be
found both inside and outside of cells. It drives our immune systems nuts
when it hides in one of our own cells and can provoke many symptoms that
are erroneously thought to be autoimmune.
• It can change protein expression on its outer surface…sort of like changing
its identity with different clothes or a pair of glasses…so our immune system
doesn’t recognize it.
• In addition to all this it is a master at hide and seek; it is wont to hide not
only inside cells, but in deep tissues.
List of 262 studies (pdf from 1905 to 2010) on the morphological transformation/shape shifting of Borrelia burgdorferi and other spirochetes.
One study in particular sticks in my mind. Published in the journal, “Infection” in 1998, it related how the spirochete changed from spiral to cyst forms in spinal fluid and then back to spiral when the all clear sounded and conditions were to its liking once more:
In vitro conversion of Borrelia burgdorferi to cystic forms in spinal fluid, and transformation to mobile spirochetes by incubation in BSK-H medium.
Brorson O, Brorson SH.
Dept. of Microbiology, Vestfold Sentralsykehus, Tønsberg.
Abstract
The purpose of this study was to examine the structural alterations of Borrelia burgdorferi when exposed to spinal fluid. Normal, mobile spirochetes were inoculated into spinal fluid, and the spirochetes were converted to cysts (spheroplast L-forms) after 1-24 h. When these cystic forms were transferred to a rich BSK-H medium, the cysts were converted back to normal, mobile spirochetes after incubation for 9 to 17 days. The cultures were examined by dark field microscopy (DFM), interference contrast microscopy (ICM) and transmission electron microscopy (TEM). When neuroborreliosis is suspected, it is necessary to realize that B. burgdorferi can be present in a cystic form, and these cysts have to be recognized by microscopy. This study may also explain why cultivation of spinal fluid often is negative with respect to B. burgdorferi.
PMID: 9646104
I recall a symposium where I saw a film (scanning electron microscopy) of Bb as it entered a macrophage(a white blood cell ) and then reemerged.... a little fatter… now cloaked (or disguised if you will) with some of that white cell. (Note that most bacteria are killed by an encounter with a macrophage; they don’t reemerge…ever!!!….they are obliterated, DEAD, kaput).
Borrelia burgdorferi DNA has been found, yea even unto our bone. The spirochete itself has been found: traveling in fibroblasts (cells that travel to injured tissue), tucked snugly between connective tissue cells, in endothelial tissue, in nerve tissue, in collagen, in synovial tissue, in the eyes, in the bladder, in the brain, the heart…you name it.
Conclusion:
When you have an organism capable of infiltrating such a wide variety of tissues, changing its characteristics to ensure survival, and changing its very form to do the same….you begin to understand why we have difficulty diagnosing and treating the disease, and how the organism can persist despite the patient taking enough antibiotics to kill the proverbial horse. Understanding the ability of the organism to infiltrate almost any organ or tissue also makes it easier to comprehend why borreliosis (Lyme disease) has been nicknamed “The New Great Imitator”. (2)
Footnotes:
(1) Understanding what this organism is capable of makes it unfathomable that the Infectious Disease Society of America does not reference its capabilities nor acknowledge them in its guidelines to clinicians, clinicians who know less about the organism than you, who have read this diary, and who think that a few weeks of antibiotics cures all.
(2) Syphilis was the original Great Imitator. Both diseases can present with a confusing array of seemingly unrelated symptoms that wax and wane and are often attributed to other causes …misdiagnosed.
Further reading for your enjoyment:
Spirochetal research continues at a snails pace around the world and at niaid: http://www.niaid.nih.gov/...
1999 speech by Willy Burgdorfer, the discoverer of Bb
http://www.canlyme.com/...
2008 paper on pleomorphic spirochetal forms
http://www.jneuroinflammation.com/...
Genomic sequence
http://cbcb.umd.edu/...
On going studies on chronic lyme at Columbia U. NYC:
The Lyme and Tick-borne Diseases Research Center
http://www.columbia-lyme.org/...
Lyme disease basics:
http://www.lymedisease.org/...
Two year study on culture vs other tests for Lyme disease: 2005
http://www.ncbi.nlm.nih.gov/...
Lyme as a neuropsychiatric illness: 1994 paper by Fallon…good references to the organism.
http://www.lymenet.de/...
Lynn Margulis, famed biologist and theorist, and my hero, long studied non pathogenic spirochetes, many of which are free living. In more recent years she has come to focus some of her considerable grey matter on two similar symbiotic spirochetes: Treponema pallidum and Borrelia burgdorferi (Bb).
http://en.wikipedia.org/...
About the author:
Once upon a time leema was an RN and so has some understanding of things biological. Her own confrontation with Lyme disease and the difficulties she experienced with both diagnosis and treatment changed her life. Shocked at the lack of knowledge and diagnostic inadequacies she was galvanized into action: first researching on line and then founding and coordinating a local support group. She has volunteered with the CA Lyme Disease Association (CALDA) and served on the DHS’ California Lyme Disease Advisory Committee. Now that she is much better (albeit subject to minor relapses)… not to mention retired….she has turned her focus to the life support of democracy in America, volunteers with dog rescue groups, plays scrabble every day, rallies with the local MoveOn council, joined her local Democratic Central Committee, and dotes on her distant grandchildren whenever possible.
