3Qs: A new path to curing chronic Lyme disease

April 11, 2014 by Angela Herring, Northeastern University

Earlier this year, the Centers for Disease Control and Prevention projected the number of undiagnosed cases of Lyme disease to be 10-fold higher than previously believed. Of the newly identified 300,000 people infected each year, between 30,000 and 60,000 fall into the category of having chronic Lyme, where symptoms persist despite zero evidence that the pathogen remains in their bodies.

With the support of a Lyme Research Alliance grant, University Distinguished Professor of Biology Kim Lewis in the College of Science is exploring alternative approaches to curing chronic Lyme disease. We asked him to explain his research goals and why now is the perfect time to find a cure.

Why is Lyme a difficult disease to identify and treat?

Lyme is one of those puzzling chronic diseases: while people that are treated by antibiotics shortly after they're bitten by the tic get cured, about 10 to 20 percent don't. So, the question is, Why not?

There two schools of thought about that. The more standard among physicians is that the lingering effects—which could last years without resolution—are effects of the immune system having a perpetual response long after the pathogen is gone. These are aches, pain, fatigue—people are really miserable.

The second school of thought is that the pathogen is still there in a dormant form. And that's where we come in. We are experts in dormant bacteria that are tolerant to antibiotics. We call them persister cells.

What do you hope to accomplish with the new grant?

I think we can contribute two important things apart from asking whether Lyme, like other pathogens, forms persister cells and whether that would explain its chronicity.

First, the treatment regimens for people with chronic Lyme are inadequate because nobody has done the proper clinical microbiology work. We need to find the best possible antibiotic or antibiotic combination for killing the pathogen. It has not yet been done because it's difficult, it's time-consuming, and it's fastidious. On top of that, most clinicians don't believe that chronic Lyme is caused by the pathogen in the first place, so why bother? But we have extensive experience with existing antibiotics, and we know which ones, in principle, will diminish the persister cell population from our work with other pathogens. So, right away we can give some recommendations to those physicians who will prescribe antibiotics for chronic Lyme. Within half a year, we should have a better regimen.

Second, we will check the experimental compounds we're working with in the lab on other , for their effectiveness against Lyme. We've published a number of papers linking persisters to clinical manifestations of the disease, so that's been widely accepted, but with Lyme you don't even know whether symptoms are caused by an irreversibly wrecked immune system or if it's the pathogen in its dormant form.

The first compounds we're going to test against Lyme are pro-drugs, which we've already found to be fairly effective against persisters of e. coli and a number of other bacteria.

We only started our Lyme work this summer, so the drug discovery may take some time. But at a minimum, we will give patients a better regiment of existing antibiotics. It's not just empty promises, where at the end of the road there will be nothing. In , you never know whether your drug will fail or not be approved. But by exploring the effectiveness of existing antibiotics, we can promise that patients will do better than they're doing right now.

Why is now the time address Lyme disease?

It's a perfect time to attack the problem now because there is an unmet need. There is this growing epidemic of Lyme disease and a growing number of people with chronic Lyme who do not have adequate therapeutic options. On the other hand, we've learned a lot from studying other and how to control them.

We had an important breakthrough last year with MRSA, a devastating infection affecting many patients. It's extremely difficult to get rid of the pathogen, and the main outcome is often amputation of a limb or death. We figured that in those cases patients die or suffer limb loss because the pathogen forms these dormant persister cells that are not killed by regular . We were able to identify a compound (called ADEP) that activates protein degradation in those cells and forces them to [self-destruct]. That encourages us that we can similarly treat other infectious diseases including Lyme.

That particular compound (ADEP) doesn't act against Borrelia, which causes Lyme—we tested that. But we now know considerably more than we knew even five years ago and our capabilities are considerably better now. That's why I think this is a great time to attack the problem.

Explore further: New Lyme disease estimate: 300,000 cases a year

Related Stories

New Lyme disease estimate: 300,000 cases a year

August 19, 2013
Health officials say Lyme disease is about 10 times more common than previously reported.

Key to Lyme disease's locale may be found in the gut of a tick

January 16, 2014
The prevalence of Lyme disease varies greatly between different locales throughout the Northeast, even though the deer ticks that transmit Lyme bacterium are common throughout the entire region.

Test for persistent Lyme infection using live ticks shown safe in clinical study

February 12, 2014
In a first-of-its-kind study for Lyme disease, researchers have used live, disease-free ticks to see if Lyme disease bacteria can be detected in people who continue to experience symptoms such as fatigue or arthritis after ...

Even after Lyme disease is gone, its remains may perpetuate inflammation

June 26, 2012
(Medical Xpress) -- Non-infectious proteins of the species of bacteria that causes Lyme disease can remain in the body for a long time after antibiotic therapy, and are capable of causing an inflammatory immune reaction that ...

Large-scale study of preventive antibiotic usage against Lyme disease

April 16, 2013
Today, at the start of the "Tick Week", the National Institute for Public Health and the Environment (RIVM) and Wageningen University are commencing a large-scale study to discover whether preventive use of antibiotics can ...

Recommended for you

Onions could hold key to fighting antibiotic resistance

January 22, 2018
A type of onion could help the fight against antibiotic resistance in cases of tuberculosis, a UCL and Birkbeck-led study suggests.

New long-acting approach for malaria therapy developed

January 22, 2018
A new study, published in Nature Communications, conducted by the University of Liverpool and the Johns Hopkins University School of Medicine highlights a new 'long acting' medicine for the prevention of malaria.

Virus shown to be likely cause of mystery polio-like illness

January 22, 2018
A major review by UNSW researchers has identified strong evidence that a virus called Enterovirus D68 is the cause of a mystery polio-like illness that has paralysed children in the US, Canada and Europe.

Study ends debate over role of steroids in treating septic shock

January 19, 2018
The results from the largest ever study of septic shock could improve treatment for critically ill patients and save health systems worldwide hundreds of millions of dollars each year.

New approach could help curtail hospitalizations due to influenza infection

January 18, 2018
More than 700,000 Americans were hospitalized due to illnesses associated with the seasonal flu during the 2014-15 flu season, according to federal estimates. A radical new approach to vaccine development at UCLA may help ...

Flu may be spread just by breathing, new study shows; coughing and sneezing not required

January 18, 2018
It is easier to spread the influenza virus (flu) than previously thought, according to a new University of Maryland-led study released today. People commonly believe that they can catch the flu by exposure to droplets from ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

not rated yet Apr 11, 2014
A cure for this disease is long overdue. People are dying, children are being born with it and people are getting reinfected multiple times. How much longer can this epidemic go on? A disease ignored will only grow in numbers

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.