Discussion in 'Lyme Disease and Co-Infections' started by justy, Dec 21, 2014.
Yeah, pretty cool, right? Remember, though, they announced this in a preliminary study like six months ago or something.
The response back then was swift and condemning on many counts:
What are the credentials of the researchers? (Not stellar)
How large was the sample? (Small)
Could the results be explained away by a different interpretation? (Each couple tested is a COUPLE, i.e., they live together in the same geographic area, and so would be exposed to the same ticks and, accordingly, the same strains of Bb. That each half of the couple tests positive for the exact same strain is almost to be expected if they live in an endemic area).
This is not what I believe. I am just anticipating how opponents will likely respond again.
Anyone interested in knowing more about this and possibilities of bacteria in bodily fluids could maybe join the EuroLyme yahoo group, interesting discussion on spirochetes found in breast milk of woman who had a acute case of Lyme in the last half of pregnancy and refused abx treatment, (ie that is with a EM rash.)
A nurse practitioner who treated pregnant woman with abx found no evidence of Lyme in children of women who had been treated with this safe abx protocol.
sorry if it sounds a bit jumbled just trying to get the gist of the discussion across. Cant re-post personal posts
I'd be curious as to how this nurse practitioner qualified "no evidence."
sorry @duncan I'm not going into any more details, its a personal post with 'evidence' but only for members.
That study was effectively an attempt to scare everyone and the CDC into more action. Even if spirochetes were found in semen and vaginal fluids, Borrelia spirochetes are not adapted to the second half of the journey and evading the innate immune system as they try and enter the sex organ tissue. In the case of Syphillis, open sores on the sexual organs provides for millions of spirochetes which have adapted to passing through the sex organ tissue and evading the innate immune system by overwhelming it with numbers. If a handful of spirochetes made 1/2 the journey, the second phase is more difficult. So even if the study actually found spirochetes, not only does that not prove sexual transmission but its very bad exploitation science which needlessly scares people with speculative comments. That sort of behavior harms the cause of solving the many Lyme mysteries and simply provides mainstream scientists harhful ammunition.
Why are they not adapted?
Please could you explain in more detail what these adaptions are?
Are you suggesting that the way in which Syphilis has adapted is to create open sores so as to more easily get into the bloodstream?
Lyme unable to evade the immune system? This is exactly what Lyme does. If it can be transferred in as little numbers as from a mosquito bite it is clear the immune system can't always clear it. That is why at least doxy is needed in early stage Lyme. Being a spirochete it can burrow into tissues with ease. It only really needs one spirochete to go intracellular and start replicating to lead to late stage Lyme. I don't see why sores are necessary.
I have just been to a clinic which has seen many many couples who both have Lyme. Indeed two of around 8 patients had partners I got to know which had it. One of the 8 got it just after the husband. One of the families I met there all had Lyme although we know feotal transmission of Lyme is of course a fact.
Not trying to bash your post! Just curious and trying to get this straight myself .
It's not like the mainstream was going to get around to thoroughly studying the matter on its own. Is everybody supposed to sit back quietly until they do for fear of spooking these sensitive souls?
At the very least doesn't this study suggest sexual transmission is possible and perhaps further study would be a good idea?
First, I am a Lyme sufferer an by no means do I not think the question of sexual transmisison is not an important question and yes it does deserve real research. Nothing is black and white. Its certainly possible that Lyme could be transmitted sexually given the right conditions. So the question is not yes or no, its how likley and what is the real risk? I follow the Lyme research and the various debates and both sides seem to argue like things were black or white. Most of the issues debated are shades of grey.
Syphilis has had thousands if not millions of years to adapt to its life cycle in which sexual transmission is primary method. Borrelia has been adapted to vector borne transmisison. Evolution is very good at optimizing each step in the path of a succesfull life cycle of a microbe like Treponema pallidum or Borrelia. If it wasn't, the microbe would die off. A critical part of these microbes life cycle is the transmission from a host that carries it and a new naive host. Syphillis has adapetd to direct host to host sexual transmission while Borrelia has adapted to vector based transmision.
There a number of factors that affect the probability of successful transmission and evolution does its best to optimize each over many thousands of generations. Its very naive to think that just because Treponema pallidum and Borrelia are spirochetes, that they both can equally traverse the others optimized path. That is just a general concept that impacts probability. Its important to think of probability as opposed to black and white. If you are predisposed to believing one way or the other, you probably don't care what I have to say. If you can think in terms of risk probability, then you are on the right track. There is a risk of dying in an automobile accident that dropped significantly with the use of seat belts. Then with airbags, it dropped even further. But you can still be killed in an auto accident even with seat belts, air bags and the safest Mercedes car.
So is Lyme sexual transmission possible? The answer is probably yes but the probability is probably very low. Just because airplanes crash and you can die in an auto accident, you probably fly and drive all the time because you know the odds are very good but not 100%. If you cannot understand the reason I'm bringing up probability and seat belts and air bags, you probably cannot understand the differences between Syphillis and Lyme sexual transmission probability and how evolution and many factors contibute to the odds of contracting one or the other sexually.
This study only looked at whether Lyme spirochetes were present in the fluids involved in sexual transmision. That is only 1/2 of the transmission path. If you looked for any pathogenic microbes in semen or vaginal fluids, you would probably be horified at what was found. There are many deadly pathogenic microbes in your body that are kept in check by your immune system. The most difficult half of the transmission path is its entry through the sexual organ tissues. Your innate immune system is the primary rapid defense that prevents microbes from finding their way through the tissue and into the blood system. If it wasn't for your innate immune system, you would not live long because its reasonably good at defending entry into your blod by pathogens trying to get through your protective tissue. Monocytes (which develop into macrophages), Neutrophils, Eosinophils, Basophils, Natural killer cells, The complement system, Cytokines and other defenses are just waiting to destroy any microbe trying to enter. Even the adptive immune system has a very low level of B and T cells that will recognize a new microbe and proliferate later. The innate immune system has both humoral ( fluid based) and cell-mediated components.
The transmission path is not symetrical, male to female and female to male. The area of invadable tissue varies significantly between a male and female. Direct access to the blood system via injuries will impact whether the innate immune system is able to stop the transmision. The number of microbes will also impact the probability. The female vaginal fluids are very hostile to microbes and are the home of part of the humoral immune system. The pH of the vaginal fuild is a very hostile living area for a spirochete. So the length of time the spirochete can live in the vaginal fluid is limited by many factors alone. In syphillis, whether the source host is experiencing a cancre sore will dramatically increase the quantity of microbes which will overwhelm the innate immune system.
The number of spirochetes passing the vaginal fluid will impact the probability. There is a big difference between 5 and 50,000 and 5 million. The innate immune system cannot be avoided by hiding in a cell. The cell will signal its infected and be killed. Avoiding the innate immune system requires either overwhelming it, sneaking directly through to the blood via a sore or tricking it. Everyone's innate immune system is different which will impact probability. Most microbes have developed "tricks" to fool the innate immune system and even the adative immune system. The number of spirochete present in body fluids peaks a few months after Borrelia infection.
Once the adaptive immune system learns and creates Memory B and T cells and antibodies to dozens of epitopes to dozens of proteins, the quantity of sprochetes is driven down. So the risk of sexual transmission will roughly peak during Spirochetemia. Then it will drop as the adaptive immune system begins working alongside the innate immune system. If someone has a persistent infection, the quantity of spirochetes will be much lower and the risk also much lower. So its all about probability. If you fly on airplanes and drive a car, you are probably taking similar risk. But its non zero.
Since syphillis must pass through the sex organ wall for success, it has different "tricks" for fooling the innate immune system. Borrelia has adapted to being injected deep into tissue and quite close to the capillaries and entry to the blood system and around the innate immune system. It has not needed the innate fooling tricks for survival while Syphilis has no option. It must enter and pass through multiple layers of tissue unless there is an open wound.
Evolution has forced Syphillis to learn tricks to avoid the innate immune system in while Borrelia has had no such need. The journey from the source sexual fluid through the female and male tissue are different. The innate immune system the spirochaete is able to pass through intact mucous membranes or compromised skin
There probably have been cases where sexual transmission ocurred just like airplanes sometimes crash. But all the factors need to be lined up for Lyme sexual transmission just like airplanes typically crash because of multiple failures. If you just understand that both men and women's sexual organs are typically exposed to many pathogens and the innate immune system prevents systemic infection, you are halfway there. Then if you understand there are many factors that can help ( low numbers ) or hurt ( receiving host wound) then you must understand its a question of likelyhood and not yes or no.
In one of the press releases on this study, it was suggested the jump in the number of cases of Lyme was a result of sexual transmission is just silly. If there are 200,000 cases each year, then the number due to sexual transmission is probably <10. Remember the auto accident analogy? The statement that the strain between two partners is the same has not been shown but even if true, they both presumably live and or are exposed to ticks together in the same places or areas. Identifying an actual strain involves a multi-locus PCR and sequencing as many as 8 genes for reasonable certainty. The PyrG gene is identical across almost 10 known strains of Bb. If people live in a geographical area then many of the strains in the area will share many identical genes. So just to be sure 2 people have the same strain requires sequencing many genes. That has not been done so its a long way from proof of the second half of the transmission path. Using just PCR, single gene squencing and monoclonal antibody testing cannot detremine the strain.
Whether you like it or not, its just a question of probability. Even if a study found many couples with identical strains, its like showing people die in airplane crashes. Yes they do. But not many as a percentage of people who fly.
Thanks for your detailed reply @LHCTom. However I do think there are some flaws in your argument.
Yes this is what we are trying to establish.
Due to the short life cycle of bacteria they can easily evolve over a few decades. Borrelia has had at least 30 years to adapt to sexual transmission. If it was ever possible to transmit even once sexually it has got a whole lot better at it by now.
The reason this makes it so much more likely is because being spirochetes they easily get into all parts of the body which other infections can't. I think this fact highly impacts probability.
No, if every time a plane crashed, the next plane taking off acquired the same fault thus was more likely to crash, planes would soon be crashing all the time.
No it didn't. It also found that 100% of the three partners having unprotected sex had identical strains. That is quite a coincidence since there are about 300 strains worldwide if it's not sexually transmitted. Dr Marty Ross considers it unlikely that even one couple would have the same strain.
As this study (and others) found Borrelia in vaginal fluids it is obviously not very affected by it.
Borrelia is a master of immune system evasion. It is also master of getting into all areas of the body tendons, brain, joints...everywhere. I don't see why it would find it a problem getting through sexual organ tissue.
Treponema pallidum does not require direct access to the blood system or it could not be transmitted to someone who doesn't have sores. It simply helps it. It is a spirochete so can burrow through tissue, so can Borrelia.
This is a non issue for Borrelia. If you can catch Lyme from a mosquito bite it is clear that this particular bacteria does not require large numbers to effectively transmit.
Intracellular replication can evade the innate immune system. An example of this is tuberculosis. Borrelia can be encapsulated in tissue such as lymphocytic cell walls hiding it from the immune system. Biofilms can protect form the innate immune system. So it can be avoided.
If it occurred once Borrelia have likely adapted by now to this method of transmission.
The difference is that we are talking about spirochetes which are very different from most pathogens due to their ability to easily go through tissues.
This is silly based on what? Your opinion?
From the study:
That sounds like fairly comprehensive analysis to me.
No it's not. You are assuming that many couples with Lyme have different strains and that the ones with the same strains have been "cherry picked"...what has been shown from this study is that three out of three couples have the same strain making the probability quite high that sexual transmission was caused in these cases. They have not been cherry picked.
Finally Dr Ross states:
This information predates the above study which gives far stronger evidence.
So...we have a bacterium which is able to get through any tissue, survive in sexual fluid no problem and is a master at immune evasion. We have LLMD who treat many partners and was found in three out of three couples to have identical strains. In my own limited experience about 1/4 of Lyme patients I have met personally have partners who also have it.
Based on all this I would say the probability of sexual transmission is extremely likely.
Yeah, I'm thinking sexual transmission may be possible, but it's probably not frequent. I say this primarily because the epidemiology of what would then be another STD should parallel similar venereal diseases, e.g. heavy urban incidence.
I dislike that some discount the possibility out of hand, but it's spread is still probably primarily vector-based
Good point @duncan
There is one possible explanation to why this isn't seen as I have been wondering myself. The Borrelia is transmitted but the co infections not resulting that the person is able to keep it under control. Dr B says here that all Lyme patients who are ill have co infections:
There's really so many variables though it's difficult to make any conclusions about anything!
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