https://www.nbcnews.com/news/amp/ncna1018476
See, https://www.pnas.org/content/early/2019/06/11/1904170116A small but significant number of people with Lyme disease continue to suffer from symptoms long after finishing an antibiotic treatment. The mystery of why may have come closer to being solved with a study published Monday that found that bits of the Lyme bacteria can persist in patients’ inflamed joints even after taking antibiotics.
Lyme arthritis, the most common feature of the late-stage disease, leaves patients with swollen, painful joints. Researchers examining synovial fluid from those inflamed joints also found antibodies to the persisting molecules, called peptidoglycans, that come from the outer covering of the Lyme bacteria, according to the study, published in the Proceedings of the National Academy of Sciences.
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When it comes to finding physical explanations for patient symptoms, it’s not necessary to determine whether PTLDS is caused by lingering bacteria or to a malfunctioning immune system, said Dr. Peter Novak, an assistant professor of neurology at Harvard Medical School and director of the autonomic laboratory at Brigham and Women’s Hospital. Novak, who also was not involved in the new study, and his colleagues have discovered patients end up with damage to their small nerves and also diminished blood flow to certain areas of the brain.
He suspects that damage is due to changes in the immune system that were kicked off by the Lyme infection and remain after the bacteria have been obliterated. As for patients who experience improvement when treated with long courses of antibiotics, Novak believes this is because many antibiotics also have an anti-inflammatory effect. . . .