Chronic Lyme Disease - AutoImmune Dysfunction? - Probably Not
I found this article to be fairly convoluted and not easy to understand. To try to understand it better myself, I copied it below, and I'm going to make a few comments (in blue) on some of my thoughts.
Wayne
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Some patients with Lyme disease still show symptoms long after their treatment has finished. Now proteins have been discovered that set these people apart from those who are easily cured.
People who experience the symptoms of Lyme disease, which include fatigue, soreness and memory or concentration loss, after treatment for the disorder are sometimes diagnosed as having chronic Lyme disease or post-Lyme disease syndrome. But these diagnoses are difficult to make, because the individuals no longer seem to harbour the bacteria that cause Lyme disease. And the symptoms could instead be indicative of chronic fatigue syndrome or depression.
First of all, post-Lyme disease syndrome is a completely made up condition. It's based on the unproven supposition that "individuals no longer seem to harbour the bacteria". Not only is this unproven, I believe it's considered to be patently false by Lyme Literate Medical Doctors (LLMDs). The last sentence about being indicative of CFS or depression just strikes me as adding an unnecessary and confusing element to this article.
Now Armin Alaedini at Weill Cornell Medical College in New York and his colleagues have found that patients diagnosed with post-Lyme disease syndrome have antibodies that suggest they carried the infection for an unusually long time. The finding, published in Clinical Immunology
1, might help the syndrome to be better understood, diagnosed and treated.
"carried" ... They're making the supposition that they carried (past tense) it for an unusually long time, but don't seem to be acknowledging that an infection could still be present, which I believe this is the case with long-term Lyme Disease. Not only do they still carry it, but the total Lyme bacteria load in the body is generally much larger. Think syphilis, and the long-term damage it can do if left untreated.
Alaedini's team looked at antibodies made in response to a protein called VlsE, which is found on the surface of Borrelia burgdorferi, the tick-borne bacterium that causes Lyme disease.
The antibodies recognize a snippet of the protein called an epitope, and recruit the immune system to attack the bacterium. The researchers found that post-Lyme sufferers have a greater variety of antibodies to this epitope than patients whose infection cleared up quickly.
This finding suggests that patients with chronic symptoms have experienced a prolonged infection, caused by microbes that have evaded the immune system by varying the epitopes they carry. As a result of these variations, the body makes new antibodies targeting the modified protein. The longer the microbe manages to keep changing, the more diverse its host's antibodies become.
Here they seem to be acknowledging the possibility of a chronic long-term infection.
Some post-Lyme sufferers had varied antibodies against VlsE epitopes despite being diagnosed and treated early, says Alaedini. "That could mean they naturally have a different antibody response to the infection than most people; it could mean they weren't treated properly; or it's possible they were reinfected and the second infection was never treated," he says.
This all seems sensible to me, but he doesn't seem to allow for the possibility of any number of other explanations.
Inflammatory role
"This is the first study I've seen that shows some immunologic difference between someone who resolves their Lyme and someone who develops post-Lyme disease syndrome," says Linda Bockenstedt, a rheumatologist and immunologist at Yale School of Medicine in New Haven, Connecticut.
The presence of varied antibodies hints that the chronic symptoms could be caused by an ongoing inflammatory response caused by antibodies mistakenly reacting to the body's own proteins, Bockenstedt suggests.
"The big question to me is whether this can lead to an autoimmune phenomenon," says Bockenstedt. "But if that were the case, I'd expect the disease to worsen without immune-modulating treatment, and it doesn't."
My understanding is that non-infectious disease specialists are more likely to consider chronic Lyme disease to be a "syndrome", implying a non-infectious causation. I find the last sentence to be particularly unsettling. "Lyme Disease doesn't worsen without immune-modulating treating?" This is telling me this person is woefully unaware of the progression of Lyme Disease, and how in most cases, does get steadily worse if allowed to progress beyond the initial acute infection phase. Again, think syphilis.
Alaedini suggests that higher levels of antibodies could increase the body's levels of cytokines, immune-system proteins that can trigger the symptoms experienced by patients with post-Lyme disease syndrome. "Various cytokine profiles have been associated with fatigue, anxiety and depression," he explains.
I do believe this is part of Lyme Disease symptoms. But this seems to dismiss the real likelihood and clinical picture that chronic Lyme Disease is a result of an ongoing infection, and does get steadily worse with time (unless effectively treated).
If these antibodies are unique to people with chronic Lyme disease, it could lead to a test and treatments for the disorder, Alaedini says. It could also guide treatment of the disease itself. "If patients with an acute infection develop antibodies to these epitopes, perhaps they require a more aggressive course of therapy," he adds.
But a predictive marker won't be useful without new therapies for the persistent symptoms, says Henry Feder Jr, a physician specializing in infectious diseases at the University of Connecticut Health Center in Farmington. If an immune response problem leads to the syndrome, antibiotics won't help. "I guarantee you that if you tell a patient they won't feel better after antibiotics, they won't," Feder says. "We need to know what's going on."
Here's another reference to an "immune system problem". So much of this article is focused on this angle, and is so lacking in noting that immune system abnormalities, instead of being a misguided autoimmune response, is instead a natural reaction to an ongoing and worsening infection in the body. Way too much attention is being paid to the notion of "syndrome".
Regarding his comment about "they won't feel better after antibiotics"; This applies to many who treat their Lyme Disease with antibiotics. They generally feel better while taking them, but often relapse dramatically after discontinuing them. Which to me indicates the ability of the bacteria to "hunker down" in the cyst form until the "hostile environment" created by the antibiotics is gone. Then they come out to try to establish colonies in other parts of the body. This is why I'm using Rife frequencies to keep my own bacteria in check. By doing the frequencies regularly, I feel I'm zapping them before they have a chance to establish beachheads elsewhere in my body.
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There were too many unsettling aspects about this article for me. It is focusing in the wrong direction as far as I'm concerned. Just my own thoughts. This could have been a very insightful article, if it hadn't been so biased toward an immune system dysfunction instead of a chronic systemic infection involved in chronic Lyme. The fact they can find Lyme bacteria DNA in the urine of chronic Lyme patients seems to be something that not enough researchers are paying attention to.
ETA: I just re-read this; I sound a little annoyed. Sorry about that, I usually try not to. 
But this article sort of got my goat!
