，根據CDC給出, 有 300,000 誰是萊姆病的影響，每年在美國的個人, 這是驚人的，這麼小的研究錢已經給理解和萊姆在這個國家和國際蜱傳疾病. 就像過去的梅毒辯論, experts have been unable to agree on whether a case definition called late/chronic Lyme disease exists. Yet some Lyme victims, 即使服用抗生素規範治療, continue to suffer from serious long-term health problems for years after they first contract the disease. Like HIV/AIDS in the early 1980s, 萊姆的世界已經有一小群專門的研究人員和臨床醫生誰仍然致力於推進和理解這種疾病好.
今天，在第 10 我的世界系列, “蜱”, 我被這三個先驅加盟: 博士. 布萊恩·法倫, 博士. 朱迪思Miklossy和博士. 伊娃·沙比. 博士. SAPI是副教授紐黑文大學 (CT) where she carries out Lyme disease research with her graduate students. 至今, 以上 70 graduate students have received training in Lyme disease related research. 博士. 朱迪思Miklossy是阿爾茨海默氏症研究中心在瑞士主任. 她是在螺旋體微生物學和神經病理學專家. 博士. Miklossy serves on the boards of several international Lyme disease foundations. 博士. 布萊恩·法倫是臨床精神病學和萊姆和蜱傳疾病研究中心主任，哥倫比亞大學醫學中心教授.
布賴恩, 你在想什麼蜱傳疾病的研究，在過去五年中完成了請你總結一下我?
There have been major advances. We’ve learned from the animal models that the Lyme infection can persist in small numbers despite antibiotic treatment; 這個一直被懷疑醫生與人類合作 – having it demonstrated in several animal models allows us to investigate whether these persistent organisms in the animals are causing disease. We’ve learned from studies of patients with chronic symptoms after treatment for Lyme disease that the immune system is often hyper-activated — that patients have elevated immune activity in the blood and in their spinal fluid. This overactive immune system itself may be leading to the chronic symptoms of fatigue, pain, and cognitive dysfunction. We’ve learned from studies of ticks that about 30% carry more than one pathogen and that the new microbe, 伯氏miyamotoi, can cause a Lyme-like illness that responds to antibiotics but which will not test positive on Lyme testing. This may explain why some patients with a Lyme-like illness never tested positive for Lyme but did get better after antibiotic therapy.
什麼是你的研究的重點，它是如何涉及到鑑定萊姆病和治療和疾病所引發萊姆的挑戰?
伊娃: Our research group studies different forms of Borrelia bacteria to better understand how Borrelia can hide from the immune system and from different therapies. 例如, our research group demonstrated that Borrelia is capable of forming a protective layer around itself – called biofilm – which could render it to be very resistant to antibiotics and provide a logical explanation as to why extensive antibiotic treatment for patients with a tick-bite history could fail. Our final goal is to better understand Borrelia survival mechanisms, and ultimately to provide new research information for the chronic Lyme debate. 先前, our Lyme disease research group has also identified an alarming increase in the co-infection rate in deer ticks, including discovery of novel co-infections such as mycoplasma and microfilarial nematode species.
朱迪思: During the last 25 years we studied Borrelia burgdorferi infection in chronic or late Lyme disease. We have published pathological confirmation of the direct involvement of Borrelia burgdorferi in the two major forms of chronic/late Lyme neuroborreliosis, namely the meningovascular form associated with cerebrovascular infarcts and the atrophic form of Lyme meningoencephalitis, associated with cortical atrophy and dementia. We have also reported data on persisting typical as well as atypical and cystic forms of Borrelia burgdorferi in the brains of patients suffering from chronic Lyme neuroborreliosis. We have also shown that Borrelia spirochetes cultivated from the brains of these patients remain virulent and cause apoptosis. 此外, we were able to reproduce in vitro the pathological hallmarks of the atrophic form of chronic Lyme meningoencephalitis.
Whether spirochetes persist in host tissues and play a direct role in the late/chronic manifestations of syphilis was also the subject of a long debate in the history of syphilis. The detection of persisting spirochetes in brains of patients suffering from syphilitic meningoencephalitis (general paresis) ended the debate and confirmed the spirochetal origin of the late/chronic neuropsychiatric manifestations of neurosyphilis.
朱迪思, what is your view on the existence of chronic Lyme disease?
今天, the question as to whether Borrelia spirochetes persist is at the center of debate with respect to Lyme disease. In order to solve the debate, we reviewed the substantial amounts of data accumulated during the last 30 years with respect to chronic/late Lyme disease. The data clearly shows that the major late/chronic forms of Lyme neuroborreliosis (meningovascular and meningoencephalitis) were clinically and pathologically confirmed and Borrelia burgdorferi was detected in tertiary brain lesions and/or cultivated from the affected brain or cerebrospinal fluid. These observations were made by many authors and in various countries including the USA and Europe. Borrelia burgdorferi is able to evade destruction by the host immune reactions, persist in host tissues and sustain chronic infection and inflammation. As published in the prestigious Handbook of Clinical Neurology, these observations represent evidences that Borrelia burgdorferi in an analogous way to Treponema pallidum is responsible for the chronic/late manifestations of Lyme neuroborreliosis.
更重要, the existence of late Lyme disease is approved by all official guidelines in the U.S., Canada and Europe. The terms “晚” 和 “chronic” 萊姆病, as in syphilis, are synonymous and define tertiary Lyme disease. The use of “chronic” Lyme disease as a different entity is inaccurate and confusing.
朱迪思, to what research do you believe scientists around the world must give priority in order to better treat patients suffering from tick-borne illnesses?
Improvement of existing, and development of new efficient diagnostic tests and therapies for Lyme disease and for the various co-infections is necessary.
Detection of Borrelia burgdorferi in infected tissues and pathological confirmation of the direct role of spirochetal infection in various other chronic/late manifestations of Lyme disease is strongly warranted. Necessity of careful consideration of Borrelia burgdorferi infection in the etiology of stroke, dementia, mood disorders and the various other late/chronic manifestations of Lyme disease would be fundamental.
Despite the fact that antibiotic therapy is less efficient in chronic/late Lyme neuroborreliosis, improvement of the neuropsychiatric symptoms or complete recovery of patients was repeatedly reported, underlying the necessity of an adequate treatment. We should not forget that syphilis was almost completely eradicated by the use of Penicillin.
朱迪思, how do we accelerate the research needed for tick-borne illnesses effectively? How can we use technology to do this?
We have all the human experts and technological tools available to further improve and accelerate the research needed for Lyme disease, 但, the most important condition, the financial support, is lacking.
Respectful open discussions, exchange and spread of knowledge between experts from all branches of medicine and sciences involved in Lyme disease research would be fundamental.
布賴恩, what do you believe is possible to accomplish in terms of research results by 2018?
由 2018, we will have much better diagnostic tests, including tests that will enable us to more sensitively identify current infection. We will have a new vaccine by then – one which is easier to deliver and safer as well. 最後, 由 2018, we will have better treatments for patients with chronic symptoms — and we will have biomarkers that help us to choose and target our treatments more appropriately. Patients with chronic symptoms will have many more choices than they do today.
有關醫生的詳細信息. 布萊恩·法倫: http://www.columbia-lyme.org/about/researchteam.html
有關醫生的詳細信息. 朱迪思Miklossy: HTTP://www.miklossy.ch/401/16601.html
有關醫生的詳細信息. 伊娃·沙比: http://www.evasapi.net/
Photos are courtesy of Dr. 朱迪思Miklossy.
欲了解更多蜱文章: 點擊這裡
在全球搜索教育, 和我一樣，全球知名的思想領袖，包括邁克爾·巴伯爵士 (英國), 博士. 邁克爾座 (美國), 博士. 萊昂特司特因 (美國), 克萊克里斯坦森教授 (美國), 博士. 琳達·達林 - 哈蒙德 (美國), 博士. 馬達夫恰範 (印度), 邁克爾·富蘭教授 (加拿大), 霍華德·加德納教授 (美國), 安迪·哈格里夫斯教授 (美國), 伊馮娜赫爾曼教授 (荷蘭), 克里斯汀Helstad教授 (挪威), 讓·亨德里克森 (美國), 玫瑰Hipkins教授 (新西蘭), 科妮莉亞Hoogland教授 (加拿大), 這位傑夫·約翰遜 (加拿大), 太太. 尚塔爾考夫曼 (比利時), 博士. Eija Kauppinen (芬蘭), 國務秘書塔皮奧Kosunen (芬蘭), 多米尼克·拉方丹教授 (比利時), 休·勞德教授 (英國), 本·萊文教授 (加拿大), 主肯麥克唐納 (英國), 巴里McGaw教授 (澳大利亞), 希夫納達爾 (印度), Ř教授. 納塔拉詹 (印度), 博士. 吳PAK (新加坡), 博士. 丹尼斯教皇 (美國), 斯瑞達拉賈戈帕蘭 (印度), 博士. 黛安·拉維奇 (美國), 理查德·威爾遜·賴利 (美國), 肯·羅賓遜爵士 (英國), 帕西SAHLBERG教授 (芬蘭), 安德烈亞斯·施萊歇 (PISA, 經合組織), 博士. 安東尼·塞爾頓 (英國), 博士. 大衛·謝弗 (美國), 博士. 基爾斯滕都沉浸式 (挪威), 總理斯蒂芬·SPAHN (美國), 伊夫Theze (法國公立高中美國), 查爾斯Ungerleider教授 (加拿大), 托尼·瓦格納教授 (美國), 大衛·沃森爵士 (英國), 迪倫Wiliam教授 (英國), 博士. 馬克沃莫爾德 (英國), 西奧Wubbels教授 (荷蘭), 邁克爾·楊教授 (英國), 和張民選教授 (中國) 因為他們探索所有國家今天面臨的大畫面的教育問題. 全球搜索教育社區頁面
ç. M. 魯賓是兩個廣為傳誦的在線系列，她接受了筆者 2011 厄普頓·辛克萊獎, “全球搜索教育” 和 “我們將如何閱讀?” 她也是三本暢銷書, 其中 真正的愛麗絲夢遊仙境.
最新評論