The Mystery of Lyme Disease – a Overview on the History of Borreliosis

Even though there had been descriptions of similar diseases from several dermatologists in the early 20th century in Europe (1909: Erythema migrans from Afzelius (S); 1924: Acrodermatitis chronica atrophicans-ACA from M. Jessner and A. Löwenstamm (D/PL); 1943: Lymphadenosis benigna cutis-Lymphozytom from Bo-Erik Bäfverstädt (S)), from a historical perspective, the myth about Lyme-Borreliosis started in 1977. At this time Allen C. Steere (M.D.), who was studying rheumathology at Yale University (now at Massachusetts general hospital and his colleagues stated, after substantial prospective trials taking place in the vicinity of Lyme / CT U.S.A., having discovered a “new disease” called Lyme-Borreliosis. They asserted that at the place of a tick bite within a time frame of a few weeks a migrant erythema may develop and that these patients significantly often show neurologic, cardial or arthritic symptoms in the following course. The same study group announced later on that the disease they discovered can be successfully treated by antibiotics. This circumstance had the implication that most possibly Lyme-Borreliosis was a tick transmitted bacterial infection. From these findings a perpetual discussion continued, so that 1983 the first international conference on Lyme’s disease took place at YALE University. The onward discussions lead to periodically held conferences alternating between Europe and USA.

A big controversy started by mid 1990’s and still today when Lyme disease became a “junk-drawer diagnosis”, covering medical conditions ranging from chronic fatigue syndrome (CFS), multiple chemical sensitivity (MCS), fibromyalgia to even psycho-somatic reactions. Everyone should know by now that fibromyalgia should be treated differently. Lyme-Borreliosis at present has become overdiagnosed and overtreated. Many apparently Lyme sick patients with chronic symptoms received long term high dosages of antibiotics without any effect or being done more harm than good. This finally lead to the situation that Steere and his colleagues once averred that even patients with a positive serology for Borrelia infection and with symptoms resembling those of CFS; MCS or fibromyalgia would not necessarily be helped with long course of antibiotics however it may be with the aid of medication similar to cymbalta. For something a bit more natural, those suffering with fibromyalgia or any type of chronic pain may look into the use of marijuana to tackle and relieve this.

From the biological perspective this phenomenon of antibiotics not helping, so highly discussed is easily explainable. On the one hand we have bacteriae transmitted by a tick bite; on the other hand we have the organism with all his burdens, malfunctioning and genetic predispositions. All the antigens the body is exposed to due to the salivarian transmission of a tick’s bite are immune system relevant and possibly can maintain ongoing systemical immune reactions. As we know the immune system can be compromised by many factors (toxins, waste products, heavy metals, dead teeth, acidic milieu, unbalanced intestinal flora composition, bowel inflammation, genetical detox deficiencies, malfunctioning interleukins, disabled immunological reactiveness, etc.). This of course can lead to a blockade in therapy and explains why some patients resist orthodox regimen and why others do respond. The answer is found in the milieu and a properly working metabolism including immunological aspects. Our treatments therefore need to address these circumstances: take away possible burdens and blocking elements, adding additional support to a compromised immune system and sustaining the vital parts that are mainly affected (e.g. joint, nerve system, muscles etc.) as basic essentials in the biological treatment protocol. Due to Willy Burgdorfer, an American scientist born and educated in Basel, Switzerland, and his scientific work, we know by now that the Lyme-Borreliosis is a tick-borne infection caused by the spirochete Borrelia burgdorferi. The reservoir of these bacterias is wild animals especially wild mice and birds. Vectors for borrelia are ticks depending on blood meals within certain periods of their life cycle.

The picture shows the reproduction cycle of a tick; from egg over larva and nymph to the adult tick. For their development larva, nymph and adult ticks need blood either from animals or humans. During the suction process the blood-borne pathogen is transmitted reciprocatively. Even though Borreliae spirochete might be transmitted, pathological symptoms might not occur in all humans or domestic animals according to their different “milieu” settings.

Borrelia burgdorferi is transmitted by the bite of infected ticks. Speaking of ticks, as we all know, they carry harmful diseases. And no one wants to experience a tick bite, as it is probably not the most pleasant thing to go through. Sometimes, they can even enter homes and cause issues there too, which is where most people draw the line and realize that it is time to get in touch with a pest control company. Knowing that you can get rid of them in no time at all could prevent you from becoming infected by these creatures.

lyme disease

Looking at the pathogenic germ from a microbiological perspective, we see that the superficial layers contain proteins that are responsible for immune reactions and for the identification by phagocytes and other elements of the unspecific infection defense of the human body. Because of the sequence of their discovery they are refered to as OspA – OspF.

OspA binds the bacteria to the epithelial cells of a tick’s bowel. After a tick’s bite and the contact of blood, the OspA is down regulated meanwhile the OspC goes up. This way the Borrelia Bacteria can release itself from the tick’s intestine and within the hämolymph it reaches its salivary glands through which secretioning the bacteria finally enters the host. The key to the difficulties in treating Lyme disease lays upon these Osp proteins that are very heterogenous within their expression and behaviour and act very dynamically in different and changing environmental influences. This once again emphasizes the biological theory.

Due to this changing capability from OspA–OspF, with many OspC subgroups, Borrelia can persist in cells and especially within bradytrophic or weakly blood supplied tissues like fascias, tendons and ligaments. This way the bacteriae have some protection against mechanism of immune defense and even antibiotics very easily. Long term antibiotics are therefore not necessarily the answer to Lyme infection and should therefore be considered only in exceptional cases.

Lyme symptoms include feverish temperatures without erythema, cephalgia, arthromyalgia radicular pain syndrome etc. Many people with early symptoms of Lyme disease develop a circular red skin rash around a tick bite. The Lyme rash can appear up to 3 months after being bitten by a tick and usually lasts for several weeks. Most rashes appear within the first 4 weeks. The rash is often described as looking like a bull’s-eye on a dartboard.

The methods for laboratory diagnostics of Lyme Borreliosis vary a lot. Literature agrees about the only proofing device for an acute Borreliosis infection is the cultural confirmation. Set up cultures make biopsies from skin, joints and liquor necessary, as well as special nutrient solutions and culture mediae not considering that the growing normally takes weeks and is only done by specialized laboratories seldomly found across the nation. The methods of direct proof of borreliae are highly specific but for the daily practice rather difficult to accomplish and in its sensitivity far too low.

The verification of Borreliae-DNA via PCR (polymerasechainreaction) might not be a 100% proof for vital borreliae, but still proof enough for an active borreliae infection. Within certain studies, especially at late manifestations of Lyme the sensitivity of PCR towards borreliae detection has been found to be marginal. This means the PCR might only be able to serve early stage patients. At the same time we find information that a PCR with negative results doesn’t exclude Lyme disease at all.

To resume once again, the methods for direct proof are less sensitive but with their specificity very high; which might be important for medical-legal expert assessments. This needs to be kept in mind.

The indirect verification methods therefore have significant importance. At the Swiss Biological Medicine Center, we first hand look for borellia-specific IgM- and IgG-antibodies (considering that IgG-antibodies are only provable within a 2-6 weeks time frame after infection) via enzyme linked immunoessay (ELISA). Secondly we use the Immunoblot (Westernblot) or Line Assays for borreliosae-specific antibodie’s detection as affirmation. Although it is observed that Immunoblot and Line Assays are the more specific and sensitive diagnostics for borreliosae specific antibodies, we recommend to request an IgG/IgM Test for diagnostics first for economic reasons; since once Lyme is proven Immunoblots don’t give much more information (s. table below).

The tested antigene need to be borreliae specific, shouldn’t cross react with other bacteriae and need to be adequately immunogenous, so that a high percentage of infected individuals generate antibodies. Literature shows that this counts for: VlsE, p58, p39 (BmpA), p22-25 (OspC) and p21 (DpbA).

ProteinantigenAntigenSpecificityComments
VlsEVariable major protein (VMP)HighSensitivity very high, only expressed in host
p58HighSensitivity very high
p39Borrelia membrane proteinHighAnti BMPA antibodies occur early
p25,24,23,22OspCHighMost important marker for IgM answer
p21DbpA (Decorin binding protein A)HighEnables binding to host specially skin

If the patient tests positive for these antigens Lyme is medically proven. An individual treatment protocol can be started after knowing the heavy metal burden and the intestinal flora composition both of which are building blocks in the correct therapy. We also always recommend a darkfield examination of the vital blood, because it’s the milieu that creates the disease not the infection itself. From a biological perspective it’s also worthwhile looking at neurotropic (Varizella zoster, Measels, Rubella, Polio, Herpes simplex, Cytomegalia) and lymphotropic (Chlamydia, Epstein Barr, Toxoplasmosis, FSME, Hepatitis B/C, Lues) “viruses” which can also contribute to a malfunctioning immune system, that normally should cope with a bacterial attack deriving from borrelia burgdorferi bacteriae.

At present the medical world also recommends to examine the antibody titers (IgG and IgM) to Ehrlichia, Babesia and Bartonella as concomitant bacteriae being transmited with a tick’s bite. From our point of view going through this might not be worth the effort, since the treatment even though test results might be positive, would remain the same anyhow.