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Interview with Prof. Ying Zhang at the NorVect Conference 2015
Published on Sep 29, 2015
Prof Ying Zhang from John Hopkins Bloomberg School of Public Health explains why Lyme disease is so difficult to treat. Having worked with Tuberculosis (TB) for many years, he sees the similarities and differences between these to bacteria. With Tuberculosis it is known that you have to treat with certain drug combinations that kill the growing form and the non-growing form (persisters) and if you treat shorter than 6 months, the patient will get a relapse.
The bacterium that causes Lyme disease is much more advanced than the TB bacterium, and the main reason is that it also takes a persisting form. These persister forms of the Borrelia bacteria cannot be cultured.
The two views – ILADS and IDSA are two different ways of seeing the same disease. Prof. Zhang thinks they are both right. When it comes to acute Lyme disease, IDSA is right. Then you only need shorter courses of treatment. When the disease turns chronic, longer courses of treatment with the right drug combinations are needed (ILADS view).
From Norvect website - Talk: Borrelia Persister Drugs: Implications for Improved Treatment Lyme disease is the leading tick-borne disease in the US and Europe. Although early stage Lyme disease can usually be cured with doxycycline or amoxicillin, late stage Lyme disease with arthritis and neurological symptoms is often refractory to antibiotic treatment, likely due in part to persisting organisms or host response to their “remnants”. Recent animal studies have clearly demonstrated the persistence phenomenon of B. burgdorferi that is not eradicated by conventional Lyme antibiotic treatment. To address the problem of B. burgdorferi persistence, we first developed a new SYBR Green I/Propidium iodide (PI) assay and then performed the first high throughput drug screens against B. burgdorferi persisters using FDA-approved drug library. We identified a number of FDA-approved drugs that are more effective at killing B. burgdorferi persisters than the current Lyme antibiotics. Future studies are needed to identify optimal drug combinations that produce the best activity against B. burgdorferi persisters in vitro, and to evaluate the promising drug combinations against B. burgdorferi persisters for more effective treatment in animal models of Borrelia infection. The outcome of this study may not only lead to improved treatment of Lyme disease but also help to address the much debated issue of antibiotic efficacy and persistence problem that have divided the field.
It was a wonderful opportunity to hear Dr Zhang present and also to have opportunity to discuss his work.
Dr Zhang told me that he studied at Birmingham University and later in London (I think he said UCL) – somewhat ironic for me in view of our Health Authorities head in the sands denial of chronic Lyme Disease, that this leading researcher in this field of why and how Borrelia persists, was trained at two of our Universities.
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