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Research Article

Persistence of Borrelia burgdorferi in Rhesus Macaques following Antibiotic Treatment of Disseminated Infection

  • Monica E. Embers mail,

    members@tulane.edu (MEE); Philipp@tulane.edu (MTP)

    Affiliation: Divisions of Bacteriology & Parasitology, Tulane National Primate Research Center, Tulane University Health Sciences Center, Covington, Louisiana, United States of America

    X
  • Stephen W. Barthold,

    Affiliation: Center for Comparative Medicine, Schools of Medicine and Veterinary Medicine, University of California Davis, Davis, California, United States of America

    X
  • Juan T. Borda,

    Affiliation: Comparative Pathology, Tulane National Primate Research Center, Tulane University Health Sciences Center, Covington, Louisiana, United States of America

    X
  • Lisa Bowers,

    Affiliation: Divisions of Bacteriology & Parasitology, Tulane National Primate Research Center, Tulane University Health Sciences Center, Covington, Louisiana, United States of America

    X
  • Lara Doyle,

    Affiliation: Veterinary Medicine, Tulane National Primate Research Center, Tulane University Health Sciences Center, Covington, Louisiana, United States of America

    X
  • Emir Hodzic,

    Affiliation: Center for Comparative Medicine, Schools of Medicine and Veterinary Medicine, University of California Davis, Davis, California, United States of America

    X
  • Mary B. Jacobs,

    Affiliation: Divisions of Bacteriology & Parasitology, Tulane National Primate Research Center, Tulane University Health Sciences Center, Covington, Louisiana, United States of America

    X
  • Nicole R. Hasenkampf,

    Affiliation: Divisions of Bacteriology & Parasitology, Tulane National Primate Research Center, Tulane University Health Sciences Center, Covington, Louisiana, United States of America

    X
  • Dale S. Martin,

    Affiliation: Divisions of Bacteriology & Parasitology, Tulane National Primate Research Center, Tulane University Health Sciences Center, Covington, Louisiana, United States of America

    X
  • Sukanya Narasimhan,

    Affiliation: Section of Rheumatology, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America

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  • Kathrine M. Phillippi-Falkenstein,

    Affiliation: Veterinary Medicine, Tulane National Primate Research Center, Tulane University Health Sciences Center, Covington, Louisiana, United States of America

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  • Jeanette E. Purcell,

    Affiliation: Veterinary Medicine, Tulane National Primate Research Center, Tulane University Health Sciences Center, Covington, Louisiana, United States of America

    Current address: Biologic Resources Laboratory, University of Illinois, Chicago, Illinois, United States of America

    X
  • Marion S. Ratterree,

    Affiliation: Veterinary Medicine, Tulane National Primate Research Center, Tulane University Health Sciences Center, Covington, Louisiana, United States of America

    X
  • Mario T. Philipp mail

    members@tulane.edu (MEE); Philipp@tulane.edu (MTP)

    Affiliation: Divisions of Bacteriology & Parasitology, Tulane National Primate Research Center, Tulane University Health Sciences Center, Covington, Louisiana, United States of America

    X
  • Published: January 11, 2012
  • DOI: 10.1371/journal.pone.0029914

Reader Comments (8)

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Author statement

Posted by membersla on 02 Mar 2012 at 15:19 GMT

We recently published this article entitled “Persistence of Borrelia burgdorferi in Rhesus Macaques Following Antibiotic Treatment of Disseminated Infection.” The subject and content of this work may be viewed very divergently, given the controversy surrounding Lyme disease treatment. Specifically, the phenomenon of post-treatment Lyme disease syndrome and its cause (s) have been viewed with much contention.
Our work, which was funded by several grants from the National Institutes of Health, is composed of two major experiments. Experiment 1 entailed a very comprehensive and time-consuming study that indicated the possibility that spirochetes could persist after antibiotic treatment, but only nucleic acid or antigen of these bacteria were detected, leaving open the question of persistence by intact organisms. Experiment 2 was intended to answer that question. The authors elected to publish these 2 studies together, as they mutually enhance the validity and scientific merit of the work.
In our study, we provide evidence demonstrating the post-treatment persistence of the B. burgdorferi spirochete that has been reported previously in a mouse model. We further demonstrate through multiple detection methods that intact spirochetes can survive antibiotic treatment in a nonhuman primate host. It is not our intent to present data in opposition of current antibiotic treatment regimens for humans, but rather to report what we believe to be objective, well-performed experiments on antibiotic efficacy in a nonhuman primate model.
These data are by no means a referendum on long-term antibiotic therapy, nor should they serve to oppose current IDSA guidelines for the treatment of Lyme disease. From the medical standpoint, these results may or may not warrant testing of additional treatments or regimens. This depends heavily on the results of further inquiry as to the duration of persistence, the viability and phenotype of persistent organisms, and the answer to the key question of whether persisters are pathogenic. Current practices could only be challenged by solid proof of better treatment options; these are currently not available.
For several decades, basic scientists and medical doctors have collaborated to understand and improve Lyme disease treatment, diagnosis and prevention. As we proceed with further inquiry into the phenomenon of PTLDS, these collaborations are essential. The continued discussion, commentary and debate will additionally be of benefit when conducted without bias.

No competing interests declared.

RE: Author statement

burraj51 replied to membersla on 03 Mar 2012 at 17:33 GMT

Dr. Embers, why was there such a long delay in publishing this important work? Are you or the other authors currently undertaking extended or follow up studies?

No competing interests declared.

RE: Persistent Borrelia past treatment (Mario Philipp)

KathleenDickson replied to membersla on 09 Mar 2012 at 10:07 GMT

We need to discover why OspA vaccination produced the same "multi-system" disease as chronic Lyme, as reported by Dennis Parenti (SmithKline) at the 1998 FDA Vaccine Meeting on LYMErix (OspA), and also reported by Dave Persing in his RICO patent (US #6, 045,804).

Mario Philipp reported that OspA exposure resulted in the immunosuppressive cytokine IL-10. Paul Duray (US Army, NCI) reported that the lymphocytes of chronic Lyme victims "resembled Epstein-Barr transformed cells."

It's a bit of a cowardly statement on the part of Philipp, clearly, to be standing in support of the IDSA "guidelines." He surely knows better.

No competing interests declared.