Is there lack of evidence for chronic Lyme disease?

[cave76]

Is there lack of evidence for chronic Lyme disease?

No there isn’t---- there are plenty.
One place has had persistence articles in place and it’s been there for years.

Persistance files:
http://lymeinfo.net/medical/LDPersist.pdf

(77 files from 1977 to 2012)

(Before that, even, Art Doherty had a very extensive “Lots of Links on Lyme” that we all pored over and discussed. The site was closed down when Geocities disbanded and went to Japan.)

Another place to find persistence articles is the great PowerPoint presentation by Dr. SP in 2008, debunking the IDSA’s contention of ‘no chronic Lyme’.

http://www.ilads.org/lyme_research/chronic_lyme.html

Is the supposed ‘lack of evidence’ the reason we’re all in this mess now?

Well, first of all there’s plenty of evidence. But even with that there are many reasons for this ‘debacle’.

First and foremost:
The spirochete responsible is one of the cleverest, devious and hard to kill bacterium around. Antigenic variety is just one of it’s ‘tricks’. Long replication time helps it survive. But I won’t go into those all those right now and Tom Grier has already done that with much more scientific knowledge than I have.

There has been no gold standard test devised yet. Nick Harris (Igenex) is the first to admit that.

Then we have the loverly IDSA who have mucked up almost everything. If their Guidelines hadn’t been published then at least some of the more recent Lyme patients might have been able to get sufficient medications to alleviate a lot of their symptoms even if they didn’t achieve remission.

[cave76]

Yes, all or many of us could find ourselves being under-treated by an Infectious Disease Guideline adherent. Absolutely no disagreement there!

I'm not sure what the rest of your post is asking or claiming except for wanting to know how many of those 77 have been cited in subsequent studies. That's easy:

"Citation databases make it possible to search cited references; that is, they search for references that are listed in the bibliographies of research publications. Users can follow a particular cited reference, or cited author, forward in time to find other articles that have also cited that author or work.

Cited references may be useful for a number of reasons:

locating current research based on earlier research, patents, reports, etc.
finding how many times and where a publication is being cited
identifying who is referencing a particular paper
exploring how a particular research topic is being used to support other research
analyzing the impact of a publication on other research in the field
tracking the history of a research idea
tracking the research of a colleague, or keeping track of your own research"
http://www.bc.edu/libraries/help/howdoi/howto/pubcitation.html

You asked if any of those citations endorse or dispute the 77?

I suggest that you or anyone interested read them and report back to us. I've read them all, several times but not recently so my memory 'doesn't serve'.

You also asked:

"Are the journals in which they are published highly regarded in a quantifiable way such as impact factor?"

"But it could be misleading to post these references without putting in to context how the number, quality, and acceptance of these reports compares to the counter viewpoint that Lyme is easy and fast to cure."

Afraid you lost me there. And probably most of the other members here.
(grin)

[wonko]

The original post refers to

"Persistance files:
http://lymeinfo.net/medical/LDPersist.pdf

(77 files from 1977 to 2012) "

To even out the playing field, how many articles from 1977-2012 support that Lyme is treatable with about two weeks of antibiotics alone?  How many report that there is no evidence for chronic Lyme, and how many report that there is no benefit of long-term antibiotics?  Are these 77 references a minority or a majority?

For the 77 references, can you tell us if, and to what extent, they have been cited in subsequent studies?  Do the citations endorse or dispute these studies?  Are the journals in which they are published highly regarded in a quantifiable way such as impact factor?

I do not doubt that there are reports in the literature which support the persistence of Lyme.  But it could be misleading to post these references without putting in to context how the number, quality, and acceptance of these reports compares to the counter viewpoint that Lyme is easy and fast to cure.

My personal experience was that about a dozen or so doctors (of various specialities) all vehemently denied the existence of chronic Lyme, and all felt 100% confident that my negative Elisa test completely ruled out the possibility that I had Lyme.  So despite the existence of literature that supports chronic Lyme and/or long-term antibiotic treatment, a patient can easily find themselves under the care of doctors who have a narrow view of how to diagnose and treat Lyme disease.

[cave76]

http://www.ncbi.nlm.nih.gov/pubmed/?term=8852456

Infection. 1996 Jan-Feb;24(1):9-16.

Kill kinetics of Borrelia burgdorferi and bacterial findings in relation to the treatment of Lyme borreliosis.

Preac Mursic V, Marget W, Busch U, Pleterski Rigler D, Hagl S.
Source
Max v. Pettenkofer Institut, Ludwig-Maximilians-Universität München, Germany.
Erratum in
Infection 1996 Mar-Apr;24(2):169.

Abstract
For a better understanding of the persistence of Borrelia burgdorferi sensu lato (s.l.) after antibiotic therapy the kinetics of killing B. burgdorferi s.l. under amoxicillin, doxycycline, cefotaxime, ceftriaxone, azithromycin and penicillin G were determined.

The killing effect was investigated in MKP medium and human serum during a 72 h exposure to antibiotics. Twenty clinical isolates were used, including ten strains of Borrelia afzelii and ten strains of Borrelia garinii.

The results show that the kinetics of killing borreliae differ from antibiotic to antibiotic.

The killing rate of a given antibiotic is less dependent on the concentration of the antibiotic than on the reaction time.

Furthermore, the data show that the strains of B. afzelii and B. garinii have a different reaction to antibiotics used in the treatment of Lyme borreliosis and that different reactions to given antibiotics also exist within one species.

The B. garinii strains appear to be more sensitive to antibiotics used in therapy. Furthermore, the persistence of B. burgdorferi s.l. and clinical recurrences in patients despite seemingly adequate antibiotic treatment is described.

The patients had clinical disease with or without diagnostic antibody titers to B. burgdorferi.

PMID: 8852456 [PubMed - indexed for MEDLINE]

I haven't found a similar article addressing this in the U.S. but it's not too far a stretch to imagine that 'our' bacteria will have the same responses, only different. :)

[cave76]

"Another trick Borrelia have up their sleeve in order to overcome a hostile environment in their host, is to change from the spirochete shape to cell wall deficient L form (intracellular form) or to the cyst form."

I don't know if this is part of antigenetic variation or not. If I've posted this in error I would appreciate being given the links to articles that prove otherwise.

Or as a common instruction to people who want to critique a statement states:

"let your presentation be well reasoned and objective. If you
passionately disagree (or agree) with the author, let your passion inspire you to new heights of thorough research and reasoned argument."