103 Inflammatory Mechanisms And Biomarkers In The Chronic Manifestations of Lyme Disease-Alaedini, Armin LYME Voice

Ep.103 Dr. Armin Alaedini is a professor at Columbia University, where he leads a research laboratory focused on studying the role of the immune system, host-microbe interaction, and diet in complex disorders. His team’s research on Lyme disease in the past 15 years has focused on the chronic and post-treatment manifestations of the infection, leading to seminal findings that provide molecular evidence of a biological basis for the patient’s symptoms. He is currently a member of the Scientific Advisory Board of Global Lyme Alliance and a Working Group Member of the NIH Advisory Council on Chronic Fatigue Syndrome. Key Takeaways:   How does inflammation become permanent?  Could there be abnormalities in the immune response system because of Lyme disease? Could there be a biological basis for persistent inflammation? There is a biological basis for the symptoms Lyme patients are facing. This is not trivial, because there wasn’t scientific evidence to say it wasn’t psychosomatic.  The infection causes inflammation. Inflammation then becomes chronic.  Why do some patients recover and others don’t? Remove the infection, and then you still have to remove the inflammation. Borrelia components could remain.  Even after treatment with antibiotics, you can still have Borrelia in the body. (Animal studies) The inflammation that patients have early on in the infection is different than the persistent inflammation that patients have in the later stages of infection. (12:00) Biological markers to demonstrate that patients have chronic persistence of inflammation. This is really important because it gives us a handle to study these patients. There is basically no federal funding for Lyme disease. The NIH gives out a minuscule amount of funding for Lyme disease. Lack of funding is a major reason we haven’t made strides. We know a lot about Borrelia (about the infection itself) but the chronic symptoms that persist after having Lyme disease haven’t been properly studied.  We need more support from the NIH and other federal agencies. Chronic Fatigue Syndrome (working group that counsels the NIH) NIH is slowly starting to be more supportive of research around CFS. CFS is a heterogeneous condition. It’s a spectrum disorder, making it very hard to study.  There is now a study section at the NIH dedicated to studying CFS. We need funding to entice new researchers in these underfunded areas. Testing for Lyme that is “accepted” as mainstream relies on the immune response to the infection itself.  We need to be able to find biomarkers in patients early on in the infection and later post-treatment Lyme disease syndrome. (30:00) We are still at the early stages of understanding (funding, research, clinical trials) these persistent symptoms.  We can’t focus only on antibiotics and antibacterial agents. (We need to think more broadly about treatment strategies)  Borrelia moves out of the bloodstream very quickly. From the blood, it goes to joints, nervous system and organs.  Clinicians and researchers process the information that they have differently. There is a very real psychological toll of unresolved symptoms on the patients.  The GUT has its own immune system and nervous system. (53:00) Neuroimmunology-The role of the immune system in neurologic and psychiatric symptoms. The gut interacts heavily with the brain. “I was initially interested in Lyme disease because the laboratory I was working in became interested in patients who were basically experiencing symptoms in response to vaccination from Lyme disease back in the 90’s.” LYMErix There is currently no vaccine for Lyme disease.  The early research that I did indicated that there may be some cross-reactivity of the immune response to the vaccine, against the nervous system. That was early research that we did, that we didn’t continue with for lack of funding.  What will treatment look like in the year 2040 for Lyme disease? Quick diagnosis, treatm