Scientists Make Paralyzed Rats Walk Again After Spinal-Cord Injury

Medical News Today
Mon, 21 Sep 2009

UCLA researchers have discovered that a combination of drugs, electrical stimulation and regular exercise can enable paralyzed rats to walk and even run again while supporting their full weight on a treadmill.

Published Nov. 20 in the online edition of Nature Neuroscience, the findings suggest that the regeneration of severed nerve fibers is not required for paraplegic rats to learn to walk again. The finding may hold implications for human rehabilitation after spinal cord injuries.

"The spinal cord contains nerve circuits that can generate rhythmic activity without input from the brain to drive the hind leg muscles in a way that resembles walking called 'stepping,'" explained principal investigator Reggie Edgerton, a professor of neurobiology and physiological sciences at the David Geffen School of Medicine at UCLA.

"Previous studies have tried to tap into this circuitry to help victims of spinal cord injury," he added. "While other researchers have elicited similar leg movements in people with complete spinal injuries, they have not achieved full weight-bearing and sustained stepping as we have in our study."

Edgerton's team tested rats with complete spinal injuries that left no voluntary movement in their hind legs. After setting the paralyzed rats on a moving treadmill belt, the scientists administered drugs that act on the neurotransmitter serotonin and applied low levels of electrical currents to the spinal cord below the point of injury.

The combination of stimulation and sensation derived from the rats' limbs moving on a treadmill belt triggered the spinal rhythm-generating circuitry and prompted walking motion in the rats' paralyzed hind legs.

Daily treadmill training over several weeks eventually enabled the rats to regain full weight-bearing walking, including backwards, sideways and at running speed. However, the injury still interrupted the brain's connection to the spinal cord-based rhythmic walking circuitry, leaving the rats unable to walk of their own accord.

Neuro-prosthetic devices may bridge human spinal cord injuries to some extent, however, so activating the spinal cord rhythmic circuitry as the UCLA team did may help in rehabilitation after spinal cord injuries.

The study was funded by the Christopher and Dana Reeve Foundation, Craig Nielsen Foundation, National Institute of Neurological Disorders and Stroke, U.S. Civilian Research and Development Foundation, International Paraplegic Foundation, Swiss National Science Foundation and the Russian Foundation for Basic Research Grants.

How PCBs May Hurt the Brain

New Studies Shed Light on Exposure to Environmental Toxin and Development of Brain Cells

Kathleen Doheny
WebMD Health News
April 13, 2009

Exposure to environmental toxins known as PCBs have long been linked with behavioral and developmental problems in children, but scientists could never say exactly how PCBs (polychlorinated biphenyls) might adversely affect the brain and lead to the problems.

Now, scientists think they may know.

The chemicals adversely affect the development of brain cells and also make brain circuits "overexcited," which has been linked in previous research to developmental problems, according to researcher Isaac N. Pessah, PhD, a professor of molecular biosciences and director of the University of California Davis Center for Children's Environmental Health.

"We think we have identified the way in which a broad class of environmental contaminants influences the developing nervous system and may contribute to neuro-developmental impairments such as hyperactivity, seizure disorders, and autism," says Pessah, a co-author on a trio of new studies examining the issue. The latest of the three is published online today in PLoS-Biology.

The findings of the three studies are called a "turning point" by another expert in the field.

One surprise finding: low levels of PCB exposure sometimes have greater ill effects than high-dose exposures.

PCBs were widely used for years in many products such as electronic components, pesticides, caulking, and flame retardants, but their production was banned in the U.S. in 1979.

Even so, the chemicals persist in the environment because they don't break down easily, explaining why high levels of PCBs can still be detected in people and in animals. PCBs are found in air, water, soil, and contaminated foods such as fish.

PCB Exposure and Effect on Learning and Brain Cells

In one of the three new studies, exposures to low doses of PCBs in animals hampered their ability to learn to swim a maze, a common test of animal learning.

The low PCB doses also adversely affected the plasticity of the animals' dendrites -- small projections branching out from the neurons or nerve cells that get signals from other cells in the body.

"This plasticity is very important for learning and memory," says study researcher Pamela Lein, PhD, associate professor of neurotoxicology at the UC Davis School of Veterinary Medicine.

The study was published in March in Environmental and Health Perspectives.

Problems in dendrite plasticity and growth have already been implicated in disorders such as autism, schizophrenia, and mental retardation, Lein says.

Lein and colleagues compared the effects of low-dose PCB exposure, high-dose exposure, and no exposure in three groups of rats that had been trained to swim and find an escape platform in a maze, and three groups not trained to swim the maze.

"The PCB treatments did affect the learning and memory," she says. "The effects were seen in the low-dose group but not the high-dose." Those in the low-dose trained group took longer to learn to swim and escape the maze, she says.

In the high-dose group, she says, the exposure may have triggered a compensatory mechanism that protected the brain cells from harm.

PCB Exposure: The Tissue Study

In a second study, the researchers looked at tissue from the animals' hippocampus, an area of the brain that regulates memory and emotion, and measured the "excitability" of neurons there before and during exposures to two different PCBs.

With one of them, says Pessah, "we can get an enhancement of excitability." Normally, information processing in the brain depends on a balance between excitation and inhibition of the neurons.

"Too much excitability is bad for the brain," Pessah says. Many neuro-developmental disorders, he says, including autism and attention deficit hyperactivity disorder or ADHD, "are thought to involve an imbalance between inhibition and excitability."

What they found in this study, he says, is that "even low levels [of PCBs] can tip the balance in the brain." The report is published in March in Toxicology and Applied Pharmacology.

PCB Exposure: The Cellular Level Clues

Finally, the researchers went to the cellular level, trying to find out more specifically how the PCBs change brain cell development as they found in the animal study and how they change the neurons' excitability, as seen in the study on brain tissue.

In the lab, they exposed receptors within the cells that regulate the release of calcium, crucial to maintain normal signaling from cell to cell, to PCBs. When they used electron microscope to create high-resolution images of the interaction between the receptors and the PCBs, they found the chemical binds to the receptors and adversely affects the calcium release. This interference accounts for the findings in the other two studies, Pessah says.

PCB Studies: Second Opinion

"I think that these studies represent a kind of a turning point for our recognition of how these chemicals, PCBs, can interfere with brain development," says R. Thomas Zoeller, PhD, professor of biology at the University of Massachusetts, Amherst. He was a journal reviewer for one study and reviewed the other two for WebMD.

"They are looking at a limited number of forms of PCB chemicals and they are linking exposures to very specific changes in proteins in the nervous system that impact brain development and behavior," he says. Because the animal model studied developmental events that are akin to human developmental events, ''for the first time we are getting a clear view of how these chemicals can impact the brain in humans," he says.

PCB Studies: Practical Applications

The new findings will add weight to the studies finding a link between exposures to PCBs and developmental problems, Lien says. "For the first time, we now have a plausible biological mechanism to explain the effect of PCBs on behavior."

One practical application of the research? Scientists may use the findings to evaluate the safety of numerous chemicals produced to take the place of PCBs, Zoeller says. "Science can't keep up with the rapid kinds of chemical changes that industry can manufacture," he says. "It would be great if we could get out in front of it and identify dangerous chemicals before people are being exposed."

The research findings may also make experts who thought lower-dose PCB exposures were not a problem think again, Pessah says.

Stem cells could save stroke victims

John von Radowitz
The Independent
Mon, 09 Mar 2009

Disabling strokes could one day be treated by replacing damaged brain tissue with stem cells, scientists have shown.

Researchers used a new technique to insert therapeutic stem cells into the brains of rats with pinpoint accuracy.

Once implanted the cells began to form new brain tissue and nerve connections.

The work is at an early stage and does not yet prove that stroke symptoms such as paralysis can be reversed.

But it demonstrates that lost brain tissue can be replaced with stem cells targeted at sites of damage.

Stem cells are immature cells with the ability to take on any of a number of specialist roles.

In previous animal experiments, stem cells implanted into the brain have tended to migrate to surrounding healthy tissue rather than fill up the hole left by a stroke.

Scientists from King's College London and the University of Nottingham overcame the problem by loading the cells onto biodegradable particles.

These were then injected through a fine needle to the precise site of damage, located using a magnetic resonance imaging (MRI) scanner.

Once implanted, the particles disappeared leaving gaps for the growth of new tissue and nourishing blood vessels.

The cells, derived from stem cells taken from mouse embryos, had already progressed some of the way to becoming neurons.

They were attached to particles made from a biodegradable plastic-like polymer called PLGA.

Dr Mike Modo, leading the King's College team from the university's Institute of Psychiatry, said: "The stem cell-loaded PLGA particles can be injected through a very fine needle and then adopt the precise shape of the cavity. In this process the cells fill the cavity and can make connections with other cells, which helps to establish the tissue.

"Over a few days we can see cells migrating along the scaffold particles and forming a primitive brain tissue that interacts with the host brain. Gradually the particles biodegrade leaving more gaps and conduits for tissue, fibres and blood vessels to move into."

Colleague Kevin Shakesheff, Professor of Advanced Drug Delivery and Tissue Engineering at the University of Nottingham, said: "This was a great collaborative project with the Kings College team and hopefully this technology will be taken to the clinical setting soon. Repairing damaged brain tissue is one of the ultimate challenges in medicine and science. It is great that we are now one step closer to achieving that goal."

The next stage will be to apply a "growth factor" chemical called VEGF with the particles to encourage the creation of new blood vessels.

The research, funded by the Biotechnology and Biological Sciences Research Council (BBSRC), is reported in the journal Biomaterials.

Strokes occur when part of the brain dies off because of a blocked or burst blood vessel.

An estimated 150,000 strokes occur in the UK each year, 67,000 of which are fatal.

Strokes cause more disability than any other chronic condition. Around 300,000 people in the UK are moderately or severely disabled because of a stroke.

Joe Korner, from the Stroke Association charity, said: "This research is another step towards using stem cell therapy in treating and reversing the brain damage caused by stroke. It is exciting because researchers have shown they are able to overcome some of the many challenges in translating the potential of using stem cells into reality.

"The potential to reverse the disabling effects of stroke seems to have been proved. However the development of stem cell therapy for stroke survivors is still in the early stages and much more research will be needed before it can be tested in humans or used in practice.

"Every five minutes someone in the UK has a stroke and it is vital that we do all we can to help those affected by stroke."

Professor Douglas Kell, chief executive of the BBSRC, said: "Stroke is a leading cause of disability in industrialised countries. It is reassuring to know that the technology for treating stroke by repairing brain damage is getting ever closer to translation into the clinic. This crucial groundwork by Dr Modo and his colleagues will surely be a solid foundation of basic research for much better treatments in the future."

Anthony Hollander, Professor of Rheumatology and Tissue Engineering at the University of Bristol, said: "We are only just beginning to understand how to use tissue engineering to cure diseases. This study shows the exciting possibility of using a biomaterial to deliver stem cells to a very specific location in the brain. It is too early to say if it will be clinically effective in patients but the more we explore these possibilities the more likely it is that we will develop successful therapies."

Le gras animal montré du doigt

vendredi 31 octobre 2008 à 16 h 37

Le régime alimentaire dans les pays occidentaux serait-il directement lié à l'apparition de l'alzheimer?

Des chercheurs de l'Université Laval affirment que les principaux marqueurs neurologiques de cette maladie neurodégénérative sont accentués dans le cerveau de souris génétiquement prédisposées, lorsque leur alimentation est riche en gras animal et pauvre en acides gras oméga-3.

Leurs travaux

Une lignée de souris transgéniques qui manifestent deux symptômes observés chez les personnes qui souffrent d'alzheimer a été utilisée dans cette expérience.

Ces rongeurs produisent des protéines bêta-amyloïdes, associées à la formation des plaques séniles dans le cerveau des personnes atteintes d'alzheimer, et des protéines tau, qui altèrent les microtubules des neurones, produisant un enchevêtrement qui rend ces cellules non fonctionnelles.

Les chercheurs ont soumis ces souris et des souris normales à différents régimes alimentaires pendant neuf mois pour ensuite comparer leurs effets respectifs sur le cerveau des rongeurs.

Les souris dont l'alimentation était pauvre en oméga-3 et riche en gras affichaient des concentrations de protéines bêta-amyloïdes et de protéines tau respectivement 8,7 fois et 1,5 fois plus élevées que les souris du groupe témoin, dont la nourriture contenait sept fois moins de gras.

Le régime riche en gras a aussi provoqué une baisse de la protéine drébrine dans le cerveau, un autre phénomène associé à l'alzheimer.

Un faible apport en oméga-3 et surtout une forte proportion de calories consommées sous forme de graisses influencent l'évolution de ces trois marqueurs de l'alzheimer dans le cerveau des souris.

Les changements métaboliques induits par pareille alimentation affectent la réponse inflammatoire dans le cerveau, pensent les chercheurs. Cela expliquerait le lien qui existe entre la consommation de gras et l'alzheimer.

Les auteurs ne peuvent affirmer avec certitude que ce qu'ils ont observé chez les souris se produise aussi chez les humains, mais ils sont portés à croire qu'une alimentation contenant plus d'oméga-3 et moins de gras saturés préviendrait le développement de l'alzheimer, à tout le moins chez les gens qui ont des prédispositions génétiques à cette maladie.

Le détail de cette étude est publié dans la revue Neurobiology of Aging.

Amalgam + MS

MS is the disease that has most often come to our attention. It is a disease in which the immune system attacks the myelin, or insulation around nerves. Historically there are many references to suspicion between Amalgam and MS. From the biological standpoint mercury can attack myelin tissues and generate an autoimmune response. Mercury can also alter the 3-dimensional form of proteins that can lead to the inhibition of catalytic activity that may be necessary in nerve impulse transmission.
Mercury damages the protective abilities of the blood-brain barrier that select what can and cannot cross into the brain, thus indirectly allowing other harmful substances to enter nervous tissue. Published scientific articles by Arvidson describe how mercury can leave the filling, go through the pulp chamber onto the nerve that activates the teeth -- the trigeminal nerve -- and follow this nerve backward (retrograde transport) into the brain. A Swedish researcher, Nylander authored one of several papers describing the close correlation between the amount of mercury in the brain of cadavers and the number of amalgam fillings present.

From results of a survey on a radio show, it was noted that mercury is not the only dental material that can stimulate MS. When asked, "If you have come down with an incurable or non-responsive disease and had dental work done within 6 months before the onset, what was the dental procedure, and what was the disease, and how long was it in between. You will have 20 seconds to tell this information." Six lines were lit up continually for the next hour and a half. The winner? Multiple sclerosis diagnosed by MRI within 90 days after the placement of a root canal.

That was a surprise, but now that we have studied root canals more, it seems far more plausible. Toxins found on extracted root canal teeth have been noted to kill some of the body's most resistant enzymes at extremely minute dosages. This contributes damaged nerve impulse transmission and to a reduction of immune defense. If these chemicals touch cells and does not kill them, they do not look like self, and therefore can stimulate an autoimmune response.

In a system I call "new math", it is noted that if a toxicity of one kind is introduced to a biological system, it has X potential for damage. If another toxin of 1 X potential is added to it, the total is not one, not two, but may be 50 times more damaging than either one by itself. In the oral cavity, it is not unusual to find Amalgams with 5 metals that produce 16 corrosion products, a root canal tooth filled with more than 10 chemicals that also produce a whole new gamut of toxins, a crown made from 6 or more non-precious metals, together with a plastic composite filling containing up to 8 chemicals. 1+1+1= what, in a conglomerate like this?

Removal of amalgam, root canals, and other offending substances from the mouths of MS patients when done according to a certain protocol has produced remarkable results in hundreds of MS patients. Not only have their motor skills improved, but blood chemistries and even protein degradation in the cerebro spinal fluid have improved. Why have the ADA and MS society banned together to prevent this information from getting to the public?

La maladie de Lyme

	Qu’est-ce que la maladie de Lyme? La maladie de Lyme est-elle fréquente? Quels sont les signes avant-coureurs de la maladie de Lyme? Quelle est la cause de la maladie de Lyme Quelles précautions doivent être prises en vue de prévenir la maladie de Lyme? Que pouvez-vous faire si vous être atteint de la maladie de Lyme? Médicaments Conseils pour mieux vivre

Qu’est-ce que la maladie de Lyme?

• La maladie de Lyme est transmise par la morsure d’une tique infectée par un microbe. Une tique est un parasite qui suce le sang des mammifères.
• Le microbe pénètre dans l’organisme à l’endroit où la tique a mordu et est transporté vers différentes parties du corps par la circulation sanguine.
• Si elle n’est pas traitée, la maladie de Lyme peut s’attaquer aux articulations, au système nerveux, au cœur et à la peau. Elle cause de l’enflure et de la douleur. Ce phénomène s’appelle l’inflammation. L’inflammation peut entraîner d’autres problèmes.

La maladie de Lyme est une maladie inflammatoire qui est transmise par la morsure d’une tique infectée par une bactérie. Cette bactérie pénètre dans l’organisme à l’endroit où la tique a mordu, commence à se multiplier et à s’acheminer vers différentes parties du corps. Si elle n’est pas traitée, la maladie de Lyme peut causer une infection qui se manifeste sous diverses formes, en particulier, sous forme d’inflammation chronique touchant les articulations, le système nerveux, le cœur et la peau.

La maladie fut décrite pour la première fois en novembre 1975, lorsqu’on diagnostiqua une arthrite rhumatoïde juvénile chez 12 enfants d’Old Lyme, petite communauté rurale du Connecticut. Dans les régions avoisinantes, plusieurs autres personnes avaient alors également signalé la survenue d’une crise d’arthrite. Un système de surveillance de la maladie fut donc mis en œuvre et l’on découvrit que 51 personnes vivant dans une région géographique limitée avaient eu la même maladie, à la même époque de l’année. La plupart avaient subi des crises brèves caractérisées par de la douleur et de l’enflure au niveau de quelques-unes des grosses articulations; bon nombre avaient remarqué plusieurs semaines auparavant l’apparition de rougeurs inhabituelles sur la peau, s’étendant progressivement. Une personne se rappela avoir été mordue par une tique là où siégeaient les lésions cutanées. Des recherches permirent de découvrir que cette forme d’éruption cutanée était identique à une autre éruption bien connue en Europe mais reliée à la morsure de la tique du mouton.

La maladie de Lyme est-elle fréquente?

• On ne sait pas exactement combien de personnes au Canada sont atteintes de la maladie de Lyme.
• La maladie de Lyme touche tant les hommes que les femmes.
• Elle peut frapper à tout âge mais, en général, ce sont les jeunes de 11 à 14 ans ou les jeunes adultes qui sont atteints.
• Les personnes qui font des activités de plein air, comme la randonnée pédestre, la chasse et l’escalade, sont peut-être plus susceptibles d’être mordues par des tiques et auraient donc un risque plus élevé de contracter la maladie de Lyme.

La fréquence des nouveaux cas semble avoir augmenté au cours des dernières années, ce qui pourrait s’expliquer par le fait qu’on reconnaît plus facilement la maladie elle-même et ses symptômes. On ne sait pas exactement combien de personnes sont atteintes de la maladie de Lyme.

La maladie de Lyme est très répandue en Europe, en Union soviétique, en Chine, au Japon et en Australie. En Amérique du Nord, elle est plus fréquente dans les régions du nord-est et du centre-nord; jusqu’à présent, elle demeure rare sur la côte Ouest. Des cas de la maladie de Lyme ont été signalés dans presque tous les états et provinces de l’Amérique du Nord, mais la majorité se concentre dans quelques états et dans quelques provinces seulement. Au Canada, le plus grand nombre de cas confirmés a été enregistré en Ontario, mais aucun n’a été signalé à Terre-Neuve, à l’Île-du-Prince-Édouard, au Yukon et dans les Territoires du Nord-Ouest.

On croit également que la popularité croissante des activités de plein air, dont la randonnée pédestre, la chasse et l’escalade, peut accroître l’incidence de la maladie parce qu’elles se font souvent dans l’habitat naturel du chevreuil. La tique qui transmet la maladie de Lyme est un parasite de cet animal qui la transmet de région en région.

On a signalé des cas de maladie de Lyme chez des personnes de tous les âges, mais sa fréquence atteint son maximum entre l’âge de 11 et de 14 ans ou chez les jeunes adultes.

Le plus souvent, la maladie de Lyme se manifeste pendant l’été. Dans les régions où l’hiver est plus doux, le caractère saisonnier de la maladie est moins marqué.

Quels sont les signes avant-coureurs de la maladie de Lyme?

• La maladie de Lyme comprend trois phases distinctes. Chacune se manifeste par des symptômes différents.
• La première phase se caractérise par l’apparition d’une éruption cutanée au site de la morsure. La région affectée peut être chaude au toucher, mais elle n’est pas douloureuse. Avec le temps, l’éruption prend de l’ampleur. Il peut s’écouler quelques jours ou quelques semaines entre le moment de la morsure de tique et l’apparition de l’éruption cutanée.
• 30 % des personnes atteintes de la maladie de Lyme n’ont pas cette éruption cutanée.
• Fatigue, maux de tête, fièvre, frissons, douleurs articulaires et musculaires, boutons ou éruption cutanée se manifestent souvent durant la phase secondaire.
• Au cours de la troisième phase, la maladie de Lyme atteint parfois d’autres parties du corps, telles que le cœur et le système nerveux.

Phase primaire localisée

On appelle phase primaire localisée, la période au cours de laquelle la maladie de Lyme fait son apparition. Si vous avez contracté la maladie de Lyme, vous aurez peut-être une éruption cutanée au site de la morsure. Dans la plupart des cas, la morsure siège à l’aine, sur les fesses, derrière le genou ou dans l’aisselle. Le délai entre la morsure de la tique et l’apparition d’une éruption cutanée varie de quelques jours à un mois. L’éruption est d’habitude de forme arrondie, son centre est blanc et son pourtour rougeâtre et la peau est parfois chaude au toucher. Cette lésion initiale de petite taille s’étend de jour en jour. D’habitude, elle n’est pas douloureuse. La plupart des gens ne se rendent pas compte qu’elles ont été mordues. Chez environ le tiers des personnes atteintes, ce stade passe tout à fait inaperçu.

Phase secondaire

Quelques jours après l’apparition des lésions cutanées, on observe fréquemment la manifestation de symptômes secondaires et de signes d’une infection plus étendue. C’est ce qu’on appelle la phase secondaire. Au cours de cette phase, vous ressentirez peut-être certains des signes suivants : sensation de malaise généralisé, fatigue, léthargie, maux de tête, fièvre et frissons. Vous aurez peut-être aussi des douleurs articulaires et musculaires, ainsi que des boutons ou une éruption cutanée à divers endroits du corps.

Phase tertiaire

Après la phase secondaire, environ 20 % des personnes atteintes bénéficient d’une rémission mais, dans la plupart des cas, la maladie évoluera vers la phase tertiaire. À ce stade, d’autres symptômes peuvent se manifester et toucher le cœur, le système nerveux et les articulations.

Moins de 10 % des personnes atteintes de la maladie de Lyme et qui ne reçoivent aucun traitement, souffriront d’une cardite (inflammation du cœur). Les premiers symptômes de la cardite sont des palpitations ou une perte de conscience inexpliquée. Cette affection peut disparaître spontanément mais, dans certains cas, elle doit faire l’objet d’un traitement médical.

Si l’inflammation causée par la maladie de Lyme s’attaque au système nerveux, certains signes, tels que maux de tête, irritabilité, sensibilité à la lumière vive et léthargie, pourraient se manifester dès le début. Environ 15 % des personnes atteintes de la maladie de Lyme risquent de souffrir de méningite (maladie qui se caractérise par des maux de tête et une raideur de la nuque) dans les semaines qui suivent l’éruption cutanée initiale.

D’autres symptômes révélant une atteinte du cerveau et des nerfs se manifestent parfois des mois, voire des années après le début de la maladie de Lyme. Par exemple, l’atteinte des nerfs des membres ou de la région de la tête se traduit par de la faiblesse musculaire, une paralysie ou une perte de sensations. La personne atteinte peut également souffrir de la paralysie de Bell, une affection qui se manifeste par une faiblesse ou une paralysie des muscles de la face. Si le cerveau est atteint, la mémoire à court terme et la capacité de concentration peuvent être diminuées. Ces troubles peuvent aussi s’accompagner de fatigue chronique, de maux de tête et de troubles du sommeil. Dans de rares cas, la maladie peut causer des convulsions et des lésions de la moelle épinière.

Le stade initial de la maladie de Lyme est souvent caractérisé par des crises intermittentes de douleurs musculaires et articulaires. Chez bon nombre de personnes, la douleur disparaît spontanément ou diminue avec le temps. Une arthrite chronique se constitue chez environ 20 % des personnes non traitées.

La plupart des personnes atteintes souffrent de brèves crises récidivantes d’arthrite touchant surtout les grosses articulations, comme celle du genou. Il est rare que plusieurs articulations soient atteintes. Les crises peuvent durer quelques jours ou quelques semaines. En général, les enfants sont moins gravement touchés. Malgré l’inflammation chronique, on observe rarement des lésions du cartilage et de l’os, comme c’est plus souvent le cas dans les autres formes d’arthrite.

Quelle est la cause de la maladie de Lyme

• La maladie de Lyme est causée par une tique infestée par un microbe. Ce microbe est une bactérie qui est transmise lorsque la tique mord la peau.

La maladie de Lyme est causée par une bactérie en forme de spirale (spirochète), appelée Borrelia burgdorferi. Cette bactérie est présente dans l’intestin de la tique, et est transmise par la peau au moment où la tique mord son hôte. Dans la plupart des cas, ces tiques sont transportées par le chevreuil et se nourrissent de son sang, mais elles peuvent aussi mordre d’autres mammifères.

Quelles précautions doivent être prises en vue de prévenir la maladie de Lyme?

• Portez des vêtements protecteurs de façon à ce que les tiques puissent difficilement atteindre votre peau. Parmi les types de vêtements appropriés, on compte le chandail à manches longues qui serre les poignets ainsi que les pantalons longs dont les extrémités sont enfilées dans des chaussettes ou des bottes.
  
• Les insectifuges contenant du DEET peuvent efficacement repousser les tiques, et il est possible d'en appliquer sur les vêtements ou directement sur la peau exposée. Suivez les instructions du fabricant. Le mode d’emploi varie selon l’âge.
  
• Vérifiez si des tiques se sont collées à vos vêtements ou accrochées à votre peau après avoir travaillé dans une région infestée par des tiques. L'inspection quotidienne de votre corps tout entier ainsi que l'extraction rapide des tiques accrochées (c.-à-d. dans un délai de 18 à 24 heures) peuvent réduire le risque d'infection.
  
• Extrayez prudemment les tiques accrochées à votre peau à l'aide de petites pinces. Saisissez la tête et le rostre de la tique le plus près possible de la peau et tirez doucement jusqu'à ce que la tique soit retirée de la peau. Ne la faites pas tourner ou pivoter et essayez de ne pas l'endommager (c.-à-d. l'écraser ou la couper) lors de l'extraction.
  
• Après avoir extrait la tique, nettoyez l'endroit où la tique s'est accrochée à votre peau avec du savon et de l'eau et désinfectez la zone au moyen d'alcool ou d'un désinfectant ménager.

Que pouvez-vous faire si vous être atteint de la maladie de Lyme?

• Si votre médecin croit que vous êtes atteint de la maladie de Lyme, il/elle procédera peut-être à un examen physique et demandera des analyses de laboratoire. Votre médecin cherchera des signes d’une éruption cutanée ou vous demandera si vous avez eu une éruption cutanée ou si vous avez été mordu par une tique.
• La plupart du temps, la maladie de Lyme peut être guérie, surtout si le traitement est instauré tôt.
• Le traitement vise à maîtriser l’inflammation et à tuer la bactérie qui a causé la maladie.
• Renseignez-vous le plus possible sur cette maladie. Adressez-vous à des personnes qui se spécialisent dans les soins aux arthritiques pour obtenir les renseignements dont vous avez besoin.

Dans la plupart des cas, la maladie de Lyme peut être guérie si elle est traitée rapidement par les mesures appropriées. Non traitée, elle risque d’évoluer et d’envahir d’autres parties du corps.

Il est très important de poser un diagnostic précis. Si votre médecin croit que vous êtes atteint de la maladie de Lyme, il/elle vous posera des questions au sujet des symptômes, des autres maladies dont vous souffrez; il vous demandera si vous avez récemment fait un voyage ou été malade et si vous avez eu des contacts avec des personnes malades. Il/elle procédera à un examen physique, cherchera des signes d’une éruption cutanée et vous fera passer des radiographies et d’autres tests afin de déterminer si l’infection et l’inflammation sont causées par un microbe.

La maladie de Lyme est souvent difficile à diagnostiquer en raison du caractère variable des symptômes et de l’évolution de la maladie. Il n’existe pas non plus d’épreuves diagnostiques spécifiques qu’on pourrait utiliser couramment pour la diagnostiquer.

Le traitement vise principalement à soulager la douleur et l’inflammation et à enrayer l’infection. Il est essentiel que vous preniez une part active au plan de traitement prescrit par votre médecin.

Médicaments

• En général, on a recours à des antibiotiques pour traiter l’infection bactérienne causée par la maladie de Lyme.

Si vous êtes atteint de la maladie de Lyme, votre médecin vous prescrira probablement des antibiotiques. La durée du traitement dépendra de vos symptômes. C’est au stade initial que la maladie de Lyme réagit le mieux au traitement antibiotique, et chez certaines personnes, elle continue de progresser malgré cette intervention thérapeutique précoce. Lorsque la maladie de Lyme évolue et envahit le cœur, ou le système nerveux, l’hospitalisation est souvent requise et le traitement repose alors le plus souvent sur l’administration d’antibiotiques par voie intraveineuse (sous forme de liquide injecté directement dans un vaisseau sanguin).

• L’acétaminophène est souvent utilisé pour soulager la douleur causée par la maladie de Lyme. Le TylenolMD est une forme bien connue d’acétaminophène. Il peut soulager la douleur, mais ne réduit pas l’inflammation.

Les médecins recommandent souvent l’acétaminophène (Tylenol®, Panadol®, Exdol®, etc.) pour soulager les douleurs modérées associées à la maladie de Lyme. L’acétaminophène est un anti-douleur, mais n’a aucune propriété anti-inflammatoire. Pour cette raison, on peut en général le prendre en toute sécurité avec la plupart des médicaments d’ordonnance. Cependant, la dose quotidienne d’acétaminophène qu’on peut prendre est limitée. Il faut donc user de prudence, surtout si vous prenez d’autres médicaments qui contiennent de l’acétaminophène (par exemple, les médicaments contre le rhume en contiennent). L’ingestion d’une dose excessive d’acétaminophène peut causer des dommages au foie.

• On a souvent recours à des anti-inflammatoires non stéroïdiens (AINS) pour soulager l’inflammation due à la maladie de Lyme. Les AINS sont une catégorie de médicaments qui aident à soulager l’enflure et la douleur articulaires et à atténuer la raideur.

À faible dose, les AINS soulagent la douleur et, à plus forte dose, ils soulagent l’inflammation. Les AINS, tels que l’AAS (Aspirine, Anacine, etc.) et l’ibuprofène (Motrin IB, Advil, etc.) sont disponibles en ventre libre. Par contre, certains AINS, tels que le Naprosyn, le Relafen, l’Indocid, le Voltaren, le Feldene et le Clinoril ne peuvent être vendus que sur ordonnance. L’effet anti-inflammatoire des AINS et de l’AspirineMD est sensiblement le même lorsqu’on prend la dose complète, mais le soulagement peut varier d’une personne à l’autre et d’un médicament à l’autre. Prendre plus d’un AINS à la fois accroît la possibilité d’effets secondaires, en particulier de maux d’estomac tels que brûlures d’estomac, ulcères et saignements. Les personnes qui prennent ces médicaments devraient songer à prendre aussi du misoprostol (Cytotec), un médicament pour protéger l’estomac.

Exercice

• Une fois que les symptômes de la maladie de Lyme sont maîtrisés, l’exercice peut contribuer à renforcer les articulations et les muscles.

Lorsque l’infection commence à disparaître, votre médecin vous prescrira peut-être des exercices pour renforcer les muscles. Des exercices d’amplitude de mouvement vous aideront à reprendre vos activités normales. Consultez toujours un médecin avant d’entreprendre un programme d’exercices.

Chaud/froid

• L’application de chaleur aide à relâcher les muscles endoloris et à soulager la douleur articulaire. Par exemple, prenez une douche chaude.
• L’application de froid aide à réduire la douleur et l’enflure. Par exemple, appliquez un sac de glace sur la région endolorie.

La chaleur et le froid peuvent soulager temporairement la douleur. L’application de chaleur soulage la douleur et la raideur en relaxant les muscles endoloris et en stimulant la circulation sanguine dans la région affectée. Selon certains, la chaleur risquerait d’exacerber les symptômes lorsque l’articulation est déjà enflammée. Par contre, le froid provoque un resserrement des vaisseaux sanguins et bloque l’influx nerveux dans l’articulation, ce qui a pour effet d’engourdir la région endolorie. L’application d’un sac de glace ou d’une compresse froide soulage l’inflammation et serait, par conséquent, la méthode de choix lorsque l’articulation est enflammée.

Protégez vos articulations

• Prenez soin de votre corps. Après des travaux exigeants ou après une tâche répétitive, faites une pause. Passez à une tâche plus facile ou accordez-vous une période de repos.
• Utilisez votre dos, vos bras et vos jambes de façon à éviter de forcer vos articulations. Par exemple, pour transporter des objets lourds, tenez-les contre vous.
• Utilisez des appareils utiles, tel qu’un chariot pour transporter vos sacs d’épicerie ou un dispositif que vous fixerez au manche des couteaux pour avoir une meilleure prise. En vous aidant d’un chariot pour marcher, vous courrez moins de risques. Une main courante fixée au mur de la douche vous permettra d’entrer et de sortir de la baignoire plus facilement.

Protéger vos articulations veut dire vous en servir de façon à éviter de les soumettre à un trop grand stress. L’un des avantages que vous en tirerez sera d’avoir moins de douleur et moins de difficulté à accomplir les tâches que vous entreprendrez. Il existe trois grands principes pour protéger vos articulations :

Faites alterner travaux légers et travaux exigeants ou répétitifs, afin de réduire le stress sur les articulations endolories et de donner aux muscles affaiblis une occasion de se reposer.

Utilisez efficacement vos articulations en adoptant une position correcte pour éviter les efforts inutiles. Utilisez les articulations les plus grandes et les plus fortes pour porter de lourdes charges. Par exemple, utilisez une bandoulière au lieu d’un sac à main. Évitez de garder la même position trop longtemps.

Utilisez des outils pratiques, comme les cannes, les chariots à bagages, les chariots à épicerie et les manches de rallonge, qui faciliteront l’exécution de vos tâches quotidiennes. Les petits appareils électroménagers, comme le four à micro-ondes, le robot culinaire ou le robot boulanger, vous seront utiles dans la cuisine. Dans la salle de bains, une main courante et un siège de toilette surélevé vous permettront d’économiser votre énergie et d’éviter les chutes.

Relaxation

• Relaxer les muscles entourant l’articulation enflammée soulage la douleur.
• Il y a plusieurs façons de se détendre. Essayez des exercices de respiration. Écoutez de la musique ou des cassettes de relaxation. Méditez ou priez. Une autre façon de se détendre est de s’imaginer en train de faire une activité agréable comme être étendu sur une plage ou assis devant un feu de foyer.
  

L’apprentissage de stratégies de relaxation et d’adaptation est un moyen de mieux maîtriser votre arthrite et de voir les choses sous un jour plus positif.

LSD May Shed Hippie Image With Swiss Medical Study

By Dermot Doherty

May 1 (Bloomberg) -- Four decades after the Grateful Dead and Timothy Leary made acid trips a counter-cultural rite of passage, Rick Doblin is trying to shake the drug's hippie image and reclaim its use as a medicine.

Doblin, who leads a group sponsoring the first study of LSD as a therapy in 36 years, says the new Swiss research may show the drug helps ease anxiety and pain in patients suffering from illnesses such as cancer and multiple sclerosis.

The research is a homecoming for LSD, which was created in 1938 by Swiss chemist Albert Hofmann, who died this week at the age of 102. The hallucinogen was banned in the 1960s, and detractors say Harvard psychology professor Leary's advice that people use LSD to ``turn on, tune in, drop out'' clashes with modern psychiatry. Doblin says lingering stereotypes stand in the way of tests that may show therapeutic uses.

``LSD is not a drug for the counter-culture,'' said Doblin, president of the Ben Lomond, California-based Multidisciplinary Association for Psychedelic Studies. ``We're trying to take it out of politics and bring it back into mainstream science.''

Doblin's group focuses on developing beneficial uses of psychedelic drugs and marijuana. In addition to psychotherapeutic and physiological research, such uses may include ``spiritual exploration, creativity research, shamanic healing,'' according to the association's Web site.

Approval for the Swiss study, led by Peter Gasser, a psychiatrist in the canton of Solothurn, followed more than two years of deliberations, including reviews by the country's ethics body and medical regulators, said Marta Kunz, a spokeswoman for the Federal Office of Public Health.

Political Opposition

The Swiss People's Party, which has criticized health office policies such as providing drug addicts with heroin on prescription, is looking for ways to block the study, spokesman Alain Hauert said in an e-mail.

``If international experts come to the conclusion that LSD can be seen as a medication, we would have another look at the situation,'' said Hauert, whose party is the largest in Switzerland. ``But for the moment our position is still a conservative one and doesn't allow such experiments.''

LSD can cause side effects ranging from sleeplessness to hallucinations. Users may also develop long-lasting psychoses or report flashbacks days or months after taking the drug, according to the U.S. Drug Enforcement Administration.

In the U.S., the drug is illegal, and suppliers and users can do jail time. In 2003, a California man was sentenced to life imprisonment and a colleague got 30 years for making and distributing more than 10 grams of LSD.

12 Patients

In the Swiss study, 8 of 12 patients will be given 200 micrograms of LSD and four will receive a 20-microgram dose. The drug will be given during two psychotherapy sessions two to four weeks apart. Patients will get six to eight more psychotherapy sessions without LSD during the trials, which will last about 18 months. Researchers will assess the patients' anxiety and pain levels as well as their quality of life.

``For some patients who are under the supervision of trained psychotherapists, LSD can be helpful,'' Doblin said. ``We're not trying to say that kids can do LSD at parties.''

Parties are exactly what Carolyn Garcia, the ex-wife of the Grateful Dead's late frontman, Jerry Garcia, associates with LSD. She joined author Ken Kesey, who discovered LSD during U.S. government-sponsored studies, for ``acid tests'' that culminated in the 1966 Trips Festival in San Francisco.

``Howling chaos and jubilant participation ruled for three nights that changed the perception of what life could be for all who were there,'' Garcia, also known as ``Mountain Girl,'' said March 21 at the World Psychedelic Forum in Basel, where she appeared on a panel with Doblin.

`Real World'

Detachment from reality isn't a good way to address illness, said Ken Checinski, a fellow of the U.K.'s Royal College of Psychiatrists. New antidepressants and psychological techniques make LSD irrelevant to modern medicine, while the potential side effects and findings of previous studies don't justify renewed research, he said.

``Sometimes if patients take drugs such as LSD, they perceive benefit, maybe because they become detached from reality, but we all have to come back and live in the real world,'' Checinski said.

Supporters of the study say opponents have placed them in a Catch-22 by blocking research into beneficial uses of LSD because there's no evidence of its benefits.

Other such drugs are starting to make a comeback in research. Scientists at the University of California, Los Angeles, are testing psilocybin, the active ingredient in so- called magic mushrooms, to treat anxiety in patients with advanced cancer. MDMA, also known as ecstasy, is being studied in countries including the U.S., Switzerland and Israel in patients with post-traumatic stress disorder.

Roots in Medicine

``LSD fell out of favor for social and political reasons and because so many people took it illegally, but these psychedelic substances started their life in medicine,'' said Ben Sessa, a member of the Royal College of Psychiatrists.

Early tests may not have shown potential benefits because of the ``variable quality'' of many of those studies, Sessa said. He argues the results nonetheless merit further investigation.

``The research that was started in the 1950s was never finished, so we need to look again at LSD without prejudice and purely as scientists,'' Sessa said. ``We need to adopt a dispassionate and evidence-based approach. There's no room for Timothy Learys.''

To contact the reporter on this story: Dermot Doherty in Geneva at Ddoherty9@bloomberg.net
Last Updated: May 1, 2008 05:12 EDT

Lyme Disease: The Unknown Epidemic

by D. J. Fletcher and Tom Klaber Millions of people who are diagnosed with multiple sclerosis, fibromyalgia, Alzheimer's, chronic fatigue syndrome and other degenerative diseases could have Lyme Disease causing or contributing to their condition. Forget just about everything you think you know about Lyme disease. It is not a rare disease, it is epidemic. It is not just tick-borne; it can also be transmitted by other insects, including fleas, mosquitoes and mites -- and by human-to-human contact. Neither is Lyme usually indicated by a bull's-eye rash; this is found in only a minority of cases. And, except when it is diagnosed at a very early stage, Lyme is rarely cured by a simple course of antibiotics. Finally, Lyme is not just a disease that makes you "tired and achy" -- it can utterly destroy a person's life and ultimately be fatal. Lyme disease, in fact, might be the most insidious -- and least understood -- infectious disease of our day. "If it weren't for AIDS," says Nick Harris, Ph.D., President of IgeneX, Inc., a research and testing laboratory in Palo Alto, California, "Lyme would be the number one infectious disease in the United States and Western Europe." Lyme disease was first recognized in the United States in 1975, after a mysterious outbreak of arthritis near Lyme, Connecticut. It wasn't until 1982 that the spirochete that causes Lyme was identified. It was subsequently named Borrelia burgdorferi (Bb), in honor of Willy Burgdorfer, Ph.D., a pioneer researcher. Many now see the disease, also called Lyme borreliosis, as more than a simple infection, but rather as a complex illness that can consist of other co-infections, especially of the parasitic pathogens Babesia and Ehrlichia. Animal studies have shown that in less than a week after being infected, the Lyme spirochete can be deeply embedded inside tendons, muscles, tissue, the heart and the brain. "Of the more than 5,000 children I've treated, 240 have been born with the disease," says Dr. Jones, who specializes in Pediatric and Adolescent Medicine. "Twelve children who've been breast-fed have subsequently developed Lyme. Bb can be transmitted transplacentally, even with in vitro fertilization; I've seen eight children infected in this way. People from Asia who come to me with the classic Lyme rash have been infected by fleas and gnats." Gregory Bach, D.O., presented a study on transmission via semen at the American Psychiatric Association meeting in November, 2000. He confirmed Bb DNA in semen using the PCR test (Polymerase Chain Reaction). Dr. Bach calls Bb "a brother" to the syphilis spirochete because of their genetic similarities. For that reason, when he treats a Lyme patient in a relationship, he often treats the spouse; otherwise, he says, they can just pass the Bb back and forth, reinfecting each other. Dr. Tang adds other avenues of infection: "Transmission may also occur via blood transfusion and through the bite of mosquitoes or other insects." Dr. Cowden contends that unpasteurized goat or cow milk can infect a person with Bb. Unreliable Testing What is the reason for the discrepancy between the government's statistics and the experience of front-line physicians? Says Dr. Jones, "The CDC criteria was developed only for surveillance; it was never meant for diagnosis. Lyme is a clinical diagnosis. The test evidence may be used to support a clinical diagnosis, but it doesn't prove one has Lyme. About 50% of patients I've seen have been seronegative [blood test negative] for Lyme but meet all the clinical criteria." Most of the standard tests used to detect Lyme are notoriously unreliable. Explains Dr. Harris, "The initial thing patients usually get is a Western Blot antibody test. This test is not positive immediately after Bb exposure, and only 60% or 70% of people ever show antibodies to Bb." Dr. Cowden favors two tests developed respectively by Dr. Whitaker and by Lida Mattman, Ph.D., Director of the Nelson Medical Research Institute in Warren, Michigan. However, both of these tests have yet to win FDA approval for diagnostic use. Explains Dr. Whitaker, "We have developed the Rapid Identification of Bb (RIBb) test. A highly purified fluorescent antibody stain specific for Bb is used to detect the organism. This test provides results in 20 to 30 minutes, a key to getting the right treatment started quickly." Dr. Mattman's culture test also uses a fluorescent antibody staining technique which allows her to study live cultures under a fluorescent microscope. "When a person is sick," says Dr. Mattman, "antibodies get tied up in the tissues, in what is called an immune complex, and are not detected in the patient's blood plasma. So it's not that the antibody isn't there or hasn't been produced; it just isn't detectable. Thus, the tests which are based on detecting antibodies give false negatives." The tests of Drs. Whitaker and Mattman do not look for antibodies but look for the organism, in the same way that tuberculosis is diagnosed. When Dr. Jones treats a Lyme patient who's in a relationship, he often treats the spouse as well; otherwise, he says, they can just pass the Bb back and forth, reinfecting each other. There are several reasons why Lyme is so difficult to test for -- and difficult to treat. Take, for instance, the bull's-eye rash -- called Erythma migrans -- that is supposed to appear after being bitten by a tick carrying the Lyme spirochete. Every doctor with whom the authors spoke said that this rash appears in only 30% to 40% of infected people. Dr. Jones said that fewer than 10% of the infected children he sees exhibit the rash. A Master Of Elusiveness More importantly, Lyme can disseminate throughout the body remarkably rapidly. In its classic spirochete form, the bacteria can contract like a large muscle and twist to propel itself forward: because of this spring-like action it can actually swim better in tissue than in blood. It can travel through blood vessel walls and through connective tissue. Animal studies have shown that in less than a week after being infected, the Lyme spirochete can be deeply embedded inside tendons, muscle, the heart and the brain. It invades tissue, replicates and destroys its host cell as it emerges. Sometimes the cell wall collapses around the bacterium, forming a cloaking device, allowing it to evade detection by many tests and by the body's immune system. The Lyme spirochete (Bb) is pleomorphic, meaning that it can radically change form. The photo on the left shows a colony of Bb both in spirochete and round cell wall deficient (CWD) forms. In the CWD form, the Lyme organism can lack the membrane information necessary for the immune system and antibiotics to recognize and attack it. Dr. Lida Mattman states that cell wall deficient organisms are more properly called cell wall divergent. The Lyme spirochete can not only change from the classic spiral into a round form, but can change back again into a spiral. The middle photo shows this process occurring in the area shown by the arrow. But the main reason that Lyme is so resistant to detection and therapy is that it can radically change form -- it is pleomorphic. Explains Dr. Whitaker, "We have examined blood samples from over 800 patients with clinically diagnosed Lyme disease with the RiBb test and have rarely seen Bb in anything but a cell wall deficient (CWD) form. The problem is that a CWD organism doesn't have a fixed exterior membrane presenting information -- a target -- that would allow our immune systems or drugs to attack it, or allow most current tests to detect it." As a CWD organism, says Dr. Mattman, Bb is extremely diverse in its appearance, its activity and its vulnerability. Adds Dr. Cowden, "Because Bb is very pleomorphic, you can't expect any one antibiotic to be effective. Also, bacteria share genetic material with one another, so the offspring of the next bug can have a new genetic sequence that can resist the antibiotic." Clinical Diagnosis The doctors the authors interviewed all had their own testing preferences, but each insisted that Lyme was a clinical diagnosis, only supported by testing -- and retesting. "We look at the patient's history and symptoms, genetic tendencies, metabolism, past immune function problems or infection," explains Dr. Bock, "as well as history and duration of antibiotic treatment, co-infection, nutritional and micronutritional status and also psychospiritual factors." Dr. Tang uses all of the above, but also analyzes the blood using darkfield microscopy -- although she cautions that not spotting the spirochete doesn't mean that the patient does not have Lyme disease. Dr. Cowden also employs muscle testing and electrodermal screening. Dr. Burrascano has developed a weighted list of diagnostic criteria and an exhaustive symptom checklist. "In pediatric screening especially," says Dr. Jones, "we ask about sudden, sometimes subtle, changes in behavior or cognitive function -- such as losing skills or losing the ability to learn new material; not wanting to play or go outside; running a fever; being sensitive to light or noise. If one has joint phenomena, we know that an inflammatory or infectious process is present. A hallmark of Lyme is fatigue unrelieved by rest." For women, Dr. Barkley has found that testing around the time of menses increases the probability of discovering the presence of Bb. "Women with Lyme have an exacerbation of their symptoms around menses," she explains. "The decline of both estrogen and progesterone at the end of the menstrual cycle is associated with the worsening of the patient's Lyme symptoms." Government Persecution Of Lyme Disease Doctors Physicians who treat Lyme disease in ways other than the established standard of care -- which means a course of antibiotics lasting no more than 30 days -- risk invasive, exhausting, time-consuming investigation by state licensing agencies, leading to possible loss of their right to practice medicine. Activists report that 50 physicians in Texas, New York, Oregon, Rhode Island, New Jersey, Connecticut and Michigan have been investigated, disciplined and/or stripped of their licenses over the past three years because of their approach to healing Lyme disease. This past November 9th, 500 patients who got well after their doctors used alternative or complementary methods joined in a protest rally in New York City. They rose to defend Dr. Joseph Burrascano, who has treated an estimated 7,000 cases. As this story was heading for publication, New York's Office of Professional Medical Misconduct was engaged in what activists call an unjustified fishing expedition that will probably last for months and will allow state bureaucrats to hunt for any irregularity that could be used to damage Dr. Burrascano. State medical boards seem to be trying to protect the medical insurance industry rather than patients. In most cases, effective alternative/complementary treatments require much more doctor time per patient and often include a broad range of medicines and supplements consumed over a much longer period of time, costing much more money than the current standard of care accepted by medical insurers. But at the rally, patients angrily rejected the medical board's suggestion that their cases demonstrated anything negative about their physician. In fact, they all insisted, it was Dr. Burrascano whose knowledge, patience and care finally freed them from the pain and debilitation that had been ruining the quality of their lives. Antibiotic Treatment Every authority the authors spoke with considered antibiotics the primary treatment for Lyme, but that the accepted "standard" antibiotic therapies (of a duration and type acceptable to insurance carriers, HMOs, mainstream physicians, etc.) are insufficient. Lyme is sometimes classified as having different stages -- early vs. chronic, or localized vs. disseminated. "The biggest distinction is between early-stage and chronic," says Dr. Whitaker. "In the beginning, many organ systems are invaded while the patient may experience no symptoms. As time goes on we see multiple system symptoms involving the whole body, especially the central and peripheral nervous systems, and the musculoskeletal, skin and circulatory systems. Many Lyme cases are diagnosed by psychiatrists. Dr. Brian Fallon is studying cognitive and other neuropsychiatric manifestations." The problem, says Dr. Barkley, is that "There isn't an adequate treatment model. So if the physician says you have Lyme, and gives you the standard antibiotic therapy, and you aren't better, the thinking is that you must have something else wrong, such as an autoimmune problem, or else you didn't have Lyme disease in the first place. Short-term oral antibiotics are effective in treating localized Lyme, but with disseminated Lyme, the requirement for either intravenously administered antibiotics or long-term oral antibiotics becomes common." In his regular practice, Dr. Bock has always tried to avoid antibiotics. But, he says, "If you go back to syphilis, the history of spirochetes is one of being able to hide out and then reappear, causing severe, devastating neurological illness. This isn't a risk I would recommend taking with Bb." Most of the physicians recommended an immediate short course of antibiotics for anyone bitten by a deer tick, or who exhibits certain symptoms. "It takes a while for the immune system to produce antibodies," says Dr. Barkley. "So Lyme testing -- other than by a skin biopsy from an active rash within 14 days following the bite -- may yield inconclusive results. Symptoms of Lyme include fever, night sweats, fatigue or a flu-like illness that does not improve within three to five days." Other symptoms reported by physicians include stiff neck, prolonged joint and muscle pain, heart palpitations, brain fog or severe headaches. "I tally all the initial symptoms and signs, and try to weed them out one by one," says Dr. Jones. However, he cautions, "Treatment duration varies with each individual. If one stops antibiotics prematurely, a more resilient Bb infection will develop that will cause more brain and body injury." Adjunct Therapies None of these physicians relied solely on antibiotics; they used immune system-strengthening protocols as well. "The immune system may be less able to respond if the person is having a hard time clearing toxins," says Dr. Bock. "You're going to add to this overload by taking antibiotics. For general immune support, we've used maitake and reishi mushrooms, ginseng and astragalus. "Natural medicine approaches include anti-inflammatory eicosanoids such as fish oil and borage seed oil; high-potency multivitamin and mineral formulas; CoQ10 and other mitochondrial nutrients; cognitive enhancement substances such as carnitine and certain herbal extracts. Acupuncture combined with physical therapy can often reduce pain. I have posted an article online that discusses these alternative approaches in more depth. Dr. Cowden recited a litany of natural immunotherapy agents. His recommendations include the following: "Transfer factor -- ImmuneFactor 2 and CellResponse are good products; Thymic Protein A; medicinal mushroom combinations such as ImmPower AHCC; glyconutrients like Ambrotose; arabinogalactan (Larix), an immune-enhancing polysaccharide; and Astragalus Supreme." Dr. Cowden also notes that "if you use a pharmaceutical antibiotic, you need to use an herbal antifungal to reduce stress on the liver and kidneys." Lifestyle Changes "Avoid sugars because they feed these bugs," advises Dr. Cowden. "It is most important to balance saliva pH between 6.7 and 7.0. Sufficient dietary minerals bring pH up if low. Reducing stress will raise pH; so will identifying and removing food, nutrient and inhalant allergies. You should identify your metabolic type and then follow the appropriate diet. Grapefruit seed extract and certain other substances, including vitamin C, can interfere with tissue uptake of the antibiotics and make them less effective. Take as few non-essential supplements as possible -- consult with a physician knowledgeable about nutrition -- and time them as far from the antibiotic as possible." Dr. Bock reminds us that, "It's also important to support the endocrine system. In some cases, cognitive abilities improved when subclinical hypothyroid problems were treated. Chronic stress can cause suppression of the immune system. Manage the effects of stress on the body Use relaxation techniques and biofeedback. Find a group for emotional support." In his practice, Dr. Jones has found that, "Taking acidophilus and other probiotics is always important. [Antibiotics kill the intestinal flora necessary for digestion and immune functions; probiotics like lactobacillus re-inoculate the intestines.] Stay away from or severely limit alcohol intake. Develop a healthier standard of living. Rest is needed. We've found that a parent who has a child with Lyme is often feeling guilty. One has to work with these difficult feelings. I emphasize that it's not a parent's fault; you can't protect your child from Lyme exposure." Present Limitations None of the experts the authors consulted claimed to completely understand Lyme or to be able to completely cure it in every case. Some people infected with Bb may never manifest the symptoms of Lyme. Others become seriously ill soon after they are infected. Treatment must be customized from patient to patient and can vary widely. "Certain people may clear Lyme without antibiotic therapy," says Dr. Barkley. "However, the other extreme is that even with antibiotics, some people with Lyme have died from this disease." Says Dr. Jones, "We have seen children from one day old to 18 years of age who have required from three months to six years of antibiotic therapy. We have had some patients on antibiotic therapy for very long periods, and we've done follow-ups for as long as 15 years post-treatment. The criterion for stopping therapy is that one must be totally Lyme disease-symptom free for two months, with no Lyme flare induced by another infection or menses and no 'Herx' [Jarisch-Herxheimer reaction of the body manifesting symptoms in response to dying Bb]." "There are very few symptoms where you shouldn't consider Lyme," says Dr. Cowden. "more than 50% of chronically ill people may have Lyme contributing to their condition." The situation is quite difficult now. "It's sad where we are with this disease," says Dr. Cowden. "You're supposed to go through the 'standard' treatment first before turning to alternative treatments. We need to turn this around, into a logical, integrated approach." The impetus for this change must come not only from the patients who have been classically infected by a tick bite, but by those who suffer from "unexplained" muscle and joint pain, unrelieved fatigue and cognitive impairment -- and by those who are afflicted with degenerative diseases that can be caused or aggravated by Lyme. Presently, such patients will find few doctors experienced in Lyme, because of the newness of the disease and lack of understanding about it -- and because those doctors who take a comprehensive approach to diagnosing and treating Lyme are commonly harassed by state medical boards, insurance companies and HMOs. It is up to patients to actually educate their doctors about the inadequacy of standard testing and the necessity for using techniques such as electrodermal screening and darkfield microscopy. And it is up to patients to become politically involved with Lyme advocacy groups, such as those listed here, to fight for their right to proper medical care. The earlier Lyme is diagnosed, the easier it is to cure. For people with chronic Lyme symptoms, the road to recovery can be long. With comprehensive integrative treatment, however -- a combination of the best of conventional and alternative medicine protocols -- their health can be continually and dramatically improved. Alternative Medicine.com Issue 41 Dr. Mercola's Comments: I just recently learned that Dr. Whitaker, who is one of the top Lyme experts in the country, has been doing a precursor of NST work, Bowen, for nearly ten years. She actually went to Australia to learn it. It is her belief that NST is one of the more important aspects of a successful treatment strategy for Lyme Disease. The apparent mechanism is a balancing of the autonomic nervous system and secondary improvement in the immune system. This certainly has been my experience with rheumatoid arthritis. Dr. Klinghardt, who was not interviewed for this article, also has a considerable amount of clinical experience with Lyme Disease and has found bee venom therapy to be helpful. There is a link to the protocol below. If you haven't clicked on the original link back to Alternative Medicine.com please do as they have some excellent Live Cell Darkfield microscopy pictures of the Lyme disease bacteria