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Volume: 1
Issue: 27
Date: 17-Dec-93

Table of Contents:

ABSTRACT: (Neuroreport) Alzheimer's Disease -- a Spirochetosis?
COMMENTARY: "Alzheimer's Disease -- a Spirochetosis?" By Carl Brenner
ABSTRACT: (Proc Natl Acad Sci) Borrelia Burgdorferi is Clonal:
          Implications for Taxonomy and Vaccine Development
NEW YORK TIMES: More Animals Are Said To Carry Lyme Disease
OP-ED: Ivy League Ticks versus Redneck Ticks, By Karen Angotti


*                  Lyme Disease Electronic Mail Network                     *
*                          LymeNet Newsletter                               *
                     Volume 1 - Number 27 - 12/17/93

I.   Introduction
II.  News from the Wires
III. Op-Ed Section -- The Lighter Side
IV.  Jargon Index
V.   How to Subscribe, Contribute and Get Back Issues

I. ***** INTRODUCTION *****

Well, we made it.  The Newsletter's first volume is now complete.

By all measures, our first year has been a huge success.  In just 12 months,
we established this publication and an international network of thousands of
participants with a common goal: to find a solution to the Lyme disease

In the process, we started building The National LymeNet, an even more
ambitious project that will link physicians, researchers and support group
leaders across the country via a computer network.  In the next few months
we will begin the final implementation phase of this project -- the testing
period.  We will provide you information on accessing the system as soon
as it becomes available.

Effective January 1, 1994, the LymeNet FAX number will be: 908-789-0028.
Please update your files to reflect this change.

Volume 2 of the LymeNet Newsletter is scheduled to begin publication in late
January.  Enjoy the Holiday season!  

This issue of the Newsletter contains:
 * An amazing abstract on the correlation between Alzheimer's disease and LD
 * A commentary on this paper by Contributing Editor Carl Brenner
 * An abstract that questions the potential effectiveness of the ospA
   vaccines currently in development
 * Part of a New York Times article discussing the increase in animal
   reservoirs for Bb
 * A humorous commentary by author Karen Angotti


II. ***** NEWS FROM THE WIRES ******

TITLE: Alzheimer's disease -- a spirochetosis?
AUTHORS: Miklossy J
ORGANIZATION: Division of Neuropathology, University of Lausanne, Switzerland.
REFERENCE: Neuroreport 1993 Jul; 4 (7): 841-8

The aetiology of Alzheimer's disease (AD), which affects a large
proportion of the aged population is unknown and the treatment unresolved.
The role of beta amyloid protein (beta A4), derived from a larger amyloid
precursor protein (APP) in AD is the subject of intense research.  Here I
report observations that in 14 autopsy cases with histopathologically
confirmed AD, spirochetes were found in blood and cerebrospinal fluid and,
moreover, could be isolated from brain tissue.  Thirteen age-matched
control cases were without  spirochetes.  Reference strains of spirochetes
and those isolated from brains of AD patients, showed positive
immunoreaction with monoclonal antibody against the beta amyloid precursor
protein.  These observations suggest that spirochetes may be one of the
causes of AD and that they may be the source of the beta amyloid deposited
in the AD brain.


By Carl Brenner
LymeNet Newsletter Contributing Editor

This paper, if subsequently validated, would be one of the most significant
-- and surprising -- publications in 20th century medicine.  Judit Miklossy,
a neuropathologist at the University of Lausanne, claims that she was able to
isolate spirochetes from the tissues and fluids of 14 patients with
Alzheimer's.  Thirteen control cases were negative for spirochetes.

The cause of Alzheimer's disease has eluded researchers since the disorder was
first described around the turn of the century.  An association with beta
amyloid protein is well documented, but the source of the amyloid protein
deposits has never been discovered.  In this study, Miklossy found both T.
pallidum and B. burgdorferi, as well as the spirochetes she cultivated from
the brain tissue of some Alzheimer's patients used in her study, showed
positive immunoreaction using monoclonal antibody against amyloid precursor
protein (APP).  According to Miklossy, this suggests "that APP may be an
integral part of the infectious agent and thus may be the source of the
excess Beta-amyloid-4 deposited in the AD brain."

Miklossy successfully cultured spirochetes from the cerebral cortexes of three
out of four AD cases and from the blood of four of five AD cases.  In
addition, she was able to observe spirochetes (via darkfield microscopy) in
the blood and cerebrospinal fluid of all 14 AD cases.  No spirochetes were
observed, nor were any successful cultures obtained, from the control cases.

Apparently, no attempt was made by the author to identify the species of the
spirochetes via protein sequencing, but the dimensions of the organisms
(8 to 30 micrometers long and .2 to .3 micrometers wide) are morphologically
suggestive of B. burgdorferi.  (B. burgdorferi is the longest and narrowest
of the borreliae, and borreliae in general are longer and more loosely coiled
than either treponemae or leptospirae).  Moreover, this would not be the
first time that cases of AD and neuroborreliosis have been alleged to occur
concurrently; two previous publications by Alan MacDonald exist on this
subject.  These papers, however, were greeted with considerable skepticism
by a significant percentage of both the Lyme and Alzheimer's research
communities.  A subsequent study found no association between the two
diseases [1].  Thus, Miklossy's findings reopen what had appeared to be a
closed issue and represent a major departure from the current thrust of
Alzheimer's research, which for the most part has rejected the idea of an

infectious etiology for the disorder.

It is difficult to discern which is more baffling: how the hundreds of
researchers investigating Alzheimer's disease could have missed the
connection to a spirochetosis if it in fact exists, or how Miklossy could
have obtained such striking results if it doesn't.  In a commentary published
in the same issue of NeuroReport, three Alzheimer's researchers from the
University of California at San Diego urge caution in evaluating Miklossy's
findings and declare their "respectful skeptic[ism]."  They point out,
correctly, that electron micrographs and photomicrographs of what appear to
be spirochetes can sometimes be misleading [2].  Still, even if the
"spirochetes" in the photos turn out to be artifacts, it would not explain
Miklossy's apparently successful attempts to culture the organisms from
patient tissues.  As the UCSD researchers point out, Miklossy's paper
"will raise the interest, if not the voices and blood pressure, of many in
the neuroscience community."  The anomalous findings will no doubt stimulate

further research into a possible relationship between neuroborreliosis and
Alzheimer's disease.

[1] Pappolla MA, Omar R, Saran B, et al. Concurrent neuroborreliosis and
Alzheimer's disease: analysis of the evidence.  Human Pathology

[2] For a discussion of this phenomenon, see Montenegro EN, Nicot WG, Smith
JK. Treponema-like forms and Artifacts.  Am J Opthalmol 1969;68:197-205.


TITLE: Borrelia burgdorferi is clonal: Implications for taxonomy and vaccine
AUTHORS: Dykhuizen DE, Polin DS, Dunn, JJ, Wilske B, Preac-Mursic V,
        Dattwyler RJ, Luft BJ
REFERENCE: Proc Natl Acad Sci USA, 90:10163-10167, November 1993

The chromosomal genes fla and p93 and the ospA gene from a linear plasmid
were sequenced from up to 15 isolates of Borrelia burgdorferi, which causes
Lyme borreliosis in man.  Comparison of the gene trees provides no evidence
for genetic exchange between chromosomal genes, suggesting B. burgdorferi is
strictly clonal.  Comparison of the chromosomal gene trees with that of the
plasmid-encoded ospA reveals that plasmid transfer between clones is rare.  
Evidence for intragenic recombination was found in only a single ospA allele.
The analysis reveals three common clones and a number of rare clones that are
so highly divergent that vaccines developed against one are unlikely to
provide immunity to organisms from others.  Consequently, an understanding
of the geographic and genetic variability of B. burgdorferi will prove
essential for the development of effective vaccines and programs for control.
While the major clones may be regarded as different species, the clonal
population structure, the geographic localization, and the widespread

incidence of Lyme disease suggests that B. burgdorferi should remain the
name for the entire array of organisms.


HEADLINE: More Animals Are Said To Carry Lyme Disease
SOURCE: The New York Times
DATE:  December 5, 1993, Sunday, Late Edition - Final
SECTION: Section 13CN; Page 4; Column 5; Connecticut Weekly Desk

STATE residents living near the coast and the mouth of the Connecticut River
still face a greater risk of getting Lyme disease than residents of more
northern or inland sections of Connecticut, health officials say.

But according to studies conducted by scientists at the Connecticut
Agricultural Experiment Station in New Haven, the tick-borne disease is well
established throughout the state, and there is no part of Connecticut where
there isn't some threat of getting the  disease.

"The disease is not only geographically spreading, it is also spreading
through the state's ecology, the chief of the experiment stations entomology
department, Dr. Louis A. Magnarelli, said. "There is evidence that more
animals serve as reservoirs of infection for the disease. "

Studies based on tick collections and the presence of natural antibodies to
the disease in the blood of deer show that Lyme disease is in all parts of
the state, Dr. Magnarelli said.

Increases in Litchfield County

The area of the state showing the greatest increase of infections is
Litchfield County, where there were very few reported cases of the disease
through the 1980's, he said.

Since the 1970's scientists have determined that white-footed mice are an
important reservoir of infection of the disease.  During the spring and
summer the tiny deer ticks, which are infected with the Lyme organism, a
spiral-shaped bacteria called Borrelia burgdorferi, feed extensively on the
mice. During the winter the bacteria survives mainly in the blood of the
infected hibernating mice.

When the juvenile deer ticks feed on the infected mice in spring and summer
they become infected with the bacteria and spread the disease to all
warm-blooded animals they feed on, including humans.

According to studies conducted by experiment station scientists in 1990 and
1991, local birds such as veeries, Carolina wrens, hooded warblers, and house
wrens not only spread the disease to new areas, they also could serve as an
important reservoir of infection, Dr. Magnarelli said.

Birds that feed on the ground are in turn fed upon by the deer ticks.  The
deer ticks will remain attached to the birds until they are engorged with the
bird's blood and then they will drop off the bird hundreds, possibly
thousands, of miles away. If the ticks are infected with the Lyme organism
Borrelia burgdorferi it could introduce the disease to a completely new area,
scientists said.

New studies indicate that the bacteria could persist in the blood of some
bird species from June to mid-August.  Uninfected ticks may become infected
with the bacteria after feeding on infected birds.

The studies indicate that birds are not only an important agent for spreading
the disease but could be an important part of the process in which the
disease becomes established and persists in an area, Dr. Magnarelli said.


Ivy League Ticks versus Redneck Ticks
By Karen Angotti
Author, "Lyme Disease: A Mother's Perspective"

When my husband went out to fetch the paper the other day, something happened
that confirmed some suspicions we had been forming for several years now.  He
glanced at the paper for about ten minutes, then ran upstairs to take a
shower.  Lo and behold, as he pulled off his sock, he found an embedded tick
happily suckling his blood from his calf.  Now, we immediately knew this was
no ordinary tick, for ordinary ticks do not bite people without wondering for
12 to 24 hours.  How do I know this?  All the research says so.  

So, after much reflection and noticing other differences, we determined that
here in Tennessee we do not have those Ivy League ticks they have up North.  
Ours must be the redneck variety without a fancy education.  Our redneck
ticks have not developed the gourmet appetites of the Ivy League varieties.
And, therefore, do not spend all that time sequestering for the choicest
cut.  They also seem to be sorely lacking in table manners because they do
not wash their hands, say their prayers, or unfold their napkin.  These
redneck ticks just say "Suppertime!" and chow down.

Another thing that managed to perplex us mightily was how we managed to
attract hitchhiking ticks while never leaving the pavement.  We would go
to get the mail and come back in with the mail *and* and unwelcome visitor.
Now, granted we do have to walk a third of a mile to get our mail, but,
according to the papers we have read, ticks are not supposed to be able
to exist in places that are hot and dry.  And as anyone who has ever
walked barefoot on black asphalt during the middle in the day in the summer
down here will tell you, asphalt is not just hot, it is scalding.  

So, not being scientists, but figuring we could surely solve thus mystery
anyway, we grabbed some magnifying glasses and started sleuthing.  Only to
find the spellbinding spectacle of our hardier, more adventuresome redneck
tick crawling out of a crack in the asphalt waving its greedy little arms
for a few minutes then scuttling back down the crack to cool off.  Those
puny Ivy League ticks -- well, maybe vitamins will help.

Ticks that fell from the sky were even more puzzling.  Our first thought
was -- wings.  But, no, anatomically they seemed to outward appearances
look like the Ivy League ticks.  However, we had already observed the
amazing feats that these incredible mongrel redneck ticks could accomplish.
So, positioning ourselves at the base of a tree with a magnifying glass
firmly in tow, we readied ourselves to see, if despite what the books say,
our ticks were climbing trees.  

After several fruitless hours, we were packing up our gear and heading home
when a frisky, grey squirrel darted up the tree.  No -- could it be?  
Well, squirrels are furry little mammals and our ticks were no dummies.  
Why climb up a tree when you can *ride* in style.  Our thinking expanded.  
We now noticed the birds fluttering around -- bluebirds, cardinals,
robins, mockingbirds, jays, purple martins, sorrows, crows, ducks,
geese, even egrets circled our house.  Our redneck ticks did not need to
grow wings!  They just climbed on board for the ride of their life.  The
Ivy League ticks?  They must not be made of the "right stuff."

And the moral of this little story is: If you believe everything the
"experts" tell you, you *will* be bitten by ticks.

IV. ***** JARGON INDEX *****

Bb - Borrelia burgdorferi - The scientific name for the LD bacterium.
CDC - Centers for Disease Control - Federal agency in charge of tracking
     diseases and programs to prevent them.
CNS - Central Nervous System.
ELISA - Enzyme-linked Immunosorbent Assays - Common antibody test
EM - Erythema Migrans - The name of the "bull's eye" rash that appears in
    ~60% of the patients early in the infection.
IFA - Indirect Fluorescent Antibody - Common antibody test.
LD - Common abbreviation for Lyme Disease.
NIH - National Institutes of Health - Federal agency that conducts medical
     research and issues grants to research interests.
PCR - Polymerase Chain Reaction - A new test that detects the DNA sequence
     of the microbe in question.  Currently being tested for use in
     detecting LD, TB, and AIDS.
Spirochete - The LD bacterium.  It's given this name due to it's spiral
Western Blot - A more precise antibody test.


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