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Breaking News
The national annual Lyme and Tick Borne Disease Conference sponsored by Columbia University and the Lyme Disease Association will be held in Boston on Friday, October 26, 2007. Treatment debate to be featured. Scientists from throughout the United States, as well as from Finland and Austria, will speak. Topics include:
Columbia University Magazine features comprehensive story on Controversies in Chronic Lyme Disease – "Rash Judgment". See columbia.edu/cu/alumni/Magazine/Summer2007/RashJudgment.html. The Columbia University Lyme and Tick Borne Diseases Research Center (LTBDRC) opened on April 30 2007 at the Medical Center, culminating years of fund-raising effort by Time for Lyme, Inc, the Lyme Disease Association, and many private donors. This is the first University based research center to address the debilitating symptoms that plague patients with chronic Lyme Disease, with the goals of focusing on the identification of better diagnostic tests, biomarkers of treatment response, and more effective and sustained treatments. While this Center is not a clinical facility that provides treatment to patients, it is a research facility that will conduct both diagnostic and treatment studies into which patients can enroll. A symposium to celebrate the opening was held on April 30 to a packed standing-room only crowd. The symposium included introductory comments by Dr. Jeffrey Lieberman (chair of Psychiatry), Dr. Lee Goldman (Executive Vice President for Biomedical Sciences and Dean of the Faculty of Health Sciences and Medicine at Columbia), Diane Blanchard and Debbie Siciliano (co-presidents of Time for Lyme, Inc), Patricia Smith (president of Lyme Disease Association), and actress Mary McDonnell (president of the Universe, Battlestar Gallatica). Scientific presentations were given by Dr. Brian Fallon (Director, LTBDRC), Dr. Ben Beard (Director, Vector Borne Diseases at CDC), Dr. Ian Lipkin (Director, Greene Infectious Disease Laboratory), Dr. Rafal Tokarz (Lyme Resaerch Fellow, Microbiologist), and Dr. James Moeller (Mathematician and Imaging Analyst). For more information about the Center and the controversies around Lyme Disease, see columbia.edu/cu/alumni/Magazine/Summer2007/RashJudgment.html. New Fellowship Program in Lyme Disease is launched. Through the generous efforts of Jennifer Weis Monsky and John Monsky and their family and friends and in gratitude to doctors who treat patients with persistent Lyme Disease (especially Dr. Kenneth Liegner), a new educational program has been launched. Starting in July 2006, we will train a newly graduated family medicine physician in the science and art of diagnosing and treating patients with Lyme and other tick-borne diseases. This Fellowship program was started because of the urgent need for physicians to be trained who can work with both adults and children with chronic Lyme disease. The decision to provide advanced training to a Family Medicine physician was based on our goals to identify an individual whose primary concern would be excellence in comprehensive patient care, whose concern was broadly multi-systemic, and whose training prepared the individual to work with both adults and children. In addition to this Fellow's multi-disciplinary post-residency education at Columbia, the Fellow will be helping us in the conduct of clinical research so that new research results can emerge from this very exciting fellowship. The Fellow will therefore develop an expertise in the critical reading of medical literature, a working knowledge of the conduct of clinical research, and an in depth knowledge of the complexities of this illness. Dr. Fallon is quoted as having said, "I wish I could do this Fellowship! This Program will be a terrific training opportunity and should help in the shaping of an outstanding new clinician for the Lyme disease patient community." In order to train more than one post-residency fellow and to make this program a more permanent training opportunity for others, we are seeking to raise $500,000 over the next 2 years. So far, we are half way toward that goal. Please check out donor opportunities if your circumstances allow you to support our efforts in that way.
Columbia University & Lyme Disease Association's 6th Annual Lyme Disease Conference scheduled for October 28, 2005 in Philadelphia. Save the date. Partial list of speakers include Dr. Sven Bergstrom (Sweden, Bb immune evasion), Dr. Gregory Storch (Washington University, St. Louis, Ehrlichiosis), Dr. Steven Norris (Texas, Virulence Determinants), Dr. Daniel Cameron (NY, Results of Placebo-controlled trial of repeated antibiotics for Chronic Lyme Disease), Dr. Martin Fried (NJ, Coinfection with Bartonella and other organisms), Dr. Ed Masters (MO, STARI: Southern Tick Associated Rash Illness), Dr. Susan Little ( OK, EM Lesions and the natural history of Borrelia and Ehrlichia in the Southern US), Dr. Richard Brown (NY, Complementary Medical Approaches to the treatment of Myalgia, Arthralgias, Fatigue, and Cognitive disorders). Check at www.lymediseaseassociation.org for updates and registration materials.
Columbia University Medical Center’s (CUMC) and NY State Psychiatric Institute’s Brian Fallon, MD, and International Lyme & Associated Diseases Society ( ILADS) Director Joseph Burrascano, MD, will participate in the "in conversation" event as the Literati tell the story of how Lyme affects their lives and impacts on their cognitive ability, giving a voice to thousands of Lyme disease victims who suffer in silence. The doctors will discuss the physiological causes of the authors’ often frustrating and sometimes alarming experiences with Lyme. Public question and answer period will follow. Books by participating authors will be on sale at the event with proceeds to the Lyme Disease Association.
To purchase tickets ($20) or get information for the May 19 event, please visit http://www.lymeliterat.org/ Further information about the authors can be found on http://www.LymeDiseaseAssociation.org NYU information http://library.nyu.edu/.
Literati with Lyme is the brain child of authors Jordan Fisher Smith and Amy Tan, and national Lyme Disease Association President Pat Smith. It is an effort by nationally-known authors, publishers, editors, literary agents, other publishing professionals, and the non-profit LDA to raise awareness of this growing infectious disease threat and to raise research funds for a cure. Literati with Lyme is supported by Columbia University Medical Center, Houghton Mifflin, Milkweed Editions, Penguin Group (USA) Inc., IGeneX Labs, the DEET Education Program, NYU Expository Writing and the School of Social Work, and a growing list of others. Donations to LDA’s Literati with Lyme are tax-deductible and will go to the LDA to support its public education and research efforts on causes and cures of Lyme disease, including the proposed Lyme disease research center at Columbia University Medical Center.
A limited number of tickets are still available for a private benefit reception for LDA hosted by Amy Tan at her Manhattan home. See Literati website for registration details.
Dr. Jim Miller of UCLA will discuss promising rabbit-model findings that may lead the way to a more effective vaccine. Dr. Paul Fawcett and Carlos Rose of Dupont Children’s Hospital will address the immune response in Lyme disease and mechanisms of symptom persistence. Dr. Ben Luft of Stony Brook will discuss the search for biomarkers for the full spectrum of Lyme Disease. Dr. Rich Marconi of the Medical College of Virginia will address new findings regarding mechanisms of immune evasion by Borrelia burgdorferi and Dr. Steve Norris of University of Texas will address determinants of virulence of Lyme disease borrelia. Dr. Chuck Pavia of New York Medical College will discuss improved methods of culturing B. burgdorferi. Dr. Brian Fallon of Columbia and Dr. Patricia Coyle of Stony Brook will present findings from their respective NIH studies of neurologic Lyme disease, addressing serologic, CSF, neurocognitive, and imaging results. On the coinfection front, Dr. David Allred of University of Florida will address mechanisms of persistence in Babesiosis while Dr. Martin Fried of Jersey Shore Medical Center will present his findings on coinfections in the GI system. Other prominent speakers will present new findings in the areas of public health (Dr. Kirby Stafford of Connecticut Agricultural Station, Dr. Julie Rawlings of Texas Department of Health), clinical manifestations and treatment (Dr. Andrew Franks of NYU, Dr. Norman Latov of Cornell Weil Medical Center, Dr. Sam Donta of Boston University, and a treatment roundtable including Dr. Lesley Fein, Dr. Ami Katz, Dr. Richard Horowitz, and Dr. Robert Bransfield).
Saturday, 4/12, 10am-2pm: Shrub Oak, NY (near Yorktown)
The Lyme Disease Association over
the last 10 years has been a pioneering financial supporter of research
conducted around the country. Many of the pivotal studies on Lyme disease
conducted at Columbia and elsewhere were made possible by the award of pilot
grants through the Lyme Disease Association.
The Greenwich Lyme Disease Task Force, an affiliate of the LDA, also has
committed itself to the support of educational, preventive, and research
efforts as demonstrated by educational forums, public health screening, and a
major financial gift given jointly by the GLDTF and the LDA to Columbia
University as the first step toward the establishment of a Research Center at Columbia
University dedicated to the study of Chronic Lyme Disease.
We expect that these changes will provide many more patients with the opportunity to participate in this valuable study. To learn more about this study, please go to Columbia NIH Lyme Study http://www.columbia-lyme.org/dept/nyspi/flatp/NIHstud-n.html. If you'd like to be screened for the study, please complete the screening form at the bottom of that page.
The second project is a study of T-cell functioning in Lyme Disease; specifically, we have added extensive T-cell studies onto our ongoing study of adults with chronic Lyme Disease, looking both for baseline markers that may be associated with the disease as well as changes in T-cell functioning in response to treatment. The third project is a study of Lyme encephalopathy to describe accurately the full array of cognitive abnormalities in Lyme Disease and to attempt to identify an objective method of defining Lyme encephalopathy. The endowed research fund, once the considerable funds needed to create such a fund are donated, will help to support pilot studies at Columbia and at other academic centers around the country.
New serologic test for Lyme disease: C6 Lyme Peptide ELISA (VlsE) (9/2000) Two research groups (University of Texas and Tulane University) reported in the December 1999 issue of the Journal of Clinical Microbiology that a newly discovered variable surface antigen, VlsE, could be used in an ELISA based antibody test for the sensitive and specific detection of Lyme Disease. The VlsE ELISA test was reported to be simple, sensitive and specific, identifying a highly conserved, immunodominant and invariant region of the Borrelia burgdorferi surface proteins. Because patients who have been vaccinated with the Lyme vaccine and because patients with other disease such as non-Lyme arthritis, infectious mononucleosis, lupus erythematosus, syphilis, and other autoimmune diseases reportedly will not test positive on the VlsE test, this new assay appears to be an excellent tool for differential diagnosis. Although this assay is highly specific for Lyme Disease, it is not yet clear how sensitive this test will be for patients with late stage neurologic Lyme Disease. Such studies will soon be underway. The C6 peptide assay detects IgG and IgM antibodies and is available from BBI Clinical Laboratories in New Britain, CT (www.bbii.com). Persistent Lyme Disease responds to additional antibiotic therapy in an uncontrolled trial (6/2000) Dr. Brian Fallon and colleagues of Columbia University reported in the Fall 1999 issue of the Journal of Spirochetal and Tick Borne Diseases that a repeated course of intravenous antibiotic therapy results in marked improvement in memory, attention, and overall functioning. Enrolled in the study were 23 patients with complaints of persistent memory problems who had previously received 4-16 weeks of intravenous antibiotic therapy for Lyme disease. Patients were tested at baseline and 4 months later. During this interval, the private physician determined treatment (intravenous, intramuscular, oral, or none). Assessments included standardized measures of cognition, depression, anxiety, and functional status. Between times 1 and 2, 5 patients were given no antibiotics and 18 were given additional antibiotics: 7 intravenously, 4 intramuscularly, and 7 orally. At time 1, there were no statistically significant group differences in cognition, depression, or anxiety between those who later received antibiotics and those who didn.t. At time 1, the 23 patients were also quite functionally disabled . far more disabled in fact than patients in other studies with congestive heart failure, type 1 diabetes mellitus, and major depression. At time 2, compared to patients who received no antibiotics and compared to patients who received a continuation of oral antibiotics, patients given intravenous antibiotics showed the greatest functional improvement (pain, physical functioning, energy) and the most cognitive improvement . even when controlling for differences in cognition at baseline between the groups. Of considerable interest was that patients who did not have a positive Western blot result currently or historically were just as likely to benefit from the repeated course of antibiotic therapy as patients who had fully reactive IgM or IgG Western blot results. This uncontrolled study suggested that repeated antibiotic treatment can be beneficial, even among patients who have been previously treated and even among patients who currently have negative Western blot test results, with the intravenous route of treatment being the most effective. The pilot data from this study served as the background to support the recent award to Dr. Fallon to conduct a placebo-controlled treatment study of persistent Lyme Disease. The full text of this article can be found at www.medscape.com. Cognitive Deficits identified in Children with Chronic Lyme Disease (12/1999). Dr. Felice Tager of Columbia University reported at the International Lyme Conference in Munich Germany in June 1999 that compared to age- and education-matched controls, children with chronic Lyme Disease may experience persistent problems with attention, mood, and behavior. These results add to a small but growing body of published data indicating that Lyme Disease may cause chronic cognitive problems in a sub-group of children with Lyme Disease. This study examined children with a well-documented history of Lyme Disease who were premorbidly healthy but who had persistent neuropsychiatric complaints subsequent to what is considered adequate treatment. The Lyme disease group, compared to healthy controls, had more psychopathology and more cognitive deficits. The psychopathology consisted primarily of higher levels of depression and anxiety. Most troubling to these children was that they felt ineffective: having to push to do schoolwork; doing poorly in subjects that were previously not problematic; not being as .good as the other kids; doing things incorrectly. The areas of psychopathology most strongly affected had to do with the secondary effects of a new onset cognitive problem. When the cognitive status was examined, the children with Lyme Disease had deficits in overall perception and organization, distractibility, general memory, and verbal memory. A closer look at the pattern of deficits suggested that these children with Lyme Disease had developed problems in visual and auditory attention. This pattern might be mistakenly diagnosed as one of primary Attention Deficit Disorder. Because these deficits would be reversible after appropriate antibiotic therapy, Dr. Tager emphasized the need for educators and parents to be aware of this association . particularly when working or living in a Lyme endemic area. Matrix Metalloproteinase Levels are elevated in the CSF of patients with chronic Lyme (12/1999) Dr. George Perides of the New England Medical Center reported at the International Lyme Conference in Munich Germany in June 1999 that MMP levels are raised in the CSF of patients with seronegative as well as seropositive Lyme Disease. This report indicated that a matrix mettalloproteinase with electrophoretic mobility corresponding to 130 kDa is found in the CSF of 78% of patients with seropositive Lyme Disease and 62% of patients with post-treatment chronic Lyme Disease vs only 6% of patients with other neurologic diseases. This team demonstrated that borrelia burgdorferi induces the expression of MMP in a dose and time-dependent manner in primary human and rat nerve tissue cultures. These findings may provide clues regarding the breakdown of the blood-brain barrier and the degradation of the brain.s extracellular matrix. The fact that seronegative and seropositive patients had comparable levels of MMP in the CSF supports the clinical observation that seronegative patients are often just as sick as seropositive patients. Further research on MMP 130 needs to be conducted to determine whether this protein is also elevated in other chronic inflammatory disorders. Unclear at this point is whether MMP 130 is a marker of active infection or a less specific marker of generalized CNS inflammation. Also of interest is whether levels of this marker correlate with abnormalities on functional brain imaging . a study that will be conducted by the Columbia Lyme team in collaboration with Dr. Klempner and colleagues at the New England Medical Center. |
