It is now estimated that up to 20% of patients diagnosed with Lyme Disease will go on to experience ongoing symptoms even after medical treatment. Some physicians refer to this as Post-Treatment Lyme Disease Syndrome (PTLDS), where patients experience symptoms such as arthritis, debilitating fatigue, muscle pain, and “brain fog,” just to name a few. And since mounting evidence suggests that infection persists in these patients, better treatments are needed.
Dr. Pothineni and colleagues from Stanford University School of Medicine tested 4,000 FDA-approved compounds for their ability to kill B. burgdorferi, the bacterium that causes Lyme disease. What they found was both promising and surprising.
The researchers developed a method called high-throughput screening, which allows for a faster and more efficient way to screen drug molecules while maintaining reliability. Out of the 4,000 compounds tested, 20 were selected for further study. They all demonstrated 95-99.8% effectiveness in preventing bacterial growth, specifically against B. burgdorferi. A few of the drugs that fell in this category were erythromycin, which is already being used to treat Lyme disease, kitasamycin, and a few antitumor drugs in the anthracycline class.
Of particular interest was a drug called disulfiram (Antabuse®), which is normally used in alcohol abuse since it acts as an alcohol dehydrogenase inhibitor. The exact mechanism of action against Lyme is still uncertain, but its long half-life of 3-4 days may be a clue. A subpopulation of B. burgdorferi found in chronic Lyme patients are known as persister cells because they lie dormant as a way to evade antibiotics and then “wake up” once the threat is gone, making them very hard to treat. This compound appears to be effective in both stationary and persister or “cyst” forms of B. burgdorferi. Dr. Pothineni and colleagues published the results of their findings in Drug Design, Development, and Therapy in 2015.
Disulfiram is known to have anti-cancer and anti-parasitic properties as well. Since the malaria-like parasitic infection known as Babesia is a common co-infection in Lyme patients, this drug may have the potential to “kill two birds with one stone.” Because of its long half-life, alcohol cannot be consumed for 2 weeks after stopping disulfiram. Human studies are needed.
Dr. Kim Lewis of Northeastern is one of the researchers working tirelessly to further these finding as well as investigating other avenues to treat Lyme disease. He recently received a grant and has set out with 4 different objectives:
- To conduct a mouse study as the next step toward a human study on the new drugs of interest
- To look at the effectiveness of different combinations of antibiotics in Lyme disease
- To single out more new drug possibilities
- To study the gut microbiome in Lyme patients and the potential to shut off the autoimmune response by altering it
For those suffering with chronic Lyme disease, it is encouraging to know there are researchers out there fighting tooth and nail to find new and better treatment options. The possibility of an alcohol abuse drug being used to treat Lyme disease is proof that no rock should be left unturned when it comes to fighting for answers to medicine’s toughest dilemmas and most hard-to-treat illnesses. The solution may hiding in the most unsuspecting places.