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Re: Scha Bb/cytokines

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Here are some data from that paper - in a similar experiment to

those in the other 2 papers which disagree 100-fold.

The live vs lysed Bb may be making a big difference in these

experiments. Radolf (2004 or 5) found them to differ strongly in

immunogenicity, especially at certain Bb:leucocyte ratios.

---------------------------------------

Cytokine and chemokine levels in whole blood cell supernatants in

different patient groups following stimulation with live borrelia

spirochetes.

Median values (range in parenthesis) in pg/ml are given.

sick more sick less asymptomatic normal,

than 6 mo than 6 mo seropositve seronegative

IL-10 387 (6 977) 70 (4 848) 68 (13 588) 155 (20 610)

TNF-a 216 (2 2055) 36 (0 2974) 231 (2 1783) 348 (3 1502)

---------------------------------------------

Pretty damn ugly data ranges there - wish they gave standard

deviations or just gave all the values.

> > I read the first paper, and the follow-up. These are tentative,

> > first read responses:

> >

> > 1) It seems odd, and very frustrating, that we are told nothing

> > about the duration of disease, prior treatment history,

> coinfection

> > test results, or current clnical presentation in these patients

> > whose monocytes were assessed for cytokine release. Yet all

> patients

> > were from one GP's practice! How hard could it have been to

> compile

> > that data?

> >

> > Without such information, we have nothing to correlate these

> > findings to but the selection criteria, which appear to have

been

> > that patients were making enough Bb antibodies to test positive

> via

> > serology.

> >

> > 2) There is at least one study I recall clearly that shows what

at

> a

> > glance seems like the inverse result. Immune cells (identified

as

> > macrohpages, not monocytes) exposed to borrelia outer surface

> > proteins in that study were seen to produce high levels of IL-

12,

> > low levels of IL-10, in a ratio extreme enough to force naive T

> > cells (Th0) into the Th1 phenotype. The hypothesis considered

> there

> > was that by generating this response, borrelial OSPs protected

the

> > bugs from effective antibody development, which they stated

> required

> > the presence of Th2 cells.

> >

> > 3) I suppose in a very speculative way you could reconcile the

> > results by saying that the positive antibody status of the 'late

> > stage' patients acrued from the higher levels of IL-10

> facilitating

> > Th2 cell, antibody-forming responses vs. the inflammmatory

> response

> > observed in response to borrelial OSPs in the other study I am

> > referring to.

> >

> > 4) You could end up with a forking immune response that looks a

> > little like this:

> >

> > In response pattern 1, high levels of inflammatory cytokines are

> > generated but effective antibody development is minimized. Any

> bugs

> > that are killed are quickly removed from the body, but not many

> are.

> >

> > In response pattern 2, low levels of inflammatory cytokines are

> > generated, but effective antibody development is increased. More

> > bugs are killed, but the inflammatory process needed to get the

> > lysed bugs and their toxins out of the body are indequate,

> allowing

> > these to accumulate.

> >

> > In the first response pattern, the immune system would play a

> > prominent role in generating symptoms, but a minor role in

> directly

> > attacking the bugs.

> >

> > In the second response pattern, the immune system would play a

> much

> > reduced role in generating symptoms, a more significant role in

> > attacking the bugs. The disease would actually be progressing

away

> > from, not toward, an 'autoimmune' model (though based on the

broad

> > reduction in cytokine release to ANY flavor of LPS, possibly

> toward

> > a model of immune deficit).

> >

> > One might expect the first hypothesized pattern to correspond

more

> > to arthralgias, the second to correspond more to central and

> > peripheral nervous system disease.

> >

> > It's just a bunch of wild speculation on my part. What a shame

> that

> > we know nothing about the actual health status of those patients

> > whose monocytes were studied.

> >

> > I would almost think it worth corresponding with the authors to

> see

> > if anything more can be learned.

> >

> > S.

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If you take this report at face value, what seems most striking is

that both TNF-alpha and TGF-beta (inflammatory / counter-

inflammatory) are elevated in the cerebrospinal fluid of the non-

chronic, suggesting a balanced immune response is needed to avoid

chronicity.

You're right, it interests me. Thanks for posting it.

> > I read the first paper, and the follow-up. These are tentative,

> > first read responses:

> >

> > 1) It seems odd, and very frustrating, that we are told nothing

> > about the duration of disease, prior treatment history,

> coinfection

> > test results, or current clnical presentation in these patients

> > whose monocytes were assessed for cytokine release. Yet all

> patients

> > were from one GP's practice! How hard could it have been to

> compile

> > that data?

> >

> > Without such information, we have nothing to correlate these

> > findings to but the selection criteria, which appear to have

been

> > that patients were making enough Bb antibodies to test positive

> via

> > serology.

> >

> > 2) There is at least one study I recall clearly that shows what

at

> a

> > glance seems like the inverse result. Immune cells (identified

as

> > macrohpages, not monocytes) exposed to borrelia outer surface

> > proteins in that study were seen to produce high levels of IL-

12,

> > low levels of IL-10, in a ratio extreme enough to force naive T

> > cells (Th0) into the Th1 phenotype. The hypothesis considered

> there

> > was that by generating this response, borrelial OSPs protected

the

> > bugs from effective antibody development, which they stated

> required

> > the presence of Th2 cells.

> >

> > 3) I suppose in a very speculative way you could reconcile the

> > results by saying that the positive antibody status of the 'late

> > stage' patients acrued from the higher levels of IL-10

> facilitating

> > Th2 cell, antibody-forming responses vs. the inflammmatory

> response

> > observed in response to borrelial OSPs in the other study I am

> > referring to.

> >

> > 4) You could end up with a forking immune response that looks a

> > little like this:

> >

> > In response pattern 1, high levels of inflammatory cytokines are

> > generated but effective antibody development is minimized. Any

> bugs

> > that are killed are quickly removed from the body, but not many

> are.

> >

> > In response pattern 2, low levels of inflammatory cytokines are

> > generated, but effective antibody development is increased. More

> > bugs are killed, but the inflammatory process needed to get the

> > lysed bugs and their toxins out of the body are indequate,

> allowing

> > these to accumulate.

> >

> > In the first response pattern, the immune system would play a

> > prominent role in generating symptoms, but a minor role in

> directly

> > attacking the bugs.

> >

> > In the second response pattern, the immune system would play a

> much

> > reduced role in generating symptoms, a more significant role in

> > attacking the bugs. The disease would actually be progressing

away

> > from, not toward, an 'autoimmune' model (though based on the

broad

> > reduction in cytokine release to ANY flavor of LPS, possibly

> toward

> > a model of immune deficit).

> >

> > One might expect the first hypothesized pattern to correspond

more

> > to arthralgias, the second to correspond more to central and

> > peripheral nervous system disease.

> >

> > It's just a bunch of wild speculation on my part. What a shame

> that

> > we know nothing about the actual health status of those patients

> > whose monocytes were studied.

> >

> > I would almost think it worth corresponding with the authors to

> see

> > if anything more can be learned.

> >

> > S.

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