Mycoplasma Article, How familiar this sounds

[Guest guest]

An Evasive Bacteria May Cause Fatigue " Syndromes "

February 4, 2000

NYT Syndicate

" Your friends, your colleagues, your boss, your family all have to take on

faith that you have an illness, and that you are telling them the truth about

the way you feel, " says Sophie Wilkinson, who has suffered with chronic

fatigue syndrome for 12 years.

Only in the last six months has a doctor finally confirmed that Sophie has an

illness.

A tiny bacteria called mycoplasma may play a role in such puzzling conditions

that defy easy diagnosis and treatment, but persist tenaciously over time.

Patients with chronic fatigue and Gulf War illness, and other chronic

disorders experience exhaustion, muscle and joint pain and a lack of mental

acuity dubbed " brain fog. "

Resistant to treatment, the diseases cause some formerly active people to

become bedridden. Others can barely work or attend school part time.

THREE MAIN SYMPTOMS

" It's not the kind of disease that you would make up, " says Sophie. " You have

no life. There's a whole constellation of symptoms that wax and wane,

depending on the particular episode. The lack of stamina is a consistent

feature. "

The elusive array of complaints shared by chronic illness patients generally

comprise a triad of symptoms:

--lack of stamina

--muscle or joint aches

--neurologic problems like poor memory and concentration. It's not clear how

mycoplasma drive these symptoms, but the tiny bacteria leave clues that

researchers are beginning to decipher.

" We can now identify the DNA of mycoplasma in the blood of some Gulf War

syndrome patients, " says Sam Donta, M.D., specialist in infectious diseases

at Boston University School of Medicine. " But just finding the DNA footprint

doesn't tell us if that's the cause of the disease. "

Mycoplasma represent the tiniest free-living bacteria. They can thrive on

open surfaces of the body including the mouth, respiratory system, the

genital tract, and the urinary tract. Unlike viruses that need to reproduce

themselves inside living cells, mycoplasma can replicate on their own.

" They have finger-like projections that stick out, and researchers have begun

to identify the chemicals that make mycoplasma sticky, " says Donta. " That

stickiness helps them live on the open surfaces of the body. "

Mycoplasma proved very difficult to grow in the laboratory for research

purposes, and remained a mystery for years. " They were first associated with

an unusual kind of pneumonia, " says Donta.

" They're tricky, because if you didn't know about mycoplasma, you might think

a patient had a viral form of pneumonia. There aren't very good drugs for the

treatment for viral pneumonia, but antibiotics work against bacterial

pneumonia. "

Today's antibiotics kill active bacteria, but mycoplasma grow too slowly, and

antibiotic treatment doesn't wipe them out. " Apparently, mycoplasma go

through very slow periods of growth with low metabolic activity, kind of like

hibernation, " says Donta.

Many antibiotics either interfere with the metabolism of the bacteria, or

destroy their cell walls. Neither approach, however, works well against the

ultra-slow-metabolizing mycoplasma, which have no cell walls.

Donta explains that scientists recently identified a few more mycoplasma, in

addition to the well-known mycoplasma pneumonii. Some were renamed, like

ureaplasma, which is associated with the urinary tract. Ureaplasmas have been

link to small birth weights and miscarriages as well as genital-urinary

diseases.

" There is strong evidence that mycoplasma species are associated with many

illnesses including chronic fatigue syndrome, rheumatoid arthritis, and other

chronic infectious diseases, " says Donta.

" Researchers discovered that mycoplasma get into the body's tissues and just

sit for a while. Periodically they become more active and take some

nutrition. Then they go into a resting phase again with low metabolism.

" That's why an antibiotic doesn't kill them, " says Donta. " Antibiotics either

target the cell wall, which mycoplasma lack, or they block metabolic pathways

used to make new proteins. "

LONGER TREATMENT NEEDED

" It could be that slow metabolic activity is the mycoplasma's staying power, "

says Donta. " Like a turtle, it may be slow, but it hangs on. "

Researchers think prolonged antibiotic treatment may improve symptoms for

some chronic sufferers of Gulf War illness. " We set up a Gulf War illness

study to track mycoplasma DNA, " says Donta. " We're trying to see if the

mycoplasma disappear in patients whose illness improves after taking the

antibiotic doxycyclene. The purpose is to learn what role, if any, mycoplasma

play in the illness. "

In the study, which is being conducted at 30 Veterans Affairs Medical Centers

around the country, patients take either the antibiotic, or a placebo for one

year. During six months of follow-up care, doctors will try to determine if

patients taking the antibiotic improved, and if they stayed better.

" DNA analysis will be done so researchers can determine if the patients who

got better showed a decrease in mycoplasma DNA, " says Donta, who leads the

study.

MULTIPLE SYMPTOM DISORDERS

There's a lot of controversy about chronic disorders like chronic fatigue

syndrome and Gulf War illness. " Some doctors think they are psychological, "

says Donta, " But I have long since given up the " evil humor' theory of

disease. Patients are suffering from these diseases even when physical exams

don't reveal anything of note. "

" I spent thousands of dollars on medical tests, " says Sophie. " And I had

doctors tell me that I was healthy when I was sitting in their office feeling

miserable. "

The National Institutes of Health recognize chronic fatigue syndrome as a

serious illness. Still, many people with the disease fail to receive

disability or insurance benefits because doctors and employers don't believe

they suffer from a debilitating condition.

Research studies in immunology, endocrinology and other fields keep probing

the mysteries of chronic illnesses in a search for urgently needed therapies.

" Wouldn't it be nice if we could wake up all of the mycoplasma bacteria, and

keep them from slowing down. And then slam them with an antibiotic, " says

Donta. " We need more research to develop drugs that work against mycoplasma. "

Copyright 2000 The New York Times Syndicate. All rights reserved.

[Guest guest]

This is really great news. Dr. Donta has been working hard at the cause of

our suffering. He knows we are ill and wants to know why instead of just

following the status quo and telling us we are fine. I wish him good luck in

his search and studies.

Kathleen