103 Inflammatory Mechanisms And Biomarkers In The Chronic Manifestations of Lyme Disease-Alaedini, Armin

Ep.103

Dr. Armin Alaedini is a professor at Columbia University, where he leads a research laboratory focused on studying the role of the immune system, host-microbe interaction, and diet in complex disorders. His team’s research on Lyme disease in the past 15 years has focused on the chronic and post-treatment manifestations of the infection, leading to seminal findings that provide molecular evidence of a biological basis for the patient’s symptoms. He is currently a member of the Scientific Advisory Board of Global Lyme Alliance and a Working Group Member of the NIH Advisory Council on Chronic Fatigue Syndrome.

Key Takeaways:

• How does inflammation become permanent?
• Could there be abnormalities in the immune response system because of Lyme disease?
• Could there be a biological basis for persistent inflammation?
• There is a biological basis for the symptoms Lyme patients are facing. This is not trivial, because there wasn’t scientific evidence to say it wasn’t psychosomatic.
• The infection causes inflammation. Inflammation then becomes chronic.
• Why do some patients recover and others don’t?
• Remove the infection, and then you still have to remove the inflammation. Borrelia components could remain.
• Even after treatment with antibiotics, you can still have Borrelia in the body. (Animal studies)
• The inflammation that patients have early on in the infection is different than the persistent inflammation that patients have in the later stages of infection. (12:00)
• Biological markers to demonstrate that patients have chronic persistence of inflammation. This is really important because it gives us a handle to study these patients.
• There is basically no federal funding for Lyme disease. The NIH gives out a minuscule amount of funding for Lyme disease. Lack of funding is a major reason we haven’t made strides.
• We know a lot about Borrelia (about the infection itself) but the chronic symptoms that persist after having Lyme disease haven’t been properly studied.
• We need more support from the NIH and other federal agencies.
• Chronic Fatigue Syndrome (working group that counsels the NIH)
• NIH is slowly starting to be more supportive of research around CFS.
• CFS is a heterogeneous condition. It’s a spectrum disorder, making it very hard to study.
• There is now a study section at the NIH dedicated to studying CFS.
• We need funding to entice new researchers in these underfunded areas.
• Testing for Lyme that is “accepted” as mainstream relies on the immune response to the infection itself.
• We need to be able to find biomarkers in patients early on in the infection and later post-treatment Lyme disease syndrome. (30:00)
• We are still at the early stages of understanding (funding, research, clinical trials) these persistent symptoms.
• We can’t focus only on antibiotics and antibacterial agents. (We need to think more broadly about treatment strategies)
• Borrelia moves out of the bloodstream very quickly. From the blood, it goes to joints, nervous system and organs.
• Clinicians and researchers process the information that they have differently.
• There is a very real psychological toll of unresolved symptoms on the patients.
• The GUT has its own immune system and nervous system. (53:00)
• Neuroimmunology-The role of the immune system in neurologic and psychiatric symptoms.
• The gut interacts heavily with the brain.
• “I was initially interested in Lyme disease because the laboratory I was working in became interested in patients who were basically experiencing symptoms in response to vaccination from Lyme disease back in the 90’s.” LYMErix
• There is currently no vaccine for Lyme disease.
• The early research that I did indicated that there may be some cross-reactivity of the immune response to the vaccine, against the nervous system. That was early research that we did, that we didn’t continue with for lack of funding.
• What will treatment look like in the year 2040 for Lyme disease? Quick diagnosis, treatment, and resolution of symptoms. Better diagnostics and treatment for various symptoms.
• The microbiome is a huge factor in health and recovery. (a.k.a diet)
• Patients are trying everything because that is what they have to do.
• “60%-70% of chronic fatigue syndrome patients also have gastrin intestinal symptoms. Which is significantly higher than the general population.” (1:02)

Connect with my guest: Dr. Armin Alaedini

Columbia University Institute of Human Nutrition-

630 West 168 Street

PH1512E, New York, NY 10032

• 212-305-4808

https://www.ihn.cumc.columbia.edu/profile/ar...