Women with chronic Lyme disease may suffer from a severe immune response triggered by the disease

Women with chronic manifestations of Lyme disease (LD) are often told they suffer from a variety of other illnesses including depression, rheumatoid arthritis, fibromyalgia and chronic fatigue syndrome or unexplained medical symptoms.

 

by Daniel J. Cameron, MD MPH

According to a study by Wormser and colleagues, from New York Medical College, “Patients with chronic Lyme disease were significantly more likely to be female than were patients diagnosed with either Lyme disease or with post-Lyme disease syndrome.”

“This finding,” says Wormser, “suggests that illnesses with a female preponderance, such as fibromyalgia, chronic fatigue syndrome, or depression, may be misdiagnosed as chronic Lyme disease.” [1]

However, it may be that women with chronic symptoms of Lyme Disease suffer instead from a severe immune response brought on by the illness.

A study by Aucott and colleagues from Johns Hopkins University School of Medicine states, “Individuals with ideally treated early Lyme disease have a greater than 12-fold higher risk of developing PTLDS [Post-Treatment Lyme Disease Syndrome] by six or twelve months post-treatment if their CCL19 [chemokine] level is higher than 111.67 pg/ml at one month post-treatment.” [2]

High CCL19 chemokine elevations have been reported in immune illnesses. “Based on this, we speculate that elevated CCL19 levels may reflect an ongoing, immune-driven reaction at sites distal to secondary lymphoid tissue,” says Aucott.

Such high CCL19 chemokine levels may be the result of a persistent infection. “Studies using rodent and primate models,” states Aucott, “have suggested that the persistence of bacteria and/or spirochetal antigens after antibiotic therapy may drive disease.” [2]

The article entitled CCL19 as a Chemokine Risk Factor for Post-Treatment Lyme Disease Syndrome: A Prospective Clinical Cohort Study suggests several approaches to managing the elevated levels of CCL19 chemokine. Aucott points out that some physicians are electing to re-treat patients who are still symptomatic. “The use of short-term antibiotic retreatment in the early, post-treatment phase of Lyme disease has yet to be formally tested, although it may be widely applied in clinical practice.”

Other approaches included prescribing medications used to treat depression in an effort to decrease cytokine levels, behavioral interventions to help cope with pain and fatigue and cognitive rehabilitation.

References:

  1. Wormser GP, Shapiro ED. Implications of gender in chronic Lyme disease. J Womens Health (Larchmt), 18(6), 831-834 (2009).
  2. Aucott JN, Soloski MJ, Rebman AW et al. CCL19 as a Chemokine Risk Factor for Post-Treatment Lyme Disease Syndrome: A Prospective Clinical Cohort Study. Clin Vaccine Immunol, (2016).


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Dr. Daniel CameronJoe JosephSheilagh CaseyCalum GrantDonna Falcone Recent comment authors
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Joe Joseph
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Joe Joseph

Hi
Can it trigger scleroderma,systemic?

Calum Grant
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Calum Grant

As a male, I have a very pronounced 28 day cycle in my symptoms, post treatment. This seems more like active infection, as autoimmunity doesn’t really make sense. Another way it’s harder for women, because they are fobbed off by telling them it’s hormones.

Sheilagh Casey
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Sheilagh Casey

Calum Grant, it is gratifying to me that you have noticed a 28-day cycle in symptoms. I am a post-menopausal woman, and have noticed the same cycle with my symptoms. I do believe it could be related to the life cycle of Borellia.

Linda Lane
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Linda Lane

Again all Lyme patients are immunosuppressed, not just woman.

http://www.truthcures.org

Craig Thompson
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Craig Thompson

Could that be the base cause of my Ankylosing Spondylitis? I do have the HLA-B27 gene. I grew up in Minnesota and Wisconsin, and was well known for having wood ticks. I don’t remember deer ticks at all, but I didn’t see all the ones Ma took off me. What do I need to look for or be tested for? I’m in Utah now, and am 56 yrs old, in constant pain.

Lynn Shepler, MD JD
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Lynn Shepler, MD JD

The study by Aucott begs the question. “Begging the question, sometimes known by its Latin name petitio principii (meaning assuming the initial point), is a logical fallacy in which the writer or speaker assumes the statement under examination to be true. In other words, begging the question involves using a premise to support itself.” grammarist.com Aucott assumes the cytokine and chemokine changes cannot be due to chronic infection. His work is a disappointment. Surely he must have observed that patients chronically ill with this disease report Jarisch-Hexheimer reactions when antibiotics are reintroduced. A Jarisch-Herxheimer reaction is driven by changes in… Read more »

Donna Falcone
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Donna Falcone

It seems to me that studies which beg the question are not unimportant, although they disappoint. Don’t they sometimes beg the question which needs to be asked NEXT? Dr. Cameron and/or Dr. Shepler…. Is there a way that you can facilitate this study, or initiate it somewhere that could do it – a graduate student in need of a study, perhaps? I’m not a scientist and so get lost in a lot of the language, but I am a female patient who suffered greately, who endured 9 years of treatment (off and on, mostly ON because I could never get… Read more »

Sheryl
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I’ve been sick for 30 years. I’ve probably been bit 20 times at least. Even tho I had a rash my Dr denied me treatment a year ago. If this is immune caused why is there such a large reaction to die off and with repetitive rounds of treatment those die offs lesson. I also have 2 coinfections, Candida causing constant horrific rashes and HSV1 and sometimes 2, also systemic as well. I was given a bag of IVIG to up my platelets for cancer surgery. I have ITP, cause unknown or immune or microbe driven. These organisms have definite… Read more »