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What is Lyme disease?
Lyme borreliosis (also Lyme disease, neuroborreliosis) is a disease that is usually caused by an infection with Borrelia burgdorferi, bacteria from the spirochete family.
The pathogens are usually transmitted through tick bites (not tick bites!). However, it cannot be ruled out that other blood-sucking insects also contribute to the spread. Human-to-human transmission is considered impossible.
Lyme disease occurs in almost all forest and plant-covered areas of Europe and North America, but also in countries such as Australia and Asia.
The occurrence of borrelia in tick populations varies greatly from region to region. Up to 30 percent of ticks can be affected. According to studies in Germany and Switzerland, antibodies indicating Lyme disease were detected in approx. 2.6 to 5.6 percent of people after a tick bite. A small proportion, around 0.3 to 1.4 percent, showed typical Lyme disease symptoms.
Most infections in this country occur in early summer. As ticks become active from a temperature of 6 degrees Celsius, you should be careful when going for walks from April to October at the latest. You can take care of yourself long before Lyme disease treatment. Wear long, light-colored clothing on which the crawling creatures are clearly visible and check yourself and your pets for tick bites after a walk. If you find a tick, you should remove it immediately and correctly.
The incubation period of Lyme disease is between 7 and 10 days on average. Around half of those affected develop a typical reddening, also known as “migratory rash” (erythema migrans). However, some sufferers do not show any migratory redness. The symptoms of the disease are then more flu-like. They include fatigue, swollen lymph nodes and fever.
However, a Lyme disease infection can only become noticeable after weeks, months and sometimes even years. It then manifests itself, for example, through skin changes (acrodermatitis chronica athrophicans), painful inflammation of the joints or signs of Lyme disease in the nervous system, such as pain or paralysis. You should seek treatment or therapy for Lyme disease as soon as it is detected.
Lyme disease symptoms and course
The course of Lyme disease is classically divided into three stages (stages I-III). However, as the disease often does not follow the sequence of stages, this classification is becoming increasingly theoretical.
Stage I-II
Around half of infections in Europe are asymptomatic, i.e. without erythema migrans (migratory rash) as an early symptom. The most common symptoms in the first few weeks are
Fatigue
Mild fever
Muscle and joint pain
Headache
Sweating
Conjunctivitis (inflammation of the conjunctiva)
Gastrointestinal complaints
Lymph node swelling
It is not easy to recognize Lyme disease symptoms as such. They vary greatly in severity and are not specific to Lyme disease. This means that they can have numerous other causes. If the Borrelia bacteria have already spread in the blood, the migratory redness can also occur in several places.
However, organic symptoms can also occur WITHOUT a noticeable tick bite, flushing or general symptoms weeks to months after infection. At this stage, early neuroborreliosis occurs due to an infestation of the nervous system. This is characterized by burning pain, which increases at night in particular, sometimes with a local connection to the bite site.
At the same time, asymmetrical and unsystematically distributed flaccid paralysis and general sensory disturbances can occur.
Myocarditis can occur, but is relatively rare in Europe (more common in the USA). Neurological deficits often appear as unilateral or bilateral facial paralysis. Acute meningitis can also occur in children.
Stage III
Symptoms of chronic Lyme disease
Nervous system
Late neuroborreliosis usually develops slowly over weeks or months and typically shows inflammatory symptoms of the central nervous system. Relatively rare in Europe is a late manifestation of Lyme disease in the heart muscle with cardiac arrhythmia or perimyocarditis (inflammation of the heart muscle and pericardium).
Skin
Acrodermatitis chronica athrophicans usually begins with swelling and bruising on the arms and legs. Subsequently, the loss of connective and fatty tissue can lead to athrophic changes. The tissue regresses.
Borrelia lymphoma (benign enlargement of lymph nodes)
Occurs more frequently in children. Preferred body parts are earlobes, nipples, genital area.
Joints
Joint inflammation that is usually intermittent or chronic. Frequently affected are: Knee, elbow and ankle joints. Smaller joints are rather rare.
Do you suffer from Lyme disease?
Hemoperfusion is a blood purification procedure that is used to treat inflammatory diseases such as Lyme disease. Please contact us for more information about a possible therapy.
Lyme disease diagnostics
The simplest and most reliable way of detecting an infection with Lyme disease is to examine the tick. It only takes a few days, provides certainty and enables Lyme disease treatment to be started quickly if necessary.
At the beginning of the disease, symptoms such as flushing or fatigue, fever, joint pain etc. often indicate a Lyme disease infection. If these are absent and symptoms associated with later stages are already occurring or symptoms persist despite treatment with antibiotics, a Borrelia serology (antibody test) should be carried out.
Antibody test (ELISA, immunoblot)
In these tests, the blood is examined for specific antibodies against Borrelia. However, false positive and false negative results are possible. A negative result does not necessarily mean that there is no Lyme disease infection, as the body only produces antibodies a few weeks after the infection. False positive results can occur due to infections with bacteria similar to Borrelia.
If a test is positive, this only means that the patient has been infected with Borrelia at some point. The test result does not indicate whether the infection is acute or latent. The same applies to the detection of antibodies in the cerebrospinal fluid (nerve water).
The diagnosis of neuroborreliosis can only be made with certainty if additional inflammatory changes can be detected in the cerebrospinal fluid.
Direct pathogen detection
Borrelia bacteria can be detected directly in addition to antibody detection. This is achieved either by cultivating the bacteria with samples from the skin or cerebrospinal fluid or by detecting the Borrelia genome using a PCR test.
Borrelia PCR
DNA fragments can be detected using PCR (polymerase chain reaction). This is usually faster than Borrelia cultivation. These tests are used if the previous test results are inconclusive or if not enough Borrelia antibodies have been produced due to a weak immune system.
Additional diagnostic options
Lymphocyte transformation test (LTT) CD56/57 in chronic Lyme disease CXCL13 test (can be detected in cerebrospinal fluid)
Lyme disease therapy
Antibiotic therapy is still the first choice in the treatment of Lyme disease. If Lyme disease is clinically suspected, antibiotic therapy should be started immediately. However, if one or more antibiotic therapies do not lead to the desired success, it makes no sense to treat Lyme disease patients with further antibiotics. This was the conclusion reached by scientists at Boston University in a study published in the New England Journal of Medicine.
The controversial discussions about the sense or nonsense of long-term antibiotic therapy in patients whose symptoms persisted after treatment were the reason for this research. Boston University conducted two randomized studies. In the first study, the researchers looked at 78 patients with seropositive IgG antibodies, in the second study 51 seronegative Lyme patients.
All study participants had been treated for Lyme disease before the start of the study. In both studies, the patients were divided into two groups: one group received antibiotic therapy, the other a placebo. Regardless of the antibody status, the antibiotic therapy did not show any better results in the Lyme disease patients than the placebo.
As already mentioned, borrelia belong to the spirochetes and therefore to the gram-negative bacteria – to put it simply, they have a thicker shell. Most Borrelia bacteria are pathogenic for humans and animals, i.e. they can cause diseases. They are able to change their shape, penetrate all body tissues and there is evidence that they can occur both intracellularly and extracellularly. They are temperature-sensitive and microaerophilic, i.e. they prefer to grow in a low-oxygen environment. They are slow to divide, which further reduces the efficacy spectrum of antibiotics.
These specific characteristics sometimes make it difficult to treat a chronic course exclusively with antibiotics, mainly because Borrelia bacteria like to reside in places in the body that are difficult to access for antibiotics in the long term. An additional problem can arise due to a dysregulated intestine: if the microbiome, i.e. the intestinal flora, is damaged, the intestinal mucosa is unprotected in some places, resulting in a leaky gut. Toxins, bacteria or bacterial fragments can pass through this leak unhindered. All gram-negative bacteria contain lipopolysaccharide, also known as LPS (endotoxin), in their membrane. The constant stimulus from LPS and exotoxins (bacterial toxins) leads to a permanent release of inflammatory substances (e.g. cytokines), which maintain chronic inflammation.
If antibiotic therapy has been exhausted, what alternatives are there?
There are now complementary medicine clinics and practices that offer hyperthermia (heat therapy) and ozone therapy and achieve good results with them. About twelve years ago, we used our knowledge and experience from cardiac surgery as perfusionists (specialists in extracorporeal perfusion) in oncology for regional chemoperfusions. This was a new field and we learned and understood how to use hyperthermia (heat therapy) and hyperoxygenation (high-dose oxygen administration) effectively. In addition, we eliminated the excess of cytostatic drugs with diafiltration (blood purification process). Cytostatic drugs slow down cell growth and cause hair loss during chemotherapy, for example. When we started looking into and using new blood purification procedures such as hemoperfusion about 5 years ago, we benefited from our experience in oncology. The solution we offer is called:
Hyperthermic hyperoxygenated hemoperfusion
Hyperthermic hyperoxygenated hemoperfusion is a special type of blood washing. Extracorporeal systems for blood purification can be constructed in different ways. We use a tubing set and integrate the adsorber for blood purification plus a heat and oxygenation unit. The heat unit allows the blood temperature to be controlled safely and precisely. This is slowly increased via the heat unit until the therapeutic range is reached. As the borrelia are thermosensitive and die at a temperature of approx. 41.6 degrees Celsius and above, the blood is heated in a targeted manner.
The maximum target blood temperature is 42 degrees Celsius. In the range between the aforementioned 41.6 and a maximum of 42 degrees Celsius blood temperature, we are guided by the circulatory parameters, i.e. how much temperature the individual circulatory situation allows. During the entire treatment, oxygen is continuously supplied via the oxygenation unit. This not only ensures maximum saturation of the erythrocytes (red blood cells) of 100 percent. It also increases the oxygen partial pressure, which influences the so-called oxygen binding curve.
The partial pressure of oxygen in the arterial blood after oxygen uptake in the lungs is normally slightly above 100 mmHg. With the oxygenation unit we achieve oxygen partial pressures between 500-700 mmHg. This leads to a rightward shift on the oxygen binding curve, which improves oxygen delivery to the tissue.
Hyperthermia and hyperoxygenation support each other:
Improved microcirculation
Vasodilation (vasodilatation)
Mobilizes the removal of waste products and toxins into the bloodstream and thus supports the effectiveness of the absorbers
Venous oxygen administration via the oxygenation unit increases the formation of prostacyclins
Positive influence on the immune system (immunomodulation)
The combination of perfusion, blood hyperthermia, hyperoxygenation and adsorption has proven itself not only in oncology, but also in chronic infections such as Lyme disease.
If you are affected, we look forward to hearing from you.
If you are also interested in other modern forms of therapy, such as apheresis, we refer you to extracorporeal blood purification procedures in VitaSangius therapy, which have been proven to improve metabolism, the immune system, organ functions and thus quality of life.
Therapy procedure with hemoperfusion
The patient (m/f/d) does not need to be fasting for this treatment. He/she can eat normally and should make sure that he/she drinks enough fluids.
In preparation for the actual therapy and to stimulate microcirculation, we use an infrared heating unit. A so-called Sheldon catheter is then placed in the femoral or jugular vein. This is a minimally invasive procedure that is performed under local anesthesia and light sedation. The advantage of the Sheldon catheter is that only one puncture is required. It is configured in such a way that an extracorporeal system can be connected and higher flows can be run.
Once the preparations have been completed, we determine the ABG (blood gas analysis) and ACT (activated clotting time) from the venous blood. For all extracorporeal perfusions, clotting must be reduced to such an extent that the blood in the system does not clot. We handle this with an individually adapted and low-dose systemic heparinization under ACT control. The prepared hemoperfusion system can then be connected. The perfusion is painless and the patient (m/f/d) can eat, drink, read or listen to music.
The total hemoperfusion time is approximately four hours. During this time, blood purification takes place through adsorption, supported by perfusion, blood hyperthermia and hyperoxygenation.
The adsorber we use for this has a broad adsorption spectrum. The effect is best described as “waste removal”. However, we also have the option of using a specific LPS adsorber. The role of LPS for the immune system is explained above.
At the end of the hemoperfusion, the blood is transported from the extracorporeal system back to the patient (m/f/d). After removal of the Sheldon catheter and an appropriate compression time of the punctured vein, the patient (m/f/d) is given a pressure bandage and can go home. The next day and after a wound check, a plaster is usually sufficient.
