Scientific Conferences

October 17, 2008.  San Francisco. Annual Lyme Conference for health professionals,

co-sponsored by Columbia University and the Lyme Disease Association, Inc. 

Scientific Program Chairs: Brian Fallon, MD (Columbia U.) and James Miller, PhD (UCLA)

October 17 in San Francisco was a landmark day for Lyme disease, with stellar presentations being provided by leading investigators from the U.S. and Canada.  At the annual conference co-sponsored by Columbia University and the Lyme Disease Association, several presentations paved the way for new inroads into our understanding of Lyme and other Tick-borne Diseases.  The keynote presentation by Dr. Steven Barthold from UC Davis highlighted that the Bb spirochete has evolved to persist within its reservoir hosts.  Dr. Barthold's work in the mouse model in conjunction with prior work by researchers at Yale, Univ of Turku in Finland, and Cornell demonstrates that Bb can persist even after antibiotic therapy, although in smaller numbers and in a less active state; this work supports the hypothesis that Bb persist in the host not because of an antimicrobial resistance but through the process of  "antimicrobial tolerance" in which spirochetes are metabolically less active and thus less vulnerable to antibiotic killing. Dr. Steven Schutzer from UMDNJ discussed the application of a cutting edge pathogen detection system (IBIST5000) which uses a broad range PCR followed by mass spectrometry to identify unknown infections; applying this methodology to adult ticks Dr. Schutzer identified several pathogens in ticks - not just B.burgdorferi; for example, Borrelia miyamotoi was seen frequently.  Dr. Armin Alaedini from Weill Medical College of Cornell University reviewed different hypotheses for persistent symptoms (molecular mimicry, neo-epitope release, heightened non-specific B cell activity) and then demonstrated by his recent research that patients with persistent symptoms after treated Lyme disease have elevated levels of anti-neuronal antibodies compared to patients who responded well to antibiotics and are no longer symptomatic; this work provides objective confirmation of an ongoing abnormally activated immune response in patients with persistent symptoms. Dr. Diego Cadavid from Biogen Idec and Massachusetts General Hospital described his work on the borrelial agent of relapsing fever which highlighted the neuroprotective importance of the anti-inflammatory cytokine IL10 (produced by microglia) - protecting the blood vessels of the brain from hemorrhage and thrombosis.  Dr. Patricia Conrad from UC Davis discussed what is known about Babesia duncani, a rare cause of human babesiosis reported in California; she emphasized that they have never been able to document persistent parasitic infection in patients with titers less than 1:5120.  Dr. Mario Philipp from U Tulane reported on the impact of  Bb on freshly collected slices from the brain cortex of rhesus macaques, demonstrating markedly elevated levels of pro-inflammatory cytokines (e.g., IL8 and TNF) and neuronal and oligodendrocyte apoptosis; these findings support the hypothesis that neurologic disturbances in Lyme disease may be mediated by the induction in the CNS of inflammatory mediators. Dr. Brian Fallon from Columbia University reviewed the literature on biomarkers of CNS Lyme disease and reported on findings of potential marked clinical significance which  suggested that the C6 index and a brain neural network may be helpful in distinguishing that subgroup of patients more likely to benefit from a repeated course of antibiotic therapy from the non-responder subgroups who may need other non-antimicrobial treatment approaches.   Dr. Chris Contag from Stanford University reported on the use of in vivo bioluminescence imaging (BLI) as a non-invasive means of detecting low levels of infection in mouse tissues; this method has been used to study infection by Listeria (revealing long term infections of the gall bladder and bone marrow).  This same imaging method can be applied to Bb infected mice to identify previously unsuspected areas of Bb sequestration, to study perinatal infection by Bb and its consequences in the mouse model, and, in conjuction with microarray analysis, to examine how Bb physiology is altered at different tissue sites.  Dr. George Chaconas from the University of Calgary in Canada presented perhaps the most popular talk because of its visual impact, describing the use of spinning disk confocal intravital microscopy to directly visualize fluorescently stained Bb in real-time, three dimensions, in living mice; spiraling spirochetes were visualized interacting with and disseminating out of the vasculature of a living mouse – the first time there has been a high resolution 3D view of dissemination of any bacterial pathogen in a living mammalian host.  Dr. John Keilp from Columbia University revealed findings from a neurocognitive study comparing patients with post-treatment Lyme disease and major depression; while deficits in processing speed were common in both groups, patient with histories of Lyme disease were more likely to show deficits in language fluency and memory. Dr. Fabio Tavora of the Armed Forces Institute described a case of Lyme carditis in a 37 year old male who died one month after a febrile illness with a second-degree AV block; on post-mortem, severe, diffuse inflammation was seen in both the right and left ventricles, accompanied by mononuclear infiltrates of the endocardium, myocardium, and epicardium; serology was positive by Western blot and the tissue was positive for Bb by PCR.  Dr. Suzanne Vernon from the CFIDS Association of America reviewed recent research on CFS, including clinical biomarkers such as acute illness severity as a predictor of longer course of illness, abnormalities in the HPA axis, differentiating genetic expression of immune markers in CFS and immune network modeling; much of this research has advanced rapidly through the application of genomic methods, revealing a tool that may be of major clinical benefit in the study of patients with persistent Lyme disease symptoms.  Closing the conference, Dr. Ben Luft from Stony Brook University described a few research ventures, including studies of different strains of Bb to identify virulence markers and non-human studies of a novel antibiotic (Tigecycline) that by inhibiting the efflux pump may be more effective in eradicating Bb spirochetes than current antibiotics.     

Below are listed DVDs that can be purchased from the Lyme DIsease Association website that contain videos of prior national Lyme Disease Conferences sponsored by Columbia University:

1) 2007. Boston.
2) 2006. Philadelphia
3) 2005. Philadelphia

Lyme & Tick-Borne Diseases: Bridging the Medical Chasm, Boston 2007

$55.00 for the DVD set, plus the conference compendium

To order by mail, please send check payable to Lyme Disease Association to the address above.

DVD Set (2) (approx. 6.75 hours) now available featuring a dozen speakers on areas impacting tick-borne diseases including the Lyme disease treatment debate, Treatment Controversies: Lyme Disease with Ray Stricker, MD (President, International Lyme & Associated Diseases Society) Treatment the ILADS Perspective; and Paul Auwaerter, MD, (Associate Professor in the Department of Medicine, Johns Hopkins University), Treatment the IDSA Perspective. 

Other speakers are:
Eisendle MD, PhD, Klaus (Focus Floating Microscopy as a Diagnostic Tool); 
Livengood, PhD, Jill (Bb in Nerve Tissue); 
Alaedini, PhD, Armin (Immunologic Findings in Chronic Lyme); 
Moeller, PhD, James (Biomarkers of Chronic Neurologic Lyme Disease: Brain Maps, Pain Pathways, & C6 ELISA); 
Clauw, MD, Dan (Fibromyalgia: A New View with Neuroimaging Findings); 
Yrjanainen, MD, PhD, Heta (Viable Bb after Ceftriaxone Therapy in Mice); 
Assi, MD, MPH, Maha (Lyme Disease Followed by Human Granulocytic Anaplasmosis in a Kidney Transplant); 
Mongodin, PhD, Emmanuel (Genomic Update); 
Feldman DVM, MPH, DACVPM, Katherine (Tularemia);
Smith, Pat, LDA President (Introduction & LDA research projects)

Please allow 4 weeks for delivery.  Thank you.

Philadelphia 2006 LDA/Columbia University Lyme & Other Tick-Borne Diseases:
Seeking Answers through Science Conference

 $49 for 2 DVD set, plus compendium

Hard to find discussions about the elusive Borrelia burgdorferi cyst forms by world renowned researchers including Øystein Brorson, MD, and the possible links between Lyme disease & dementia by Alan MacDonald, MD.  Also Jeffrey D. Rothstein, MD, Ph.D. from Johns Hopkins University discusses new discoveries about antibiotics: "β-Lactam Antibodies Offer Neuroprotection by Increasing Glutamate Transporter Expression."  

Other Speakers:

David Ecker, Ph.D. – "Emerging Infections: Universal Biosensor Detection"
Roger Lasken, Ph.D. – "Beyond PCR to Whole Genome Amplification"
Keith Clay, Ph.D. – "Microbial Diversity within Ticks"
Elisabeth Aberer, MD – "Laboratory Diagnosis of Lyme Disease in Europe "
Manuel Moro, DVM, MPH, Ph.D. – "Babesia microti Causes Down Regulation of Cytokines and Increased Severity of Lyme Arthritis" 
Daniel Cameron, MD, MPH – "Designing Research in the Clinical Setting"
Diego Cadavid, MD – "Tissue Response to Chronic Borrelia Infection"
Elisabeth Aberer, MD – "Cyst and L Forms in Dermatological Lyme and Persistence"
Øystein Brorson, MD – "Cyst Forms and Antimicrobial Efficacy"
Ernest Visconti, MD – "Looking Beyond Lyme: Differential Diagnosis"
Brian A. Fallon, MD, MPH – "Uses and Abuses of Neuroimaging in Lyme Disease"
Also, Pat Smith, LDA President, Lyme Disease: National Overview

Philadelphia  2005 Conference DVDs
DVD set (2, approximately 6 hours total) of the LDA Lyme & Other Tick-Borne Diseases Conference: Emerging Tick-Borne Diseases, Philadelphia 2005 is now available! Includes Dr Sven Bergstrom on Relapsing Fever Borrelia; Dr. Steve Norris on Virulence Determinanats of Borrelia burgdorferi; Dr. Gregory Storch on Ehrlichiosis; Dr Martin Fried, Unique Dermatologic Manifestations of Tick-Borne Diseases; Dr. Ed Masters on STARI, AKA, Master's Disease; Dr. Terry Schultze on Assessment and Management of Vector Tick Populations; Dr. Susan Little on Tick-borne Diseases in the Southern US; Results of Lyme Disease Treatment Trial, Dr. Dan Cameron; 3D Culturing of Borrelia burgdorferi in a Micro Gravity Chamber, Dr Paul Duray; and Complementary Medicine Approaches to Treatment of Chronic Lyme Symptoms, Dr Richard Brown. $30 Compendium $10