Thursday, May 9, 2013

Mysteria bugs

In the past I talked about mystery bugs -- I know a few things I didn't before. One researcher at NIH, still unpublished, came upon the issue through serendipity. He was looking at some stem cells and found they were "contaminated" with a protozoan. But his samples were not contaminated. The bug was a consistent finding.  He then spent a lot of time trying to identify the bug. Its DNA sequencing, not complete, shows something novel. Definitely not Babesia. What is paradgm shattering and probably wont be recognized for decades, is that humans are born with symbiotic organisms. This is something not known to occur in any family of living organism higher than cockroaches! Symbionts are not necessarily bad: in fact they are likely necessary for good health. Symbiotic organisms can be comensual: no harm, no foul. Or they can be mutualistic: you scratch my back, I'll scratch yours. They might  be pathological, maybe only in immune suppressed or opportunistic scenarios. As it turns out, some observations have been made that the numbers are high is some disease states and low in others. In other words, the bug count is not predictably high in all disease states. The idea of blindly trying to kill all the bugs may be a very bad idea. Mainstream scientist, with electron microscopes and large DNA sequencing labs are onto all this, but not yet talking. It appears Dr. Fry has independently found the same thing. We are born with the organism in our cells, tissues. It appears the same applies to at least one bacteria and one virus. Described as Chinese dolls: the protozoan within human cells, the bacteria within the protozoan and the virus within the bacteria.

This should not be confused with the human microbiome. It is widely reported that our bodies host 10 times more procaryotic/bacterial cells, than eucaryotic/human cells. A huge diversity of bacteria, thought of as our normal "fauna and flora," inhabits our bodies carrying out comensual and mutalistic roles. These bacteria are believed to be acquired after birth and occupy specific niches. Mostly the bacteria are found in the gut, skin and mucous membrane surfaces. They do not live in other compartments considered sterile such as bone marrow elements and blood.

The mystery bugs discussed above are present inside our cells, are apparently passed from mother to fetus inter-utero and are apparently present in large numbers but not previously observed. I have been told these organisms are camouflaged within the nuclei of human cells.

Then there is the issue of mystery bacteria. They don't show up in stains like Bartonella and DNA identification has been elusive. My sense that many of these are symbionts and.they may seen in large numbers in  patients whom are ill or immunosuppressed. At least one symbiotic bacteria has been observed, an unknown L-form. These unknowns are not something we need to target per se, but may be seem as a bell-weather, marking the severity of disease.They may not stain because their basic structure is something we do not yet understand: we don't have the right strain. Some bacteria have very unusual structures.

This leads me to the next Blog.

Goodbye Family Practice, after 30 years

I have now transitioned from primary/care to a Lyme consultative practice.

I don't get to diagnose patients in the "general population."

The chief complaint of patients visiting a primary doctor is musculoskeletal in nature about 30% of the time. For some reason, the incidence of peripheral neuropathy is on the rise; I was surprised to read that "idiopathic." unknown cause, is found more often than diabetes. ( old joke: idiopathic means the patient is pathological and the the doctor is an idiot). OK, so how many of these patients and others have Lyme disease?

Then there is the growing population diagnosed with fibromyalgia:  many treated with drugs that are supposed to help but only make things worse.

The really sick patients might see 40 doctors before visiting with an "LLMD" if they are lucky.

Many patients will be left disabled with "mystery diagnoses."

Of course if I am not there to diagnose a few,  my former patients will suffer the fate of so many others. Perhaps when patients hear I have left primary care to treat Lyme disease it might communicate something.

HMOs and managed care allows for 6-8 minute visits with a primary care doctor and focused evaluations by specialists who never see the bigger picture. Even the more open minded physicians operate in a system which deprives them of the energy or time to look elsewhere.

This is all rather depressing so I will turn my attention elsewhere.