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Monday, December 17, 2018

Dapsone, wonder drug? Not just about killing germs

People have been excited about trying Dapsone for PTLDS.  Horowitz has had good clinical results. Then Zhang did the test tube trials and it was a bust. It’s a sulfa drug and I have not been impressed using sulfa drugs treating Lyme.  Dapsone is used for leprosy, skin conditions including acne and dermatitis herpetiformis – the skin condition associated with celiac disease. With this portfolio I wouldn't have thought Lyme.  Dapsone may be a true wonder drug, one off the radar since it has been around forever (since 1937, predating penicillin, first synthetized in 1908) and there is no money in it for pharmaceutical companies. But what a drug! 

There are many ways the drugs may be repurposed and it is not just about killing germs, at least not directly.
Dapsone has tremendous anti-inflammatory properties with widespread effects on immune function. It positively impacts:  effector cells, cytokines, adhesion molecules, prostaglandins, leukotrienes, interleukins, tumor necrosis factor, leukocyte activation, ROS (reactive oxygen species), folate antagonist (this I knew) and a lot more. 
It is active against bacteria and protozoa, including malaria (Babesia?). 
It is bacteriostatic, not bactericidal and suppresses: strep, staph, pneumococcus, mycobacteria and more. 

I has been successfully used in rheumatoid arthritis with efficacy comparable to more toxic drugs.
It has steroid sparing effects which may make it useful in a wide variety of inflammatory and autoimmune disorders
It prevents UV associated photosensitivity (think doxy during the summer). 
It is well adsorbed into all tissues, including the brain. It may have neuroprotective effects (human stroke study). ?Brain fog in Lyme patients. 
It may have anti-cancer effects, even against brain tumors. 
It might be effective for life extension (works in a worm).  We are not worms.  
It may help kill Lyme through non-antibiotic effects. For example, it improves immune function and generates ROS which have natural antibiotic properties. 
There is much more.
It has potential toxicity and side effects which must be monitored.  

It sounds too good to be true, so I include the reference.

Archives of Dermatology (2014) 306:103-124, Wozel, Blasum (University of Dresden, Germany)
Open access with extensive references.


Unknown said...

Dear Dr. Jaller. The term PTLDS is used to deny care by private insurers, the DOD, Veterans'affairs, national health systems in other countries. They take the 'post treatment' very literally & use the CDC/NIH references for PTLDS described as MUS to dismiss the symptoms as psychosomatic. Its best not to legitimize this harmful term that is used to deny care. thanks-Jenna

Lyme report: Montgomery County, MD said...

Thanks for your comment. All of the researchers use the term. Its not my term and I don't like it. I prefer chronic Lyme disease -- that is what it is. With PTLDS the experts, like Zhang say the cause is unknown (he knows darn well persistence is a major issue but can't say it for political reasons. Sciences proves persistence of bacteria over and over and over again. The term is useful RE disability and has helped a patient in that regard. PTLDS is a step up, better than post Lyme syndrome it replaces, with its claim the bacteria are gone or it is autoimmune. Insurance companies deny care because they use IDSA experts as reviewers who still accuse us of quackery. It is a top down problem: Ivys and IDSA. Paradigms don't change until the old guard dies off. Hitting an end run with legislators is the only viable option at this time. The notion of PTLDS is proof positive that the illness is not psychosomatic, one of its selling points. Look at the proposed definition etc.
Best wishes

Tara Omar said...
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lymie said...

Going to ignore the above comment. Where do these people come from?

But on the subject of dapsone, not getting excited about something that is toxic and has to be watched carefully. Many lyme patients are far from their treating doc. If they end up in a local hospital because of dapsone, I predict a bad situation. This drug requires close supervision apparently.

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