Lawrence Afrin, MD | Mast cell activation disease foundations and applications in tick-borne disease management. #LivLymeSummit@liv_lyme
@liv_lyme Afrin | mast cell activation syndrome (MCAS) is different than mastocytocis. While some MCAS have a KIT mutation, "It is the activation of the mast cells, not abnormal growth, that is contributing to the excess symptoms in MCAS." #LivLymeSummit
Afrin | this is the tip of the iceberg for mast cell diseases. Mast cells are the original immune cell. Remember everything. Dominant in skin/GI, interfaces w/nerves, in walls of all vessels. #LivLymeSummit
Afrin | many, many, many triggers for mast cells besides IgE: pressure, trauma, heat, cold, UV, stress, the list goes on... #LivLymeSummit
Afrin | there are many patients who have symptoms of mastocytosis that lack the markers. says doctors need to consider MCAS. Estimates MCAS is affecting up to 17% of general first-world population.
Afrin | will find tryptase is normal in about 80% in MCAS patients; heparin, CGA, PGD, LTE and histamine are often elevated; leads to inflammation in multiple organs and systems & CNS. "patients often stop complaining because they've given up reporting" #LivLymeSummit
Afrin | "Infection of any type triggers some mast cell activation." "a TBD has potential to trigger in the MCAS patient to trigger: normal, aberrant and permanent activation of mast cells" #LivLymeSummit
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@Lymenews The largest study, on which the CDC based its recommendation, showed one thing—a single dose of doxycycline reduced the incidence of rash in a small group of people. That’s it. (Nadelman 2001) 2/
@Lymenews End point: "Erythema migrans occurred at the site of the tick bite in 8 of the 247 subjects in the placebo group (3.2 percent), as compared with 1 of the 235 subjects in the doxycycline group (0.4 percent, P<0.04)" Seven fewer rashes! nejm.org/doi/10.1056/NE…
@Lymenews The ticks in the Nadelman study were identified by an entomologist. As the authors pointed out, patients and clinicians are not skilled at distinguishing I. scapularis from other ticks and arthropods, and even from scabs or debris. (Sood 1997) 4/
"In the USA, B. burgdorferi often disseminates in the blood during the first few weeks of infection in a process that requires the binding of Borrelia surface adhesins to host integrins on the vascular endothelium28–30. " 2/
"As shown in mice, the spread of B. burgdorferi through the vasculature or lymphatics is dependent on the inter-actions of spirochaetal surface molecules and endothe-lial cell membrane proteins." 3/
Thread: A major barrier to progress in understanding the neurologic manifestations of #LymeDisease has been a lack of a tractable laboratory animal model to evaluate the mechanisms of central nervous system pathogenesis.
For decades we have seen study after study of Lyme arthritis. As it turns out the most frequently reported Lyme symptoms are neurological symptoms: memory loss and cognitive impairment, sleep impairment, psychiatric manifestations, headaches, neuropathy and more. 2/
This is the first study, to my knowledge, that shows how Borrelia burgdorferi gets into the central nervous system, how the immune system responds, and how the bacteria adapt to the immune system. #Lyme
Meet the researcher Catherine Brissette, Ph.D. globallymealliance.org/meet-researche…
In an encouraging development yesterday @CDC_NCEZID representative Ben Beard made an important announcement--a new "national strategy" for vector-borne diseases. I'll explain in a thread 1/n lymedisease.org/framework-vect… via @Lymenews
The Kay Hagan Tick Act, passed in 2019, called for @hhs to develop a national strategy to address issues related to vector-borne diseases. The Lyme community fought hard for the passage of the #TICKactlymedisease.org/tick-act-appro… via @Lymenews 2/
The geothermal features in Yellowstone are amongst my top 10 favorite sites on this planet. Here’s a bit of #microbio history on the PCR test I’d like to share.
Pictured: Grand Prismatic at the Midway Geyser Basin @YellowstoneNPS
“Until the 1980s, our ability to study DNA was limited. Things we take for granted today such as DNA fingerprinting to identify criminals, DNA medical diagnoses, DNA-based studies of nature, and genetic engineering did not exist.”
“But in 1985, the polymerase chain reaction (PCR) was invented. PCR is an artificial way to do something that living things do every day—replicate DNA. PCR is the rocket ship of replication, because it allows scientists to make billions of copies of a piece of DNA in a few hours.