Lonnie R Marcum, PT, BSHCA Profile picture
Wife/Mother•Science Writer•PT•HC Admin•Disease Detective•Voracious Reader•Connoisseur of Coffee•Graduate CSUN 1993• HHS 2019-2022 TBDWG Tick Subcommittee
12 Jul
New | Lyme arthritis: linking infection, inflammation and autoimmunity. #LymeDisease (a thread) 1/
"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/ Image
"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/
Read 29 tweets
3 Feb
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…
Read 15 tweets
23 Sep 20
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 #TICKact lymedisease.org/tick-act-appro… via @Lymenews 2/
The idea was for @HHSGov to co-ordinate with other federal agencies and departments, including the @CDCgov @EPA @US_FDA @NIH @DeptofDefense @USDA @USGS and others, to get everybody working towards the same goals. 3/ Image
Read 12 tweets
9 Aug 20
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.
Read 7 tweets
26 Jun 20
What has the #Lyme community learned from the #COVID19 pandemic?
(1) In a matter of weeks, the federal government can allot trillions of dollars to one disease.
2) In a matter of weeks, the @CDCgov can develop and mass produce a new test.
Read 6 tweets
3 Apr 20
Thread. @Sermo survey of 6,227 physicians worldwide: 85% of US physicians report #COVID19 testing takes 2-5 days or longer, while nearly half of international physicians report testing is completed within just 24 hours. Image
Survey @Sermo says, 91% of US physicians and 83% of international physicians say the status of #COVID19 testing is far below what is needed. Image
Survey @Sermo says "Physicians most request life science firms develop new rapid tests for COVID-19, followed by new drugs that offer immunity to front-line workers and accelerate efforts to test existing drugs to treat #COVID19" Image
Read 4 tweets
14 Mar 20
Fantastic Coronavirus Disease (COVID-19) – Research and Statistics. #COVID19 via @OurWorldInData

Why it is so important to #SlowTheSpread Image
The WHO described the #symptoms of 55,924 laboratory confirmed cases of #COVID19 in China in the period up to February 20.
The visualization here shows this data. Image
This visualization shows the severity of symptoms suffered by 44,415 Chinese patients confirmed to have coronavirus in the early period up to February 11. #COVID19 #symptoms Image
Read 7 tweets
26 Jan 20
Another eye opening read: "Rickettsiosis Subcommittee Report to the TBDWG" hhs.gov/ash/advisory-c…
Six common tick species are now involved in the transmission of Rocky Mountain spotted fever and/or other agents of the spotted fever group Rickettsiae in the United States (R. rickettsii, R. parkeri, R. massiliae, and R. 364D are proven human pathogens) Image
Gah! 72% of Rhipicephalus sanguineus ticks (brown dog ticks) in California found to carry Rickettsia massiliae. (Beeler et al., 2011) I mean, seriously, what doctors are even aware of this let alone testing for it?
Read 4 tweets
25 Jan 20
Borrelia burgdorferi DO NOT secrete toxins or other virulence factors. Lyme disease is both proinflammatory also immunomodulatory & immunosuppressive. What causes #LymeDisease is the immune response to the bacteria, not the bacteria itself.
The difference in severity and spectrum of #LymeDisease varies among patients. The reasons for this variation include different tropisms among B.b. strains and differences in the host immune responses. 👇 Image
The most commonly prescribed antibiotics for Lyme disease aren't that effective at killing Borrelia. Even combinations of these Abx have a hard time eradicating.
Borrelia burgdorferi, the Causative Agent of Lyme Disease, Forms Drug-Tolerant Persister Cells aac.asm.org/content/59/8/4… Image
Read 8 tweets
19 Jan 20
My thoughts on late manifestations of Lyme disease (Stage 3 "Chronic Lyme") & major histocompatibility complex (MHC)
Expression of MHC decrease in Langerhans' cells in the skin of patients with acrodermatitis chronica atrophicans #LymeDisease onlinelibrary.wiley.com/doi/abs/10.104…
Despite a strong immune response against B. burgdorferi the infection can become chronic, even after several courses of antibiotic treatment. #Lyme arthritis is one of those manifestations.
Read 19 tweets
30 Nov 19
NEW| @NIH Strategic Plan For Tickborne Disease Research.
niaid.nih.gov/sites/default/… Image
@NIH "The 2018 (TBDWG) report also called for developing an NIH strategic plan to coordinate a trans-NIH research effort to address TBD research priorities."

New @NIH Strategic Plan for TBD Research. 👇 Image
@NIH The annual number of tick-borne diseases continues to increase with Lyme disease accounting for more than 80% of reported cases. Image
Read 4 tweets
26 Nov 19
New | Changing of the guard: How the Lyme disease spirochete subverts the host immune response. jbc.org/cgi/content/lo… via @jbiolchem
@jbiolchem "One of the many fascinating features of this unique pathogen is an elaborate system for antigenic variation whereby the sequence of the surface-bound lipoprotein VlsE is continually modified through segmental gene conversion events." #LymeDisease
@jbiolchem "This perpetual changing of the guard allows the pathogen to remain one step ahead of the acquired immune response, enabling persistent infection." #LymeDisease
Read 8 tweets
20 Nov 19
New | Regulation of macrophage activity by surface receptors contained within Borrelia burgdorferi-enriched phagosomal fractions.

"The common gamma chain mediates the phagocytosis..." dx.plos.org/10.1371/journa… via @PLOSPathogens Image
@PLOSPathogens "Thus, the overall signature response to a specific pathogen is dictated by the addition of the signals initially emanating from surface receptors, further modulated by the interaction of intracellular signals generated as a result of the internalization of the pathogen. "
@PLOSPathogens "Our results show that the repertoire of surface proteins involved in this response is complex and composed of several classes of receptors, including C-lectins, scavenger receptors, siglecs and Fc receptors."
Read 9 tweets
29 Oct 19
Heartbroken to hear former US Senator Kay Hagan, of North Carolina, has died, following a three-year struggle with encephalitis caused by tick-borne Powassan virus. lymedisease.org/tick-borne-pow…
Powassan is a Flavivirus (related to Zika, Dengue, West Nile, and tick-borne encephalitis virus) carried by the same black-legged tick that transmits Lyme disease. Flaviviridae are a deadly family of viruses known to cause brain swelling. /2 lymedisease.org/lyme-sci-powas…
Black-legged ticks are especially dangerous as they are found in 1/2 of all U.S. counties and can transmit more than one pathogen at a time--including Powassan virus. #POWV Image
Read 8 tweets
12 Oct 19
New | A Multiplexed Serologic Test for Diagnosis of Lyme Disease for Point-of-Care Use. #LymeDisease jcm.asm.org/content/early/…
New microfluidic assay (mChip-Ld) detects B.b. antigens: VlsE and a proprietary synthetic 33-mer peptide (PepVF) to capture sensitivity in all disease stages, and OspC for early Lyme disease. Provides results in as little as 15 minutes. #LymeDisease
With specificity set at 95%, the sensitivity of mChip-Ld ranged between 80% (95% CI: 56% to 94%) and 85% (95% CI: 74% to 96%) for two panels of early Lyme disease, and was 100% (95% CI: 83% to 100%) for Lyme arthritis.
Read 5 tweets
22 Sep 19
Susan Green, PC @NatCapLyme | Legislation-The Perfect Storm. @liv_lyme #LivLymeSummit
IDSA guidelines: “First time I’ve seen all the Lyme group’s come together” ImageImage
@NatCapLyme @liv_lyme Green | “We VOTE and We CARE! This is a call to action.” @liv_lyme #LivLymeSummit Image
Green | was extremely moved by Olivia’s testimony to the HHS TBDWG. “This is why I’m here today” @liv_lyme #LivLymeSummit Image
Read 4 tweets
22 Sep 19
Jyotsna Shah, PhD, CCLD, MBA @IgenexI | High prevalence of tick-borne co-infections: Why it is important to include testing for Lyme and co-infections in patients w/ Lyme-like symptoms, and why a panel approach is necessary. @liv_lyme #LivLymeSummit Image
@IgenexI @liv_lyme Shah | 1° finding Babesia as co-infection, TBRF, then Bartonella. However not finding Bartonella in ticks. Lyme disease is most prevalent tick-borne infection. #LivLymeSummit ImageImageImage
Shah | Borrelia species all over the world, not just East Coast B31. People travel. “You want a test that detects infection!” Patients don’t care which strain, simply want a diagnosis & proper treatment. #LivLymeSummit Image
Read 7 tweets
22 Sep 19
Kristen Honey, PhD, PMP @Stanford @HHSCTO | Lyme Innovation: Every Included. “we need to listen to patients” “we need to tip the odds in our favor.” #LivLymeSummit @liv_lyme Image
@Stanford @HHSCTO @liv_lyme Honey @khoney | when you account for medical care, lost wages... estimates are in the 10’s of billions of dollars for the costs to society of Lyme disease. #LivLymeSummit
Honey | telling her personal story of Lyme: “I was recruited by a tick in 1999.” “Lyme disease is extremely isolating.” #LivLymeSummit
Read 10 tweets
22 Sep 19
Jayakumar Rajadas, PhD @StanfordMed | use of Disulfiram for the treatment of unresolved Lyme infections and associated detrimental host immune response. A silver bullet? #LivLymeSummit @liv_lyme Image
@StanfordMed @liv_lyme Rajadas | Identification of new drug candidates against Borrelia burgdorferi using high-throughput screening. #LivLymeSummit ncbi.nlm.nih.gov/pmc/articles/P…
Rajadas | giving a nice thank you to his collaborators. Funding by @liv_lyme & @BayAreaLyme Zhang @JohnsHopkinsSPH Embers @Tulane, Kenneth Liegner, MD & others. #LivLymeSummit Image
Read 13 tweets
22 Sep 19
Adrian Baranchuk, MD, FCCS @adribaran @QueensUCanada @QueensUGME | Lyme Carditis: Manifestations of Lyme disease in the electrical system. #LivLymeSummit @liv_lyme Image
@adribaran @QueensUCanada @QueensUGME @liv_lyme Baranchuk | The only way we're going to make progress is if we all work together. We need better education and more awareness. #LivLymeSummit
@adribaran @QueensUCanada @QueensUGME @liv_lyme Baranchuk | There are varying degrees of heart block. Some patients may have vague symptoms: fainting, shortness of breath, chest pain. Myopericarditis is global inflammation of the heart, like @drneilspector may require heart transplant. #LivLymeSummit
Read 9 tweets
21 Sep 19
Lawrence Afrin, MD | Mast cell activation disease foundations and applications in tick-borne disease management. #LivLymeSummit @liv_lyme Image
@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
@liv_lyme Afrin | Characterization of Mast Cell Activation Syndrome. #MCAS #LivLymeSummit ncbi.nlm.nih.gov/pmc/articles/P…
Read 9 tweets