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Relapse With Lyme Disease

Cell Wall Deficient Bacteria, L-form Bacteria, Cysts, Spheroplasts, Biofilm Colonies


Pleomorphism is the ability of a bacteria to convert into alternative forms and is one mechanism Lyme bacteria use to survive in the body, thus causing relapse after treatment.  Lyme bacteria (Borrelia) can transform from an organism with a cell wall, into a cell wall deficient organism. This transformed organism is referred to as the L-form or cell wall deficient (CWD) bacteria. This is thought to be a survival form of the wild type or original bacteria.  See govt publication:

Cystic forms of Borrelia burgdorferi sensu lato: induction, development, and the role of RpoS.

Dipartimento di Scienze Biomediche, sez. Microbiologia, UniversitÓ degli Studi di Trieste, Trieste, Italy. rmurgia@dsbmail.units.it

It has been demonstrated recently that cells of Borrelia burgdorferi sensu lato, the etiological agent of Lyme disease, transform from mobile spirochetes into nonmotile cystic forms in the presence of certain unfavourable conditions, and that cystic forms are able to reconvert to vegetative spirochetes in vitro and in vivo. The purpose of this study was to investigate the kinetics of conversion of borreliae to cysts in different stress conditions such as starvation media or the presence of different antibiotics. Using the same experimental conditions we also investigated the possible role in cyst formation of RpoS, an alternative sigma factor that controls a regulon in response to starvation and transition to stationary phase. We observed that beta-lactams penicillin G and ceftriaxone, the antibiotics of choice in Lyme borreliosis treatment, favoured the production of cysts when used with serum-depleted BSK medium. In contrast, we observed a low level of cyst formation in the presence of macrolides and tetracyclines. In order to elucidate the role of the rpoS gene in cyst formation we analyzed the reaction of the rpoS mutant strain in comparison with its wild-type in different conditions. Under the same stimuli, both the wild-type borrelia and the rpoS knock-out isogenic strain produced cystic forms with similar kinetics, thus excluding the participation of the gene in this phenomenon. Our findings suggest that cyst formation is mainly due to a physical-chemical rearrangement of the outer membrane of Borrelia burgdorferi sensu lato leading to membrane fusion and controlled by different regulation mechanisms.



(The L-form got its name from the Lister Institute in London, where it was first isolated.) There are other names that pleomorphic bacteria and the survival forms are referred to; such as spheroblasts, cysts, blebs, biofilm colony, granular forms.  Very few researchers have focused on these alternative forms and the terminology can be confusing. 

See this video showing several forms of Lyme in the blood:  https://www.youtube.com/watch?v=aRwrgoA7Fb0 

Lyme colony:  https://www.youtube.com/watch?v=yfPg_kcFyZA&NR=1

Though CWD forms have are not a new discovery, it has been only recently that a closer look has been taken at their role in chronic disease.  It is now suspected that these CWD bacteria may cause chronic illnesses including rheumatoid arthritis, Chronic Fatigue Syndrome, Lyme disease, Multiple Sclerosis, sarcoidosis, scleroderma, tuberculosis, Parkinson's Disease, Alzheimers Disease, Leu Gehrig's Disease, and other illnesses.

The L-form is a treatment concern in many bacteriological infections. Conversion from the natural form to the CWD form can occur from taking antibiotics that inhibit the cell wall development of the natural form.  Cephalosporins and penicillins (beta-lactams such as ceftin, bacillin, rocephin) can kill the natural spirochete form efficiently, however, some spirochetes will convert into the CWD form because of the antibiotic treatment.  When the antibiotic is stopped or when conditions return that allow for cell wall development, the L-forms can convert back to their normal form, thius causing relapse.  The CWD forms themselves may cause different symptoms than the parent form.  CWD forms have been seen clumped in aggregates or colonies in patient blood and tissue samples.  The same antibiotics that are effective in killing spirochetes will not work against the CWD forms. 

See this video for conversion of spirochete to cyst or CWD form, with the application of penicillin to the culture:  https://www.youtube.com/watch?v=Lp01htoTqWU&NR=1

In vitro studies (in lab cultures) have shown that distilled water can convert some bacteria to the L-form as can the above mentioned antibiotics.  Cerebrospinal fluid is suspect in converting Lyme bacteria to CWD forms or cyst forms, which is why looking for Lyme spirochetes in cerebrospinal fluid is often not productie in finding active Lyme spirochetes.  (There is some confusion regarding cyst forms in the literature, and whether they are a different survival form from the CWD forms in diseases such as Lyme Disease.)  Studies with videos made from microscope observations, often use penicillin to cause the spirochete to convert to the L-form.  Why some physicians prescribe penicillins for Lyme, makes little sense since it guarantees relapse.

Lyme literate physicians are aware of this situation and often prescribe doxycycline, minocycline, zithromycin, biaxin, in combination with flagyl, tinidazole, or plaquenil (hydroxycholorquine), in rotations as antibiotic treatment, since these have not been shown to cause conversion from the natural form of the bacteria, to the cyst form.  However, there was one study showing doxycyline did cause conversion from wild type/natural form, to cysts and L forms, in cell culture. 


Tinidazole, flagyl and plaquinil have been shown in vitro (in the lab culture, not in the body) to inhibit conversion to cyst and to partially degrade cysts.  Biofilms are highly resistant to antibiotics due to protection of inner layers of organisms by the group culture.

See link for a thorough review of L-form bacteria discoveries.  http://bacteriality.com/2007/08/18/history/

Lyme spirochetes on red blood cells:  https://www.youtube.com/watch?v=grqHL5lbBuA&feature=related

Borrelia attached to red blood cell, shedding granules:  https://www.youtube.com/watch?v=deh_txOHtNk

More on Cysts and life cycle stages of Bb


General Historical Info on Bb, Treponema cysts and l-forms


Treatment For L-Form Disease
A literature search reveals few treatment discussions for L-form bacteria.  Most researchers believe that L-forms in the body are normal, since healthy research subjects have been shown to harbor them.  However, other scientists who have extensively studied L-forms disagree.  The reason CWD or L-forms are pathogenic in some and not others is not understood.  Lida Mattman has studied CWD L-forms for many years.  She asserts that Parkinson's Disease is caused by a species of Lyme she has tentatively named Borrelia bergdorferi parkinsoni
Trevor Marshall has implemented a protocol for the treatment of sarcoidosis which he claims also treats other L-form infections, including Lyme.  His protocol uses Benicar to control the imbalance of two forms of vitamin D ratio, pulsed antibiotic doses using minocycline and zithromax.  See link for discussion of Marshall Protocol:  http://www.marshallprotocol.com/forum2/364.html
Link To Lyme Disease Association Website, Video Clips of Borrelia (Lyme)