Establishment of a continuous in vitro culture of Babesia duncani reveals unusually high tolerance to recommended therapies (2018, Abraham et al)

Open access, full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311517/

 

Most people have no idea...

 

This study has been on my mind a lot recently and I thought maybe people want to discuss.

This is personally of interest to me since I test positive for this parasite. I am also a member of some online patient groups where nobody reports being able to fully eradicate it. From my observation, a lot of people report being able to treat until their symptoms go away, but they relapse easily.

I am not educated enough to do the pharmacokinetic calculations to convert the IC50 values in this study to see how they compare to the dosages of medications that I have been prescribed.

Also, it is worth noting that Babesiosis is usually studied in the sense of acute illness, not a chronic fatiguing illness that typically results when infected with Babesia and Borrelia.

 

Both b duncani and microti may run chronic, at least as far as I can deduce. There is some positive news purportedly for sufferers of long term b microti, but even then, you'll probably know treatment recommendations are a minimum of six weeks, and that with a tier 3 drug, and no guarantees.

I've tested positive muitple times for microti, most recently this year by Mayo.

The three B's get the short shrift quite a bit. There's a reason out there, somewhere.

Edit to add: When they run chronic, my understanding is each of the B's can fall out of character, that is, they can assume qualities that are strikingly similar to ME/CFS.

 

Speaking of long term TBD sequelae, do these symptoms after Tick-Borne-Encephalitis strike a cord?

https://www.sciencedaily.com/releas...e_disease+(Lyme+Disease+News+--+ScienceDaily)

 

It's hard to tell with tick-borne encephalitis, but yes, those symptoms could describe mine.

 

Don't think TBE is in the US. But these symptoms noted in the article could - I'd think - ring a bell with many in this forum. Unlike the 3 B's, TBE is caused by a virus.

 

Is this with an antibody titer or direct visualization?

Do they offer anything in terms of treatment?

 

Antibody titre, off and on. Most of the time I test negative. I can usually anticipate a flare as I test positive for hemolyitic anemia just before I do. I've tested microti-positive through Mayo and the NIH, so, eh, pretty good facilities.

Treatment? Yes, I cannot remember what I took, though. It was three or four years ago. I can't remember much of this morning. I remember I thought it was expensive. Anti malarial with an abx for a protracted period, as I recall, but cannot say with any certainty.

I didn't re-read the duncani study you posted, so I cannot speak to the duration of the treatment protocols for duncani. But, if it can matter for microti, who knows?

You've reached out to the authors, yes?

 

No, not yet. Waiting on some more testing to see if my results have changed after 6 months of continuous treatment.

 

One thing I've learned over way too long is that research-smarts is not necessarily the same as clinical-smarts. In many ways they are cross-elastic and overlap. Sometimes, however, they can be divorced from one another. I love reading the research, but I often take findings with a grain of salt, and do the best I can to make sure it's grounded. Conversely, I listen intently to what my clinicians advise, but make sure I double check that advice against available reputable research. We are traversing in no-man's land in some regards, and it doesn't hurt to have guard rails.

It can be a crap-shoot relative to know where to go for reliable insight.

 

Yes, I understand completely. Apparently Fallon's group at Columbia also does clinical assessments with patients, which is interesting seeing as they are also on the forefront of the research.

In an ideal world I'd like to have one of the researchers from this paper attempt to culture the Babesia from my blood, and then see which therapies are effective on it. I am not sure if this is even possible.

 

Here is an interesting followup published today:

https://www.frontiersin.org/articles/10.3389/fcimb.2021.624745/full

Botanical Medicines Cryptolepis sanguinolenta, Artemisia annua, Scutellaria baicalensis, Polygonum cuspidatum, and Alchornea cordifolia Demonstrate Inhibitory Activity Against Babesia duncani

Abstract:

Human babesiosis is a CDC reportable disease in the United States and is recognized as an emerging health risk in multiple parts of the world. The current treatment for human babesiosis is suboptimal due to treatment failures and unwanted side effects. Although Babesia duncani was first described almost 30 years ago, further research is needed to elucidate its pathogenesis and clarify optimal treatment regimens. Here, we screened a panel of herbal medicines and identified Cryptolepis sanguinolenta, Artemisia annua, Scutellaria baicalensis, Alchornea cordifolia, and Polygonum cuspidatum to have good in vitro inhibitory activity against B. duncani in the hamster erythrocyte model. Furthermore, we found their potential bioactive compounds, cryptolepine, artemisinin, artesunate, artemether, and baicalein, to have good activity against B. duncani, with IC50 values of 3.4 μM, 14 μM, 7.4 μM, 7.8 μM, and 12 μM, respectively, which are comparable or lower than that of the currently used drugs quinine (10 μM) and clindamycin (37 μM). B. duncani treated with cryptolepine and quinine at their respective 1×, 2×, 4× and 8× IC50 values, and by artemether at 8× IC50 for three days could not regrow in subculture. Additionally, Cryptolepis sanguinolenta 90% ethanol extract also exhibited no regrowth after 6 days of subculture at doses of 2×, 4×, and 8× IC50 values. Our results indicate that some botanical medicines and their active constituents have potent activity against B. duncani in vitro and may be further explored for more effective treatment of babesiosis.


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And a personal update: despite the fact that my symptoms are getting progressively more severe, my Babesia FISH and antibody titer are now negative, which I presume is from the months of various treatments.