Mixed Borrelia burgdorferi and Helicobacter pylori Biofilms in Morgellons Disease Dermatological Specimens

Abstract

Background: Morgellons disease (MD) is a dermopathy that is associated with tick-borne illness. It is characterized by spontaneously developing skin lesions containing embedded or projecting filaments, and patients may also experience symptoms resembling those of Lyme disease (LD) including musculoskeletal, neurological and cardiovascular manifestations. Various species of Borrelia and co-infecting pathogens have been detected in body fluids and tissue specimens from MD patients. We sought to investigate the coexistence of Borrelia burgdorferi (Bb) and Helicobacter pylori (Hp) in skin specimens from MD subjects, and to characterize their association with mixed amyloid biofilm development. Methods: Testing for Bb and Hp was performed on dermatological specimens from 14 MD patients using tissue culture, immunohistochemical (IHC) staining, polymerase chain reaction (PCR) testing, fluorescent in situ hybridization (FISH) and confocal microscopy. Markers for amyloid and biofilm formation were investigated using histochemical and IHC staining. Results: Bb and Hp were detected in dermatological tissue taken from MD lesions. Bb and Hp tended to co-localize in foci within the epithelial tissue. Skin sections exhibiting foci of co-infecting Bb and Hp contained amyloid markers including β-amyloid protein, thioflavin and phosphorylated tau. The biofilm marker alginate was also found in the sections. Conclusions: Mixed Bb and Hp biofilms containing β-amyloid and phosphorylated tau may play a role in the evolution of MD.

<p>Classification and Staging of Morgellons Disease: Lessons from Syphilis</p>

“…Recent studies linking Borrelia infection and MD provide evidence meeting many of the criteria proposed by Fredricks and Relman's molecular guidelines for establishing disease causation with sequence-based technology. 12,13,15,19 There are approximately 52 recorded species of Borrelia, of which 21 are classified into the LD group and 29 are classified into the RFB group (two species remain unclassified). Both Bb and RFB have been consistently detected in MD specimens.…”

“…15 Confocal microscopy of mixed aggregates revealed that Bb occupied the central portion of aggregates while Hp occupied the periphery, suggesting that they could have different functional roles, but also suggesting that Bb infection was established first followed by Hp infection. 15 In either case, the results suggest that mixed Borrelia biofilms may play a role in MD development and contribute towards Borrelia persistence and disease chronicity. Although the role of other pathogens and mixed infections in MD skin remains to be determined, it is possible that other microorganisms play a part in MD development and could be co-involved etiological factors in individual patients.…”

“…Bbsl and RFB have been repeatedly and consistently detected in tissue and fluid specimens taken from MD subjects. 8,9,12,13,15 Furthermore, using sensitive molecular methodologies, Bb and RFB have been directly detected and cultured from skin lesions demonstrating MD pathology, 8,9,12,13,[15][16][17][18] thus satisfying many of the criteria outlined in Fredricks and Relman's molecular guidelines for establishing disease causation. 19 Borrelia spirochetes have been detected in MD tissue and body fluid specimens, both directly in dermatological specimens and in cultures from 25 North American MD patients using a combination of microscopic, histopathological and molecular methods.…”

“…These pathogens include the coinfecting tickborne pathogens Bartonella henselae and Rickettsia spp., and the common human pathogens Helicobacter pylori (Hp) and T. denticola. 8,13,15,[23][24][25] Mixed Bb and Hp aggregate structures consistent with biofilms that contain alginate and amyloid protein structures have been identified in MD skin specimens. 15 Confocal microscopy of mixed aggregates revealed that Bb occupied the central portion of aggregates while Hp occupied the periphery, suggesting that they could have different functional roles, but also suggesting that Bb infection was established first followed by Hp infection.…”

“…8,13,15,[23][24][25] Mixed Bb and Hp aggregate structures consistent with biofilms that contain alginate and amyloid protein structures have been identified in MD skin specimens. 15 Confocal microscopy of mixed aggregates revealed that Bb occupied the central portion of aggregates while Hp occupied the periphery, suggesting that they could have different functional roles, but also suggesting that Bb infection was established first followed by Hp infection. 15 In either case, the results suggest that mixed Borrelia biofilms may play a role in MD development and contribute towards Borrelia persistence and disease chronicity.…”