Oral spirochetes as a proxy for Borrelia

First-line treatment for Lyme disease — or Lyme borreliosis — is broad-spectrum tetracycline-class antibiotic therapy, which is assumed to eliminate Borrelia from the body, but a question that remains is the following:

Why is treatment for Lyme borreliosis considered successful when living spirochetes are still present in saliva after treatment?

The etiological agent of Lyme disease is Borrelia burgdorferi, a species from a family of helical bacteria called spirochetes. The Spirochaetaceae family includes two important genera: Treponema, and Borrelia. The species Borrelia burgdorferi is the most recognized species associated with Lyme disease. Treponema is common to the human mouth, and includes over 75 different species, the pathogenicity of which is yet to be determined primarily because only a small number can be reliably cultured. Among the known pathogens of the genus is Treponema denticola, associated with oral inflammation, tissue destruction, and bone resorption.

Treponema and Borrelia are both spirochete genera that contain species with known pathogenicity.

Do antibiotics kill spirochetes?
Yes, but sometimes when spirochetes are in stressful conditions during antibiotic treatment they go into round body form, which is an umbrella term for several types of changes in morphology that the spirochete undergoes to protect itself from antibiotics. This rapid change sometimes turns them into “persister” bacteria, which remain dormant until conditions in the body are supportive again, in which case they return to their active helical form and continue to do damage to the body.

How do antibiotics kill spirochetes?
The standard antibiotic treatment for Lyme diseases is a protein synthesis inhibitor, which stops spirochete proliferation by disrupting a process that allows protein generation in the bacterial cell. This treatment is often combined with other antibiotics at the same time, called combination therapy.

There is growing evidence to suggest that bacterial biofilms, which are increasingly common, may provide a resistant structure strong enough to prevent thorough systemic efficacy of antibiotics. The oral cavity has naturally occurring biofilms in the form of plaque, and it is notable that after combination therapy, active spirochetes in high abundance are still seen in the saliva.

What is unique about Lyme-N is that it has demonstrated not only instant kill of spirochetes, but also shows strong support for biofilm penetration.

If I still have oral spirochetes after taking antibiotics, does this mean I still have Lyme disease?
Our findings after years of research have indicated that in cases where antibiotics do not resolve Lyme disease symptoms, it is because the antibiotic treatment was not effective in terms of elimination. This is further supported by live microscopy of a saliva samples post-antibiotics showing active spirochetes in the saliva. We have not seen evidence to suggest that antibiotics eliminate spirochetes from the body in all cases.