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CHRONIC LYME DISEASE: SYMPTOMS, VISION AND A NEW APPROACH TO TREATMENT BASED ON A THEORY OF NEUROTOXIN-MEDIATED ILLNESS.
Citation:
Shoemaker, R. AND H. K. Hudnell. CHRONIC LYME DISEASE: SYMPTOMS, VISION AND A NEW APPROACH TO TREATMENT BASED ON A THEORY OF NEUROTOXIN-MEDIATED ILLNESS. Presented at American Society for Microbiology, Lewes, Delaware, April 7-9, 2000.
Description:
Evidence suggests that the estuarine dinoflagellate, Pfiesteria piscicida, and/or morphologically related organisms (Pf-MRO) may release a toxin(s) which kills fish and adversely affects human health. The North Carolina study investigated the potential for persistent health effects in watermen occupationally exposed to Pf-MRO affected estuaries. The results indicated that visual contrast sensitivity (VCS), an indicator of visual pattern detection ability, was reduced by about 30% in the potentially exposed estuary cohort relative to an unexposed age-, gender- and education-matched cohort of offshore workers. A recent study in Maryland investigated the potential for undiagnosed cases of Possible Estuary Associated Syndrome (PEAS), as termed by the CDC, in people having residential and/or recreational exposure to Pf-MRO affected estuaries. The presence of PEAS-associated symptoms was higher, and age-adjusted VCS was significantly lower, in the estuary cohort (N=77) relative to two combined control cohorts (N=87), one without exposure to bodies of water (N=53) and one with exposure to offshore waters (N=34). In the estuary cohort, 37 individuals met the CDC symptomology criteria for PEAS diagnosis and had lower VCS than other cohort members. VCS recovered and symptomology abated after 2 weeks of treatment with cholestyramine. A double-blind, placebo controlled trial showed a similar cholestyramine effect, but no placebo effect. Cholestyramine, the original drug approved for hypercholesterolemia, has previously been reported to enhance the elimination rates of a variety of toxins, presumably by interruption of enterohepatic recirculation through toxin entrapment in its polymeric structure and an anion-exchange process. Control studies showed that repeated VCS testing alone did not improve VCS scores, and that cholestyramine treatment did not affect VCS in hypercholesterolemia patients. These results suggest that: 1) susceptible individuals may acquire PEAS through resid