Biofilms and Their Effect on Lyme Disease

It has been well established that up to 30% of patients who are diagnosed and treated for Lyme disease experience post-treatment Lyme disease syndrome (PTLDS). PTLDS is characterized by persistent symptoms that can last for months or years. These symptoms can include fatigue, cognitive impairment, joint and muscle aches, and neuropathy, among others. There are a few factors that contribute to the development of PTLDS and one of them is the ability of the bacteria to hide beneath biofilms and evade any attempts to eradicate it. Dr. Eva Sapi published results of her research in 2016 demonstrating that the bacteria that causes Lyme disease, Borrelia burgdorferi, can form biofilms in the body which help them persist despite treatment.
What Are Biofilms?
Biofilms are a community of micro-organisms that live together in what can be visualized as a slimy matrix. The slimy matrix is made up of proteins, polysaccharides, and eDNA or genetic material shed by organisms. Plumbers understand biofilms due to their ability to form when micro-organisms persist in plumbing systems and damage pumps and the water system. Biofilms can spread pathogens, such as Legionella bacteria, through water distribution systems. The World Health Organization estimates that 15% of hospital patients contract infections caused by pathogens spread through biofilms. New research finds that 80% of all bacterial infections are biofilm based. Staph aureus and pseudomonas are two of the most common biofilm-forming bacteria.
How Biofilms Develop: Five-Step Process
1.) Individual bacteria migrate and aggregate together in communities.
2.) When the numbers of the bacteria are high enough, they are able to use a process known as quorum sensing to communicate with each other to sense their population density and adjust their gene expression. Together they respond to nutrient availability, defend themselves against other microorganisms, and avoid toxic compounds to survive.
3.) They secrete biopolymers into the environment. Biopolymers are a complex group of molecules that can include proteins, DNA, carbohydrates, lipids, and more. They protect microorganisms and anchor them to surfaces, i.e. tissue in the body.
4.) Biofilms fully develop by forming microcolonies and water channel structures and become more layered. Fully mature biofilms function as three dimensional communities.
5.) Some bacteria are embedded deep in the matrix and don’t have access to nutrients at the surface of the biofilm. They go dormant so that when you use an anti-microbial agent to kill an infection, these dormant bacteria don’t ingest the agent, so they don’t die. These dormant bacteria are called persister cells. With time, persister cells emerge from dormancy and regrow the colony. This makes biofilm-based infections difficult to kill.
Biofilm Studies Reveal New Information
New studies have shown that biofilms are dynamic and may not always follow the five-step process. It has been established that biofilms can be attached or detached in the body. Biofilms can be anchored to surfaces throughout the body, including the respiratory tract, urinary tract, and soft tissue wounds. They can also form on medical devices. Detached biofilms are bacterial cells or clusters that have been released from the surface of a biofilm. Changes in barometric pressure, temperature, and chemistry can lead to detachment as well as the use of biofilm busting agents. I have many patients that report that changes in barometric pressure can aggravate their symptoms and I have questioned if this is due to the dynamic nature of biofilms.
Strategies to Address Biofilms
1. Inhibit Quorum Sensing
Inhibiting quorum sensing can prevent infections from continually renewing themselves. Quercetin and Luteolin have been shown to inhibit quorum sensing in staphylococcus aureus infections. Quercetin and baicalin are important quorum sensing inhibitors in pseudomonas infection. Since staph aureus and pseudomonas are two of the most common biofilm forming bacteria, it’s likely that the quorum sensing inhibitory properties of quercetin, luteolin, and baicalin may transfer to other bacteria
2. Biofilm Busters
In addressing an infection that has been persistent, it is best to use whatever agents are known or suspected to kill or harm the bacteria, while adding both biofilm disruption and immune support, to get a better outcome. If you know that an anti-microbial agent has worked in the past at controlling an infection, but the infection comes back, you can consider using the same agent that worked before and adding biofilm disruption to the treatment. This will give the anti-microbial agent more effective penetration into the biofilm.
In addition, my protocols always include a period of pulsing the anti-microbial agents, i.e., antibiotics or herbal remedies. Higher doses of anti-microbial agents can break through biofilms as well as help eradicate more of the bacteria.
Many natural substances found in our diet such as phytochemicals and essential oils as well as others have been shown to disrupt biofilms. Eating a healthy mostly plant-based diet rich in vegetables, fruits, and spices can assist in preventing and disrupting biofilms.
Natural ways of breaking through biofilms include:
- Bismuth subnitrate has been shown to have very good anti-biofilm effects against staph, pseudomonas, and proteus bacterial infections. Adding alpha lipoic acid and DMPS can enhance its anti-biofilm activity.
- In addition to disrupting quorum sensing it can also disrupt biofilms.
- Viruses can be used to engulf bacteria and break through biofilms to eradicate them.
- Lactoferrin can prevent biofilm formation, eradicate established biofilms, and make biofilms more susceptible to other treatments. It also binds to iron which is an essential nutrient for bacteria.
- Essential oils such as cedar, clove, cinnamon, carvacols, propolis, rosemary.
- Curcumin has been found to have synergy with anti-bacterial agents against biofilm producing bacteria.
- Curcumin and N-Acetyl Cysteine (NAC) have been shown to break through biofilms created by H. pylori bacteria.
- Nattokinase, serrapeptidase and Lumbrokinase as well as proteases, amylases, DNAses and Beta-Glucosidase when taken on an empty stomach.
- Garlic contains organosulfur compounds that can inhibit bacterial adhesion and biofilm formation.
- EGCG is the active ingredient in green tea.