Evaluation of Natural and Botanical Medicines for Activity Against Growing and Non-growing Forms of B. burgdorferi (2020) Feng et al

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https://www.frontiersin.org/article...m_campaign=ba-sci-fmed-botanical-lyme-disease

Lyme disease is the most common vector-borne disease in the US and Europe. Although the current recommended Lyme antibiotic treatment is effective for the majority of Lyme disease patients, about 10–20% of patients continue to suffer from persisting symptoms. There have been various anecdotal reports on the use of herbal extracts for treating patients with persisting symptoms with varying degree of improvements.

However, it is unclear whether the effect of the herb products is due to their direct antimicrobial activity or their effect on host immune system. In the present study, we investigated the antimicrobial effects of 12 commonly used botanical medicines and three other natural antimicrobial agents for potential anti-Borrelia burgdorferi activity in vitro.

Among them, 7 natural product extracts at 1% were found to have good activity against the stationary phase B. burgdorferi culture compared to the control antibiotics doxycycline and cefuroxime. These active botanicals include Cryptolepis sanguinolenta, Juglans nigra (Black walnut), Polygonum cuspidatum (Japanese knotweed), Artemisia annua (Sweet wormwood), Uncaria tomentosa (Cat's claw), Cistus incanus, and Scutellaria baicalensis (Chinese skullcap).
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In subculture studies, only 1% Cryptolepis sanguinolenta extract caused complete eradication, while doxycycline and cefuroxime and other active herbs could not eradicate B. burgdorferi stationary phase cells as many spirochetes were visible after 21-day subculture.
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B. burgdorferi can evade the immune system response (15, 16) and multiple studies have shown that the bacteria is capable of persisting in diverse tissues across a variety of animal models despite aggressive and prolonged antibiotic therapy (17–19).

In addition to the mammalian studies noted above, B. burgdorferi persistence following antibiotic treatment has been demonstrated in human studies and case reports (20–23).
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While antibiotic retreatment has been associated with improved clinical outcomes (27, 28), antibiotic therapy appears to be more effective against the actively dividing spirochete form. In addition, it has been shown that B. burgdorferi can change morphology and form biofilm-like microcolonies consisting of stationary phase persister bacteria (29–31). Traditional antibiotics have poor activity against the atypical persister forms (round bodies, microcolonies, and biofilm) and we have previously worked to identify novel drugs and drug combinations that are effective against these atypical forms (29, 30, 32).
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