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11/13/2017 Effectiveness of Samento and Banderol on Borrelia Burgdorferi (July 2010) Townsend Letter for Doctors & Patients
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From the Townsend Letter
July 2010
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In Vitro Effectiveness of Samento and
Banderol Herbal Extracts on the Different
Morphological Forms of Borrelia
Burgdorferi
by Akshita Datar, Navroop Kaur, Seema Patel,
David F. Luecke, and Eva Sapi, PhD
Lyme Disease Research Group
University of New Haven
Abstract
A tick-borne, multisystemic disease, Lyme borreliosis caused by the
spirochete Borrelia burgdorferi has grown into a major public health
problem during the last 10 years. The primary treatment for chronic
Lyme disease is administration of various antibiotics. However,
relapse often occurs when antibiotic treatment is discontinued. One
possible explanation for this is that B. burgdorferi become resistant to
antibiotic treatment, by converting from their vegetative spirochete
form into different round bodies and/or into biofilmlike colonies.
There is an urgent need to find novel therapeutic agents that can
eliminate all these different morphologies of B. burgdorferi. In this
study, two herbal extracts, Samento and Banderol, as well as
doxycycline (one of the primary antibiotics for Lyme disease
treatment) were tested for their in vitro effectiveness on several of the
different morphological forms of B. burgdorferi (spirochetes, round
bodies, and biofilmlike colonies) using fluorescent, darkfield
microscopic, and BacLight viability staining methods. Our results
demonstrated that both herbal agents, but not doxycycline, had very
significant effects on all forms of B. burgdorferi, especially when used
in combination, suggesting that herbal agents could provide an
effective therapeutic approach for Lyme disease patients.
Borrelia burgdorferi, the primary causative agent of Lyme disease, is a spirochetal
bacterium that can adopt different inactive forms, such as cystic and granular
forms (round bodies), as well as colonylike aggregates both in vivo and in vitro, in
the presence of unfavorable conditions such as exposure to the antibiotics
commonly used for treating Lyme borreliosis.1-4 Unfortunately, when B.
burgdorferi is in these inactive forms, conventional antibiotic therapy will not
destroy the bacteria.3 Still to date, the frontline treatment for Lyme disease is
administration of pharmaceutical antibiotics such as doxycycline, minocycline,
clarithromycin, penicillin G, and ceftriaxone.4,5 Many studies have shown that in
spite of continued and high-dose antibiotic therapy, chronic Lyme disease is not
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treated successfully in many cases.6 Also, in the absence of ongoing antibiotic
treatment, relapse is common.7,8 This means that even after antibiotic treatment,
the host immunity fails to prevent recurrence.8 One possible explanation for this
clinical observation is the presence of different morphological forms of B.
burgdorferi, which mayprotect it from the antibacterial therapy. Soon after
treatment, relapse is observed, most likely because the B. burgdorferi can revert to
the spirochetal form. Furthermore, the cost of antibiotic treatment, especially when
administered intravenously, is substantial. Antibiotic therapy may also cause
multiple undesirable side effects.9 Thus, there is an urgent need for novel, more
efficient, and more cost-effective treatment approaches that can efficiently
eliminate all forms of B. burgdorferi.
There is an alternative clinical treatment option gaining wide use, called Cowden
Condensed Support Program, that utilizes several herbal extracts designed to
eliminate microbes in Lyme disease patients. Richard Horowitz, MD, president of
the International Lyme and Associated Diseases Educational Foundation
(ILADEF), has prescribed this protocol for over 2000 of his patient and reports
that it has been effective for more than 70% of them. The two herbal agents from
the Cowden Condensed Support Program selected for this study are Samento (a
pentacyclic chemotype of Cat's Claw [Uncaria tomentosa] that does not contain
tetracyclic oxindole alkaloids), with reported antibacterial and antiviral properties,
and Banderol (Otoba sp.), known to have antibacterial, antiprotozoal and anti-
inflammatory effects.10-12 Both herbal agents are used during the first two months
of Cowden Condensed Support Program, then in rotation with other antimicrobials
for the duration of this 6-month protocol.
In this study, we evaluated these natural antimicrobial herbal extracts as well as
doxycycline (one of the primary pharmaceutical antibiotics for Lyme disease
treatment) for their potential effects on the different forms of B. burgdorferi.
The infectious B31strain of B. burgdorferi used in this study, obtained from
American Type Tissue Collection(ATCC# 35210), was culturedin 5% CO2 at 34
oC, in Barbour–Stoener–Kelly H (BSK H) medium supplemented with 6% rabbit
serum (Sigma, St. Louis, Missouri) to midlogarithmic stage (2 × 107 cells/ml).
Samento and Banderol were obtained from Nutramedix LLC (Jupiter, Florida).
Doxycycline was obtained from Sigma. A wide range of concentrations of
Samento and Banderol were initially tested to determine the effective
concentrations (1:100–1:1000 dilutions). For doxycycline, a concentration 10×
higher than the reported minimum bactericidal concentration (250 µg/ml) was
used.13 Triplicate test tubes containing BSK H medium, with and without the
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appropriately diluted antimicrobial agents, were inoculated with a final density of
5 × 106 cells/ml of the test organism.
Direct cell counting methods with Petroff-Hausser counting chambers and
morphological studies using fluorescent and darkfield microscopic techniques, as
well as LIVE/DEAD BacLight Bacterial Viability Assay (Life Technologies Corp,
Carlsbad, California), were utilized to assess the effect of the antimicrobial agents.
For statistical analyses, one sample paired T-test was performed using NCSS
statistical software (NCSS LLC, Kaysville, Utah).
Samento & Banderol Herbal Extracts
Figure 1A
Figure 1B
11/13/2017 Effectiveness of Samento and Banderol on Borrelia Burgdorferi (July 2010) Townsend Letter for Doctors & Patients
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Figure 1C
Figures 1: The in vitro susceptibility of the spirochete and round-body forms
of the B31 B. burgdorferi to Samento and Banderol extracts and to
doxycycline (250 µg/ml) for 96 hours' treatment period using direct cell
counting and darkfield morphological evaluation methods. (A) Samento
extract; (B) Banderol extract; (C) Samento + Banderol extracts. As a negative
control, 0.25% ethanol was a used. *P- values >0.05 indicates statistical
significance.
In the first set of experiments, we tested the in vitro susceptibility of the spirochete
and round-body forms of the B. burgdorferi B31 strain to Samento and Banderol
extracts for 96 hours, then direct cell counting and darkfield morphological
evaluation methods were used to measure the effects of the antimicrobial agents.
For both herbal extracts, the dilution of 1:400 most efficiently eliminated both the
spirochetal and round-body forms (Figure 1A and 1B). However, when we used
the combination of Samento and Banderol extracts, 1:300 dilution showed the
most effectiveness, and this concentration was chosen for further study (Figure
1C). As a negative control, 0.25% ethanol treatment was also included in all
experiments, because these herbal extracts contain ~25% ethanol to transport the
nutrients into the cells and for stability.
In these experiments, we also compared the effect of Samento and Banderol with
doxycycline, the most common antibiotic treatment agent for Lyme disease
treatment in a 96-hour treatment period. Our results showed that doxycycline (250
µg/ml) was very effective in eliminating the spirochetal form of B. burgdorferi, but
it significantly increased the round-body forms. Comparing this doxycycline data
with that of the herbal extracts, Banderol and the combination of Samento and
Banderol (1:300) were more efficient in eliminating both the spirochetal and
round-body forms of B. burgdorferi in vitro (Figures 1A–C).
In the next set of experiments, we evaluated the effect of the different
antimicrobial agents on biofilmlike colonies of B. burgdorferi. The cultures were
treated as described above for 96 hours and stained with BacLight fluorescent
viability stains, which can help visualize the effects of the antimicrobial agents on
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the bacterial cells (Figure 2). The green fluorescent stain (SYTO 9, with
excitation/emission maxima of about 480/500 nm) colors healthy bacteria that
have intact membranes, thus staining live cells; and the red dye (propidium iodide
with excitation/emission maxima of about 490/635 nm) colors bacteria with
damaged membranes, by displacing the green dye, thus staining dead cells.
Figures 2: BacLight viability staining of B31 strain of B. burgdorferi after 96-
hour treatment using SYTO 9 green-fluorescent nucleic acid stain (live cells)
and propidium iodide, a red-fluorescent nucleic acid stain (dead cells). (A)
Control; (B) Samento (1:300 dilution); (C) Banderol (1:300 dilution); (D)
Samento + Banderol (1:300 dilution); (E) Doxycycline (250 µg/ml). All images
are taken at 40× magnification.
Figure 2A
Figure 2B
Figure 2C
In the absence of antimicrobial agents,
B. burgdorferi is forming biofilmlike
colonies (Figure 2A) with mainly live
bacterial cells. In the presence of
Samento extract (1:300), the colonies
were significantly smaller and less
organized (Figure 2B), but they did
stain with green dye, indicating that live
cells remained. In the presence of
Banderol extracts, the size of colonies
did not show any reduction; however,
the cells inside the colonies are >90%
dead.
In the presence of both herbal extracts,
no sign of any colony formation was
observed in the cultures, but we found
evidence of a few individual nonmotile
but green spirochetes and round bodies.
In the presence of doxycycline (250
µg/ml), the average colony size was
increased and contained mainly live
round-body forms.
In this study, our working hypothesis
was that for an efficient therapy, we
have to find antimicrobial agents that
can eliminate all the forms of B.
burgdorferi. During the course of
Borrelia infection, the bacteriumcan
shift among the different forms,
11/13/2017 Effectiveness of Samento and Banderol on Borrelia Burgdorferi (July 2010) Townsend Letter for Doctors & Patients
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Figure 2D converting from the spirochete form to
the others when presented with an
unfavorable environment and reverting
to the spirochete when the condition is
again favorable for growth.1-4 To
successfully eradicate B. burgdorferi,
antimicrobial agents should eliminate
all those forms, including the
spirochetes, round bodies, and
biofilmlike colonies.
Here we have provided evidence that
two natural antimicrobial agents
(Samento and Banderol extracts) had
significant effect on all three known
forms of B. burgdorferi bacteria in vitro.
We have also demonstrated that
doxycycline, one of the primary
antibiotics used in the clinic to treat
Lyme disease, only had significant
effect on the spirochetal form of B.
burgdorferi.5
Figure 2E
Our later results might provide some explanation for why relapse is so common
after discontinuing antibiotic therapy. For example, some of the recent reports on
animal experiments demonstrated that although pharma ceutical antibiotics are
effective in ameliorating disease, the infection may persist even after seemingly
effective therapy, which suggested that Borrelia may remain viable even after
antibiotic administration.14-15 If those pharmaceutical antibiotics only eliminate
one form of this bacterium, the other forms could be the source of the persistent
disease.
The other very important fact needs to be considered for an effective treatment for
Borrelia infection: this bacterium typically has a life span ranging from several
weeks to six to eight months; therefore, it may take six to eight months for even
one generation of Borrelia to become exposed to the antimicrobial for
elimination.16 Since the herbal extracts like Samento are reported to be nontoxic,
they can be safely taken daily for the long period of time necessary to thoroughly
eradicate Borrelia from an infected body.17
In summary, our study has provided in vitro research data on a novel treatment
11/13/2017 Effectiveness of Samento and Banderol on Borrelia Burgdorferi (July 2010) Townsend Letter for Doctors & Patients
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approach using herbal antimicrobial agents to efficiently eradicate B. burgdorferi,
the Lyme disease bacterium.
Corresponding Author
Eva Sapi, PhD
University of New Haven
Department of Biology and Environmental Sciences
300 Boston Post Road
West Haven, Connecticut 06516
esapi@newhaven.edu
Notes
1. Gruntar I, Malovrh T, Murgia R, Cinco M. Conversion of Borrelia garinii
cystic forms to motile spirochetes in vivo. Acta Pathol Microbiol Scand.
2001;109:383–388.
2. Brorson Ø, Brorson SH. In vitro conversion of Borrelia burgdorferi to cystic
forms in spinal fluid, and transformation to mobile spirochetes by incubation in
BSK-H medium. Infection. 1998;26:44–50.
3. Miklossy J, Kasas S, Zurn AD, McCall S, Yu S, McGeer PL. Persisting
atypical and cystic forms of Borrelia burgdorferi and local inflammation in Lyme
neuroborreliosis. J Neuroinflammation. 2008;25:5–40.
4. Brorson Ø, Brorson SH, Scythes J, MacAllister J, Wier A, Margulis L.
Destruction of spirochete Borrelia burgdorferi round-body propagules (RBs) by the
antibiotic tigecycline. Proc Natl Acad Sci U S A. 2009 Nov;106(44):18656–18661.
5. Burrascano J. Advanced topics in Lyme disease. In: Managing Lyme Disease.
15th ed. 2005:1–33.
6. Krause PJ, Foley DT, Burke GS, Christianson D, Closter L, Spielman A.
Reinfection and relapse in early Lyme disease. Am Trop Med Hyg.
2006;75(6):1090–1094.
7. Klempner M, Linden MD, Hu T, J Evans J, et al. Two controlled trials of
antibiotic treatment in patients with persistent symptoms and a history of Lyme
disease. N Engl J Med. 2001;345:85–92.
8. Horowitz R. Classical and integrative medical approaches in chronic Lyme
disease: new paradigms in diagnosis & treatment. 8th Annual International Lyme
and Associated Diseases Society (ILADS) Conference; 2007 October.
9. Matsuura T, Shimizu Y, Fujimoto H, et al. Minocycline-related lupus.
Lancet.1992;340:1553.
10. Ccahuana-Vasquez RA, Santos SS, Koga-Ito CY, Jorge AO. Antimicrobial
activity of Uncaria tomentosa against oral human pathogens. Braz Oral Res. 2007
Jan-Mar;21(1):46–50.
11. Valerio LG Jr, Gonzales GF. Toxicological aspects of the South American
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herbs cat's claw (Uncaria tomentosa) and Maca (Lepidium meyenii): a critical
synopsis. Toxicol Rev. 2005;24(1):11–35.
12. Weniger B, Robledo S, Arango GJ, et al. Antiprotozoal activities of Colombian
plants. J Ethnopharmacol. 2001 Dec;78(2–3):193–200.
13. Baradaran-Dilmaghani R, Stanek G. In vitro susceptibility of thirty Borrelia
strains from various sources against eight antimicrobial chemotherapeutics.
Infection. 1996 Jan–Feb;24(1):60–63.
14. Bockenstedt LK, Mao J, Hodzic E, et al. Detection of attenuated, noninfectious
spirochetes in Borrelia burgdorferi-infected mice after antibiotic treatment. J Infect
Dis. 2002; 186:1430–1437.
15. Barthold SW, Hodzic E, Imai DM, Feng S, Yang X, Luft BJ. Ineffectiveness of
tigecycline against persistent Borrelia burgdorferi. Antimicrob Agents Chemother.
2010 Feb;54(2):643–651.
16. Samuels DS and Radolf JD. Borrelia: Molecular Biology, Host Interaction and
Pathogenesis. Caister Academic Press; 2010.
17. Reinhard K-H. Uncaria tomentosa (Willd.) D.C.: Cat's claw, Una de Gato, or
Saventaro. J Alt Comp Med. 1999;5:143–151.
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