ASSOCIATION OF SPIROCHETAL INFECTION WITH MORGELLONS DISEASE
Marianne J Middelveen,1 Divya Burugu,2 Akhila Poruri,2 Jennie Burke,3 Peter J Mayne,1 Eva Sapi,2 Douglas G Kahn,4 and Raphael B Strickera,1
US National Library of Medicine
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- PMC3954163
Version 1. F1000Res. 2013; 2: 25.
Published online 2013 Jan 28. doi: 10.12688/f1000research.2-25.v1
PMCID: PMC3954163
Association of spirochetal infection with Morgellons disease
Marianne J Middelveen,1 Divya Burugu,2 Akhila Poruri,2 Jennie Burke,3 Peter J Mayne,1 Eva Sapi,2 Douglas G Kahn,4 and Raphael B Strickera,1
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Abstract
Morgellons disease (MD) is an emerging multisystem illness characterized by skin lesions with unusual filaments embedded in or projecting from epithelial tissue. Filament formation results from abnormal keratin and collagen expression by epithelial-based keratinocytes and fibroblasts. Recent research comparing MD to bovine digital dermatitis, an animal infectious disease with similar skin features, provided clues that spirochetal infection could play an important role in the human disease as it does in the animal illness. Based on histological staining, immunofluorescent staining, electron microscopic imaging and polymerase chain reaction, we report the detection of Borrelia spirochetes in dermatological tissue of four randomly-selected MD patients. The association of MD with spirochetal infection provides evidence that this infection may be a significant factor in the illness and refutes claims that MD lesions are self-inflicted and that people suffering from this disorder are delusional. Molecular characterization of the Borrelia spirochetes found in MD patients is warranted.
Introduction
Morgellons disease (MD) is an evolving skin disease associated with filaments found beneath unbroken skin or projecting from spontaneously-appearing, slowly-healing skin lesions 1. In addition to dermopathy, patients may also exhibit debilitating musculoskeletal and neurological manifestations resembling the symptoms of Lyme disease 1, 2. Similarities were found between MD and bovine digital dermatitis (BDD), a disease common in dairy herds and characterized by keratin filament formation in skin lesions that frequently occur above the hind feet of cows 3, 4. Chronic BDD lesions demonstrate proliferation of long keratin filaments, and microscopic examination of histological sections from this tissue has revealed the presence of various Treponema spp. among enlarged keratinocytes throughout the stratum spinosum and dermal papillae 5– 9.
The etiology of BDD is considered to be multifactorial with coinvolvement of spirochetes and other bacterial pathogens 10– 14. In the animal disease, repeated detection of spirochetes from lesions and sero-reactivity to Borrelia burgdorferi antigens provides evidence of spirochetal involvement 10– 14. Successful experimental infection with tissue homogenates and pure cultured treponemes has confirmed that spirochetes are primary etiologic agents 15, 16.
Like BDD, MD filaments are produced by epithelial cells and stem from the stratum basale and from the root sheath of hair follicles, thus providing evidence that the filaments are cellular in origin 3, 4. Furthermore, immunohistochemical and histological staining has demonstrated that these filaments have a collagen as well as a keratin component 5, 17. Like cattle with BDD, patients with MD also produce antibodies reactive to Borrelia burgdorferi antigens 18. Multisystemic symptoms resembling Lyme disease also imply a possible spirochetal etiology for MD 1– 3, 18, 19. The frequent clinical diagnosis of Lyme disease and coinfecting tick-borne pathogens in MD patients suggests a multifactorial etiology and possible vectoring by ticks 1– 3, 18, 19.
In light of the proven spirochetal association with BDD and the possible association with MD, we undertook a histological, electron microscopic and PCR study of MD dermatological tissue samples to investigate the presence of spirochetes in these samples. In addition, bacterial culture was conducted to investigate the possibility of viable spirochetes in MD tissue.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3954163/