RobWireGuy said...
Does a Bartonella die-off generate a herx effect?? I've read numerous articles stating that this does not happen, unlike Bb. Any insight ?
hi Rob,
i have looked into this a little in the past and will share what i found
my understanding is that the research in this area is incomplete - and gaps in our understanding may have been filled by assumptions - and then the resulting theories reported as fact
firstly the actual cause of herx reactions - especially the ones that chronic lyme sufferers experience lasting from several days to a week or more are not well understood
they differ from the typical herx reaction originally characterised from treating syphilis patients - which occur within hours of initiating antimicrobial treatment and resolve within 24hrs - often much sooner - just a few hours.
in general herx reactions are often assumed to be caused by exposure of lipopolysaccharide from the dead bodies of killed gram negative bacteria triggering an inflammatory immune response -
i think LPS was singled out as its the best known highly immunogenetic compound shared by many bacteria
i think Buhner may have written in his bartonella book that bartonella does not produce Lipopolysaccharide or very little - and therefore if a person is "herxing" - it cannot be due to bartonella die off
in fact there is research which shows bartonella does indeed produce lipopolysaccharide
but the research indicates that bartonella LPS actually blocks normal inflammatory responses ( this is likely an evolutionary adaptation to allow the bacteria to survive in the blood of its host long term - as any bacterial infection in the blood is normally associated with very high fevers - something bartonella especially chronic bartonella is not known for)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2044526/
however - research is incomplete
there are many potential substances and mechanisms inside bacteria that can trigger an immune response - not only LPS
borrelia for instance have lipoproteins that make up their outer membrane and these have been found to be 50x more inflammatory than typical LPS
it may not even be the the LPS or Lipoproteins from dead bacteria that drive the main herx response
in fact
some later research shows that white blood cells that engulf damaged and dying bacteria caused by antibiotics - can go on to produce extremely high levels of inflammatory compounds for days after ingesting the live bacteria - and this is a good candidate for long lasting herx reactions
thus
bartonella may indeed drive powerful herx reactions by some of these other mechanisms
certainly - we often see severe herx reactions reported in people with bartonella in their system
but its also true that most people who become chronically ill seem to have more than a single infection
so it may be difficult to isolate which infection is driving which reaction
i hope its of some help