≪ ≫

Summary

Although environmentally acquired illness can be a challenge to diagnose, once these disorders have been correctly identified, removal of the primary inciting cause and treatment aimed at reducing inflammation and oxidative stress are very helpful to eliminate pain in most cases. A root-cause approach and therapies directed at the interruption of pain at the molecular level are most effective in these patients.

References

  • 1. Mast W.E., Burrows W.M. Erythema chronicum migrans and ‘Lyme arthritis’. JAMA 1976;236(21):2392.
  • 2. Steere A.C., Malawista S.E., Snydman D.R., Shope R.E., Andiman W.A., Ross M.R., Steele F.M. Lyme arthritis: an epidemic of oligoarticular arthritis in children and adults in three Connecticut communities. Arthritis Rheum 1977;20( 1):7—17.
  • 3. Burgdorfer W. Discovery of the Lyme disease spirochete and its relation to tick vectors. Yale J Biol Med 1984;57(4):515—520.
  • 4. Steere A.C., Hutchinson G.J., Rahn D.W., Sigal L.H., Craft J.E., DeSanna E.T., Malawista S.E. Treatment of the early manifestations of Lyme disease. Ann Intern Med 1983;99(l):22-26.
  • 5. Hall Stephen S. Iceman autopsy. National Geographic 2011. Archived from the original on 19 October 2011.
  • 6. Mead P.S. Epidemiology of Lyme disease. Infect Dis Clin North Ain 2015:29(2): 187—210.
  • 7. https://www.cdc.gov/lyme/stats/tables.html (accessed 15 October 2018).
  • 8. Shapiro Eugene D., Gerber Michael A. Lyme disease. Clin Infect Dis 2000;31(2):533-542.
  • 9. Watson S.C., Liu Y.. Lund R.B.. Gettings J.R., Nordone S.K.. McMahan C.S., Yabsley M.J. A Bayesian spatio-temporal model for forecasting the prevalence of antibodies to Borrelia burgdorferi, causative agent of Lyme disease, in domestic dogs within the contiguous United States. PLOS ONE 2017;12(5).
  • 10. Steere A.C., Dwyer E„ Winchester R. Association of chronic Lyme arthritis with HLA-DR4 and HLA-DR2 alleles. N Engl J Med 1990;323(4):219-223.
  • 11. Logigian E.L., Kaplan R.F., Steere A.C. Chronic neurologic manifestations of Lyme disease. N Engl J Med 1990;323(21):1438—1444.
  • 12. Seltzer E.G., Gerber M.A., Cartter M.L., Freudigman K., Shapiro E.D. Long-term outcomes of persons with Lyme disease. JAMA 2000;283(5):609—616.
  • 13. Rupprecht T.A., Koedel U., Fingerle V., Pfister H.W. The pathogenesis of Lyme neuroborreliosis: from infection to inflammation. Mol Med 2008:14(3—4):205—212.
  • 14. Ramesh G., Didier P.J., England J.D., et al. Inflammation in the pathogenesis of Lyme neuroborreliosis. Am J Pathol 2015;185(5):1344-1360.
  • 15. Singh S.K., Girschick H.J. Lyme borreliosis: from infection to autoimmunity. Clin Microbiol Infect 2004:10(7):598—614.
  • 16. Smith R.P., Schoen R.T., Rahn D.W., et al. Clinical characteristics and treatment outcome of early Lyme disease in patients with microbiologically confirmed erythema migrans. Ann Intern Med 2002; 136(6) :421 —428.
  • 17. Bratton Robert L., Whiteside J.W., Hovan M.J., Engle R.L., Edwards F.D. Diagnosis and treatment of Lyme disease. Mayo Clin Proc 2008;83(5):566-571.
  • 18. Bunikis Jonas, Barbour Alan G. Laboratory testing for suspected Lyme disease Medical Clinics 2002;86(2):311-340.
  • 19. Waddell L.A., Greig J., Mascarenhas M., Harding S., Lindsay R., Ogden N. The accuracy of diagnostic tests for Lyme disease in humans, A systematic review and meta-analysis of North American research. PLOS ONE 2016;ll(12):e0168613. doi:10.1371/journal.pone.0168613
  • 20. Kalish Robert A., McHugh Gail, Granquist John, Shea Barry, Ruthazer Robin, Steere Allen C. Persistence of immunoglobulin M or immunoglobulin G antibody responses to Borrelia burgdorferi 10-20 years after active Lyme disease. Clin Infect Dis 2001 ;33(6):780—785.
  • 21. Aucott John, Morrison Candis, Munoz Beatriz, Rowe Peter C, Schwarzwalder Alison, West Sheila K. Diagnostic challenges of early Lyme disease: lessons from a community case series. BMC Infect Dis 2009;9(1):1—8.
  • 22. Pritt B.S., Mead P.S., Johnson D.K.H., et al. Identification of a novel pathogenic Borrelia species causing Lyme borreliosis with unusually high spirochaetaemia: a descriptive study. Lancet Infect Dis 2016; 16(5 ):556-564.
  • 23. https://www.hhs.gov/ash/advisory-committees/tickbornedisease/reports/testing-and-diagnostics-20 18-5-9/index.html (accessed 24 February 2019).
  • 24. Wormser G.P., Dattwyler R.J., Shapiro E.D., et al. The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the infectious diseases society of America. Clin Infect Dis 2006;43(9): 1089-1134.
  • 25. Johnson L., Strieker R.B. The infectious diseases society of America Lyme guidelines: a cautionary tale about the development of clinical practice guidelines. Philos Eth Humanit Med 2010:5-9.
  • 26. Melia Michael T, Auwaerter Paul G. Time for a different approach to Lyme disease and long-term symptoms. N Engl J Med 2016;374(13):1277—1278.
  • 27. Rebman Alison W., Bechtold Kathleen T, Ting Yang, Mihm Erica A., Soloski Mark J., Novak Cheryl B., Aucott John N. The clinical, symptom, and quality-of-life characterization of a well-defined group of patients with posttreatment Lyme disease syndrome. Front Med 2017;4:1-10.
  • 28. Middelveen M.J., Sapi E., Burke J., et al. Persistent Borrelia infection in patients with ongoing symptoms of Lyme disease. Healthcare (Basel) 2018;6(2):33. doi:10.3390/healthcare6020033
  • 29. Feng J., Auwaerter P.G., Zhang Y. Drug combinations against Borrelia burgdorferi persisters in vitro: eradication achieved by using daptomycin, cefoperazone and doxycycline. PLOS ONE 2015;10(3):e0117207.
  • 30. Sharma Bijaya, Brown Autumn V., Matluck Nicole E., Hu Linden T., Lewis Kim. Borrelia burgdorferi, the causative agent of Lyme disease, forms drug-tolerant persister cells. Antimicrob Agents Chemother 2015;59(8):4616—4624.
  • 31. Strieker Raphael B. Counterpoint: long-term antibiotic therapy improves persistent symptoms associated with Lyme disease. Clin Infect Dis 2007:45(2): 149-157.
  • 32. Cameron Daniel I, Johnson Lorraine B., Maloney Elizabeth L. Evidence assessments and guideline recommendations in Lyme disease: the clinical management of known tick bites, erythema migrans rashes and persistent disease. Expert Rev Anti-Infect Ther 2014;12(9):1103—1135.
  • 33. Feng Jie, Shi W., Miklossy J., Tauxe G.M., McMeniman C.J., Zhang Y. Identification of essential oils with strong activity against stationary phase Borrelia burgdorferi. Antibiotics 2018;7(4):89.
  • 34. Feng J., Zhang S., Shi W„ Zubcevik N.. Miklossy J., Zhang Y. Selective essential oils from spice or culinary herbs have high activity against stationary phase and biofilm Borrelia burgdorferi. Front Med 2017;4:169.
  • 35. Goc A., Rath M. The anti-borreliae efficacy of phytochemicals and micronutrients: an update. TlterAdv Infect Dis 2016;3(3—4):75—82.
  • 36. Swanson S.J., Neitzel D., Reed K.D., Belongia E.A. Coinfections acquired from ixodes ticks. Clin Microbiol Rev 2006;19(4):708-727.
  • 37. https://www.cdc.gov/ticks/diseases/index.html (accessed 23 February 2019).
  • 38. Douwes J., Thorne R, Pearce N.. Heederik D. Bioaerosol effects and exposure assessment: progress and prospects. Annals Occup Hygeine 2003:47(3): 187-200.
  • 39. Rao C.Y., Riggs M.A., Chew G.L., et al. Characterization of airborne molds, endotoxins, and glucans in homes in New Orleans after hurricanes Katrina and Rita. Appl Environ Microbiol 2007;73(5>:1630—1634.
  • 40. Wu F., Jacobs D., Mitchell C., Miller D., Karol M.H. Improving indoor environmental quality for public health: impediments and policy recommendations. Environ Health Perspect 2007; 115(6):953—957.
  • 41. Wayne L. Bryden PhD, mycotoxins in the food chain: human health implications. Asia Рас J Clin Nutr 2007:16 (Suppl 1 ):95—101.
  • 42. Maresca Marc, Yahi N., Younes-Sakr L., Boyron M., Caporiccio B., Fantini J. Both direct and indirect effects account for the pro-inflammatory activity of enteropathogenic mycotoxins on the human intestinal epithelium: stimulation of interleukin-8 secretion, potentiation of interleukin-1 beta effect and increase in the transepithelial passage of commensal bacteria. Toxicol Appl Pharmacol 2008;228(1):84—92.
  • 43. Oswald I.P., Marin D.E., Bouhet S., Pinton P, Taranu I., Accensi F. Immunotoxicological risk of mycotoxins for domestic animals. Food Addit Contain 2005;22(4):354-360.
  • 44. Doi K., Uetsuka K. Mechanisms of mycotoxin-induced neurotoxicity through oxidative stress-associated pathways. Int J Mol Sci 2011;12(8):5213—5237.
  • 45. Ahearn Donald, Simmons R.B., Crow S.A., Rose L.J. Volatile organic compounds associated with microbial growth in automobile air conditioning systems. Curr Microbiol 2000;41(3):206-209.
  • 46. https://www.greatplainslaboratory.com/gplmycotox (accessed 23 February 2019).
  • 47. Solfrizzo M., Visconti A., Avantaggiato G., Torres A., Chulze S. In vitro and in vivo studies to assess the effectiveness of cholestyramine as a binding agent for fumonisins. Mycopathologia 2001:151(3): 147.
  • 48. Underhill K.L., Rotter B.A.. Thompson B.K., Prelusky D.B.. Trenholm H.L. Effectiveness of cholestyramine in the detoxification of zearalenone as determined in mice. Bull Environ Contain Toxicol 1995;54(1):128.
  • 49. James L.J., Smith T.K. Effect of dietary alfalfa on zearalenone toxicity and metabolism in rats and swine. J Anim Sci 1982;55( 1): 110—118.
  • 50. Smith T.K. Effect of dietary protein, alfalfa, and zeolite on excretory patterns of 5',5',7',7'-[3H]zearale- none in rats. Can J Physiol Pharmacol 1980; 58(11): 1251—1255. doi: 10.1139/y80-191.
  • 51. https://www.biofuelscoproducts.umn.edu/sites/biodieselfeeds.cfans.umn.edu/ftles/cfans_asset_413777. pdf (accessed 23 February 2019).
  • 52. Schmitt B., Vicenzi M., Garrel C., Denis F.M. Effects of N-acetylcysteine, oral glutathione (GSH) and a novel sublingual form of GSH on oxidative stress markers: a comparative crossover study. Redox Biol 2015:6:198-205.
  • 53. Guilford F.T., Hope J. Deficient glutathione in the pathophysiology of mycotoxin-related illness . Toxins 2014;6(2):608—623.
  • 54. Siddiqui M.Z. Boswellia serrata, a potential antiinflammatory agent: an overview. Indian J Pharm Sci 2011:73(3):255—261.
  • 55. Winking M., Sarikaya S., Rahmanian A., Jodicke A., Boker D.K. Boswellic acids inhibit glioma growth: a new treatment option? J Neurooncol 2000;46(2):97.
  • 56. Catanzaro D., Rancan S., Orso G., et al. Boswellia serrata preserves intestinal epithelial barrier from oxidative and inflammatory damage. PLOS ONE 2015;10(5):e0125375.
  • 57. Barakat Bassant M., Ahmed Hebatalla I., Bahr Hoda I.. Elbahaie Alaaeldeen M. Protective effect of boswellic acids against doxorubicin-induced hepatotoxicity: impact on Nrf2/HO-l defense pathway. OxidMed Cell Longev 2018;Article ID 8296451:10.
  • 58. Abe Y., Hashimoto S., Horie T. Curcumin inhibition of inflammatory cytokine production by human peripheral blood monocytes and alveolar macrophages. Pharmacol Res 1999:39(1 ):41 —47.
  • 59. Singh S., Aggarwal B. Activation of transcription factor NF-кВ is suppressed by curcumin (diferuloyl- methane). J Biol Chem 270(42):24995-25000.
  • 60. Nakagawa Y., Mukai S., Yamada S. et al. Short-term effects of highly-bioavailable curcumin for treating knee osteoarthritis: a randomized, double-blind, placebo-controlled prospective study. J Orthop Sci 2014;19(6):933.
  • 61. Zhou S., Zhang S., Shen H., et. al. Curcumin inhibits cancer progression through regulating expression of microRNAs. Tumour Biol 2017:39(2).
  • 62. Kunnumakkara A.B., Anand P., Aggarwal B.B. Curcumin inhibits proliferation, invasion, angiogenesis and metastasis of different cancers through interaction with multiple cell signaling proteins. Cancer Lett 2008;269(2):199-225.
  • 63. Mijnhout G.S., Alkhalaf A., Kleefstra N., Bilo H.J. Alpha lipoic acid: a new treatment for neuropathic pain in patients with diabetes? Neth J Med 2010:68(4): 158—162.
  • 64. Agathos E., Tentolouris A., Eleftheriadou I., et al. Effect of a-lipoic acid on symptoms and quality of life in patients with painful diabetic neuropathy. J Ini Med Res 2018;46(5):1779—1790.
  • 65. Nascimento O.J., Pessoa B.L., Orsini M., et al. Neuropathic pain treatment: still a challenge. Neurol Int 2016;8(2):6322.
  • 66. Younger J., Parkitny L., McLain D. The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain. Clin Rheumatol 2014;33(4):451—459.
  • 67. Smith J.P., Bingaman S.I., Ruggiero F., Mauger D.T., Mukherjee A., McGovern C.O., Zagon I.S. Therapy with the opioid antagonist naltrexone promotes mucosal healing in active Crohn’s disease: a randomized placebo-controlled trial. Dig Dis Sci 2011 ;56(7):2088—2097.
  • 68. Smith J.P., Stock H., Bingaman S., Mauger D., Rogosnitzky M., Zagon I.S. Low-dose naltrexone therapy improves active Crohn’s disease. Am J Gastroenterol 2007;102(4):820-828.
  • 69. Cree B.A., Kornyeyeva E., Goodin D.S. Pilot trial of low-dose naltrexone and quality of life in multiple sclerosis. Ann Neurol 2010:68(2): 145-150.
  • 70. Younger J., Noor N„ McCue R., Mackey S. Low-dose naltrexone for the treatment of fibromyalgia: findings of a small, randomized, double-blind, placebo-controlled, counterbalanced, crossover trial assessing daily pain levels. Arthritis Rheum 2013;65(2):529—538.
  • 71. Younger J., Mackey S. Fibromyalgia symptoms are reduced by low-dose naltrexone: a pilot study. Pain Med 2009;10(4):663-672.
  • 72. Bihari B. Bernard Bihari, MD: low-dose naltrexone for normalizing immune system function. Altern Ther Health Med 2013;19(2):56-65.
  • 73. Hutchinson M.R., Zhang Y., Brown K., et al. Non-stereoselective reversal of neuropathic pain by naloxone and naltrexone: involvement of toll-like receptor 4 (TLR4). Eur J Neurosci 2008;28(l):20-29.
  • 74. Lewis S.S., Loram L.C., Hutchinson M R. et al. (+)-Naloxone, an opioid-inactive toll-like receptor 4 signaling inhibitor, reverses multiple models of chronic neuropathic pain in rats .J Pain 2012;13(5):498-506.
  • 75. Chopra P, Cooper M.S. Treatment of complex regional pain syndrome (CRPS) using low dose naltrexone (LDN). J Neuroimmune Pharm 2013;8(3):470-476.
  • 76. DAgostino G., La Rana G., Russo R., et al. Central administration of palmitoylethanolamide reduces hyperalgesia in mice via inhibition of NF-кВ nuclear signalling in dorsal root ganglia. Eur J Pharmacol 2009:613( 1 —3):54—59.
  • 77. Kuehl E, Jacob T„ Ganley 0., Ormond R., Meisinger M. The identification of N-(2- hydroxyethyl)-palmitamide as a naturally occurring anti-inflammatory agent. J Am Chem Soc 1957;79 (20):5577—5578.
  • 78. Paladini A., Fusco M., Cenacchi T., Schievano C., Piroli A., Varrassi G. Palmitoylethanolamide, a special food for medical purposes, in the treatment of chronic pain: a pooled data meta-analysis. Pain Phys 2016;19(2):11—24.
  • 79. Gatti A., Lazzari M., Gianfelice V., Di Paolo A., Sabato E., Sabato A.F. Palmitoylethanolamide in the treatment of chronic pain caused by different etiopathogenesis. Pain Med 2012;13(9): 1121-1130.
  • 80. Gabrielsson L., Mattsson S., Fowler C.J. Palmitoylethanolamide for the treatment of pain: pharmacokinetics, safety and efficacy. Br J Clin Pharmacol 2016;82(4):932-942.
  • 81. Aloe L., Leon A., Levi-Montalcini R. A proposed autacoid mechanism controlling mastocyte behaviour. Agents Actions 1993;39(Spec No):C145-C147.
  • 82. Mazzari S., Canella R., Petrelli L., Marcolongo G., Leon A. A42-hydroxyethyl) hexadecamide is orally active in reducing edema formation and inflammatory hyperalgesia by down-modulating mast cell activation. Ear J Pharmacol 1996;300(3):227-236.
  • 83. Marini I., Bartolucci M.L., Bortolotti F., Gatto M.R., Bonetti G.A. Palmitoylethanolamide versus a nonsteroidal anti-inflammatory drug in the treatment of temporomandibular joint inflammatory pain. J Orofac Pain 2012;26(2):99-104.
 
Source
Previous chapter
Pain Management in Environmentally Acquired Illness
Next chapter
Regenerative Medicine in Pain Management