Could Dapsone be the cure for Lyme persisters?
We are always searching for the “holy grail” of treatments within the Lyme and tickborne community. We dabble with medication combinations, restrictive diets, herbals, homeopathy, light and magnet therapy only to have symptoms return for many. Prominent researchers continue to test treatments in labs and animal/ human studies to better understand where deficits exist, in hopes of developing more effective regimens.
Lyme providers postulate the existence of Chronic Lyme and the link to cystic forms that evade treatment. In some cases this may be true but researchers, Drs. Kim Lewis of Northwestern University and Ying Zhang of John Hopkins University have compelling evidence suggesting that persister cells exist in Lyme disease hiding comfortably in biofilms of the body. These persister cells are dormant, protected cells untouched by conventional treatment.
These findings paved the way for Lyme providers to determine treatments to address them. In steps Dr. Richard Horowitz.
Dr. Horowitz and Dr. Freeman conducted studies with their own patients to determine treatment combinations utilizing Dapsone to combat Chronic Lyme. They published those findings in Precision Medicine. Many others are beginning to integrate Dapsone cautiously with some of their Lyme persister patients.
Horowitz, R.I.; Freeman, P.R. Precision Medicine: retrospective chart review and data analysis of 200 patients on dapsone combination therapy for chronic Lyme disease/post-treatment Lyme disease syndrome: part 1. International Journal of General Medicine 2019:12 101–119
I’ve also initiated the protocols and am cautiously implementing within my pediatric population. The children chosen to participate are prescreened carefully and determined to be compliant with regimens.
Dapsone isn’t a new drug. Topical forms are used liberally within the Dermatologic community to combat cystic acne. Historically we’ve used Dapsone to treat leprosy, also a persistent cell bacteria.
Many of the patients in Horowitz’s study thus far have had positive results and some seemingly cured. Dapsone doesn’t come without its own host of potential complications. Dapsone works by inhibiting the bacteria’s ability to utilize dihydrofolic acid, blocking folate metabolism. This mechanism not only blocks the bad bacteria’s folate source but healthy cells may also be inhibited.
Those suffering from G6PD could experience hemolysis or breaking of the red blood cells. Dapsone is also rough on the liver causing elevated enzymes in some.
Patients prescribed this regime are placed on hefty folate doses to combat the inhibitory effects of the drug and given detox regimens focused upon liver clearance.. Frequent bloodwork to measure complete blood studies and metabolic panels are drawn to closely monitor tolerance of the drug.
Dapsone, given its long-acting nature, can trigger more severe herxing or die-off reactions from Lyme. Most patients experience significant die-off reactions that may be managed with a comprehensive detox protocol to quell inflammation.
Dapsone use in children may be given in small, weight-based dosing. Side effects of methemoglobinemia or hemolysis is usually dose dependent but with close monitoring and supportive therapies many side effects can be avoided.
If you are interested in trialing your child on the Dapsone protocol, please contact the office for a consult with me to discuss further.
Be Well!
Somer DelSignore PCCNP, BCPNP
Pediatric Integrative Lyme/PANS Expert
