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DBL%20Hendrix%20small.png College chemistry, 1983

Derek Lowe The 2002 Model

Dbl%20new%20portrait%20B%26W.png After 10 years of blogging. . .

Derek Lowe, an Arkansan by birth, got his BA from Hendrix College and his PhD in organic chemistry from Duke before spending time in Germany on a Humboldt Fellowship on his post-doc. He's worked for several major pharmaceutical companies since 1989 on drug discovery projects against schizophrenia, Alzheimer's, diabetes, osteoporosis and other diseases. To contact Derek email him directly: derekb.lowe@gmail.com Twitter: Dereklowe

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In the Pipeline: Don't miss Derek Lowe's excellent commentary on drug discovery and the pharma industry in general at In the Pipeline

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May 7, 2013

Another Germ Theory Victory - Back Pain?

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Posted by Derek

The "New Germ Theory" people may have notched up another one: a pair of reports out from a team in Denmark strongly suggest that many cases of chronic low back pain are due to low-grade bacterial infection. They've identified causative agents (Propionibacterium acnes) by isolating them from tissue, and showed impressive success in the clinic by treating back pain patients with a lengthy course of antibiotics. Paul Ewald is surely smiling about this news, although (as mentioned here) he has some ideas about the drug industry that I can't endorse.

So first we find out that stomach ulcers are not due to over-dominant mothers, and now this. What other hard-to-diagnose infections are we missing? Update - such as obesity, maybe?

Comments (25) + TrackBacks (0) | Category: Infectious Diseases


COMMENTS

1. Tim on May 7, 2013 11:53 AM writes...

Stupiditis would be a great place to start...

Permalink to Comment

2. Charles Abrams on May 7, 2013 12:41 PM writes...

Obesity? You wrote about it in January, surprised you didn't link to it here.

Is Obesity an Infectious Disease?

Permalink to Comment

3. interested reader on May 7, 2013 1:22 PM writes...

I think that it is very dangerous to ascribe the pathogenesis of chronic and poorly treatable diseases like back pain to low-grade infections. The story of "chronic Lyme disease" offers a cautionary tale. Patients who are experiencing real pain are desperate for treatments that are more effective than "tincture of time". They grasp at solutions like long term antibiotics, often unaware that such treatment carries with it substantial potential for serious side effects, e.g., C. difficile colitis.

Permalink to Comment

4. milkshaken on May 7, 2013 1:57 PM writes...

maybe stomach ulcers are due to over-dominant mothers in law...

Permalink to Comment

5. luysii on May 7, 2013 2:09 PM writes...

What needs explanation is why we all don't have back pain, as most of us have the organism on our skin. Perhaps the antibiotic(s) used are treating something else.

Permalink to Comment

6. A Non-Mousse on May 7, 2013 2:19 PM writes...

I second luysii. Our backs are pretty unintelligently designed (strike 1037 against intelligent design).

Permalink to Comment

7. David Kwan on May 7, 2013 2:31 PM writes...

MMS already been curing back aches, headaches, and other "incurable" diseases for more than a decade! Check it out.

Permalink to Comment

8. Sideline Chemist on May 7, 2013 2:38 PM writes...

This may be another case of certain sub-populations of people with a particular immune diffency who are susceptible to certain bacteria. The rest of us have no problems keeping the bacteria in check, but those susceptible folks emerge with low-back pain. May be similar to the PML virus where most folks happily co-live with it but if the immune system is degraded in certain populations the virus becomes a threat.

Permalink to Comment

9. Boghog on May 7, 2013 2:57 PM writes...

> What other hard-to-diagnose infections are we missing?

"Uninspired CEOs unleashing six sigma onto their scientists."

- Bernard Munos, Forbes, 4/29/2013

Permalink to Comment

10. Chris Swain on May 7, 2013 3:07 PM writes...

"What needs explanation is why we all don't have back pain, as most of us have the organism on our skin. Perhaps the antibiotic(s) used are treating something else."

As I read it there has to have been a prior injury that becomes infected.

Permalink to Comment

11. Anonymous on May 7, 2013 3:30 PM writes...

Everyone knows that obesity is caused by the disease organism spectrococcus bigmacus.

Permalink to Comment

12. pete on May 7, 2013 5:23 PM writes...

@4 milk
bacteria = pain in the back
mother in law = pain in the derriere (and ulcer)

Permalink to Comment

13. Stephen on May 7, 2013 5:24 PM writes...

Note that these infections are in the spine and are probably due to damaged disks. This is not muscular pain caused by a vigorous game of tennis.

Permalink to Comment

14. barry on May 7, 2013 7:22 PM writes...

I'd be more impressed if there were epidemiology showing that back-pain sometimes went away when the patient did a course of antibiotics for something else.
Millions of people have taken millions (billions?) of courses of antibiotics over the last sixty years.

Permalink to Comment

15. barry on May 7, 2013 7:22 PM writes...

I'd be more impressed if there were epidemiology showing that back-pain sometimes went away when the patient did a course of antibiotics for something else.
Millions of people have taken millions (billions?) of courses of antibiotics over the last sixty years.

Permalink to Comment

16. Sisyphus on May 7, 2013 11:01 PM writes...

Prostate cancers are caused by the same viral infections that are implicated in uterine cancers.

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17. Alchemyst on May 8, 2013 6:41 AM writes...

and I thought obesity was a result of hand to mouth disease....

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18. Bruce Grant on May 8, 2013 9:42 AM writes...

Not to mention the recent studies published in Nature Medicine and NEJM, linking gut flora to the metabolism of L-carnitine and lecithin into TMAO, and inflammatory mediator apparently implicated in coronary artery disease.

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19. Kent G. Budge on May 8, 2013 10:40 AM writes...

Bruce @18:

I got pretty excited about the TMAO results at first, but not everyone is convinced:

http://justoneminute.typepad.com/main/2013/04/eggs-are-a-problem-again-something-is-fishy.html

Permalink to Comment

20. barry on May 13, 2013 10:36 PM writes...

nothing special about P. Acne's sensitivity to antibiotics. I suppose the intra-vertebral space may be inaccessible to many antibiotics? Certainly it's not a PK compartment that we sample routinely. But Azithromycin especially seems to get everywhere in mammals. And millions of courses of treatment later, there should be an epidemiological signal that backpain is responsive to a course of Azithromycin.

Permalink to Comment

21. Sean on May 14, 2013 7:52 AM writes...

This research really stikes a cord with me - as I have AS (Anylosing Spondylitis) which is also linked to gut bacteria (Klebsiella) - and affects lower back as one of its symptoms.

Gut damage - diet and food intolerence also play a big part - they bugs are probably in the gut initially and most likely from dairy products.

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