As the saying goes, seeing is believing. And most importantly, seeing leads to understanding. Where Lyme is concerned, understanding is the first step in healing.

Even in a science lab, it is a big challenge to see something as small as the Borrelia bacteria. However, thanks to donations provided by private foundations such as, and individual contributions, Dr. Eva Sapi and her team of scientific researchers are able to see high resolution images with the help of a high-tech gizmo called an Atomic Force Microscope. You can see these images, too, as they become available (follow their Facebook page for more on that).

The Lyme Disease Research Group's groundbreaking work helps reduce the suffering of Lyme disease patients. Below, read our conversation with Dr. Sapi to find out what her team is discovering, and see where they are headed next.

You might not know this, but federal and state funding is not provided for this important research, and this hardworking team of professionals and graduate students depends on the kindness of people who care. If you are interested in helping support the number-one goal of Dr. Sapi's research team—to kill the Lyme bug—join the UNH Facebook page and check out the links to Atomic Force Microscope images of Borrelia. Your purchase can help fund their research in the coming year.

About our guest: Dr. Eva Sapi (pronounced Ava Shoppy) is a Professor of Biology and Environmental Science at the University of New Haven, CT, and the head of the Lyme Disease Research Group.

UNE’s Lyme Research Group’s goal: to kill Borrelia

LDRD: Welcome to our podcast, and thank you so much for taking the time to catch us up with your research.

ES: Thanks for having me.

LDRD: Yes, definitely. So, I saw an article last week, about you and your hardworking team, and we often, on our website here we often talk about treatment and the difficulties of diagnosing Lyme, but we don’t often get to talk with the scientist behind the curtain, and this is where the rubber meets the road. The Borrelia must be understood in order for us to reach any kind of diagnosis or treatment.

So you and your team work on understanding the Borellia bacteria. And because of your groundbreaking work, you have made some interesting and surprising discoveries lately, so I’d love for you talk about your recent research.

ES: Right now we have only one very simple point in the lab, which is trying to kill Borrelia, understand? And in the last ten years, that goal is actually still not fulfilled, because we find different morphed forms and it is not that easy to kill.

I mean, you all know how many controversies there are right now with Lyme disease. Whether it can be chronic or not chronic, or what happens when you take antibiotics, etc.

Does Borrelia survive antibiotic treatment?

ES: About ten years ago we started to do some research, and we actually took all those antibiotics used in Lyme disease treatment, and what we found in the very beginning was after adding these antibiotics into the Borrelia culture, we have seen some forms which were able to survive the treatment.

So in the last ten years, we have been trying to understand why these forms can survive, and whether these forms are important or not in the body.

What causes antibiotic failure in Lyme Disease?

What you probably heard in the last couple of weeks, is that we are trying to publish a study from the last couple of years, where we found a form called biofilm. This form is extremely resistant to antibiotics, and we’re trying to prove that this form indeed exists in the body and it might be the cause of the antibiotic failures.

LDRD: Okay, right. And this research is possible because of the new microscope that was funded by the grant money that came from, is that right?

New microscope shows Borrelia in high resolution

ES: Yes, that is correct. Our research is not funded by state and federal grants, actually, all of the funds come from private foundations. And one of the major events was two years ago, and we were able to purchase something called an “atomic force microscope,” which is a very specific kind of microscope, it’s able to see Borrelia in a very high resolution image, even live, so we don’t even need to fix the sample. So this is a very new technology, and I’m really happy to report it is working very well. We realize that atomic force microscope [has given us] the most important images.

LDRD: Wonderful. So are these images available for the layperson to see, or are they only available within the scientific journals?

ES: I mean right now, we would like to publish it, obviously, and because you still have to prove that this form exists in the body. And you will see, after publication in the next couple of months there will be some criticism, and I hope that people will be strong enough to see beyond the criticism.

And just because you mention, we have other images, and the research group right now is a little low on funds, so we are going to do some fund raising with these images. So yes, some images will be available for the public.

LDRD: Great, okay, well when you do that please let us know and we will do our best to get the word out to raise funds for that important work.

ES: Thank you very much.

LDRD: Yes, absolutely!

Mice studies prove form of Borrelia survives antibiotics

LDRD: So you mentioned that these studies have to go through a rigorous peer review process, and I was just wondering, what are some of the criticisms that the biofilm discovery work is coming up against?

ES: Right now, Unfortunately, the biofilm is not really accepted in the field. And it’s a little bit surprising because biofilms are known as pathogens, and are actually widely accepted.

One of the criticisms, if the biofilms indeed exist, now we have to go back to all those antimicrobial studies, and we actually have to repeat them, because now we have to see if the antibiotics are effective against biofilm. And again, this is, you’re going back 20 years, and practically, you have to reconsider all those studies.

Thought it was a cyst form, found biofilm

Research scientist Emir Hodzic conducted lots of studies in mice in the late 1990s. He was sure that he saw a form of Borrelia survive, so it will be very interesting to see what he sees.

Dr. Hodzic did not see biofilm, but in 2008-2014, he was able to prove that there must be a form which can survive antibiotic treatments. We were searching for this form—we thought first that it was a cyst form, but we found something even more interesting, called biofilm.

If this paper is published it will really open up a tinder box, and there will be a conversation about that.

Stevia as Trojan Horse?

LDRD: Okay.

So, I saw something that really raised my eyebrows, and I was really excited to see the word stevia come up in one of your comments about looking at some of the agents that might be able to dissolve the biofilm, if indeed that is what is going on, that the biofilm is actually there.

ES: We try to find effective agents for the biofilm. We have effective agents for the spirochete form. But unfortunately for biofilm, those agents are not really effective. So for the last several years, we’ve been looking for antibiotics and natural agents for Borrelia biofilm.

And, I know that stevia sounds a little bit unusual, but actually for the research paper in 2011, we tried a different sugar and sugar substitutes to see if they would have the antimicrobials. And that was actually the reason we started to work with sugars and sugar substitutes. And stevia was just one of them.

Stevia has antimicrobial effect

And it was a surprise, about two years ago, when we found that indeed, stevia was very, very effective, and that’s when [the paper was going through the review process]. Just this morning I was writing back some responses to the reviewers, and I’m hoping that the paper is published very soon.

LDRD: Wow, that is very interesting to me. And I have to tell you, I was excited to put stevia in my tea, every time I do it now. So, do you think that makes any difference? I mean, you probably can’t speculate on what kind of effect stevia would have in a body, but…

Continued studies on Stevia needed

ES: I mean, obviously we need to continue the study. That was the first study we used whole stevia leaf extract. We extract some components of stevia which other people used for antimicrobials, and it wasn’t effective against Borrelia. So there’s something in stevia, in the leaf extract, which we still have to go back and conduct another study and try to find what is in it.

But again, the interesting thing about stevia, if you think about it, is it is a sweetener, they use it in our coffee, but also lots of studies show us that it has an antimicrobial effect.

We were thinking right now maybe the combination, that, it is a functional food and maybe Borrelia thinks that it’s food, and takes it down, and in the meantime it has an antimicrobial effect.

We really feel that maybe it’s the Trojan Horse effect going on here, and we’ll be able to treat Borrelia like that.

Future directions of Lyme research — Searching for biofilms

LDRD: So what is in the near future for you, in terms of publishing and making your current research well known?

ES: Right now, we would like to go back to the organs. We want to see which organs are the strongest for Borrelia. And I’m working with other people right now, the study is almost finished, in fact we need only one or two more experiments.

But I would like to see why so many people actually die from Lyme disease.

Usually the major issue is the heart gets involved. So we actually had a study where we looked at the heart, to see whether we can find these biofilms and how frequently.

Death by Lyme investigated

And we used, after two different models, one was a heart, we got some heart tissue from mice, and this is a very interesting case. One of the famous Lyme disease cases, where the person actually died from Lyme disease, so we go back and now we’re going to look at the heart and other organs, to see whether we can find these biofilms and maybe square it with what happened to this patient.

So I would like to go back to the organs. And also we had a […], when we tried to co-culture Borrelia and human cells to see what happens when the two meet, what kind of changes happen to the human cells when Borrelia infects them.

So these are the two directions we’re going in right now.

LDRD: Okay, that sounds really complex to me. I know that part of your groundbreaking work has been, you actually have the ability to create Borrelia in the culture, right?

Research helps confirm patients with Lyme Disease

ES: Yes, so we can culture out Borrelia from patients who have Lyme disease, and their sensitivity still looks very good, so I hope we’re going to have a confirmation for all those patients who ELISA [has never worked on] to prove that they have Lyme disease.

LDRD: That’s wonderful. That is definitely necessary. A lot of people have so much, they waste so much time just trying to get a proper diagnosis in order to get treatment.

ES: I agree, I agree.

Dr. Sapi’s personal Lyme story

LDRD: So some of the people listening may not realize that in addition to being a scientist and the director of the Lyme Disease Research Group, you have something else in common with us, which is that you have had Lyme. Can you tell me a little bit about how that’s going for you right now?

ES: Oh, it was about ten years ago, and I didn’t get diagnosed promptly, same as probably most of your audience. And unfortunately at one point, I really couldn’t get up from a chair, I was so dizzy.

I saw doctor after doctor, and a natural doctor suggested herbal compounds. I didn’t know whether to take it or not, I wasn’t sure whether that would be my answer. But at this point I had no other choice.

No overnight recovery

ES: So I started to take them, and it took me some time. It wasn’t like an overnight recovery. But after several months I started to feel better. And there were about two years, where I started to feel like oh, I might beat this disease.

LDRD: Yes, wow, well that’s really similar to the way I felt too. Just exactly what you said, it was not an overnight thing. It was a very slow ascending back to the land of the living.

ES: Yes, and there are theories about why, genetics or something like that. Sometimes you need to be patient with your body.

Lyme can kill

LDRD: Definitely. And I don’t think that a lot of people realize that Lyme can kill.

In the general population, I know that a lot of people have said to me that their friends and family don’t think they’re sick, they certainly look fine.

So that is one of the tricky things about having Lyme disease is that you may look healthy, and you may even be able to continue to work, but you’re not well, and sometimes those symptoms don’t show up on the outside.

ES: Yes. “You look too healthy to be sick,” I know. I got that, I definitely got that. That’s why I think that the heart studies will be so important. Because if Borrelia affects the heart, that definitely can kill.

Lyme disease masked as heart disease?

ES: And again, the question is, how many people die from heart attacks, and disease, and maybe that was Borrelia. So I really would like to go back and examine the organ structure, maybe it can cause some kind of heart condition, or some other condition.

LDRD: It’s almost like the Borrelia is going for the heart because it’s the center of life, right? It’s the main, the last organ to go when we die, so it’s the first thing to be attacked.

ES: I think Borrelia sees us as food. [Laughter from us both.] What does Borrelia want? It wants to survive. We have to eat.

So I know it’s a little bit morbid, but you know, I don’t know that we are more than a food supply for Borrelia.

LDRD: No, that’s a really good way to look at it, though, because we have to objectify these things. And also, it’s good to laugh.

ES: Absolutely.

But you’re right, the heart is the very center and this is why I want to go back to the mouse heart. Maybe some certain strains would have different effects, the European strains and the North American strains, and some others.

If we can see something like that, it will be very, very important, to see what kind of Borrelia is infecting the body.

Support Lyme research with your purchase of microscope images

LDRD: Is there anything more you would like people to know about your work? And of course, I would like to underscore the fundraising point that you just brought up. So if you would like to say a few words about that, and then tell people where they can find out more about your work?

ES: Sure, thank you. First, I want to thank everybody because I know probably most of your audience actually sent us some money for the atomic force microscope. I know it was lots of different donations.

Join UNH Facebook page

Right now, we’re trying to operate our research, so not just the research, but everything about that is on our a Facebook page, so you can just search for the UNH Facebook page, you can search and purchase some of those atomic force microscope images for some small donations. [This will help fund UNH’s Lyme Disease research in the coming year.]

ES: Other than that, again, thank you very much for all of the emails and all of the phone calls. I know that your audience is looking at your research and support that. And sometimes it is very important, because, as you can imagine, it’s not just those emails coming to my inbox, there are other emails that are sometimes very upsetting, so thank you for all your support.

LDRD: Thank you so much for being out there on the cutting edge, Dr. Sapi, to you and your team. You are one of our heroes, and we really appreciate you.

Thank you for your time, and I’ll let you go with all of our blessings to you.

ES: Thank you.

For further information about Atomic Force Microscope images of Borrelia and about the UNH Lyme Disease Research Group, please contact:

Dr. Eva Sapi
Professor of Biology and Environmental Science
[email protected]

Lyme Disease Research Group.