University of New Haven professor’s research focuses on ‘horrible’ Lyme disease Research underway at University of New Haven

WEST HAVEN >> For years, Eva Sapi was an ovarian cancer researcher, first as a post-doctoral researcher at the Yale School of Medicine and then at University of New Haven.

Then, she had a nasty bout with Lyme disease, a “horrible disease” that, as she put it, “made me realize that other diseases could be as important as ovarian cancer.”

Her own experience with an often-misunderstood disease that in her case initially was misdiagnosed changed the course of her professional life.

Now Sapi, an associate professor and University Research Scholar in UNH’s Department of Biology and Environmental Science, heads the university’s Lyme disease research group, working with more than 10 student researchers at a time

Together, they do groundbreaking research into the way borrelia burgdorferi, the bacteria that causes Lyme disease, can rearrange its structure, including by forming a slime-like “biofilm” that she believes enables the disease to “hide” during efforts to treat it with antibiotics.

The research investigates ways in which biofilm might allow borrelia to resist harsh environmental conditions such as antibiotic treatments.

Sapi’s work includes clinical trials with Curza, a Provo, Utah, pharmaceutical research company developing a new drug that aims to penetrate the biofilm to more effectively treat the disease.

Mark Zaretsky - New Haven Register) University of New Haven Associate Professor Eva Sapi, at far right, who heads UNH's Lyme disease program, with five or her students in their lab on the school's West Haven campus. The students, clockwise from front left, are Kayla Socarron, Khusani Gupde, Jason Torres, Shafiq Shaikh and Rumanah Kasliwala. less Mark Zaretsky - New Haven Register) University of New Haven Associate Professor Eva Sapi, at far right, who heads UNH's Lyme disease program, with five or her students in their lab on the school's West Haven ... more Photo: Journal Register Co. Photo: Journal Register Co. Image 1 of / 3 Caption Close University of New Haven professor’s research focuses on ‘horrible’ Lyme disease 1 / 3 Back to Gallery

Having done an initial clinical trial at UNH that found the drug to be 60 percent more effective in treating Lyme disease than traditional antiobiotics, Curza now is entering a second phase that at the University of California, Davis that will test the drug on mice.

But one drug may just be the tip of the iceberg, Sapi suggested.

Over a number of years, “We looked at over 100 different agents. The Curza one was one of them,” Sapi said. But “we found several agents which worked as well.”

One of the agents that worked particularly well as a possible treatment for Lyme disease was, of all things, Stevia, the natural sweetener, Sapi said.

“It actually worked very well for borrelia,” she said. “Bee venom also was very effective. So we have several agents that are at least as effective as the antibiotics.”

Lyme disease is a tick-borne, hard-to-diagnose illness named for the town of Lyme, where it was first identified in 1975. Early symptoms include an expanding red ring or rash that can appear around the tick bite, as well as flu-like symptoms such as fever, fatigue and muscle aches. Subsequent symptoms that can develop if the disease is not promptly treated can include heart problems, arthritis and neurologic problems.

On average since 1998, the state Department of Public Health has reported about 3,000 cases annually to the Centers for Disease Control and Prevention, but the CDC estimates that there are approximately 10 times more people diagnosed with Lyme disease than the yearly reported number.

That means, using the CDC estimate, that about 30,000 people are diagnosed with Lyme disease each year in Connecticut.

Sapi, a native of Hungary who earned her doctorate in genetics at Eotvos Lorand University in Budapest before coming to the U.S. for postdoctoral training in molecular biology at the Yale School of Medicine, also was urged to take on Lyme disease by her UNH dean at the time, who suggested that working at a smaller research institution, it might make sense for her to do research on something “state-related.”

“It was sort of a rocky road. I didn’t realize” at first “that asking certain questions was not allowed” within the tight-knit community of Lyme disease researchers.

Sapi’s research on the role of biofilm — which she says is “known to be almost impossible to eliminate it from the body” — has been controversial, with many of the doctors who treat Lyme disease continuing to do with a maximum of four weeks of antibiotics.

“After that, if you’re still sick, it has to be something else,” she said, describing the prevailing feelings that attribute any post-treatment sickness to something called “post-Lyme syndrome.”

Sapi first published research on her findings in 2012 in the online publication PLOS-ONE, a peer-reviewed, international science journal. She said that at one point, she organized a conference that some others in the field tried to shut down because of fears that it would propagate her way of thinking.

She currently is waiting for a new research paper, now in a second level of review, to get accepted “in a highly-rated journal.” The paper argues “that biofilm exists, can persist in the body and can find ways to hide,” she said.

If it is accepted, “it should at least open the door” to other forms of thinking, Sapi said.

“If people don’t want to study something, they should at least let someone else study it,” she said.

Among the other research done locally on Lyme disease is a 2012 study by the Yale University School of Medicine that found that while mice infected with borrelia burgdorferi responded to antibiotics, traces of proteins from the bacteria remained long after the bacteria itself had been wiped out.

The lead author of that study, Dr. Linda Bockenstedt, the Harold W. Jockers Professor of Medicine and Rheumatology at Yale School of Medicine, didn’t immediately return calls for comment on Sapi’s work, but has previously told the Connecticut Post, with regard to Sapi’s work, that it’s hard to make a good determination about the behavior of borrelia burgdorferi based solely on test tube research.

“Biofilm requires a certain number of bacteria in a small space to form,” Bockenstedt told the Post. “Whether it would form in a human or animal infected by a tick bite is not known.”

But Sapi’s research suggests that it’s not just proteins that get left behind.

The borrelia bacteria, which has been around for 15 to 20 million years, is “so smart” and has learned over all those years how to survive, she said. “Inside, they have different cells” which, like colonies of ants, have different tasks, Sapi said.

“Some of the cells are the sleepers,” she said, and “antibiotics don’t work on the sleepers.”