Bockenstedt, Linda

Linda Kathryn Bockenstedt, MD

Harold W. Jockers Professor of Medicine (Rheumatology); Director, Professional Development & Equity

Departments & Organizations

Internal Medicine:Rheumatology |Dermatology: Skin Diseases Research Center, Yale | Psychiatry: Stress & Addiction Clinical Research Program | SWIM | Yale Medical Group

Research Interests

Pathogenesis of Lyme disease; Tick-borne infections; Innate immunity; Multiphoton imaging; Faculty development in context of team science more...

Education

M.D., Ohio State University, 1981

Selected Publications

Liu, N., A.A. Belperron, C.J. Booth, and L.K. Bockenstedt (2009) Caspase 1-inflammasome is not required for control of murine Lyme borreliosis. Infect. Immun. 77: 3320-3327.

Vesely, D.L., D. Fish, M. Shlomchik, D.H. Kaplan, and L.K. Bockenstedt. (2009). Langerhans cell deficiency impairs Ixodes scapularis suppression of Th1 responses in mice. Infect. Immun. 77:1881-1887.

Belperron, AA, CM Dailey, CJ Booth, and LK Bockenstedt (2007) Marginal zone B-cell depletion impairs murine host defense against Borrelia burgdorferi infection. Infect. Immun. 75:3354.

Research & Publications

Research Organizations

Internal Medicine: Rheumatology | Dermatology: Skin Diseases Research Center, Yale | Psychiatry: Stress & Addiction Clinical Research Program |SWIM

Research Interests

Pathogenesis of Lyme disease; Tick-borne infections; Innate immunity; Multiphoton imaging; Faculty development in context of team science

Research Summary

Laboratory studies the pathogenesis of Lyme disease, a tick-borne infection with the spirochete Borrelia burgdorferi. Has used the murine model of Lyme borreliosis to investigate the host immune response to the spirochete and mechanisms by which the spirochete persists in the host. Using molecular genomic, proteomic and imaging approaches, is studying 1) spirochete interactions with ticks and host tissues, including immune cells; 2) mechanisms of spirochete evasion of innate and adaptive immune defenses; and 3) protein profiles of spirochetes during acute and chronic infection for improving diagnostic tests. Opportunities for research training in these areas are available for interested students and fellows.

Selected Publications

• Liu, N., A.A. Belperron, C.J. Booth, and L.K. Bockenstedt (2009) Caspase 1-inflammasome is not required for control of murine Lyme borreliosis. Infect. Immun. 77: 3320-3327.
• Vesely, D.L., D. Fish, M. Shlomchik, D.H. Kaplan, and L.K. Bockenstedt. (2009). Langerhans cell deficiency impairs Ixodes scapularis suppression of Th1 responses in mice. Infect. Immun. 77:1881-1887.
• Belperron, AA, CM Dailey, CJ Booth, and LK Bockenstedt (2007) Marginal zone B-cell depletion impairs murine host defense against Borrelia burgdorferi infection. Infect. Immun. 75:3354.
• Bockenstedt LK, N Liu, I Schwartz, and D Fish (2006) MyD88 deficiency enhances acquisition and transmission of Borrelia burgdorferi by Ixodes scapularis ticks. Infect Immun 74:2154.
• Belperron AA, CM Dailey, and LK Bockenstedt (2005) Infection-induced marginal zone B cell production of Borrelia hermsii-specific antibody is impaired in the absence of CD1d. J Immunol 174:5681.
• Liu N, RR Montgomery, SW Barthold, LK Bockenstedt (2004) Myeloid differentiation antigen 88 deficiency impairs pathogen clearance but does not alter inflammation in Borrelia burgdorferi-infected mice. Infect Immun 72:3195.
• Bockenstedt LK, J Mao, E Hodzic, SW Barthold, D Fish (2002) Detection of attenuated, non-infectious spirochetes after antibiotic treatment of Borrelia burgdorferi infected mice. J Infect Dis 186:1430-7
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Contact Info

(203) 785-2453 - Office

(203) 785-7053 - Fax

(203) 737-5430 - Clinic

(203) 785-7053 - Fax

(203) 785-7660 - Lab

Email

Locations

Lab

The Anlyan Center

300 Cedar Street

S-520

New Haven, CT 06519

Academic Office

The Anlyan Center

300 Cedar Street

S525C

New Haven, CT 06519

Patient Care

Yale Rheumatology

Yale Physicians Building

800 Howard Avenue

3rd Floor

New Haven, CT 06519

Mailing Address

Internal Medicine/Rheum

PO Box 208031

300 Cedar Street

New Haven, CT 06520-8031

QUOTE- "“chronic Lyme disease.” This term is used by a small number of practitioners (often self-designated as “Lyme-literate physicians”) to describe patients whom they believe have persistent B. burgdorferi infection, a condition they suggest requires long-term antibiotic treatment and may even be incurable. Although chronic Lyme disease clearly encompasses post–Lyme disease syndrome, it also includes a broad array of illnesses or symptom complexes for which there is no reproducible or convincing scientific evidence of any relationship to B. burgdorferi infection." Source

QUOTE- "When physicians who diagnose chronic Lyme disease obtain laboratory tests to provide support for their diagnoses, they often rely heavily on “Lyme specialty laboratories.” Such laboratories may perform unvalidated in-house tests that are not regulated by the Food and Drug Administration, or they may perform standard serologic tests interpreted with the use of criteria that are not evidence-based.1" Source

QUOTE- "Antibiotic therapy can cause considerable harm to patients treated for chronic Lyme disease or post–Lyme disease symptoms." Source

QUOTE- "Although anecdotal evidence and findings from uncontrolled studies have been used to provide support for long-term treatment of chronic Lyme disease,18-20 a response to treatment alone is neither a reliable indicator that the diagnosis is accurate nor proof of an antimicrobial effect of treatment." Source

QUOTE- "It is highly unlikely that post–Lyme disease syndrome is a consequence of occult infection of the central nervous system." Source

QUOTE- "dditional evidence against the hypothesis that chronic symptoms are due to persistent infection is the fact that antibodies against B. burgdorferi in many of these patients are undetectable, which is inconsistent with the well-established immunogenicity of the spirochete's lipoproteins." Source

QUOTE- "Although B. burgdorferi can develop into cystlike forms in vitro under certain conditions that can be created in the laboratory,50 there is no evidence that this phenomenon has any clinical relevance." Source

QUOTE- "How should clinicians handle the referral of symptomatic patients who are purported to have chronic Lyme disease? The scientific evidence against the concept of chronic Lyme disease should be discussed and the patient should be advised about the risks of unnecessary antibiotic therapy. ... If a diagnosis for which there is a specific treatment cannot be made, the goal should be to provide emotional support and management of pain, fatigue, or other symptoms as required. Explaining that there is no medication, such as an antibiotic, to cure the condition is one of the most difficult aspects of caring for such patients. Nevertheless, failure to do so in clear and empathetic language leaves the patient susceptible to those who would offer unproven and potentially dangerous therapies. Additional advice to clinicians is included in the Supplementary Appendix, available with the full text of this article at www.nejm.org." Source

QUOTE- "Physicians and laypeople who believe in the existence of chronic Lyme disease have formed societies, created charitable foundations, started numerous support groups (even in locations in which B. burgdorferi infection is not endemic), and developed their own management guidelines." Source

QUOTE- "Chronic Lyme disease is the latest in a series of syndromes that have been postulated in an attempt to attribute medically unexplained symptoms to particular infections. Other examples that have now lost credibility are “chronic candida syndrome” and “chronic Epstein–Barr virus infection.”57,58 The assumption that chronic, subjective symptoms are caused by persistent infection with B. burgdorferi is not supported by carefully conducted laboratory studies or by controlled treatment trials. Chronic Lyme disease, which is equated with chronic B. burgdorferi infection, is a misnomer, and the use of prolonged, dangerous, and expensive antibiotic treatments for it is not warranted." Source

July 28, 2008 | 2 comments

Linda Bockenstedt: A scientific family tradition

A 1974 Westinghouse finalist first takes on stuttering, then Lyme disease—and now the systemic biases of academic medicine

By Laura Vanderkam

Linda Bockenstedt Linda Bockenstedt

LINDA BOCKENSTEDT

FINALIST YEAR: 1974

HER PROJECT: Using white noise to fight stuttering

WHAT LED TO THE PROJECT: As Linda Bockenstedt was growing up in Dayton, Ohio, her engineer father helped launch her medical research career in two ways: First, he believed that girls could do science projectsevery bit as well as boys—and encouraged his daughters to do such projects. Second, he had a friend with a pronounced stutter.

The stutter fascinated her. "I remember seeing how he struggled to speak, and got curious about why that might be," says Bockenstedt, who had enrolled as a full-time college student at local Wright State University at age 15. As a science project to enter in contests, she figured she would test an idea: People who stuttered might have a bit of an echo in the brain pathways between their ears and the parts of their brains that were responsible for hearing. What if she overwhelmed those pathways, however? She tried it and found that, in her subjects, listening to white noise while speaking improved stuttering considerably. Linda entered her results in the 1974 Westinghouse Science Talent Search. She knew about the competition because her older sister, Paula, had been a finalist in 1971—a designation she soon learned they would share.

THE EFFECT ON HER HER CAREER: Becoming a Westinghouse finalist stoked Bockenstedt's fascination with the human body. After graduating from Harvard at age 19, she went to medical school, did a residency in internal medicine at Yale, and except for a fellowship at the University of California, San Francisco, has been a practicing rheumatologist and researcher at Yale ever since. Her main area of research has been studying the immune response to the bacterium that causes Lyme disease.

WHAT SHE'S DOING NOW: In the 1980's Bockenstedt—along with sister Paula, a hematologist at the University of Michigan Medical Center—was a pioneer as a woman in academic medicine. She and many others assumed that women would make up half the tenured faculty at such schools before too long.They don't. So today, Bockenstedt still sees patients and does research, but she's also taken on a new role: the Yale University School of Medicine's director for professional development and equity.

In Bockenstedt's new position, she attacks the reasons that many talented women and minority researchers fail to reach their academic potential. "My goal is to try to even the playing field here, and help all faculty at the assistant professor level understand what the requirements are for promotion, and help mentor them so they can achieve their personal goals," she says.

She was tapped for the job because "she has been successful in coming up through the ranks at Yale and knows the challenges of academic medicine as both a clinician and a researcher," says Carolyn Mazure, professor of psychiatry and associate dean for faculty affairs at Yale's medical school. She also "understands that a diverse faculty, particularly in terms of gender and minority representation, adds value to the academic experience."

For Bockenstedt, it's proof that encouragement pays off. Bockenstedt's father encouraged his two daughters to go into science. Now Paula's two daughters are pursuing medical research, and Linda's high school–aged daughter will be doing research this summer, hopefully producing results she can enter in what is now the Intel Science Talent Search. "It's been a tradition," Bockenstedt says. "My sister and I were raised in an environment that was supportive of women doing medicine and science. Our children are recognizing that they can do the same thing."

http://www.scientificamerican.com/article.cfm?id=westinghouse-bockenstedt-women-in-science