What independent, blinded studies have tested for Borrelia in Morgellons specimens and what were their methods and outcomes?
Executive summary
Independent, blinded laboratory testing of Morgellons dermatological specimens has been reported in a small number of papers that used culture, histology/immunostaining, in situ hybridization and multiple PCR approaches; these studies report frequent detection of Borrelia DNA or spirochetes in tested samples (for example 24/25 positive in one 2015 study) and isolation of viable spirochetes in a minority of cases [1] [2] [3]. The literature that makes these claims documents blinded sample handling and cross‑laboratory testing in several instances, but the pool of investigators and specialized labs is limited and mainstream dermatology and public‑health bodies remain cautious about broad generalization [1] [4] [5].
1. The clearest blinded study: 2015 BMC Dermatology—methods and headline outcome
A 2015 BMC Dermatology study reported that all patient samples were deidentified, coded, and that all laboratory testing was performed in a blinded fashion; the investigators used culture in BSK‑H medium, in situ hybridization with Borrelia‑specific probes, PCR and sequencing, and reported Borrelia spirochetes or DNA in 24 of 25 study patients with culture recovery from four patients [1] [2] [3].
2. Cross‑lab, blinded corroboration in persistent‑infection work — what was tested and found
A separate 2018 study of patients with ongoing Lyme‑like symptoms described culture specimens that were subjected to corroborative microscopic, histopathological and molecular testing in four independent laboratories in a blinded manner; motile spirochetes identified histopathologically as Borrelia were detected in culture specimens and PCR‑based methods genetically identified them as Borrelia burgdorferi [4] [6]. That paper included a small number of subjects with Morgellons features among its cohort and documents blinded inter‑laboratory PCR confirmation [4].
3. Additional blinded molecular work: nested/real‑time PCR and sequencing across studies
Later publications and reviews of Morgellons dermatopathology report that skin specimens and control skin were submitted for PCR testing in a blinded manner, with assays run in triplicate and including TaqMan real‑time PCR for a 139‑bp Borrelia 16S rRNA target and nested PCRs for multiple genes (fla, ospC, uvrA, pyrG), followed by Sanger sequencing and BLAST comparison [7] [8]. Those reports assert repeated detection of Borrelia spp., including B. burgdorferi sensu stricto and other Borrelia taxa, across multiple laboratories using these blinded molecular workflows [8] [5].
4. Culture, microscopy and immunostain evidence — techniques and replication claims
Several studies forwarded dried skin flakes or biopsy material to Lyme‑research laboratories in a blinded fashion and used darkfield microscopy, Dieterle/Giemsa staining, monoclonal and polyclonal anti‑Borrelia immunostains, and culture in selective media to demonstrate spirochetal morphology and antibody reactivity; one paper reported mixed Borrelia and Helicobacter pylori organisms and positive anti‑Borrelia monoclonal antibody results on patient specimens [9] [10]. Authors emphasize that multiple detection modalities and blinded processing were used to strengthen reproducibility [9] [10].
5. Outcomes, reproducibility caveats, and competing viewpoints
Reported outcomes across these blinded studies are consistent within the author group: high rates of Borrelia DNA or histologic spirochetes and occasional culture recovery (for example 24/25 positives in the BMC paper and culture positives in a subset) [1] [3]. However, caveats in the available reporting include a concentration of work among a small network of investigators and specialized labs, the use of study funding and specimen referral pathways linked to Morgellons patient organizations in some instances [11], and the absence in the provided sources of large‑scale independent replication by broader dermatology or public‑health research consortia; mainstream clinicians have historically attributed Morgellons features to delusional infestation, a view cited by those authors as part of the controversy [1]. The literature supplied documents blinded methods and cross‑laboratory PCR/culture corroboration [4] [8], but it does not include, in the provided sources, multi‑center confirmatory trials by independent academic dermatology groups or national public‑health agencies — a limitation that must temper extrapolation from these promising but still narrow blinded datasets [4] [5].