The Pathobiome: Stealth Infections and the Brain

In this episode, host James Maskell sits down with Nikki Schultek, founding director of the Pathobiome Research Center at the Philadelphia College of Osteopathic Medicine and founder of the Alzheimer's Pathobiome Initiative, a global research consortium.

Schultek's path into this work began with her own illness 11 years ago — a multi-system chronic condition driven by a tick bite and co-infections including Chlamydia pneumoniae, which went misdiagnosed by 12 specialists for a year before Dr. Charles Stratton at Vanderbilt identified and treated the underlying infections, restoring her to roughly 95% of her former health. That experience, and the fear of not watching her young children grow up, led her to found Intracell Research Group and later become what she calls a "collaboration architect" — connecting siloed researchers across immunology, microbiology, neuropathology, and epidemiology who study different pathogens (herpesviruses, Chlamydia, Borrelia, Bartonella, fungi, syphilis) but rarely collaborate with one another.

The conversation covers the evidence linking infection to Alzheimer's disease: animal studies showing pathogens like C. pneumoniae can induce amyloid-like plaques in wild-type mice; the historical near-miss in which Alzheimer's disease could have been named after Dr. Oscar Fischer, who described bacterial-colony-like structures in tangles and plaques during the pre-antibiotic syphilis era; and emerging research suggesting amyloid and tau may act as innate immune "firefighters" responding to infection rather than purely destructive proteins. Schultek highlights her consortium's 2023 landmark paper in Alzheimer's & Dementia, which catalogued 86 case reports of infectious dementias reversed through targeted antimicrobial treatment.

Maskell and Schultek also discuss the heterogeneity of individual cases — from periodontal pathogens like Porphyromonas gingivalis to tick-borne co-infections — and the need for precision, patient-specific approaches that account for genetics, exposome, and hormonal factors. The episode closes with a discussion of what's needed to move the field forward: greater federal and philanthropic funding, better multi-pathogen and host-biomarker testing, industry investment in targeted (rather than broad-spectrum) antimicrobial therapies, and expanded insurance coverage — particularly for PANS/PANDAS families currently priced out of diagnostic testing.

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About the Guest:

Nikki Schultek is the founding direc