Assessment Of Patients With Borrelia Infection

National Institute Of Allergy And Infectious Diseases

Investigators

Linked publications, trials & patents

Abstract

Tickborne diseases are a serious health threat that has steadily risen, with reported cases more than doubling over the past 13 years. Lyme disease, or Lyme borreliosis, accounts for more than 80% of the reported cases of tickborne diseases in the US. It is estimated that over 476,000 cases of Lyme disease diagnosed and treated per year in the US, and over 200,000 cases estimated in Europe. Our current work addresses the following areas in Lyme disease: development of new tests and biomarkers for infection, investigation of persistence of infection with B. burgdorferi in humans, and investigation of the role of immune response in Lyme disease and post treatment Lyme disease syndrome (PTLDS). We have three clinical protocols exploring diverse aspects of Lyme disease and tickborne infections that are currently open to recruitment. In these, and past clinical studies, we have evaluated more than 800 patients. Together with this large clinical database, we have assembled a large biorepository that has served to explore multiple avenues of research in Lyme borreliosis and tickborne diseases. In the past year, have a series of publications. We described the characteristics of patients with early Lyme neuroborreliosis presenting with facial palsy in our cohort, pointing attention to important clues in the history (exposure to ticks in an endemic area, but not necessarily a history of recognized tick bite, constitutional symptoms and/or skin lesions, and presentation in the summer months) that help with early diagnosis. Most patients had an excellent recovery, and the recovery was similar for patients who received antibiotics alone or both antibiotics and corticosteroids. In another publication, we showed that B. burgdorferi, which can accumulate intact phospholipids from its environment to support growth, and that antibody responses to host phospholipids occur in mice and patients with acute Lyme disease. Further study will be required to determine whether these antibodies have utility in early diagnosis of Lyme disease, tracking of the response to therapy. We have also help study the serologic response to Anaplasma phagocytophilum and Babesia microti, two emerging tick-borne pathogens in the United States. Using a peptide array to select sets of linear peptides, we identified peptides that can be a useful tool for detection of antibody reactivity to both of these pathogens. We have also helped with a longitudinal cohort study to characterize the clinical sequelae and persistent symptoms after COVID-19. The initial findings of this study have been published.