Chronic Lyme Disease

Lantos, Paul M.

doi:10.1016/j.idc.2015.02.006

Cited by 97 publications

(94 citation statements)

References 93 publications

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“…A subset of human patients with persistent clinical signs leads to a diagnosis of chronic Lyme disease, more commonly called posttreatment Lyme disease syndrome. Most studies conclude that long‐term antibiotic treatment of patients with what is presumed to be chronic Lyme disease does not affect outcome, although this is an issue of frequent debate …”

Section: Prognosismentioning

confidence: 99%

“…Most studies conclude that long-term antibiotic treatment of patients with what is presumed to be chronic Lyme disease does not affect outcome, although this is an issue of frequent debate. 113 The prognosis for seropositive horses that are treated for vague or undocumented clinical signs believed to be Lyme disease is unclear and in most cases Lyme disease is not confirmed. It is also unclear whether antibiotic treatment reliably eliminates the infection because many horses remain seropositive for many months or even years after antibiotic treatments.…”

Section: Prognosismentioning

confidence: 99%

See 1 more Smart Citation

Borrelia burgdorferiInfection and Lyme Disease in North American Horses: A Consensus Statement

Divers

Gardner²,

Madigan

et al. 2018

Veterinary Internal Medicne

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Borrelia burgdorferi infection is common in horses living in Lyme endemic areas and the geographic range for exposure is increasing. Morbidity after B. burgdorferi infection in horses is unknown. Documented, naturally occurring syndromes attributed to B. burgdorferi infection in horses include neuroborreliosis, uveitis, and cutaneous pseudolymphoma. Although other clinical signs such as lameness and stiffness are reported in horses, these are often not well documented. Diagnosis of Lyme disease is based on exposure to B. burgdorferi, cytology or histopathology of infected fluid or tissue and antigen detection. Treatment of Lyme disease in horses is similar to treatment of humans or small animals but treatment success might not be the same because of species differences in antimicrobial bioavailability and duration of infection before initiation of treatment. There are no approved equine label Lyme vaccines but there is strong evidence that proper vaccination could prevent infection in horses.

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Section: Prognosismentioning

confidence: 99%

Section: Prognosismentioning

confidence: 99%

Borrelia burgdorferiInfection and Lyme Disease in North American Horses: A Consensus Statement

Divers

Gardner²,

Madigan

et al. 2018

Veterinary Internal Medicne

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“…Borrelia burgdorferi, the principal human pathogen in the United States, is responsible for approximately 300,000 LD cases per year (1). LD is problematic because early diagnosis is easily missed due to flu-like symptoms, which only transiently appear in humans during an early stage of disease (2)(3)(4)(5). When missed and therefore left untreated, LD becomes chronic, presenting itself as skin lesions, arthritis, and carditis and occasionally with subsequent nervous system involvement (6,7).…”

mentioning

confidence: 99%

Antibody Response to Lyme Disease Spirochetes in the Context of VlsE-Mediated Immune Evasion

et al. 2017

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Lyme disease (LD), the most prevalent tick-borne illness in North America, is caused by Borrelia burgdorferi. The long-term survival of B. burgdorferi spirochetes in the mammalian host is achieved though VlsE-mediated antigenic variation. It is mathematically predicted that a highly variable surface antigen prolongs bacterial infection sufficiently to exhaust the immune response directed toward invariant surface antigens. If the prediction is correct, it is expected that the antibody response to B. burgdorferi invariant antigens will become nonprotective as B. burgdorferi infection progresses. To test this assumption, changes in the protective efficacy of the immune response to B. burgdorferi surface antigens were monitored via a superinfection model over the course of 70 days. B. burgdorferi-infected mice were subjected to secondary challenge by heterologous B. burgdorferi at different time points postinfection (p.i.). When the infected mice were superinfected with a VlsEdeficient clone (ΔVlsE) at day 28 p.i., the active anti-B. burgdorferi immune response did not prevent ΔVlsE-induced spirochetemia. In contrast, most mice blocked culture-detectable spirochetemia induced by wild-type B. burgdorferi (WT), indicating that VlsE was likely the primary target of the antibody response. As the B. burgdorferi infection further progressed, however, reversed outcomes were observed. At day 70 p.i. the host immune response to non-VlsE antigens became sufficiently potent to clear spirochetemia induced by ΔVlsE and yet failed to prevent WT-induced spirochetemia. To test if any significant changes in the anti-B. burgdorferi antibody repertoire accounted for the observed outcomes, global profiles of antibody specificities were determined. However, comparison of mimotopes revealed no major difference between day 28 and day 70 antibody repertoires.

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“…Although several antibiotic regimens are available for the treatment of LD, in some patients the symptoms are reported to be persistent even after antibiotic treatment. Thus, infected patients may require alternative antibiotics or other treatment options [10]. Long-term treatment with antibiotics has been found to result in adverse events (AEs) [11,12].…”

Section: Introductionmentioning

confidence: 99%

Transplantation of Human Embryonic Stem Cells in Patients with Multiple Sclerosis and Lyme Disease

Shroff¹

2016

Am J Case Rep

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Case seriesPatient: Male, 42 • Female, 30Final Diagnosis: Human embryonic stem cells showed good therapeutic potential for treatment of multiple sclerosis with lyme diseaseSymptoms: Fatigue • weakness in limbsMedication: —Clinical Procedure: Human embryonic stem cells transplantationSpecialty: TransplantologyObjective:Rare diseaseBackground:Multiple sclerosis (MS) is an inflammatory and neurodegenerative disease in which the myelin sheath of nerve cells is damaged. It can cause delayed neurologic symptoms similar to those seen in Lyme disease (LD) patients. Thymus derived T-cells (myelin reactive) migrate to the blood brain barrier and stimulate an inflammatory cascade in the central nervous system. Cell based therapies play an important role in treating neurological diseases such as MS and LD.Case Report:Human embryonic stem cell (hESC) therapy was used to treat two patients with both MS and LD. The hESCs were administered via different routes including intramuscular, intravenous, and supplemental routes (e.g., deep spinal, caudal, intercostal through eye drops) to regenerate the injured cells. Both the patients showed remarkable improvement in their functional skills, overall stamina, cognitive abilities, and muscle strength. Furthermore, the improvement in the patients’ conditions were assessed by magnetic resonance tractography and single photon emission computed tomography (SPECT).Conclusions:Therapy with hESCs might emerge as an effective and safe treatment for patients with both MS and LD. Well-designed clinical trials and follow-up studies are needed to prove the long-term efficacy and safety of hESC therapy in the treatment of patients with MS and LD.

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Chronic Lyme Disease

Cited by 97 publications

References 93 publications

Borrelia burgdorferiInfection and Lyme Disease in North American Horses: A Consensus Statement

Borrelia burgdorferiInfection and Lyme Disease in North American Horses: A Consensus Statement

Antibody Response to Lyme Disease Spirochetes in the Context of VlsE-Mediated Immune Evasion

Transplantation of Human Embryonic Stem Cells in Patients with Multiple Sclerosis and Lyme Disease

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