Effect of Statin Use on the Clinical Manifestations, Laboratory Test Results and Outcome of Lyme Neuroborreliosis

Ogrinc, Katarina; Kastrin, Andrej; Lotrič‐Furlan, Stanka; Bogovič, Petra; Rojko, Tereza; Kišek, Tjaša Cerar; Ružić‐Sabljić, Eva; Wormser, Gary P.; Strle, Franc

doi:10.3390/jcm9092995

Cited by 2 publications

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“…We are not aware of any clinical study of the effect of statin use on the progression and outcome of early LB, manifesting as EM. However, it was recently reported that statin use is not associated with clinical manifestations, laboratory test results, and outcome in patients with Bannwarth’s syndrome [ 13 ], which is consistent with our results. Experimental studies, on the other hand, have shown that simvastatin and lovastatin have an inhibitory effect on borrelial growth in vitro [ 8 ] as well as promote clearance of borreliae in a murine model of LB [ 12 ].…”

Section: Discussionsupporting

confidence: 93%

“…It is not known whether the anti-borrelial effects of statins found in in vitro conditions and in animal models are applicable to humans, or if hyperlipidemia is associated with progression of borrelial infection in humans. Statin pretreatment was recently found to not be associated with clinical manifestations, laboratory test results, and outcomes in patients with Bannwarth’s syndrome [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Association between statin use and clinical course, microbiologic characteristics, and long-term outcome of early Lyme borreliosis. A post hoc analysis of prospective clinical trials of adult patients with erythema migrans

et al. 2021

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Background Statins were shown to inhibit borrelial growth in vitro and promote clearance of spirochetes in a murine model of Lyme borreliosis (LB). We investigated the impact of statin use in patients with early LB. Methods In this post-hoc analysis, the association between statin use and clinical and microbiologic characteristics was investigated in 1520 adult patients with early LB manifesting as erythema migrans (EM), enrolled prospectively in several clinical trials between June 2006 and October 2019 at a single-center university hospital. Patients were assessed at enrollment and followed for 12 months. Results Statin users were older than patients not using statins, but statin use was not associated with Borrelia seropositivity rate, Borrelia skin culture positivity rate, or disease severity as assessed by erythema size or the presence of LB-associated symptoms. The time to resolution of EM was comparable in both groups. The odds for incomplete recovery decreased with time from enrollment, were higher in women, in patients with multiple EM, and in those reporting LB-associated symptoms at enrollment, but were unaffected by statin use. Conclusion Statin use was not associated with clinical and microbiologic characteristics or long-term outcome in early LB.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Association between statin use and clinical course, microbiologic characteristics, and long-term outcome of early Lyme borreliosis. A post hoc analysis of prospective clinical trials of adult patients with erythema migrans

et al. 2021

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Cholesterol Contributes to Risk, Severity, and Machine Learning-Driven Diagnosis of Lyme Disease

Forrest

O’Neal

Pedra

et al. 2023

Clinical Infectious Diseases

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Background Lyme disease is the most prevalent vector-borne disease in the United States, yet its host factors are poorly understood and diagnostic tests are limited. We evaluated patients in a large health system to uncover the role of cholesterol in the susceptibility, severity, and machine learning-based diagnosis of Lyme disease. Methods A longitudinal health system cohort comprised 1,019,175 individuals with electronic health record data and 50,329 with linked genetic data. Associations of blood cholesterol level, a cholesterol genetic score comprising common genetic variants, and burden of rare loss-of-function (LoF) variants in cholesterol metabolism genes with Lyme disease were investigated. A portable machine learning model was constructed and tested to predict Lyme disease using routine lipid and clinical measurements. Results There were 3,832 cases of Lyme disease. Increasing cholesterol was associated with greater risk of Lyme disease and hypercholesterolemia was more prevalent in Lyme disease cases than controls. Cholesterol genetic scores and rare LoF variants in CD36 and LDLR were associated with elevated Lyme disease risk. Serological profiling of cases revealed parallel trajectories of rising cholesterol and immunoglobulin levels over the disease course, including marked increases in individuals with LoF variants and high cholesterol genetic scores. The machine learning model predicted Lyme disease solely using routine lipid panel, blood count, and metabolic measurements. Conclusions These results demonstrate the value of large-scale genetic and clinical data to reveal host factors underlying infectious disease biology, risk, and prognosis, and the potential for their clinical translation to machine learning diagnostics that do not need specialized assays.

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Effect of Statin Use on the Clinical Manifestations, Laboratory Test Results and Outcome of Lyme Neuroborreliosis

Cited by 2 publications

References 24 publications

Association between statin use and clinical course, microbiologic characteristics, and long-term outcome of early Lyme borreliosis. A post hoc analysis of prospective clinical trials of adult patients with erythema migrans

Association between statin use and clinical course, microbiologic characteristics, and long-term outcome of early Lyme borreliosis. A post hoc analysis of prospective clinical trials of adult patients with erythema migrans

Cholesterol Contributes to Risk, Severity, and Machine Learning-Driven Diagnosis of Lyme Disease

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