Tag Archives: post treatment Lyme disease syndrome

GLA Point of View on New Lyme Disease Study

by Timothy Sellati, Ph.D., Chief Scientific Officer, GLA

A study funded in part by Global Lyme Alliance could spur further investigation into the cause of persistent symptoms, a source of medical controversy.

A controversial aspect of discourse in the medical and scientific community has been whether and how long some patients can suffer from symptoms initially triggered by infection with Borrelia burgdorferi, a bacterial spirochete and the causative agent of Lyme disease.  The underlying question being, can Lyme disease be chronic and are there clinical parameters by which this condition or syndrome can be defined?

Approximately 329,000 people in the U.S. are clinically diagnosed each year with Lyme disease.  Studies have reported a wide range (5 to 30 percent) of these individuals go on to experience Post-treatment Lyme disease syndrome (PTLDS).  PTLDS is a disorder defined as the development of significant fatigue, widespread musculoskeletal pain and/or cognitive difficulties that arise within six months after completion of antibiotic therapy for physician-documented Lyme disease and that last for at least six months.

The latest study to tackle this question, “The Clinical, Symptom, and Quality-of-Life Characterization of a Well-Defined Group of Patients with Posttreatment Lyme Disease Syndrome,” led by John N. Aucott, M.D., (associate professor of medicine at the Johns Hopkins University School of Medicine and director of the Johns Hopkins Lyme Disease Clinical Research Center) and funded in-part by Global Lyme Alliance.  The results were published in the December issue of Frontiers in Medicine demonstrating that PTLDS is a real disorder that causes severe symptoms in the absence of clinically detectable infection. Key to the success of this study was the meticulous way in which the researchers gathered prior medical records for evidence of Lyme disease that excluded patients with conditions that may mimic those of PTLDS and whose inclusion would confound interpretation of results.  In a well-curated population of 61 patients, Johns Hopkins researchers found that although physical exam and laboratory tests showed few objective abnormalities distinguishing PTLDS patients from healthy control subjects, standardized symptom questionnaires revealed that patients with PTLDS are highly and clinically significantly symptomatic, with a poor health-related quality of life. PTLDS patients exhibited levels of fatigue, musculoskeletal pain, sleep disturbance, and depression which were both clinically relevant and statistically significantly higher than controls.  Perhaps most importantly, the study showed that PTLDS can be successfully identified using a systematic approach to diagnosis and symptom measurement.

An important conclusion drawn from the study is that “As the prevalence of PTLDS continues to rise, there will be an increased need for physician education to more effectively identify and manage PTLDS as part of integrated patient care.”  Aucott cautions that because so little is known about the origins of PTLDS, its underlying cause has remained unclear, and a range of hypotheses exist.  However, with the advent of this study and the ability to unequivocally identify PTLDS patients suffering from persistent symptoms, investigators can begin the search for the cause and biological markers of this chronic Lyme syndrome and, ultimately, a means to prevent its development in the first place.

To review the press release from Johns Hopkins Medicine, click here. 


timothy sellatiTimothy J. Sellati, PH.D. is Chief Scientific Officer at Global Lyme Alliance

As GLA’s Chief Scientific Officer, Dr. Sellati leads GLA’s research initiatives to accelerate the development of more effective methods of diagnosis and treatment of Lyme and other tick-borne diseases.

GLA: Lyme Disease Research Symposium Highlights

by Mayla Hsu, Ph.D
Director of Research and Science, GLA

GLA hosts top researchers to discuss Lyme disease research.

 

How can we understand Lyme disease better? Are there drugs that can kill persistent bacteria? Why do some Lyme patients get well, while others remain sick? Questions like these were discussed at the 2017 Global Lyme Alliance Research Symposium, which was held March 31-April 1 in Greenwich, CT.

About 30 scientists from all over the United States met to share the latest data about Lyme disease. These were researchers who have received GLA grants, as well as Scientific Advisory Board members whose expertise spans both the clinical and basic sciences.

Norma Russo, board member, GLA; Dr. Ying Zhang, Johns Hopkins University
Norma Russo, board member, GLA; Dr. Ying Zhang, Johns Hopkins University

One highlight was the discussion of a new way of using the mouse model of Lyme disease, in which evidence of brain penetration by spirochetes has been found. In the past, this has not always been easy to demonstrate, and the new data will fuel further discovery of its direct effect on neurological infection and brain function.

Another area of discussion was focused on the 10-20% of Lyme disease patients who despite antibiotic therapy are not cured. Such patients often suffer debilitating pain, fatigue, and neurocognitive difficulties, which are termed post-treatment Lyme disease syndrome (PTLDS). Understanding the immune response in PTLDS patients and what causes a chronic inflammatory state is the subject of GLA-funded work, both in the mouse model as well as in the study of human subjects.

The search for more effective treatments for Lyme disease patients was also presented in talks and posters. The bacterium that causes Lyme disease is called Borrelia burgdorferi. When grown in the test tube and treated with antibiotics, some bacteria survive as persisters, which are very slow-growing bacteria. In patients, persisters may be the cause of long-lasting symptoms. Therefore, new drugs and drug combinations that directly target persister bacteria are a focus of research interest.

Lew Leone_Armin Alaedini
Lew Leone, board member, GLA: Dr. Armin Alaedini, Columbia University

The symposium wrapped up with a lively group conversation about the diagnostic blood test for Lyme disease, with widespread agreement that the existing two-tiered test recommended by the Centers for Disease Control is unacceptably insensitive. What it should be replaced with, however, is still being debated.

Overall, GLA was pleased to host this gathering of premier-level scientists. The newer research underway will in due course be published in high-quality, peer-reviewed scientific journals consulted by authorities in the tick-borne research field. We look forward to seeing the final results and to supporting ongoing studies.