LYME DISEASE--ETIOLOGICAL AGENT

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Lyme disease and related disorders is an arthropod-borne disease caused by the spirochete, Borrelia burgdorferi. The disease is widespread with cases reported from Europe, Asia, Africa, Australia and North America. The hard tick, Ixodes dammini is the major vector of the spirochete in northeastern and midwestern United States where the majority of the cases of Lyme disease occur. The number of cases of Lyme disease diagnosed is increasing and the distribution of I. dammini appears to be enlarging. The epidemiology of Lyme disease is complex and present control measures are inadequate. Laboratory diagnosis of this disease is hampered by a slow host immune response and isolation of the spirochete from patients has been a low yield procedure. Borrelia burgdorferi by an unknown mechanism(s) can evade the immune response of the host and persist in tissues resulting in chronic arthritis and progressive neurological disease. The chronic forms of Lyme disease may be unresponsive to the presently recommended antimicrobial therapy. The specific aims of this proposal are: (1) genetic studies of Borrelia burgdorferi; (2) development of a vaccine for Lyme disease; (3) spirocheticidal assay for antibodies to B. burgdorferi; (4) detection of B. burgdorferi antigens in the body fluids of the host; (5) antibiotic susceptibility studies; (6) monitoring the establishment of Ixodes dammini and B. burgdorferi in a suburban residential area with a high density deer population and (7) improvement of cultural conditions for isolation and growth of the Lime disease spirochetes. The information gained in these studies should result in diagnostic tests for Lyme borreliosis. This would make it feasible to diagnose many more cases than is currently possible, resulting in better patient care and avoidance of late infection sequelae. The host parasite and antibiotic studies should increase our understanding of the persistence of the spirochete in the host and provide information for determining the most efficacious treatment of the disease. Improving and defining the presently available culture medium will facilitate isolation of the borreliae from host tissues as well as allowing higher cell yields for antigen preparations. The DNA studies of B. burgdorferi will provide an important foundation for a classification scheme and will be used as an epidemiological tool.