RECURRENT LYME DISEASE

该子项目是利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得主要资金， 因此可以在其他CRISP条目中表示。列出的机构是 中心，不一定是研究者的机构。 莱姆病是美国最常报告的蜱传感染。生活在莱姆病流行地区的人们经常反复暴露于未感染的以及感染的硬蜱叮咬，并且已经报告了这种感染的反复发作。我们发现，在罗得岛的布洛克岛，大约14%的莱姆病患者反复感染，随后的感染症状比最初的感染症状少。目前尚不清楚是否有类似的复发率和较轻的临床结果在复发发作发生在地方性大陆网站。目前还不清楚是什么阻止大多数人在反复接触伯氏疏螺旋体感染的蜱时经历初始感染或复发感染。虽然对致病病原体的免疫可能有助于限制复发，但针对蜱虫载体的免疫反应也可能有助于预防初次和重复感染。我们的前两个目标是比较复发莱姆病的频率和临床结果在布洛克岛和大陆网站在南部新英格兰和纽约。我们的第三个目标是研究免疫反应之间的关系。肩胛肌唾液腺蛋白和对原发性和复发性B的发展的保护。伯氏菌感染我们特别提出三个具体目标。 1.确定在布洛克岛、RI和新英格兰南部和纽约的居民中，原发性和复发性莱姆病的频率是否不同。 2.确定莱姆病反复发作的急性症状是否比莱姆病首次发作严重。 3.确定针对蜱肩硬蜱的免疫因子是否对B具有保护作用。莱姆病的传播以及它们是否与原发性和复发性莱姆病的发病率呈负相关。 这项拟议的工作将为理解复发性莱姆病的频率和临床结果以及针对蜱媒的免疫因素如何限制复发性莱姆病和其他蜱媒感染的发生率提供基础。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Lyme disease is the most frequently reported tick-borne infection in the United States. People who live in areas that are endemic for Lyme disease are often repeatedly exposed to bites of uninfected as well as infected Ixodes ticks and recurrent episodes of this infection have been reported. We found that about 14% of people experiencing Lyme disease on Block Island, Rhode Island suffered recurrent infection and that subsequent episodes of infection were associated with fewer symptoms than the initial infection. It is unclear whether a similar rate of recurrence and a milder clinical outcome during recurrent episodes occur at endemic mainland sites. It is also unclear what prevents the majority of people from experiencing either initial infection or recurrent infection when they are repeatedly exposed to Borrelia burgdorferi-infected ticks. Although immunity against the causative pathogen probably helps limit recurrence, immune responses directed against the tick vector also may help prevent initial and repeated infections. Our first two objectives are to compare frequency and clinical outcomes of recurrent Lyme disease on Block Island and at mainland sites in southern New England and New York. Our third objective is to examine relationships among immune responses to I. scapularis salivary gland proteins and protection against the development of primary and recurrent B. burgdorferi infections. In particular, we propose three specific aims. 1. Determine whether the frequencies of primary and recurrent Lyme disease differ among residents of Block Island, RI and of southern New England and New York. 2. Determine whether the acute symptoms of repeated episodes of Lyme disease are less severe than the initial episode of Lyme disease. 3. Determine whether immune factors directed against the tick Ixodes scapularis are protective against B. burgdorferi transmission and whether they correlate inversely with the incidence of primary and recurrent Lyme disease. This proposed body of work will provide a basis for understanding the frequency and clinical outcome of recurrent Lyme disease and how immune factors directed against the tick vector may limit the incidence of recurrent Lyme disease and other tick-borne infections.