Assessment Of Patients With Borrelia Infection

蜱传疾病是一种严重的健康威胁，在过去13年中报告的病例增加了一倍多。莱姆病或莱姆病疏螺旋体病占美国蜱传疾病报告病例的80%以上。据估计，美国每年诊断和治疗的莱姆病病例超过476，000例，欧洲估计超过200，000例。我们目前的工作涉及莱姆病的以下领域：开发新的感染检测和生物标志物，调查B感染的持续性。本研究旨在研究莱姆病和治疗后莱姆病综合征（PTLDS）中免疫应答的作用。我们有三个临床方案，探索莱姆病和蜱传感染的各个方面，目前正在招募。在这些和过去的临床研究中，我们评估了800多名患者。与这个大型临床数据库一起，我们已经组装了一个大型生物储存库，用于探索莱姆病和蜱传疾病的多种研究途径。 在过去的一年里，有一系列的出版物。我们描述了在我们的队列中表现为面瘫的早期莱姆病神经疏螺旋体病患者的特征，指出了历史上的重要线索（在流行地区暴露于蜱虫，但不一定是公认的蜱虫叮咬史，全身症状和/或皮肤病变，以及夏季的表现），有助于早期诊断。大多数患者恢复良好，单独使用抗生素或同时使用抗生素和皮质类固醇的患者恢复情况相似。在另一篇文章中，我们证明了B。这些研究表明，莱姆病是一种能够从其环境中积累完整磷脂以支持生长的莱姆病，并且在小鼠和急性莱姆病患者中发生对宿主磷脂的抗体应答。需要进一步研究以确定这些抗体是否可用于莱姆病的早期诊断，跟踪对治疗的反应。我们还帮助研究了对嗜吞噬细胞无浆体和微小巴氏杆菌的血清学反应，这是美国两种新出现的蜱传病原体。使用肽阵列来选择线性肽组，我们鉴定了可以作为检测对这两种病原体的抗体反应性的有用工具的肽。 我们还帮助进行了一项纵向队列研究，以描述COVID-19后的临床后遗症和持续症状。这项研究的初步结果已经发表。

Tickborne diseases are a serious health threat that has steadily risen, with reported cases more than doubling over the past 13 years. Lyme disease, or Lyme borreliosis, accounts for more than 80% of the reported cases of tickborne diseases in the US. It is estimated that over 476,000 cases of Lyme disease diagnosed and treated per year in the US, and over 200,000 cases estimated in Europe. Our current work addresses the following areas in Lyme disease: development of new tests and biomarkers for infection, investigation of persistence of infection with B. burgdorferi in humans, and investigation of the role of immune response in Lyme disease and post treatment Lyme disease syndrome (PTLDS). We have three clinical protocols exploring diverse aspects of Lyme disease and tickborne infections that are currently open to recruitment. In these, and past clinical studies, we have evaluated more than 800 patients. Together with this large clinical database, we have assembled a large biorepository that has served to explore multiple avenues of research in Lyme borreliosis and tickborne diseases. In the past year, have a series of publications. We described the characteristics of patients with early Lyme neuroborreliosis presenting with facial palsy in our cohort, pointing attention to important clues in the history (exposure to ticks in an endemic area, but not necessarily a history of recognized tick bite, constitutional symptoms and/or skin lesions, and presentation in the summer months) that help with early diagnosis. Most patients had an excellent recovery, and the recovery was similar for patients who received antibiotics alone or both antibiotics and corticosteroids. In another publication, we showed that B. burgdorferi, which can accumulate intact phospholipids from its environment to support growth, and that antibody responses to host phospholipids occur in mice and patients with acute Lyme disease. Further study will be required to determine whether these antibodies have utility in early diagnosis of Lyme disease, tracking of the response to therapy. We have also help study the serologic response to Anaplasma phagocytophilum and Babesia microti, two emerging tick-borne pathogens in the United States. Using a peptide array to select sets of linear peptides, we identified peptides that can be a useful tool for detection of antibody reactivity to both of these pathogens. We have also helped with a longitudinal cohort study to characterize the clinical sequelae and persistent symptoms after COVID-19. The initial findings of this study have been published.