Assessment Of Patients With Borrelia Infection

蜱传疾病是一种严重的健康威胁，其数量稳步上升，报告的病例在过去13年中增加了一倍多。莱姆病或莱姆氏螺旋体病占美国报告的蜱传疾病病例的80%以上。据估计，美国每年诊断和治疗的莱姆病病例超过47.6万例，欧洲估计超过20万例。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，调查人类伯氏疏螺旋体感染的持续性，以及调查免疫反应在莱姆病和治疗后莱姆病综合征（PTLDS）中的作用。我们有三个临床方案探索莱姆病和蜱传感染的不同方面，目前正在开放招募。在这些和过去的临床研究中，我们已经评估了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库，用于探索莱姆病和蜱传疾病的多种研究途径。

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.