Assessment Of Patients With Borrelia Infection

壁虱传播的疾病是一种严重的健康威胁，而且一直在稳步上升，报告的病例在过去13年中增加了一倍多。莱姆病，或莱姆疏螺旋体病，占美国报告的扁虱传播疾病病例的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记物，调查人类感染伯氏杆菌的持续性，以及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，探索莱姆病和壁虱传播感染的不同方面，目前正在接受招募。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资料库，用于探索莱姆疏螺旋体病和壁虱传播疾病的多种研究途径。 在过去的一年里，有一系列的出版物。我们描述了我们队列中表现为面瘫的早期莱姆氏神经疏松症患者的特征，指出了有助于早期诊断的历史上的重要线索(在流行地区接触扁虱，但不一定是公认的扁虱叮咬史，体质症状和/或皮肤损害，以及夏季月份的表现)。大多数患者恢复良好，单独接受抗生素或同时接受抗生素和皮质类固醇治疗的患者恢复情况类似。在另一篇文章中，我们展示了伯氏杆菌，它可以从环境中积累完整的磷脂来支持生长，并且对宿主磷脂的抗体反应在急性莱姆病小鼠和患者中发生。还需要进一步的研究来确定这些抗体在莱姆病的早期诊断、跟踪治疗反应方面是否有用。我们还帮助研究了对美国两种新出现的壁虱传播病原体--巨噬细胞无形体和微小巴贝斯虫的血清学反应。使用多肽阵列来选择一组线性多肽，我们发现这些多肽可以作为检测抗体对这两种病原体的反应性的有用工具。 我们还帮助进行了一项纵向队列研究，以表征新冠肺炎后的临床后遗症和持续症状。这项研究的初步发现已经发表。

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.