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，报告的病例从2004年到2016年增加了一倍多。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，欧洲国家每年报告的莱姆病病例近13万例，并对这种感染进行了监测。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，我们发表了我们与儿童国家研究所的合作研究，该研究显示，大多数被诊断为莱姆病儿童的父母报告说，他们的孩子在完成抗生素治疗后六个月内康复。这项研究收集了102名年龄在5岁到18岁之间的儿童的父母的调查回应，这些儿童在入学前6个月到10年间被诊断出患有莱姆病。10岁至18岁的青少年也被邀请完成针对青少年的问卷调查。根据这些家长调查的答复，75%的儿童在完成治疗后6个月内完全康复：31%的儿童在1个月内康复；30%的儿童在1至3个月内康复；14%的儿童在4至6个月内康复。在研究中，大约22%的儿童在完成治疗后至少经历了一种症状，持续了六个月或更长时间；其中9%的儿童的症状被归类为治疗后莱姆病综合征。在调查时，6%的儿童没有完全恢复，1%的儿童出现了严重到足以损害日常功能的症状。这项研究支持了先前的数据，表明莱姆病儿童的总体预后良好，并可以帮助临床医生管理家庭对儿童莱姆病患者治疗后恢复时间的不同期望。治疗后的莱姆病症状在儿童和成人中仍然知之甚少，需要更多的研究来更好地了解这些长期症状并确定治疗目标。 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。

Tickborne diseases are a serious health threat that has steadily risen, with reported cases more than doubling from 2004 to 2016. 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 are diagnosed and treated per year in the US, and almost 130,000 cases are reported annually from European countries with surveillance for the infection. 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, we have published our collaborative study with Childrens National Research Institute, which showed that most parents of children diagnosed with Lyme disease reported that their kids recovered within six months of completing antibiotic treatment. The study collected survey responses from the parents of 102 children ages 5 to 18 years who had been diagnosed with Lyme disease between six months and 10 years before enrollment. Adolescents ages 10 to 18 years old were also invited to complete adolescent-specific questionnaires. According to these parent survey responses, 75% of children fully recovered within six months of completing treatment: 31% of all children recovered within one month; 30% recovered in one-to-three months; and 14% recovered in four-to-six months. Approximately 22% of children in the study experienced at least one symptom that persisted six or more months after completing treatment; of those, 9% had symptoms classified as post-treatment Lyme disease syndrome. Six percent of the children were not fully recovered at the time of the survey, with 1% experiencing symptoms significant enough to impair daily functioning. This study supports previous data showing an excellent overall prognosis for children with Lyme disease and can help clinicians manage families expectations about the varying post-treatment recovery times of pediatric Lyme disease patients. Post-treatment Lyme disease symptoms remains poorly understood in children and adults, and more research is needed to better understand these prolonged symptoms and identify treatment targets. 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 pathogens.