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Lyme disease and the pursuit of a clinical cure

Lyme disease, caused by the spirochete Borrelia burgdorferi, is the most common vector-borne illness in the United States. Many aspects of the disease are still topics of controversy within the scientific and medical communities. One particular point of debate is the etiology behind antibiotic treat...

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Autores principales: Adkison, Heather, Embers, Monica E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10244525/
https://www.ncbi.nlm.nih.gov/pubmed/37293310
http://dx.doi.org/10.3389/fmed.2023.1183344
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author Adkison, Heather
Embers, Monica E.
author_facet Adkison, Heather
Embers, Monica E.
author_sort Adkison, Heather
collection PubMed
description Lyme disease, caused by the spirochete Borrelia burgdorferi, is the most common vector-borne illness in the United States. Many aspects of the disease are still topics of controversy within the scientific and medical communities. One particular point of debate is the etiology behind antibiotic treatment failure of a significant portion (10–30%) of Lyme disease patients. The condition in which patients with Lyme disease continue to experience a variety of symptoms months to years after the recommended antibiotic treatment is most recently referred to in the literature as post treatment Lyme disease syndrome (PTLDS) or just simply post treatment Lyme disease (PTLD). The most commonly proposed mechanisms behind treatment failure include host autoimmune responses, long-term sequelae from the initial Borrelia infection, and persistence of the spirochete. The aims of this review will focus on the in vitro, in vivo, and clinical evidence that either validates or challenges these mechanisms, particularly with regard to the role of the immune response in disease and resolution of the infection. Next generation treatments and research into identifying biomarkers to predict treatment responses and outcomes for Lyme disease patients are also discussed. It is essential that definitions and guidelines for Lyme disease evolve with the research to translate diagnostic and therapeutic advances to patient care.
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spelling pubmed-102445252023-06-08 Lyme disease and the pursuit of a clinical cure Adkison, Heather Embers, Monica E. Front Med (Lausanne) Medicine Lyme disease, caused by the spirochete Borrelia burgdorferi, is the most common vector-borne illness in the United States. Many aspects of the disease are still topics of controversy within the scientific and medical communities. One particular point of debate is the etiology behind antibiotic treatment failure of a significant portion (10–30%) of Lyme disease patients. The condition in which patients with Lyme disease continue to experience a variety of symptoms months to years after the recommended antibiotic treatment is most recently referred to in the literature as post treatment Lyme disease syndrome (PTLDS) or just simply post treatment Lyme disease (PTLD). The most commonly proposed mechanisms behind treatment failure include host autoimmune responses, long-term sequelae from the initial Borrelia infection, and persistence of the spirochete. The aims of this review will focus on the in vitro, in vivo, and clinical evidence that either validates or challenges these mechanisms, particularly with regard to the role of the immune response in disease and resolution of the infection. Next generation treatments and research into identifying biomarkers to predict treatment responses and outcomes for Lyme disease patients are also discussed. It is essential that definitions and guidelines for Lyme disease evolve with the research to translate diagnostic and therapeutic advances to patient care. Frontiers Media S.A. 2023-05-24 /pmc/articles/PMC10244525/ /pubmed/37293310 http://dx.doi.org/10.3389/fmed.2023.1183344 Text en Copyright © 2023 Adkison and Embers. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Adkison, Heather
Embers, Monica E.
Lyme disease and the pursuit of a clinical cure
title Lyme disease and the pursuit of a clinical cure
title_full Lyme disease and the pursuit of a clinical cure
title_fullStr Lyme disease and the pursuit of a clinical cure
title_full_unstemmed Lyme disease and the pursuit of a clinical cure
title_short Lyme disease and the pursuit of a clinical cure
title_sort lyme disease and the pursuit of a clinical cure
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10244525/
https://www.ncbi.nlm.nih.gov/pubmed/37293310
http://dx.doi.org/10.3389/fmed.2023.1183344
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