A more diverse antibody profile may distinguish people who experience chronic, persistent symptoms of Lyme disease, according to researchers at New York City's Weill Cornell Medical College.
Some people who are bitten by ticks and contract Lyme disease complain that their symptoms—including pain, lethargy, neurological problems and memory loss—persist for months or years after the infection has been treated with antibiotics. Controversy has swirled around such claims because physicians and researchers have been unable to find any trace of Borrelia burgdorferi, the spirochete bacterium that causes Lyme, in these so-called post-Lyme disease patients. But now, Weill Cornell immunologist Armin Alaedini and colleagues have uncovered a molecular signature that may explain why Lyme disease lingers in some, but not others.
Alaedini and his team found a greater variety of antibodies to a B. burgdorferi surface protein, VIsE, in post-Lyme patients than in those who did not report chronic symptoms of the disease. The results, published on the website of Clinical Immunology last month, "could mean [some patients] naturally have a different antibody response to the infection than most people; it could mean they weren't treated properly; or it's possible they were reinfected and the second infection was never treated," Alaedini told Nature.
Whatever the cause of its persistence, the findings suggest that B. burgdorferi is hanging around in some Lyme patients and that symptoms of post-Lyme disease syndrome may be the result of an inflammatory response, as the immune system works overtime to produce a wider variety of VIsE antibodies to combat continual mutations in the bacterial protein. The research also opens the door to the possibility of a predictive biomarker that could help physicians identify Lyme patients at risk for developing the chronic form of the disease and treat them with more aggressive courses of antibiotics.