Lyme Disease: The Quest for Magic Bullets

Abstract

Lyme disease represents a growing public health threat. Recent molecular and genetic studies have confirmed that Borrelia burgdorferi, the spirochetal agent of Lyme disease, is one of the most complex bacteria known to man. Affinity for multiple cell types and the presence of non-replicating forms of B. burgdorferi have contributed to persistent infection and failure of simple antibiotic regimens. The controversial clinical science of Lyme disease has impeded reliable diagnosis and effective treatment of this protean illness. Two major clinical hurdles are the absence of a therapeutic endpoint in treatingLyme disease and the presence of tick-borne coinfections that may complicate the course of the illness. New strategies for the diagnosis, treatment and prevention of Lyme disease are urgently needed.

Controversies related to diagnosis and treatment of Lyme borreliosis worldwide

“…Jak stwierdzają R.B. Stricker, A. Lautin, J.J. Burrascano [46], jedną z istotnych przyczyn kontrowersji dotyczących leczenia boreliozy jest brak wiarygodnych testów, dzięki którym byłoby możliwe monitorowanie leczenia i określenie momentu wyleczenia oraz obecności koinfekcji, które mogą komplikować przebieg choroby. W Stanach Zjednoczonych borelioza, choroba przenoszona przez krętki Borrelia burgdorferi, jest najczęstszą chorobą w kraju.…”

The First Evidence of Lyme Neuroborreliosis in Southern Bosnia and Herzegovina

“…Thus, LB represents a growing public health threat in the world [ 3 , 8 ]. Recent molecular and genetic studies have confirmed that B. burgdorferi , the spirochetal agent of LB, is one of the most complex bacteria known [ 15 ]. This should alert all physicians to take into account the presence of Lyme neuroborreliosis in southern Bosnia and Herzegovina as a new problem for epidemiologists and other physicians.…”

Treatment of Lyme borreliosis

“…This could avoid long-term, and therefore potentially side-effect-prone, antibiotic treatment. As can be expected, there is a lot of controversy on the subject of chronic Lyme disease [29,62,68]. …”