Post-treatment Lyme Disease as a Model for Persistent Symptoms in Lyme Disease

Rebman, Alison W.

doi:10.3389/fmed.2020.00057

Cited by 99 publications

(108 citation statements)

References 187 publications

(273 reference statements)

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“…The most commonly observed symptoms of the patients in this study included back pain, dizziness, fatigue, muscle pain, and weakness in the extremities. This finding corresponds with those in other studies; fatigue, joint pain, difficulty in focusing, muscle pain, and memory were rated among the most common and/or severe [16,38,40,[45][46][47][48]. After calculating the change in number of patients with each symptom before and after treatment, it was found that the majority of symptoms improved in most of the symptom categories.…”

Section: Response To Treatment At the Body Systems Levelsupporting

confidence: 90%

“…More research is needed on patient responses to treatment, both retrospective and prospective cohort studies, following both of the treatment guidelines designed to aid physicians in developing treatment regimens. The lack of this information has resulted in uncertainty for both patients and those treating them [47], a situation that needs to be resolved as the number of infections increases.…”

Section: Discussionmentioning

confidence: 99%

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Lyme Disease Patient Outcomes and Experiences; A Retrospective Cohort Study

Rogerson

Lloyd

2020

Healthcare

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Lyme disease is a vector-borne illness caused by Borrelia spp. bacterium spread by ticks to humans and other mammals. Despite being prevalent in many regions of the world, there remains considerable uncertainty surrounding many aspects of the disease, and consensus on the most appropriate and effective means of treating the illness remains to be achieved. Recommendations published by the Infectious Diseases Society of America (IDSA) and the International Lyme and Associated Diseases Society (ILADS), the primary guidelines followed by health care professionals treating Lyme disease, diverge in many of their key recommendations, including treatment duration. Given this lack of consensus, surprisingly little research has been conducted on patient outcomes following different treatment approaches. In this study, patient outcomes were evaluated from a cohort of 210 Canadian Lyme disease patients seeking treatment at one US Lyme disease clinic following a treatment regimen conforming to the ILADS treatment guidelines. It was found that the majority of Lyme disease patients at the clinic responded positively to treatment and a significant (p < 0.05) decrease in symptoms was observed over time. This study, along with related studies, may help to guide physicians to provide their patients with the most effective care.

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Section: Response To Treatment At the Body Systems Levelsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Lyme Disease Patient Outcomes and Experiences; A Retrospective Cohort Study

Rogerson

Lloyd

2020

Healthcare

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“…A conservative estimate of the prevalence of PTLDS in the United States in 2020 is 800,000 (51). The etiopathology of PTLDS is unknown, and the disease lacks suitable laboratory diagnostics and therapeutic methods (5). We aimed to address this ambiguity by investigating the microbiome, which has been shown to play an important role in diseases with symptom overlap with PTLDS.…”

Section: Discussionmentioning

confidence: 99%

“…and cognitive difficulties for more than 6 months after completion of antibiotic treatment (4)(5)(6)(7)(8). The etiopathology of PTLDS is unknown, but it presents with symptoms that overlap those of other diseases, including chronic fatigue syndrome (5,9), depression, fibromyalgia (5), and multiple sclerosis (10).…”

mentioning

confidence: 99%

A Distinct Microbiome Signature in Posttreatment Lyme Disease Patients

Morrissette

Pitt

González

et al. 2020

mBio

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Lyme disease is the most common vector-borne disease in the United States, with an estimated incidence of 300,000 infections annually. Antibiotic intervention cures Lyme disease in the majority of cases; however, 10 to 20% of patients develop posttreatment Lyme disease syndrome (PTLDS), a debilitating condition characterized by chronic fatigue, pain, and cognitive difficulties. The underlying mechanism responsible for PTLDS symptoms, as well as a reliable diagnostic tool, has remained elusive. We reasoned that the gut microbiome may play an important role in PTLDS given that the symptoms overlap considerably with conditions in which a dysbiotic microbiome has been observed, including mood, cognition, and autoimmune disorders. Analysis of sequencing data from a rigorously curated cohort of patients with PTLDS revealed a gut microbiome signature distinct from that of healthy control subjects, as well as from that of intensive care unit (ICU) patients. Notably, microbiome sequencing data alone were indicative of PTLDS, which presents a potential, novel diagnostic tool for PTLDS. IMPORTANCE Most patients with acute Lyme disease are cured with antibiotic intervention, but 10 to 20% endure debilitating symptoms such as fatigue, neurological complications, and myalgias after treatment, a condition known as posttreatment Lyme disease syndrome (PTLDS). The etiology of PTLDS is not understood, and objective diagnostic tools are lacking. PTLDS symptoms overlap several diseases in which patients exhibit alterations in their microbiome. We found that patients with PTLDS have a distinct microbiome signature, allowing for an accurate classification of over 80% of analyzed cases. The signature is characterized by an increase in Blautia, a decrease in Bacteroides, and other changes. Importantly, this signature supports the validity of PTLDS and is the first potential biological diagnostic tool for the disease.

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“…Einzelne Autoren halten das Vorliegen einer chronischen Borreliose im Sinne einer persistierenden Infektion trotz einer regelgerecht durchgeführten antibiotischen Behandlung für möglich [37,38]. Für diese postulierten chronischen Infektionen werden teilweise morphologische Varianten von B. burgdorferi diskutiert, die den Erregern eine Persistenz trotz antibiotischer Behandlung erlauben [39].…”

Section: Chronische Verläufe Trotz Antibiotischer Behandlung Und Unspunclassified

Neuroborreliose

Dersch¹,

Rauer²

2020

Neurologie up2date

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Post-treatment Lyme Disease as a Model for Persistent Symptoms in Lyme Disease

Cited by 99 publications

References 187 publications

Lyme Disease Patient Outcomes and Experiences; A Retrospective Cohort Study

Lyme Disease Patient Outcomes and Experiences; A Retrospective Cohort Study

A Distinct Microbiome Signature in Posttreatment Lyme Disease Patients

Neuroborreliose

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