posted
Immune system research may help predict who gets long-term complications from Lyme Disease
Date:
April 16, 2014
Source:
Johns Hopkins Medicine
Summary:
The groundwork has been laid for understanding how variations in immune responses to Lyme disease can contribute to the many different outcomes of this bacterial infection seen in individual patients.
"Physicians have recognized for many years that Lyme disease is not a uniform disease process and can vary in outcomes," says the senior author of the report.
"Our experiments have linked such differences to specific immune pathways controlled by elements of the immune system,
which in turn might help us understand both the good immune processes that clear up the infection and the bad ones that cause injury and prolong symptoms.
This could be a big step forward in managing this disease."
A team of scientists led by Johns Hopkins and Stanford University researchers has laid the groundwork for understanding how variations in immune responses to Lyme disease
can contribute to the many different outcomes of this bacterial infection seen in individual patients. A report on the work appears online April 16 in PLOS One.
"Physicians have recognized for many years that Lyme disease is not a uniform disease process and can vary in outcomes," says Mark Soloski, Ph.D., a professor of medicine at the Johns Hopkins University School of Medicine and senior author of the report.
"Our experiments have linked such differences to specific immune pathways controlled by elements of the immune system,
which in turn might help us understand both the good immune processes that clear up the infection and the bad ones that cause injury and prolong symptoms.
This could be a big step forward in managing this disease."
Lyme disease is caused by the bacterium Borrelia burgdorferi, which is transmitted to humans through the bite of infected ticks.
The U.S. Centers for Disease Control and Prevention estimates that there are 300,000 new cases of Lyme disease a year.
Symptoms can include fever, headache, fatigue and a characteristic circular, red skin rash called erythema migrans, which occurs early in the disease.
Arthritis, nervous system abnormalities and heart rhythm abnormalities can appear weeks or months after infection.
Although treatment with antibiotics usually restores pre-infection health within a few weeks, some patients develop post-treatment Lyme disease syndrome,
whose symptoms include fatigue, pain or joint and muscle aches that can last for several months.
The exact cause is not well understood, and the symptoms are difficult to treat, the researchers say.
In a bid to identify why symptoms persist in some patients and not others, the Johns Hopkins team searched for the biological "signature" of the early stages of Lyme disease by measuring the levels of immune system molecules, called cytokines, chemokines
and acute phase makers -- proteins released by the liver as part of the process of inflammation.
These molecules, which are also called mediators, orchestrate the complex interactions of the immune system response to infection, including inflammation.
Specifically, the team studied levels of 58 cytokines and chemokines plus seven acute phase markers in blood from 44 patients diagnosed with Lyme disease and 23 healthy people used as controls for comparison.
The team's analysis identified two subsets of Lyme disease in patients in the acute (early) stage of infection -- "mediator-high" and "mediator-low."
The levels of three chemokines in particular -- CXCL9, CXCL10 and CCL19 -- were increased in the mediator-high group and returned to normal levels after antibiotic treatment and the disappearance of the rash.
Chemokines are small signaling molecules that attach to specific sites, called receptors, on a certain type of immune cells.
These three chemokines in particular guide a type of immune cell called T lymphocytes into tissues to aid in the clearance of infection.
The movement of T cells from the bloodstream to the site of infection also contributes to inflammation, which can cause tissue injury, Soloski notes.
There was also an increase in the acute phase proteins released by the liver, including CRP and serum amyloid A.
Lyme disease patients displaying high mediator levels at the initial pretreatment visit (acute disease) also had more severe symptoms,
higher rates of bacterial antibody production, greater rates of elevated liver enzymes and low blood lymphocytes levels.
Elevated levels of liver enzyme activity are common during infection and other diseases and may indicate that the liver is a site of infection during human Lyme disease.
Individuals in the mediator-low group appear to represent Lyme disease patients who failed to mount a vigorous immune response, the researchers reported.
The results of the study indicate that the levels of chemokines in the blood and the levels of their specific receptors on the T cells they stimulate
might prove to be important biomarkers for Lyme disease, and they could be linked to specific symptoms of the disease, Soloski says.
Biomarkers are biological characteristics or molecules whose levels in the body or tissues can be measured to identify a specific biological state or condition (e.g., disease or response to therapy).
Although the study wasn't specifically designed to learn about post-treatment Lyme disease syndrome,
the authors speculate that the variations in the pattern of mediators they observed strongly influence whether particular patients will recover from Lyme disease or develop long-term post-treatment symptoms.
"This study gives us basic data that will help us look for evidence of prolonged inflammation after completion of therapy and might, in the long term,
help us identify biomarkers that predict that a particular person will develop post-treatment Lyme disease syndrome," Soloski says.
"And since the chemokines that were elevated are key to the movement of T cells, blocking them might prevent them from moving into tissues and prolonging inflammation. This is one of the long-term aims of our work."
The above story is based on materials provided by Johns Hopkins Medicine. Note: Materials may be edited for content and length.
Journal Reference: 1.Mark J. Soloski, Lauren A. Crowder, Lauren J. Lahey, Catriona A. Wagner, William H. Robinson, John N. Aucott.
Serum Inflammatory Mediators as Markers of Human Lyme Disease Activity. PLoS ONE, 2014; 9 (4): e93243 DOI: 10.1371/journal.pone.0093243
Johns Hopkins Medicine. "Immune system research may help predict who gets long-term complications from Lyme Disease." ScienceDaily. ScienceDaily, 16 April 2014. <www.sciencedaily.com/releases/2014/04/140416171951.htm>.
GretaM
Frequent Contributor (1K+ posts)
Member # 40917
posted
Well it's a start...
And I think it is interesting that it mentioned the liver being a site of infection in human lyme disease.
This tells me that the data from this study did not match previous data from animal studies.
So finally, in writing that lyme in humans is different than lyme in animals.
It's a step.
Although when I read post-lyme syndrome, my blood pressure peaks and steam spills forth from my ears. Posts: 4358 | From British Columbia, Canada | Registered: Jun 2013
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springshowers
Frequent Contributor (1K+ posts)
Member # 19863
posted
I was given some info from a medical professional that there is a genetic component and a peptide that is a problem identified that makes family sets that can not fight off infections same as others and ESP in certain people who have genetic family history of moving from one area to another with new different types of things to fight off. Like generational history so that weakness is passed down in generations.
Its documented in my family history and Also women having a fatigue issue and years after breast cancer that they untimately died from.
[ 04-21-2014, 07:30 AM: Message edited by: Robin123 ]
Posts: 2747 | From Unites States Of America | Registered: Apr 2009
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posted
I wonder if the presence of the cytokines etc indicate not genetic predispositions but lyme and co-infectors that are STILL ACTIVE!
I also read an article about the idea that some "genetic" issues are actually pathogen loads being passed along inter-generationally.
Posts: 372 | From british columbia | Registered: Feb 2012
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poppy
Frequent Contributor (1K+ posts)
Member # 5355
posted
Not sure how prediction is going to help those who have already arrived at this situation. Hoping there is more to this than telling us who is going to be hurt the worst. And what does longterm complications mean--damage from the ongoing infection? Damage ongoing without infection?
When is someone going to just admit the obvious, that we are still infected, and then find something that works better than what we have? Really, if the big guys can pretend they don't already know this, how can we expect any honest medicine from them? How can we trust what they say about other health problems? What they have been allowed to do is tarnish medicine and science.
Posts: 2888 | From USA | Registered: Mar 2004
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surprise
Frequent Contributor (1K+ posts)
Member # 34987
posted
Totally agree with last 2 posters, as I absolutely loathe the 'cop out' of 'it's genetic.'
The same coverup (from the same people, the CDC) goes with autism.
Give me a break! It's an epidemic: 1980 1 child in 10,000 2014 1 child in 54 It is scientifically impossible to have a genetic epidemic.
It is environmental. In the case of Lyme and co., the environment is bacteria.
Chicken verses egg I have thought about: so the GMO foods, excess toxins, heavy metals, pollution, and infections have altered the human DNA? Okay, that I can see.
-------------------- Lyme positive PCR blood, and positive Bartonella henselae Igenex, 2011. low positive Fry biofilm test, 2012. Update 7/16- After extensive treatments, doing okay! Posts: 2518 | From USA | Registered: Nov 2011
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