Post-treatment Lyme disease syndrome may be driven by remnants of infection

Lyme disease is a well-known illness caused by the Borrelia burgdorferi bacteria and transmitted through tick bites. While it is often treated with antibiotics, some patients continue to experience symptoms long after the infection has been cleared. This condition, known as Post Treatment Lyme Disease (PTLD), affects approximately 14% of patients who have undergone early antibiotic therapy.

Research conducted by Northwestern University scientists sheds light on why some individuals develop PTLD. The study suggests that remnants of the Borrelia burgdorferi cell wall may be responsible for triggering a chronic inflammatory response in the body. These remnants, specifically peptidoglycan, are shed during treatment but can linger in the liver for weeks to months after the infection has been resolved.

The persistence of peptidoglycan in the body may be similar to the mechanism behind long COVID-19, where viral molecules trigger an unnecessary immune response leading to ongoing symptoms. This discovery opens up new avenues for understanding and treating chronic illnesses that result from previous infections.

In the case of Lyme disease, peptidoglycan fragments were found in the synovial fluid of patients with Lyme arthritis, indicating a prolonged immune response to the bacterial remnants. The unique structural properties of Borrelia burgdorferi’s peptidoglycan may contribute to its persistence in the body, particularly in the liver where it cannot be effectively cleared.

By targeting the inflammatory response triggered by peptidoglycan, researchers hope to develop more accurate diagnostic tests and treatment options for PTLD patients. Monoclonal antibodies that specifically target peptidoglycan could be a promising approach to neutralizing the inflammatory molecule and alleviating symptoms in individuals who do not respond to traditional antibiotic therapy.

Overall, the findings from this study provide valuable insights into the underlying causes of PTLD and offer potential strategies for managing chronic symptoms associated with Lyme disease. Further research and clinical trials are needed to validate these findings and develop targeted therapies for individuals with persistent Lyme-related symptoms.