Borrelia burgdorferi DO NOT secrete toxins or other virulence factors. Lyme disease is both proinflammatory also immunomodulatory & immunosuppressive. What causes #LymeDisease is the immune response to the bacteria, not the bacteria itself.
The difference in severity and spectrum of #LymeDisease varies among patients. The reasons for this variation include different tropisms among B.b. strains and differences in the host immune responses. 👇
The most commonly prescribed antibiotics for Lyme disease aren't that effective at killing Borrelia. Even combinations of these Abx have a hard time eradicating.
Borrelia burgdorferi, the Causative Agent of Lyme Disease, Forms Drug-Tolerant Persister Cells aac.asm.org/content/59/8/4…
There are many studies showing Borrelia persist after antibiotic therapy.
So why do some patients get better and others do not? It turns out many of these antibiotics have anti-inflammatory and anti-immunomodulatory properties apart from their antimicrobial action. ncbi.nlm.nih.gov/pmc/articles/P…
Tetracyclines (a common treatment for Lyme) are broad-spectrum antibiotics, comprised of four main drugs: tetracycline, doxycycline, minocycline, and lymecycline. These are their anti-inflammatory properties.
Evidence exists that persisting B. burgdorferi can be metabolically active, expressing certain bacterial genes and inducing gene expression changes in the infected host, despite being non-culturable following antibiotic treatment (Greenmyer et al., 2018).
ncbi.nlm.nih.gov/pmc/articles/P…
I'm really happy to see this TBDWG subcommittee is asking hard questions about the persistence of Borrelia and pathogenesis of #LymeDisease and looking for better treatments. Let's do this!
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