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Lyme Disease: Breakthrough Could Lead to Better Treatments

by Dr. Lakshmi Venkataraman on June 18, 2019 at 2:50 PM

Highlights:

A new molecule called peptidoglycan has been identified in Lyme arthritis patients
Peptidoglycan was present in the synovial fluid of affected joints of patients
This could lead to the development of better diagnostics and treatments for Lyme disease

A breakthrough has occurred that could lead to new treatments for Lyme disease, suggests a new study from Virginia Tech, USA. The research team has discovered a cellular component that causes Lyme arthritis, which is a major late-stage symptom of Lyme disease.

Lyme arthritis is a very painful and highly debilitating condition. The study findings indicate that when the causative bacterium Borrelia burgdorferi multiplies in the body, it releases a cellular component known as peptidoglycan that can produce severe inflammatory reactions.

Facts about Lyme Disease

Lyme disease is caused by the bacterium B. burgdorferi and transmitted by infected ticks
Lyme disease is the highest reported vector-borne disease in the US
Lyme disease incidence has increased over 6,000 percent in the past 15 years in Virginia, USA
300,000 people are diagnosed with Lyme disease annually in the US
Climate change will increase the prevalence of Lyme disease

The lead author of the study was Dr. Brandon L. Jutras, PhD, who is an Assistant Professor in the Department of Biochemistry, College of Agriculture and Life Sciences, at Virginia Tech, USA.

‘A molecule called peptidoglycan in the synovial fluids of affected joints in patients with Lyme arthritis was identified, which could help in developing new diagnostics and treatments for Lyme disease.’

The study was carried out with active collaboration from Professor Allen C. Steere, MD, who is Director of Translational Research, Rheumatology Unit at Massachusetts General Hospital and Professor of Medicine at Harvard Medical School, Boston, Massachusetts, USA. More importantly, Professor Steere discovered and named Lyme disease in 1975.

The study, which has been published in the Proceedings of the National Academy of Sciences of the United States of America (PNAS), is the fruit of four years of painstaking research that began when Jutras was a postdoctoral fellow in the lab of Dr. Christine Jacobs-Wagner, PhD, who is a Professor in the Department of Microbial Pathogenesis at Yale School of Medicine, New Haven, Connecticut, USA.

Study Procedure

Clinical samples were obtained from confirmed Lyme disease patients
Patients were refractory to oral and/or intravenous antibiotics
Peptidoglycan was present in the synovial fluids of the patients
Peptidoglycan was purified from other bacterial components
Mouse model was used to test if arthritis could be induced by peptidoglycan alone

Study Findings

Peptidoglycan is responsible for Lyme arthritis in late-stage Lyme disease
Peptidoglycan was detected in the synovial fluid of affected joints in patients with Lyme arthritis, who did not have any active infection
In the mouse model, injection of purified peptidoglycan caused severe joint inflammation within 24 hours, proving that peptidoglycan can cause arthritis
This rapid inflammatory reaction could arise from the unique molecular structure of peptidoglycan in the bacterium B. burgdorferi

With reference to the study findings, Jutras says: "We are interested in understanding everything associated with how patients respond, how we can prevent that response, and how we could possibly intervene with blocking therapies or therapies that eliminate the molecule entirely."

Implications of the Study

The study findings will help to develop better techniques to diagnose Lyme disease and Lyme arthritis in patients with non-specific symptoms, by detecting peptidoglycan in synovial fluid.

Future Plans

Experiments are being planned to better understand the chemical structure of peptidoglycan, which will help to elucidate how the molecule persists in the body and produces other manifestations of Lyme disease. This will be followed by developing therapeutic strategies to target and destroy the peptidoglycan molecule. This will resolve the symptoms and help in the recovery of patients with Lyme disease.

Concluding Remarks

Jutras concludes: "This discovery will help researchers improve diagnostic tests and may lead to new treatment options for patients suffering from Lyme arthritis." He adds: "This is an important finding, and we think that it has major implications for many manifestations of Lyme disease, not just Lyme arthritis."

Reference:

Borrelia burgdorferi peptidoglycan is a persistent antigen in patients with Lyme arthritis - (https:www.pnas.org/content/early/2019/06/11/1904170116)

Source: Medindia

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