Lyme disease: Uphill Struggle

@article{Abbott2006LymeDU,
  title={Lyme disease: Uphill Struggle},
  author={Alison Abbott},
  journal={Nature},
  year={2006},
  volume={439},
  pages={524-525}
}
  • A. Abbott
  • Published 2 February 2006
  • Medicine
  • Nature
The first vaccine against Lyme disease was withdrawn because patients distrusted it. Should market forces be allowed to shape the next one, asks Alison Abbott. 

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Identification of LFA-1 as a candidate autoantigen in treatment-resistant Lyme arthritis.

TLDR
Individuals with treatment-resistant Lyme arthritis, but not other forms of arthritis, generated responses to OspA, hLFA-1, and their highly related peptide epitopes, and identification of the initiating bacterial antigen and a cross-reactive autoantigen may provide a model for development of autoimmune disease.

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PCR testing may be able to show whether Lyme arthritis that persists after antibiotic treatment is due to persistence of the spirochete, and can detect B. burgdorferi DNA in synovial fluid.

Multiple cross‐reactive self‐ligands for Borrelia burgdorferi‐specific HLA‐DR4‐restricted T cells

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T cell cross‐reactivity is a common phenomenon and the existence of cross-reactive epitopes alone does not imply molecular mimicry‐mediated pathology and autoimmunity.

ASSOCIATION OF CHRONIC LYME ARTHRITIS WITH HLA‐DR4 and HLA‐DR2 ALLELES

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Particular Class II major histocompatibility genes determine a host immune response to B. burgdorferi that results in chronic arthritis and lack of response to antibiotics, and appear to act as independent, dominant markers of susceptibility.