{"id":47836,"date":"2025-04-24T23:15:09","date_gmt":"2025-04-24T23:15:09","guid":{"rendered":"https:\/\/www.europesays.com\/uk\/47836\/"},"modified":"2025-04-24T23:15:09","modified_gmt":"2025-04-24T23:15:09","slug":"lingering-bacterial-debris-may-drive-post-treatment-lyme-symptoms","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/uk\/47836\/","title":{"rendered":"Lingering Bacterial Debris May Drive Post-Treatment Lyme Symptoms"},"content":{"rendered":"<p><strong>Summary: <\/strong>New research suggests that lingering cell wall fragments from the Lyme disease bacterium, Borrelia burgdorferi, may be responsible for persistent symptoms long after antibiotic treatment. These fragments, made of a unique form of peptidoglycan, appear to accumulate in the liver and joints, triggering inflammation and immune responses even after the infection is gone.<\/p>\n<p>This mechanism resembles theories behind long COVID, where the immune system reacts to residual viral components. The findings could pave the way for targeted treatments and diagnostic tools that focus on inflammation rather than active infection.<\/p>\n<p><strong>Key Facts:<\/strong><\/p>\n<ul class=\"wp-block-list\">\n<li><strong>Persistent Debris:<\/strong> Lyme bacteria\u2019s unique peptidoglycan can linger for months post-treatment.<\/li>\n<li><strong>Inflammatory Trigger:<\/strong> These remnants may drive ongoing symptoms like joint pain and fatigue.<\/li>\n<li><strong>New Targets:<\/strong> Researchers are exploring monoclonal antibodies to neutralize the leftover molecules.<\/li>\n<\/ul>\n<p><strong>Source: <\/strong>Northwestern University<\/p>\n<p><strong>Symptoms that persist long after Lyme disease is treated are not uncommon \u2014\u00a0a\u00a02022 study found\u00a0that 14% of patients who were diagnosed and treated early with antibiotic therapy would still develop Post Treatment Lyme Disease (PTLD). <\/strong><\/p>\n<p>Yet doctors puzzle over the condition\u2019s causes and how to help their patients through symptoms ranging from severe fatigue and cognitive challenges to body pain and arthritis.<\/p>\n<p>Now, Northwestern University scientists believe they know what causes the treated infection to mimic chronic illness: the body may be responding to remnants of the\u00a0Borrelia burgdorferi\u00a0(the bacteria that causes Lyme) cell wall, which breaks down during treatment yet lingers in the liver.<\/p>\n<p>This matches one theory behind the underlying causes of long COVID-19 in that persisting viral molecules may encourage a strong, albeit unnecessary, immune response, said bacteriologist\u00a0Brandon L. Jutras.<\/p>\n<p>\u201cLyme and long COVID-19 are clearly vastly different diseases, but it\u2019s possible that they share a more general mechanism of inappropriate inflammation caused by remnants of a previous infection,\u201d said Jutras, who led the research.<\/p>\n<p>\u201cThe maladaptive response is a product of an infection, but perhaps not necessarily an active one in all cases.\u201d<\/p>\n<p>Peptidoglycan is a structural feature of virtually all bacterial cells and a common target of antibiotics, including penicillin.<\/p>\n<p>The research, to be published April 23 in the journal Science Translational Medicine, tracked the biodistribution of peptidoglycan from different bacteria, in real time, and found that all cell wall material is rapidly shed, but Lyme disease\u2019s peptidoglycan persists for weeks to months.<\/p>\n<p>Lyme arthritis is one of the more common long-term impacts of exposure to Lyme. If a patient has a swollen knee, for instance, it is full of synovial fluid, a natural lubricant found in joints. Jutras said his team looked at the fluid in humans and found that pieces of the peptidoglycan were omnipresent weeks to months after treatment.<\/p>\n<p>\u201cIn the context of Lyme arthritis, if you give patients anti-inflammatory, disease-modifying antirheumatic drugs, they get better,\u201d Jutras said.<\/p>\n<p>\u201cSome of these very same patients do not get better after oral and IV antibiotics, which implies there is something unique about how patients respond at a genetic level.\u201d<\/p>\n<p>Jutras, who joined Northwestern faculty last summer, is an associate professor of microbiology-immunology at Northwestern University Feinberg School of Medicine and a member of the Center for Human Immunobiology at Northwestern.<\/p>\n<p>He has been studying Lyme disease for more than 15 years, beginning in graduate school, and was previously an associate professor at Virginia Tech University.<\/p>\n<p>\u201cPeptidoglycan is kind of like a structural skeleton in virtually all bacteria, acting as a big protective bag for the bacterium,\u201d Jutras said.<\/p>\n<p>\u201cPenicillin and amoxicillin and dozens of other drugs target peptidoglycan synthesis because it\u2019s a molecule that is specific to bacteria, it has similar structural features across the kingdom, and it\u2019s essential.\u201d<\/p>\n<p>Lyme\u2019s peptidoglycan, however, is structurally unique, and this difference may be behind its persistence in humans. Instead of looking the same as with other bacteria, the Lyme peptidoglycan is fundamentally distinct, which is facilitated in part by sucking up sugars from its tick vector.<\/p>\n<p>Upon bacterial cell death \u2014 by antibiotics or the immune system \u2014 surviving molecules tend to relocate to the liver, which can\u2019t process the modified peptidoglycan.<\/p>\n<p>Without this modification, it seems likely that the peptidoglycan would clear right away, as in other infections.<\/p>\n<p>\u201cThe unusual chemical properties of Borrelia peptidoglycan promote persistence, but it\u2019s the individual patient response to the molecule that likely impacts the overall clinical outcome,\u201d Jutras said.<\/p>\n<p>\u201cSome patients will have a more robust or stronger immune response, which could result in a worse disease outcome, while the immune system of others may largely ignore the molecule.<\/p>\n<p>\u201cSo, in essence, it\u2019s not about whether the molecule is there or not, it\u2019s more about how an individual responds to it.\u201d<\/p>\n<p>Jutras hopes the groundbreaking findings will lead to development of more accurate tests, possibly for PTLD patients, and refined treatment options when antibiotics have failed.<\/p>\n<p>To effectively stymie PTLD, instead of neutralizing an infection that may no longer exist, efforts are underway to neutralize the inflammatory molecule, including weaponizing monoclonal antibodies to target peptidoglycan for destruction.<\/p>\n<p><strong>Funding: <\/strong>The research was supported by the National Institutes of Allergy and Infectious Diseases (R21AI159800, R01AI173256, R01AI178711), the Steven &amp; Alexandra Cohen Foundation, the Department of Defense (TB220039), the Global Lyme Alliance and the Bay Area Lyme Foundation.<\/p>\n<p>About this neurology and Lyme disease research news<\/p>\n<p class=\"has-background\" style=\"background-color:#ffffe8\"><strong>Author: <\/strong><a href=\"http:\/\/neurosciencenews.com\/cdn-cgi\/l\/email-protection#aac6c3c6cb84d8cfd3c4c5c6ced9eac4c5d8dec2ddcfd9decfd8c484cfcedf\" target=\"_blank\" rel=\"noreferrer noopener\">Win Reynolds<\/a><br \/><strong>Source: <\/strong><a href=\"https:\/\/northwestern.edu\" target=\"_blank\" rel=\"noreferrer noopener\">Northwestern University<\/a><br \/><strong>Contact: <\/strong>Win Reynolds \u2013 Northwestern University<br \/><strong>Image: <\/strong>The image is credited to Neuroscience News<\/p>\n<p class=\"has-background\" style=\"background-color:#ffffe8\"><strong>Original Research: <\/strong>Closed access.<br \/>\u201c<a href=\"https:\/\/doi.org\/10.1126\/scitranslmed.adr2955\" target=\"_blank\" rel=\"noreferrer noopener\">The peptidoglycan of\u00a0Borrelia burgdorferi\u00a0can persist in discrete tissues and cause systemic responses consistent with chronic illness<\/a>\u201d by Brandon L. Jutras et al. Science Translational Medicine<\/p>\n<p><strong>Abstract<\/strong><\/p>\n<p><strong>The peptidoglycan of\u00a0Borrelia burgdorferi\u00a0can persist in discrete tissues and cause systemic responses consistent with chronic illness<\/strong><\/p>\n<p>Persistent symptoms after an acute infection is an emerging public health concern, but the pathobiology of such conditions is not well understood. One possible scenario involves the persistence of lingering antigen.<\/p>\n<p>We have previously reported that patients with postinfectious Lyme arthritis often harbor the peptidoglycan (PG) cell wall of\u00a0Borrelia burgdorferi, the Lyme disease agent, in the synovial fluid of their inflamed joints after treatment.<\/p>\n<p>However, it is not yet known how\u00a0B. burgdorferi\u00a0PG persists, in what form, or if it may play a role in other postinfectious complications after Lyme disease.<\/p>\n<p>Using a murine model, we developed a real-time in vivo system to track\u00a0B. burgdorferi\u00a0PG as a function of cell wall chemistry and validated our findings using both molecular and cellular approaches.<\/p>\n<p>Unlike typical bacterial PG, the unique chemical properties of polymeric\u00a0B. burgdorferi\u00a0PG drive murine liver accumulation, where the cell wall material persists for weeks.<\/p>\n<p>Kupffer cells and hepatocytes phagocytose and retain\u00a0B. burgdorferi\u00a0PG and, although liver occupancy coincides with minimal pathology, both organ-specific and secreted protein profiles produced under these conditions bear some similarities to reported proteins enriched in patients with chronic illness after acute infection.<\/p>\n<p>Moreover, transcriptomic profiling indicated that\u00a0B. burgdorferi\u00a0PG affects energy metabolism in peripheral blood mononuclear cells.<\/p>\n<p>Our findings provide mechanistic insights into how a pathogenic molecule can persist after agent clearance, potentially contributing to illness after infection.<\/p>\n","protected":false},"excerpt":{"rendered":"Summary: New research suggests that lingering cell wall fragments from the Lyme disease bacterium, Borrelia burgdorferi, may be&hellip;\n","protected":false},"author":2,"featured_media":47837,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[215,1033,105,8119,219,233,220,11364,26103,16,15],"class_list":{"0":"post-47836","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-brain-research","9":"tag-cognition","10":"tag-health","11":"tag-lyme-disease","12":"tag-neurobiology","13":"tag-neurology","14":"tag-neuroscience","15":"tag-northwestern-university","16":"tag-post-lyme-syndrome","17":"tag-uk","18":"tag-united-kingdom"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@uk\/114395488164745225","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/47836","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/comments?post=47836"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/47836\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media\/47837"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media?parent=47836"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/categories?post=47836"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/tags?post=47836"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}