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Researcher receives grant to develop improved Lyme disease diagnostics and therapeutics

team


Assistant Professor Brandon Jutras, left, and research scientist and Edward Via College of Osteopathic Medicine medical student Mari Davis, right, in the lab at the Fralin Life Sciences Institute. Photo by Alex Crookshanks for Virginia Tech. CREDIT Credit Virginia Tech

Lyme disease is carried by black-legged ticks and infects people when they are bitten and transmit the bacterium Borrelia burgdorferi. Black-legged ticks are especially common in the northeastern United States, and people are exposed to the ticks usually during outdoor activities. Warming temperatures and climate change have caused tick populations to explode and infiltrate more areas of the country, increasing the chance of getting the disease.

The Centers for Disease Control and Prevention estimate that 476,000 people are infected with Lyme disease every year in the United States.

Early symptoms of Lyme disease are fever, headache, fatigue, and the possibility of a telltale bullseye rash at the bite site. If left untreated, the infection can spread to the joints, heart, and nervous system and cause debilitating long-term conditions including Lyme arthritis, carditis, and neuroborreliosis. Sometimes patients can still develop these symptoms despite proper therapy.

Brandon Jutras, assistant professor in the Department of Biochemistry in the College of Agriculture and Life Sciences, received a grant from the Global Lyme Alliance to improve diagnostic testing for all stages of Lyme disease and to develop new ways to treat patients when conventional treatment options have failed.

“We’re thrilled to partner with the Global Lyme Alliance, a longstanding organization dedicated to improving the outcome of patients suffering from this enigmatic disease,” said Jutras, an affiliated faculty of the Fralin Life Sciences Institute and the Center for Emerging, Zoonotic, and Arthropod-Borne Pathogens.

“This grant gives us the opportunity to try radical and innovative approaches like monoclonal antibody therapy. I applaud the Global Lyme Alliance for supporting this high-risk, high-reward research.”

When the infection is caught early and treated with antibiotics in the preliminary stages, patients often recover quickly without long-term effects. Patients who are treated in later stages of the disease may continue to suffer from ongoing symptoms, termed post-treatment Lyme disease.

“Late-stage complications of Lyme disease are due to how our immune system responds. With this funding, we are now able to test new ways to prevent our immune system from overreacting,” said Jutras.

Jutras recently made a discovery that may transform the way we understand acute and chronic symptoms of Lyme disease and Lyme arthritis.

“According to the CDC, cases of vector-borne diseases, such as Lyme disease transmitted from vectors to people, more than doubled between 2004 and 2018 in the United States. The Jutras lab already made a number of important discoveries about the bacterium that causes Lyme disease, B. burgdorferi,” said X.J. Meng, University Distinguished professor and interim director of the Fralin Life Sciences Institute.

 “The Jutras lab recently discovered that the Lyme disease spirochete possesses a unique property in that it sheds peptidoglycan after it infects the human host. This discovery affords the opportunity for scientists to develop novel diagnostics by utilizing a unique biomarker for different stages of Lyme disease. This new grant from the Global Lyme Alliance will now allow the Jutras lab to further explore innovative therapeutic strategies against Lyme disease.”

Virtually all bacteria have a cell-wall component called peptidoglycan. But, as it turns out, the peptidoglycan of the Lyme disease bacterium is unique. They also shed it as they replicate. The B. burgdorferi peptidoglycan can be found in the joints of Lyme arthritis patients with post-treatment Lyme disease, and it can cause arthritis on its own. 

The Jutras lab is developing methods focused on using peptidoglycan as a marker for new diagnostic tests for Lyme disease. Their research now includes using anti-peptidoglycan antibodies to improve existing diagnostics.

“An overarching goal of the Global Lyme Alliance is to foster transformative advances in the diagnosis and treatment of patients suffering from post-treatment Lyme disease. In pursuit of this goal, we are excited to fund the research of Dr. Jutras,” said Timothy J. Sellati, chief scientific officer of the Global Lyme Alliance. “The unique nature of B. burgdorferi peptidoglycan may lend itself to serving as a biomarker for bacterial persistence after treatment and as a target for removal as a means of minimizing or eliminating an underlying reason for persistent symptomatology.”

The Jutras lab is currently developing new ways to either mask or destroy lingering B. burgdorferi peptidoglycan to treat patients suffering from post-treatment Lyme disease.

“In a very short amount of time, Dr. Jutras has developed an impactful research program that engages several Virginia Tech students in Lyme disease research,” said Glenda Gillaspy, professor and department head of biochemistry in the College of Agriculture and Life Sciences. “Together, Dr. Jutras and his team are poised to use biochemical and molecular techniques to help innovate this field, and this recent award will provide significant and important support for the work.”

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Concern about rise in Lyme disease cases




Surging numbers of people are being diagnosed with Lyme disease

Surging numbers of people are being diagnosed with Lyme disease

“Surging numbers of people are being diagnosed with Lyme disease as cases spread from rural areas to the suburbs,” the Daily Mail reports.




The ongoing rise in Lyme disease cases in the UK – thought to be driven by climate change, leading to warmer winters – has been known by public health officials for some time. Reported cases in England and Wales rose from 268 in 2001 to 959 in 2011, but the true figure is thought be much higher. Current estimates put the actual figure at around 3,000 cases a year in England and Wales.

It may also be the case that the disease is, as the Mail puts it, “moving into the suburbs,” or least into the parks. A recent study from September 2015 found ticks that could potentially carry infection in two South London parks: Richmond Park and Bushy Park.

This latest media interest in Lyme disease is driven by the fact that a number of high-profile people on both sides of the Atlantic have reported contracting the infection, such as billionaire founder of Phones4U John Caudwell and High School Musical star Selena Gomez.

So what exactly is Lyme’s disease, what are the symptoms and treatments, and most importantly, how can you stop yourself contracting the condition? Find out below.

What is Lyme disease?

Lyme disease, or Lyme borreliosis, is a bacterial infection spread to humans by infected ticks.

Ticks are tiny spider-like creatures found in woodland and heath areas. They feed on the blood of birds and mammals, including humans. Ticks that carry the bacteria responsible for Lyme disease are found throughout the UK and in other parts of Europe and North America.

Lyme disease can often be treated effectively if it’s detected early on. But if it’s not treated or treatment is delayed, there’s a risk you could develop severe and long-lasting symptoms.

Signs and symptoms of Lyme disease

Many people with early-stage Lyme disease develop a distinctive circular rash at the site of the tick bite, usually around three to 30 days after being bitten.

The rash is often described as looking like a bull’s-eye on a dart board. The affected area of skin will be red and the edges may feel slightly raised.

The size of the rash can vary significantly and it may expand over several days or weeks. Typically, it’s around 15cm (6 inches) across, but it can be much larger or smaller than this. Some people may develop several rashes in different parts of their body.

However, around one in three people with Lyme disease won’t develop this rash.

Some people with Lyme disease also experience flu-like symptomsin the early stages, such as tiredness (fatigue), muscle pain, joint pain, headaches, a high temperature (fever), chills and neck stiffness.

More serious symptoms may develop several weeks, months or even years later, if Lyme disease is left untreated or is not treated early on. These can include:

pain and swelling in the joints (inflammatory arthritis)

problems affecting the nervous system – such as numbness and pain in your limbs, paralysis of your facial muscles, memory problems and difficulty concentrating

heart problems – such as myocarditis, pericarditis, heart block and heart failure




meningitis – which can cause a severe headache, a stiff neck and increased sensitivity to light

Some of these problems will slowly get better with treatment, although they can persist if treatment is started late.

A few people with Lyme disease go on to develop long-term symptoms similar to those of fibromyalgia or chronic fatigue syndrome.

When to see your GP

You should see your GP if you develop any of the symptoms described above after being bitten by a tick, or if you think you may have been bitten. Make sure you let your GP know if you’ve spent time in woodland or heath areas where ticks are known to live.

Treating Lyme disease

If you develop symptoms of Lyme disease, you will normally be given a course of antibiotic tablets, capsules or liquid. Most people will require a two- to four-week course, depending on the stage of the condition.

If you are prescribed antibiotics, it’s important to finish the course, even if you are feeling better, because this will help ensure that all the bacteria are killed.

Preventing Lyme disease

There is currently no vaccine available to prevent Lyme disease. The best way to prevent the condition is to be aware of the risks when you visit areas where ticks are found and to take sensible precautions.

You can reduce the risk of infection by:

keeping to footpaths and avoiding long grass when out walking

wearing appropriate clothing in tick-infested areas (a long-sleeved shirt and trousers tucked into your socks)

wearing light-coloured fabrics that may help you spot a tick on your clothes

using insect repellent on exposed skin

inspecting your skin for ticks, particularly at the end of the day, including your head, neck and skin folds (armpits, groin and waistband) – remove any ticks you find promptly

checking your children’s head and neck areas, including their scalp

making sure ticks are not brought home on your clothes

checking that pets do not bring ticks into your home in their fur

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Lyme disease – Signs and symptoms of Lyme disease




Lyme Disease rash

Lyme Disease rash Lyme Disease




Lyme disease, or Lyme borreliosis, is a bacterial infection spread to humans by infected ticks.

Ticks are tiny spider-like creatures found in woodland and heath areas. They feed on the blood of birds and mammals, including humans. Ticks that carry the bacteria responsible for Lyme disease are found throughout the UK and in other parts of Europe and North America.

It’s estimated there are 2,000 to 3,000 new cases of Lyme disease in England and Wales each year. About 15% of cases occur while people are abroad.

Lyme disease can often be treated effectively if it’s detected early on. But if it’s not treated or treatment is delayed, there’s a risk you could develop severe and long-lasting symptoms.

 

Signs and symptoms of Lyme disease

Early symptoms

Many people with early-stage Lyme disease develop a distinctive circular rash at the site of the tick bite, usually around three to 30 days after being bitten. This is known as erythema migrans.




The rash is often described as looking like a bull’s-eye on a dart board. The affected area of skin will be red and the edges may feel slightly raised.

The size of the rash can vary significantly and it may expand over several days or weeks. Typically it’s around 15cm (6 inches) across, but it can be much larger or smaller than this. Some people may develop several rashes in different parts of their body.

However, around one in three people with Lyme disease won’t develop this rash.

Some people with Lyme disease also experience flu-like symptoms in the early

Lyme Disease tick

Lyme Disease tick

stages, such as tiredness (fatigue), muscle pain, joint pain, headaches, a high temperature (fever), chills and neck stiffness.

Later symptoms

More serious symptoms may develop several weeks, months or even years later if Lyme disease is left untreated or is not treated early on. These can include:

pain and swelling in the joints (inflammatory arthritis)

problems affecting the nervous system – such as numbness and pain in your limbs, paralysis of your facial muscles, memory problems and difficulty concentrating

heart problems – such as inflammation of the heart muscle (myocarditis) or sac surrounding the heart (pericarditis), heart block and heart failure

inflammation of the membranes surrounding the brain and spinal cord (meningitis) – which can cause a severe headache, a stiff neck and increased sensitivity to light

Some of these problems will get better slowly with treatment, although they can persist if treatment is started late.

A few people with Lyme disease go on to develop long-term symptoms similar to those of fibromyalgia or chronic fatigue syndrome. This is known as post-infectious Lyme disease. It’s not clear exactly why this happens, but it’s likely to be related to overactivity of your immune system rather than persistent infection.

When to see your GP

You should see your GP if you develop any of the symptoms described above after being bitten by a tick, or if you think you may have been bitten. Make sure you let your GP know if you’ve spent time in woodland or heath areas where ticks are known to live.

Diagnosing Lyme disease is often difficult as many of the symptoms are similar to other conditions. A spreading rash some days after a known tick bite should be treated with appropriate antibiotics without waiting for the results of a blood test.

Blood tests can be carried out to confirm the diagnosis after a few weeks, but these can be negative in the early stages of the infection. You may need to be re-tested if Lyme disease is still suspected after a negative test result.

In the UK, two types of blood test are used to ensure Lyme disease is diagnosed accurately. This is because a single blood test can sometimes produce a positive result even when a person doesn’t have the infection.

If you have post-infectious Lyme disease or long-lasting symptoms, you may see a specialist in microbiology or infectious diseases. They can arrange for blood samples to be sent to the national reference laboratory run by Public Health England (PHE), where further tests for other tick-borne infections can be carried out.

How you get Lyme disease

If a tick bites an animal carrying the bacteria that cause Lyme disease (Borrelia burgdorferi), the tick can also become infected. The tick can then transfer the bacteria to a human by biting them.

Ticks can be found in any areas with deep or overgrown vegetation where they have access to animals to feed on.

They’re common in woodland and heath areas, but can also be found in gardens or parks.

Ticks don’t jump or fly, but climb on to your clothes or skin if you brush against something they’re on. They then bite into the skin and start to feed on your blood.

Generally, you’re more likely to become infected if the tick remains attached to your skin for more than 24 hours. But ticks are very small and their bites are not painful, so you may not realise you have one attached to your skin.

Who’s at risk and where are ticks found?

People who spend time in woodland or heath areas in the UK and parts of Europe or North America are most at risk of developing Lyme disease.

Most tick bites happen in late spring, early summer and autumn because these are the times of year when most people take part in outdoor activities, such as hiking and camping.

Cases of Lyme disease have been reported throughout the UK, but areas known to have a particularly high population of ticks include:

Exmoor

the New Forest and other rural areas of Hampshire

the South Downs

parts of Wiltshire and Berkshire

parts of Surrey and West Sussex

Thetford Forest in Norfolk

the Lake District

the North York Moors

the Scottish Highlands

It’s thought only a small proportion of ticks carry the bacteria that cause Lyme disease, so being bitten doesn’t mean you’ll definitely be infected. However, it’s important to be aware of the risk and seek medical advice if you start to feel unwell.

Treating Lyme disease

If you develop symptoms of Lyme disease, you will normally be given a course of antibiotic tablets, capsules or liquid. Most people will require a two- to four-week course, depending on the stage of the condition.

If you are prescribed antibiotics, it’s important you finish the course even if you are feeling better, because this will help ensure all the bacteria are killed.

If your symptoms are particularly severe, you may be referred to a specialist to have antibiotic injections (intravenous antibiotics).

Some of the antibiotics used to treat Lyme disease can make your skin more sensitive to sunlight. In these cases, you should avoid prolonged exposure to the sun and not use sunbeds until after you have finished the treatment.

There’s currently no clear consensus on the best treatment for post-infectious Lyme disease because the underlying cause is not yet clear. Be wary of internet sites offering alternative diagnostic tests and treatments that may not be supported by scientific evidence.

Preventing Lyme disease

There is currently no vaccine available to prevent Lyme disease. The best way to prevent the condition is to be aware of the risks when you visit areas where ticks are found and to take sensible precautions.

You can reduce the risk of infection by:

keeping to footpaths and avoiding long grass when out walking

wearing appropriate clothing in tick-infested areas (a long-sleeved shirt and trousers tucked into your socks)

wearing light-coloured fabrics that may help you spot a tick on your clothes

using insect repellent on exposed skin

inspecting your skin for ticks, particularly at the end of the day, including your head, neck and skin folds (armpits, groin, and waistband) – remove any ticks you find promptly

checking your children’s head and neck areas, including their scalp

making sure ticks are not brought home on your clothes

checking that pets do not bring ticks into your home in their fur

How to remove a tick

If you find a tick on your or your child’s skin, remove it by gently gripping it as close to the skin as possible.

Use a pair of tweezers that won’t squash the tick (such as fine-tipped tweezers), or use a tick removal tool (available from pet shops or vets). Pull steadily away from the skin without twisting or crushing the tick.

Wash your skin with water and soap afterwards, and apply an antiseptic cream to the skin around the bite.

Don’t use a lit cigarette end, a match head or substances such as alcohol or petroleum jelly to force the tick out.

Some veterinary surgeries and pet shops sell inexpensive tick removal devices, which may be useful if you frequently spend time in areas where there are ticks.

“Chronic Lyme disease”

There has recently been a lot of focus on Lyme disease in the media, with much attention on people who’ve been diagnosed with “chronic Lyme disease”.

This term has been used by some people to describe persistent symptoms such as tiredness, aches and pains, usually in the absence of a confirmed Lyme disease infection. It’s different to “post-infectious Lyme disease” (see above), which is used to describe persistent symptoms after a confirmed and treated infection.

It’s important to be aware that a diagnosis of chronic Lyme disease is controversial. Experts do not agree on whether the condition exists, or whether the symptoms are actually caused by a different, undiagnosed problem.

In either case, there’s no evidence to suggest people diagnosed with chronic Lyme disease can pass the condition on to others, and there’s little clear evidence about how best to treat it.

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Common Hidden and Invisible Illnesses Explained – Please share to raise awareness




If you saw a person in a wheelchair or on crutches struggling to move, would you accuse them of milking it for attention? Not unless you were a truly malign, cold-hearted individual. If you saw a seemingly healthy person climbing out of a car that’s just been parked in a disabled parking spot, would you accost them and insist that they park elsewhere? Quite possibly, but before you do, it’s worth taking the time to consider whether that person actually does need the spot, even though they seem healthy.

There’s a little insight into the world of the hidden illness sufferer. Aside from the crippling physical pain they courageously endure on a daily basis, there’s also the frustration and torment of unsympathetic observers who take their exterior appearance at face value and believe that there’s nothing wrong. It doesn’t have to be a physical illness, either. Depression is also classified as a hidden illness, as it is a medical condition which might be highly concealed but has an enormously damaging impact on a person’s day-to-day life.




For people living with hidden illnesses, a basic degree of understanding and empathy from others is greatly appreciated. If you hear someone saying profusely that they’re feeling unwell, don’t just brush their words aside as the attention-seeking whines of a serial complainer. Ask them if there is anything you can do to make them feel a bit better. A person without a chronic illness just does not know the extent of the suffering of those with such illnesses.

This infographic from Burning Nights neatly summarises 10 of the most common hidden illnesses so that we can all obtain a small level of understanding. This include multiple sclerosis, rheumatoid arthritis, fibromyalgia, osteoarthritis, depression, Ehlers-Danlos syndrome, Lyme disease, Lupus and CRPS. Maybe the next time we see a seemingly healthy person occupying a handicapped parking space, we won’t be so hasty in our judgement.

Common Hidden Illnesses Explained [Infographic]