Research has major implications for the treatment of tick-borne diseases, such as Lyme disease, which is an increasingly chronic and consistently prevalent public health issue.
A University of Maryland (UMD) researcher has uncovered information on how the bacteria that causes Lyme disease persists in the body and fights early, innate immune responses.
Professor of Veterinary Medicine Utpal Pal, Ph.D., who has been studying Borrelia burgdorferi, the bacteria that cause Lyme disease, for 12 years, and his team have isolated a protein produced by the bacteria that disables one of the body’s first immune responses, giving insight into mechanisms that are largely not understood. Pal has previously produced a protein marker used to identify this bacterial infection in the body. has major implications for the treatment of tick-borne diseases, such as Lyme disease, which is an increasingly chronic and consistently prevalent public health issue.
“Most people don’t realize that they are walking around with more bacterial cells in their bodies than their own cells, so we are really bags of bacteria,” explains Pal. “Most [bacteria] are good, but the second your body detects something that is a pathogen that can cause disease, your immune system starts to work.”
Once disease causing bacteria are detected, the body’s immune system sends a nonspecific wave of attack to kill the invaders. This can happen within a few hours or take days. If this doesn’t work, it takes the immune system seven to 10 days to discover the ‘enemy’ and to send a second wave of reinforcements, specifically targeting the bacteria to kill.
“Lyme disease is actually caused by your immune system,” explains Pal. “[Borrelia burgdorferi] bacteria win the first battle, and your body overreacts so much that it causes intense inflammation in all the joints and areas that the bacteria spreads to…. Borrelia is then killed, but the inflammation remains and causes many of [the] symptoms for Lyme disease. That is why killing Borrelia in the first wave of immunity is so important.”
The Centers for Disease Control and Prevention (CDC) estimate about 300,000 cases of Lyme disease annually in the United States and the numbers have been on the rise locally and across the country.
“The majority of all vector-borne diseases in the US are actually tick-borne, and 6 of the 15 distinct tick diseases are transmitted by the Ixodes tick we study in our lab,” says Pal. “The symptoms of these diseases present similarly to many other illnesses and are hard to pin down, so they are vastly underreported and an even bigger public health concern locally and globally than people realize.” Now, chronic Lyme disease is a growing concern. Six to twelve months after traditional antibiotic therapy, many people have non-objective symptoms that return with varying intensity and no current treatment strategy, known as Post-Treatment Lyme Disease Syndrome.
Professor Pal’s research has shed some light on this issue and paved the way for future research and treatment options by discovering that even without the protein used to beat the first wave of immune defense, infection can reoccur in the body weeks later. “This means there is a second line of defense for Borrelia just like for our body’s immune system. This had never been observed before and gives us insight into what could be causing these chronic Lyme disease cases,” explains Pal.
Pal is frequently consulted for his expertise and has written books on this highly versatile bacteria. He currently holds two concurrent multi-million dollar RO1 grants from the National Institutes of Health (NIH) for his work on tick-borne diseases. “I am fascinated by Borrelia, and this discovery will open the door for much more work to treat and control important diseases like Lyme disease,” says Pal.
Pal’s paper, Plasticity in early immune evasion strategies of a bacterial pathogen, is published in the Proceedings of the National Academies of Science.