Information about NIAID research on antibiotic treatment for Lyme disease
NIAID conducts and supports research on Lyme disease diagnostic procedures
Lyme disease, or borreliosis, is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of an infected blacklegged deer tick. It is the most common tickborne infectious disease in the United States.
State health departments reported 42,743 confirmed or probable cases to the Centers for Disease Control and Prevention (CDC) in 2017. Reported cases are not believed to reflect the actual incidence of Lyme disease, and CDC estimates that 300,000 cases likely occur annually. The incidence of Lyme disease, as with many other tick-borne diseases, has increased dramatically over the past 10 years.
To learn about risk factors for Lyme Disease and current prevention and treatment strategies visit the MedlinePlus Lyme Disease site.
NIAID supports clinical research trials to develop better ways of diagnosing, treating, and preventing Lyme disease. People who have been diagnosed with Lyme disease or who suspect that they have Lyme disease may be eligible to participate.
Scientists are searching for better ways to diagnose, treat, and prevent tickborne diseases. They are also looking for ways to control the tick populations that transmit microbes.
The overarching goals of the NIAID Lyme disease research program are to develop better
methods of diagnosing, treating, and preventing this disease in humans. To accomplish these
objectives, the NIAID Lyme disease research portfolio includes a broad range of activities
focusing on the pathogen, the vector, and the vertebrate hosts.
NIAID scientists and colleagues are investigating a potential treatment strategy against Lyme disease that would directly suppress Borrelia burgdorferi, the bacterium that causes the disease.
Adriana Marques, M.D.
Lyme disease, or Lyme borreliosis, is a multisystem illness caused by the spirochete Borreliella (Borrelia) burgdorferi. B. burgdorferi is transmitted by ticks of the Ixodes ricinus complex (the deer or black-legged tick). Lyme disease is the leading vector-borne disease in the United States, with an estimate of 300,000 cases a year.
Lyme disease usually begins with the characteristic skin lesion, erythema migrans, at the site of the tick bite. After several days or weeks, the spirochete may spread hematogenously and patients may develop neurologic, cardiac and rheumatologic involvement. While most patients recover from Lyme disease with antibiotic therapy, a percentage of patients have persisting or relapsing subjective complaints after therapy. This syndrome of nonspecific symptoms has been named post-treatment Lyme disease syndrome (PTLDS).
Our research has focused on exploring disease mechanisms in B. burgdorferi infection; assessing clinical outcomes in Lyme disease; development of new diagnostic tests and identification of biomarkers of infection; characterization of immunological responses to B. burgdorferi; and on investigation of potential causes of PTLDS.
We also are searching for the cause of Southern Tick-Associated Rash Illness (STARI). STARI is a rash similar to erythema migrans that is associated with the bite of the lone-star tick. The cause of the rash is unknown, as is the natural course of the associated disease.
Tokarz R, Mishra N, Tagliafierro T, Sameroff S, Caciula A, Chauhan L, Patel J, Sullivan E, Gucwa A, Fallon B, Golightly M, Molins C, Schriefer M, Marques A, Briese T, Lipkin WI. A multiplex serologic platform for diagnosis of tick-borne diseases. Sci Rep. 2018 Feb 16;8(1):3158. doi: 10.1038/s41598-018-21349-2.
Marques A, Schwartz I, Wormser GP, Wang Y, Hornung RL, Demirkale CY, Munson PJ, Turk SP, Williams C, Lee CR, Yang J, Petzke MM. Transcriptome Assessment of Erythema Migrans Skin Lesions in Patients with Early Lyme Disease Reveals Predominant Interferon Signaling. J Infect Dis. 2017 Dec 27 ;217(1). doi: 10.1093/infdis/jix563.
Turk SP, Williams C, Marques A. Xenodiagnosis Using Ixodes scapularis Larval Ticks in Humans. Methods Mol Biol. 2018;1690:337-346. doi: 10.1007/978-1-4939-7383-5_26.
Uhde M, Ajamian M, Li X, Wormser GP, Marques A, Alaedini A. Expression of C-Reactive Protein and Serum Amyloid A in Early to Late Manifestations of Lyme Disease. Clin Infect Dis. 2016 Dec 1;63(11):1399-1404.
Wills AB, Spaulding AB, Adjemian J, Prevots DR, Turk SP, Williams C, Marques A. Long-term Follow-up of Patients With Lyme Disease: Longitudinal Analysis of Clinical and Quality-of-life Measures. Clin Infect Dis. 2016 Jun 15;62(12):1546-51. doi: 10.1093/cid/ciw189.
Marques A, Telford SR 3rd, Turk SP, Chung E, Williams C, Dardick K, Krause PJ, Brandeburg C, Crowder CD, Carolan HE, Eshoo MW, Shaw PA, Hu LT. Xenodiagnosis to detect Borrelia burgdorferi infection: a first-in-human study. Clin Infect Dis. 2014 Apr;58(7):937-45. doi: 10.1093/cid/cit939.
Tick-borne diseases are a serious public health problem. Lyme disease, or Lyme borreliosis, is a multisystem illness caused by the spirochete Borreliella (Borrelia) burgdorferi. B. burgdorferi is transmitted by ticks of the Ixodes ricinus complex (the deer or black-legged tick). Lyme disease is the leading vector-borne disease in the United States, with an estimate of with an estimate of 476,000 people treated for Lyme disease a year.
Lyme disease usually begins with the characteristic skin lesion, erythema migrans, at the site of the tick bite. After several days or weeks, the spirochete may spread hematogenously and patients may develop neurologic, cardiac, and rheumatologic involvement. While most patients recover from Lyme disease with antibiotic therapy, a percentage of patients have persisting or relapsing subjective complaints after therapy. This syndrome of nonspecific symptoms has been named post-treatment Lyme disease syndrome (PTLDS).
Our research has focused on exploring disease mechanisms in B. burgdorferi infection; assessing clinical outcomes in Lyme disease; development of new diagnostic tests and identification of biomarkers of infection; characterization of immunological responses to B. burgdorferi; and on investigation of potential causes of PTLDS.
We also are searching for the cause of Southern Tick-Associated Rash Illness (STARI). STARI is a rash similar to erythema migrans that is associated with the bite of the lone star tick, Amblyomma americanum. The cause of the rash is unknown, as is the natural course of the associated disease.
Immune responses to multiple tick bites or multiple tick exposures can induce tick resistance in animal models and consequently protection against B. burgdorferi transmission. Similar findings are seen in humans, but little is known about the nature of the protective immune response. We study the response to tick bites to identify critical aspects of the human innate and adaptive immune responses in skin and blood following exposure to uninfected I. scapularis ticks; and monitor the acquisition of a tick-associated skin immunity. This research could lead to the identification of tick salivary proteins that are targets of host immunity and might serve as targets for an anti-tick vaccine.
Gwynne PJ, Clendenen LH, Turk SP, Marques AR, Hu LT. Antiphospholipid autoantibodies in Lyme disease arise after scavenging of host phospholipids by Borrelia burgdorferi. J Clin Invest. 2022 Mar 15;132(6).
Marques A, Okpali G, Liepshutz K, Ortega-Villa AM. Characteristics and outcome of facial nerve palsy from Lyme neuroborreliosis in the United States. Ann Clin Transl Neurol. 2022 Jan;9(1):41-49.
Marques AR, Strle F, Wormser GP. Comparison of Lyme Disease in the United States and Europe. Emerg Infect Dis. 2021 Aug;27(8):2017-2024.
Jain K, Tagliafierro T, Marques A, Sanchez-Vicente S, Gokden A, Fallon B, Mishra N, Briese T, Kapoor V, Sameroff S, Guo C, Marcos LA, Hu L, Lipkin WI, Tokarz R. Development of a capture sequencing assay for enhanced detection and genotyping of tick-borne pathogens. Sci Rep. 2021 Jun 11;11(1):12384.
Turk SP, Lumbard K, Liepshutz K, Williams C, Hu L, Dardick K, Wormser GP, Norville J, Scavarda C, McKenna D, Follmann D, Marques A. Post-treatment Lyme disease symptoms score: Developing a new tool for research. PLoS One. 2019;14(11):e0225012.
Tokarz R, Mishra N, Tagliafierro T, Sameroff S, Caciula A, Chauhan L, Patel J, Sullivan E, Gucwa A, Fallon B, Golightly M, Molins C, Schriefer M, Marques A, Briese T, Lipkin WI. A multiplex serologic platform for diagnosis of tick-borne diseases. Sci Rep. 2018 Feb 16;8(1):3158.