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Review

Lyme Disease in Humans

1
Departments of Medicine, UConn Health, Farmington, CT 06030, USA
2
Departments of Pediatrics, UConn Health, Farmington, CT 06030, USA
3
Departments of Genetics and Genome Sciences, UConn Health, Farmington, CT 06030, USA
4
Departments of Molecular Biology and Biophysics, UConn Health, Farmington, CT 06030, USA
5
Departments of Immunology, UConn Health, Farmington, CT 06030, USA
6
Division of Infectious Diseases, Wadsworth Center, NY Department of Health, Albany, NY 12208, USA
7
Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
8
Department of Infectious Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia
*
Author to whom correspondence should be addressed.
Curr. Issues Mol. Biol. 2021, 42(1), 333-384; https://doi.org/10.21775/cimb.042.333
Received: 19 September 2020 / Revised: 15 October 2020 / Accepted: 12 November 2020 / Published: 11 December 2020

Abstract

Lyme disease (Lyme borreliosis) is a tick-borne, zoonosis of adults and children caused by genospecies of the Borrelia burgdorferi sensu lato complex. The ailment, widespread throughout the Northern Hemisphere, continues to increase globally due to multiple environmental factors, coupled with increased incursion of humans into habitats that harbor the spirochete. B. burgdorferi sensu lato is transmitted by ticks from the Ixodes ricinus complex. In North America, B. burgdorferi causes nearly all infections; in Europe, B. afzelii and B. garinii are most associated with human disease. The spirochete's unusual fragmented genome encodes a plethora of differentially expressed outer surface lipoproteins that play a seminal role in the bacterium's ability to sustain itself within its enzootic cycle and cause disease when transmitted to its incidental human host. Tissue damage and symptomatology (i.e., clinical manifestations) result from the inflammatory response elicited by the bacterium and its constituents. The deposition of spirochetes into human dermal tissue generates a local inflammatory response that manifests as erythema migrans (EM), the hallmark skin lesion. If treated appropriately and early, the prognosis is excellent. However, in untreated patients, the disease may present with a wide range of clinical manifestations, most commonly involving the central nervous system, joints, or heart. A small percentage (~10%) of patients may go on to develop a poorly defined fibromyalgia-like illness, post-treatment Lyme disease (PTLD) unresponsive to prolonged antimicrobial therapy. Below we integrate current knowledge regarding the ecologic, epidemiologic, microbiologic, and immunologic facets of Lyme disease into a conceptual framework that sheds light on the disorder that healthcare providers encounter.

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MDPI and ACS Style

Radolf, J.D.; Strle, K.; Lemieux, J.E.; Strle, F. Lyme Disease in Humans. Curr. Issues Mol. Biol. 2021, 42, 333-384. https://doi.org/10.21775/cimb.042.333

AMA Style

Radolf JD, Strle K, Lemieux JE, Strle F. Lyme Disease in Humans. Current Issues in Molecular Biology. 2021; 42(1):333-384. https://doi.org/10.21775/cimb.042.333

Chicago/Turabian Style

Radolf, Justin D., Klemen Strle, Jacob E. Lemieux, and Franc Strle. 2021. "Lyme Disease in Humans" Current Issues in Molecular Biology 42, no. 1: 333-384. https://doi.org/10.21775/cimb.042.333

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