Search Results (3,482)

On heavily traveled highway corridors, traffic congestion, lane merges, toll facilities, and complex interchanges frequently trigger sudden and aggressive deceleration, commonly referred to as harsh braking (HB). Such maneuvers reflect near-miss driving conditions that may precede crashes. Traditional traffic safety analyses rely primarily on historical crash records, a reactive approach that limits agencies’ ability to identify and address emerging risks in a timely manner. Because HB events are continuously captured by connected-vehicle telematics, they provide an opportunity to evaluate roadway safety risk more proactively. This study investigates the applicability of harsh braking events as a surrogate indicator of crash risk on New Jersey interstate highways. The analysis uses more than 8.5 million connected-vehicle telemetry records from Drivewyze and approximately 45,000 police-reported crashes collected between July and December 2024. HB events were identified using a deceleration threshold of 6 ft/s² (approximately 0.2g) and spatially matched to one-mile highway segments along with crash data. Spatial analysis shows that both HB events and crashes are highly concentrated along major corridors, including I-95, I-80, I-78, and I-287, with notable clustering near toll plazas and complex interchange areas. Temporal patterns indicate that harsh braking activity increases substantially during late fall, likely reflecting seasonal congestion and adverse weather conditions. To quantify the relationship between HB events and crash frequency, Negative Binomial (NB) and Zero-Inflated Negative Binomial (ZINB) regression models were estimated at the segment level. Results reveal a positive and statistically significant association between HB events and crash counts. In the preferred ZINB model, each additional HB event is associated with approximately a one percent increase in expected crash frequency. While the effect of individual events is small, repeated harsh braking activity corresponds to a meaningful increase in crash risk; for example, an increase of 10 HB events corresponds to an expected crash frequency of about 10% higher. Overall, the findings suggest that connected-vehicle HB data can complement traditional crash records by providing early indications of elevated risk. Incorporating HB monitoring into highway safety programs may support proactive identification of hazardous locations and more timely deployment of targeted countermeasures. Full article

Effectively activating protective CD8⁺ T cell immunity specifically against cancer antigens is an important pathway to prevent the growth of various types of cancers. A major obstacle in this approach is variations in cancer antigens among patients. A valuable material to overcome the antigen variation among cancer patients is the use of each individual’s own cancer cells for immunization. In colorectal cancer (CRC), approximately one-third of the patients who receive curative surgical resection have a recurrence of cancer. Therefore, the use of surgically resected CRC for immunotherapy to specifically activate the protective CD8⁺ T cells against their own cancer cells is a valuable approach to prevent the recurrence of cancer. However, since cancer-specific antigens are often not strongly immunogenic, a potent immunostimulant is required as an adjuvant for efficiently facilitating the activation of cancer-specific protective CD8⁺ T cells. We recently identified that a protein molecule, the amino-terminus region of the dense granule protein 6 (GRA6Nt) of Toxoplasma gondii, selectively activates innate expressions of IFN-γ and IL-18 and functions as a powerful adjuvant when used in immunization with nonreplicable (treated with mitomycin C or irradiated) MC38 CRC cells to potently activate the cytotoxic activity and IFN-γ production of CD8⁺ T cells against cancer cells. In addition, immunization using the GRA6Nt protein adjuvant effectively inhibits the growth of identical CRC cells after its challenge implantation, which mimics a recurrence of the surgically resected CRC used for the immunizations. In contrast to the two nucleotide- or deoxynucleotide-based Toll-like receptor agonists currently being used as adjuvants in cancer immunotherapy in clinical settings, GRA6Nt is a protein molecule. Thus, the rGRA6Nt protein adjuvant provides a new pathway in cancer immunotherapy to effectively activate the protective CD8⁺ T cells specific for the individual’s cancer cells to prevent the recurrence of surgically resected CRC in patients. Full article

Ischemia and reperfusion (IR) injuries may produce deleterious effects on hepatic tissue after liver surgery and transplantation. The consequences of IR are more evident in pathological steatotic livers. Spirulina (Arthrospira platensis) is known for its potential to modulate inflammatory responses and enhance antioxidant defenses. The current investigation assessed whether spirulina pretreatment mitigates hepatic IR injury exacerbated by steatosis in rats. Thirty male Wistar rats were divided into five groups: sham, IR, HFD, HFD + IR, and SP1000 (HFD + IR + spirulina 1000 mg/kg/day; oral gavage). Liver injury, oxidative stress, inflammatory signaling, and inflammasome/pyroptosis-related markers were assessed using serum transaminases, hematoxylin–eosin staining, immunofluorescence, and qRT-PCR. High-fat diet-fed rats developed steatosis, which significantly worsened IR-induced liver damage, as shown by the respective steatosis histological score, the elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST), and higher expression of inflammatory markers, including Toll-like receptor (TLR4), nuclear factor kappa B (NF-κB), tumor necrosis factor alpha (TNF-α), and interleukin-1 beta (IL-1β) and inflammasome/pyroptosis-related transcripts, namely NOD-like receptor family pyrin domain-containing 3 (NLRP3), interleukin-18 (IL18), and gasdermin D (GSDMD). Oxidative stress was exacerbated, as reflected by higher levels of malondialdehyde (MDA) and reduced antioxidant defenses (superoxide dismutase (SOD) activity, reduced glutathione (GSH) content, glutathione peroxidase (GPx) expression, and heme oxygenase-1 (HO-1) expression). Furthermore, HFD + IR upregulated sterol regulatory element-binding protein-1c (SREBP-1c) expression and downregulated AMP-activated protein kinase (AMPK) expression. Spirulina supplementation significantly attenuated liver injury and transaminase release, reduced MDA, restored antioxidant parameters, downregulated inflammatory and inflammasome-related gene expression, and shifted both SREBP-1c and AMPK expressions toward control levels. Full article

This study investigates the immunomodulatory effects and underlying mechanisms of KEMPFPK, a peptide derived from bovine β-casein, using integrated in vitro, in silico, and in vivo approaches. In RAW264.7 macrophages, KEMPFPK enhanced proliferation, phagocytosis, and migration and selectively upregulated the chemokine MCP-1. Under LPS-induced inflammation, KEMPFPK suppressed pro-inflammatory cytokines (IL-1β, TNF-α) and NO production while promoting the anti-inflammatory cytokine IL-10. These effects were mediated through the inhibition of NF-κB and MAPK signaling pathways. Molecular docking predicted high-affinity binding of KEMPFPK to Toll-like receptors (TLR2 and TLR4), suggesting a potential mechanism for its immunomodulatory activity. In cyclophosphamide (CTX)-induced immunosuppressed mice, KEMPFPK administration restored immune organ indices, rebalanced serum cytokine levels, and modulated humoral immunity. Importantly, KEMPFPK was associated with a significantly reshaped gut microbiota profile, characterized by the promotion of beneficial genera (e.g., Ligilactobacillus, Adlercreutzia) and the suppression of opportunistic pathogens (e.g., Escherichia–Shigella). These findings establish KEMPFPK as a dual-phase immunomodulator and suggest that its effects may involve direct immune cell regulation coupled with indirect microbiota remodeling. This study provides a scientific foundation for the application of KEMPFPK in immunomodulatory functional foods. Full article

The tomato leaf miner, Tuta absoluta (Meyrick) (Lepidoptera: Gelechiidae), poses a significant threat to global tomato production. However, environmentally sustainable management strategies for this pest, as well as its mechanisms of insecticide resistance, remain insufficiently understood. Broflanilide, a novel meta-diamide compound, can bind specifically to the transmembrane domain of the RDL subunit, causing prolonged opening of the chloride channel, disruption of neurotransmission, and ultimately insect paralysis and death. This study employed the leaf immersion method to conduct bioassays on the second-instar larvae of T. absoluta to evaluate physiological responses to sublethal concentrations of the novel amide insecticide broflanilide. Subsequently, high-throughput transcriptome sequencing was performed to investigate changes in gene expression and metabolic pathways. Bioassay results determined the larval sublethal concentrations of broflanilide to be 0.136 mg/L (LC₁₀) and 0.210 mg/L (LC₃₀). Sublethal exposure significantly prolonged the larval period, reduced pupal weight, and inhibited fecundity of female adults. Transcriptomic and qPCR analyses revealed that, compared with the control (CK), expression of the vitellogenin gene Vg decreased by 15.99% and 30.27% under LC₁₀ and LC₃₀ treatments, respectively, while its receptor gene VgR decreased by 11.56% and 24.49%. Similarly, expression of chitin synthase genes chs1 and chs2 declined by 13.56% and 30.17% (chs1), and 7.85% and 19.45% (chs2), respectively. Gene expression analysis elucidated how sublethal insecticides treatment impact larval development and fecundity. Furthermore, the study revealed upregulation of cytochrome P450-mediated detoxification pathways and Toll/Imd immune signaling pathways under broflanilide stress, indicating activation of a coordinated defense response in T. absoluta. Sublethal broflanilide exposure modulated larval gene expression to balance growth, development, and stress adaptation. Such exposure exerts selective pressure on susceptible populations, potentially driving adaptive shifts in detoxification metabolism and contributing to the development of field resistance. These findings advance our understanding of the sublethal effects of novel insecticides and provide valuable insights for insecticide deployment strategies and resistance management. Full article

Infectious diseases remain a major cause of mortality and disability worldwide. This burden is driven, in part, by antimicrobial resistance (AMR) and the re-emergence of epidemic and pandemic threats, underscoring the need for translational research to address knowledge gaps exposed by recent pandemics. Despite significant advances enabled by antibiotics and antivirals, their effectiveness is increasingly constrained by resistance development, limited pathogen spectra, and prolonged development timelines that fail to keep pace with rapidly shifting epidemiology. Diagnostic limitations impede timely pathogen identification and hinder the development of treatment regimens informed by pathogen mechanisms of action. Severe infections frequently involve dysregulated host responses, including hyperinflammation, inflammasome activation, and endothelial or immunothrombotic injury, which may progress to sepsis, immunoparalysis, or chronic sequelae, highlighting the limitations of pathogen-centered paradigms. Conventional biomarkers and culture-based microbiology are often slow or nonspecific, while molecular assays may not reliably distinguish colonization from active infection or capture host-response heterogeneity shaped by age, immune competence, and disease stage. This review synthesizes mechanistic and translational insights across three interrelated axes: (i) host–pathogen interactions, with a focus on innate immune sensing networks (e.g., Toll-like receptors, inflammasomes, RIG-I-like receptors, and cGAS-STING) and microbial replication and immune evasion strategies; (ii) clinical and public health implications, spanning acute organ dysfunction syndromes, post-acute infection syndromes, and AMR-driven health system strain; and (iii) emerging therapeutics along a continuum of pathogen-, virulence-, host-, and immune-directed approaches. Emphasis is placed on anti-virulence therapeutics, bacteriophage therapy, monoclonal antibodies, and engineered immune modalities within frameworks of quantitative translational pharmacology and implementation science. Finally, an integrative conceptual framework encompassing mechanistic phenotypes, host-response diagnostics, and stage-adapted therapeutic combinations is proposed to guide rational intervention across endemic infections and future pandemic preparedness. Full article

Herpes simplex virus type 2 (HSV-2) is the primary pathogen responsible for genital herpes. Predominantly transmitted via sexual contact, HSV-2 not only poses significant physical and psychological burdens on infected individuals but also substantially elevates the risk of HIV acquisition and represents a potentially fatal threat to newborns. Following primary infection, HSV-2 establishes lifelong latent infection within the sacral ganglia. Currently, there are no vaccines or therapeutics capable of eradicating this latent virus reservoir or effectively preventing initial infection. The core impediment to developing such interventions lies in the incomplete elucidation of the protective immune mechanisms against HSV-2 and its precise molecular pathogenesis. The host immune response against HSV-2 hinges critically on the coordinated interplay between innate and adaptive immunity. The innate immune system, serving as the first line of defense, acts to curtail early viral replication and initiate adaptive responses. This is achieved through mechanisms, including the genital mucosal barrier, activation of Toll-like receptors (TLRs), the cGAS-STING signaling pathway, interferon (IFN)-mediated antiviral effector functions, and activation of innate immune cells such as natural killer (NK) cells and dendritic cells (DCs). Crucially, however, HSV-2 counteracts these host defenses by expressing immune modulatory proteins (e.g., ICP0, ICP27, ICP35) that target key host antiviral signaling pathways, thereby affecting immune evasion. Within the adaptive immune response, neutralizing antibodies generated by the humoral immunity can provide localized protection at mucosal sites, but their protective efficacy is limited due to sophisticated viral immune evasion mechanisms. Cellular immunity, particularly mediated by CD4+ T cells, constitutes the core mechanism for viral clearance and suppression of recurrent outbreaks. Notably, tissue-resident memory T cells (TRMs) play a pivotal role in controlling the reactivation of latent HSV-2 within the ganglia. This review integrates current research advances to delineate the innate and adaptive immune mechanisms engaged during HSV-2 infection from the perspective of the dynamic host–virus interplay, with an ultimate aim to provide a theoretical foundation informing the rational development of preventive vaccines and therapeutic agents against HSV-2. Full article

Lacticaseibacillus rhamnosus CRL1505 enhances antiviral immunity at mucosal sites, but its capacity to modulate liver immune responses remains unclear. Therefore, this study evaluated whether this immunomodulatory bacterium protects against Toll-like receptor 3 (TLR3)-mediated acute hepatitis induced by poly(I:C), and whether this effect depends on mucosal adhesion. BALB/c mice received the wild-type CRL1505 strain or the Δmbf CRL1505 mutant lacking the mucus-binding factor gene prior to poly(I:C) challenge. Liver injury, serum transaminases, and hepatic expression of interferons (IFNs), antiviral factors, inflammatory mediators, and regulatory cytokines were evaluated 48 h later. Poly(I:C) challenge induced acute hepatitis characterized by increased ALT/AST levels, leukocyte infiltration, and elevated hepatic IFNs and proinflammatory cytokines. The CRL1505 strain administration significantly reduced TNF-α, IL-1β, and IL-6 while enhancing IFNs, antiviral factors, and the regulatory cytokines IL-10 and IL-27, resulting in improved transaminase levels and attenuated liver damage. Notably, the Δmbf CRL1505 mutant conferred protection comparable to the wild-type strain. These findings demonstrate that L. rhamnosus CRL1505 exerts immunomodulatory and hepatoprotective effects during TLR3-driven hepatitis and that mbf-mediated adhesion is not required for this protection. Overall, CRL1505 emerges as a promising preventive strategy to enhance antiviral defenses and limit inflammation-associated liver injury. Full article

Background: Maternal immune activation (MIA) during pregnancy is a known risk factor for several neurodevelopmental and psychiatric disorders, including schizophrenia. In rodent models, MIA is commonly induced using polyinosinic/polycytidylic acid (Poly(I/C)), a viral mimetic that activates Toll-like receptor 3 (TLR3) signaling and elicits an inflammatory response in both the dam and the fetuses. MIA results in various behavioral abnormalities in offspring, including deficits in social interaction. Recent studies have shown that MIA decreases the ability to maintain mitochondrial membrane potential (ΔΨm), the electrical component of the electrochemical gradient required for ATP production and alters mitochondrial protein expression in brain tissue isolated from adult offspring. Methods: In the present study, we monitor ΔΨm non-invasively in vivo using a previously published bioluminescence probe in juvenile and adult MIA offspring. We then investigated gene expression in the medial prefrontal cortex of MIA offspring by analyzing a previously published RNA sequencing dataset in combination with MitoCarta3.0, a comprehensive inventory of genes involved in mitochondrial function. Finally, we tested the hypothesis that this mitochondrial dysfunction contributes to the behavioral deficits observed in MIA offspring. Results: We have observed impaired ΔΨm maintenance in juvenile MIA offspring that persists into adulthood. Also, we found that MIA alters the expression of many genes associated with mitochondrial energy production. We demonstrated that nicotinamide riboside, a precursor to NAD⁺ known to restore ΔΨm, significantly attenuates MIA-induced social interaction deficits. Conclusions: Together, these findings highlight mitochondrial function as a promising therapeutic target for symptoms associated with schizophrenia and support the potential for drug discovery aimed at enhancing mitochondrial health. Full article

Post-weaning piglets are vulnerable to intestinal barrier disruption and microbiota imbalance, which can be exacerbated by bacterial endotoxin; this study assessed whether a synbiotic diet based on grape seed and camelina meals plus Lactobacillus probiotics can attenuate an Escherichia coli lipopolysaccharide (LPS) challenge. Twenty weaned piglets were randomized (n = 5/group) to control, LPS, synbiotic (SYN), or SYN+LPS diets for 21 days. The control diet consisted of a complete standard corn–soybean-based feed. The SYN diet contained a basal diet with 5% prebiotic mix (grape seed meal–camelina meal) and 0.1% probiotic mix including Lactobacillus acidophilus, Lactobacillus paracasei, and Lactobacillus rhamnosus; on day 21, the LPS and SYN+LPS animals received an LPS challenge and were sampled 3 h later. The expression of colonic genes coding for proteins like tight junctions, mucus/epithelial function, Toll-like receptors and signaling molecules involved in innate response was quantified by quantitative PCR arrays, and the microbiota composition was profiled by 16S rRNA sequencing. The LPS challenge reduced the expression of barrier- and mucus-associated genes and increased that of Toll-like receptors and signaling pathway markers, accompanied by microbial shifts, with reduced beneficial taxa and increased Megasphaera elsdenii. The synbiotic diet counteracted these transcriptional and microbial changes. Overall, the synbiotic supported epithelial integrity and moderated innate immune activation during acute endotoxin stress after weaning. Full article

This LCA study addresses the research gap concerning the comprehensive environmental implications of using paving block aggregates (PBA), derived from crushed waste concrete paving blocks (CPB), as a sustainable replacement for natural aggregates in cementitious materials. While the concrete industry faces twin challenges—high CO₂ emissions from cement and the massive ecological toll of extracting 20 Gt/year of natural aggregates—a systematic life cycle assessment of this specific waste stream was necessary, especially one that considered potential material interaction trade-offs. The study’s conclusions offer critical insight into achieving genuine sustainability. Consistently, cement production was identified as the overwhelming environmental hotspot, contributing over 90% of the global warming potential (GWP) across all scenarios. This finding indicates that even substantial changes in aggregate sourcing can only deliver limited GWP reductions unless accompanied by strategies targeting cement-related emissions. While substituting natural aggregates with PBA generally provided environmental benefits, a crucial trade-off was identified: the significantly higher dosage of superplasticizer required to maintain the workability of the PBA mixes. For mortar, the burden from the increased plasticizer became a major secondary hotspot, occasionally offsetting the gains from aggregate replacement. In these scenarios, the contribution of admixtures to the total GWP was sufficiently high to reduce or negate the environmental benefits achieved through aggregate substitution. In contrast, aggregate replacement proved more favorable in concrete than in mortar, as the concrete scenarios showed a weaker correlation between environmental impact and plasticizer use. The authors conclude that future strategies must prioritize reducing cement content and, critically, systematically consider the necessary use of admixtures to ensure that the intended environmental improvements are genuine and not counteracted by the side effects of material substitution. The quantified LCA results demonstrate that cement reduction offers the highest mitigation potential, while admixture optimization is essential to prevent secondary environmental hotspots, particularly in mortar applications. Full article

The United States has undergone rapid and, at times, unprecedented political changes in 2025. Recent national polling indicates that many Americans—across political parties—believe that the country is heading in the wrong direction. In a preregistered study with more than 7000 adults residing in the United States, we explored the implications of these widespread concerns for individuals’ psychological functioning. As theorized, individuals who believed that the political climate was worsening and viewed the United States as failing to live up to its core national values experienced lower efficacy, both in terms of their personal ability to influence politics (i.e., individual efficacy) and their confidence in the government to uphold its obligations to the nation and its residents (i.e., government efficacy). In turn, these individuals reported worse overall well-being and less effective coping in response to stressors related to the political climate. These relationships persisted after accounting for the participants’ 2024 presidential vote choice and political party affiliation. Together, these findings suggest that the political turbulence Americans are experiencing exerts a measurable, bipartisan toll on Americans’ psychological and social health. Full article

The intestinal barrier undergoes profound changes with age, impacting local immunity and systemic health, yet the mechanisms coordinating immune and microbial dynamics across the lifespan remain incompletely understood. Toll-like receptor 4 (TLR4) serves as a key mediator of host–microbiota interactions. This study investigated age-related changes in barrier function and the role of TLR4 using C57BL/6J and TLR4 knockout (TLR4^−/−) mice across key developmental stages: pups (postnatal day 9), adults (2–4 months), middle-aged (7–9 months), and old (16–19 months). Through a multi-layered approach integrating histology, microbiome profiling, short-chain fatty acid (SCFA) analysis, cytokine quantification, ex vivo functional assays, and transcriptomics, we identified a multi-phase process of intestinal remodeling. Pup-P9 mice exhibited immature colonic structure, a simple microbiota dominated by Firmicutes and Proteobacteria, and undetectable acetic acid level. Adults reached peak diversity and SCFA concentrations, marked by a rise in Bacteroidota and the emergence of Akkermansia. In middle and old age, pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α) increased, Bacteroidota declined while Firmicutes, Actinobacteria, and Turicibacter expanded, and aged colons showed blunted ex vivo responses to IL-1β. This age-associated functional decline phenotype was absent in TLR4^−/− mice, supporting the involvement of TLR4 signaling. Transcriptomics further revealed biphasic PI3K/Akt activation in both pups-P9 and old mice. Together, these findings suggest a systemic rewiring of host metabolic and immune signaling pathways in response to an aging microbiota, highlighting this dynamic, lifespan-wide microbiota–host signaling axis as a potential intervention target. Full article

Background: Latent tuberculosis infection (LTBI) is the principal reservoir for active tuberculosis, with >85% of cases attributable to reactivation. Bacillus Calmette-Guérin fails to block this transition, leaving a critical gap in prevention. Methods: An immunoinformatics/reverse-vaccinology pipeline was applied to seven dormancy-related antigens retrieved from Mycobrowser. T-cell epitopes were predicted with NetMHCI/IIpan-4.1 and B-cell epitopes with ABCpred; antigenicity, allergenicity, and toxicity were evaluated with VaxiJen, AllerTOP, and ToxinPred. Secondary/tertiary structures were modeled with PSIPRED and AlphaFold-3; docking to Toll-like receptors (TLR) 2/4 and 100 ns molecular dynamics simulations assessed complex stability. Immune responses were simulated with C-ImmSim, and the mRNA sequence was human-codon-optimized using ExpOptimizer. Results: The resulting construct, RP14914P, encodes 14 cytotoxic T lymphocyte, 9 helper T lymphocyte, and 14 B-cell epitopes within an 866-aa, 90.4 kDa polypeptide. Antigenicity score = 0.7797, immunogenicity score = 8.58629. and no toxicity or allergenicity was predicted. Physicochemical analysis: instability index = 28.65, and solubility = 0.513. Estimated population coverage is 82.35% and 99.67% for Human Leukocyte Antigen (HLA)-I and HLA-II globally. Docking energies: −1477.8 kcal/mol (TLR2) and −1480.1 kcal/mol (TLR4). Molecular dynamics trajectories confirm stable binding. Immune simulation predicts potent activation of Natural Killer cells, macrophages, and dendritic cells, Th1 polarization, high interferon-γ/interleukin-2 secretion, and durable memory. Conclusions: In silico analyses predict that RP14914P exhibits favorable immunogenicity, safety, and broad population coverage, suggesting its potential as a promising mRNA vaccine candidate to prevent LTBI reactivation. However, these computational predictions require thorough experimental validation to confirm the vaccine’s immunogenicity and protective efficacy. Full article

The cause of chronic neurological effects associated with Lyme disease (LD) remains unclear. We propose that bacterial extracellular vesicles (BEVs) released by Borrelia burgdorferi, the causative agent of LD, exacerbate spirochete-induced damage and serve as a persistent source of antigenic stimulation. We showed that, over a 10-day period, in vitro cultures of B. burgdorferi B31 produced 38,000 BEVs per spirochete with a distinctive double-membrane structure and median diameter of 143.3 nm. BEVs contained known immunogenic and immunomodulatory molecules such as peptidoglycan, p66, flagellar filament protein (FlaB), basic membrane proteins A/B/D, BdrV, GroEL, CRASP-1, ErpA8, glycerophosphodiester phosphodiesterase, p37, OMS28, p13, OspA/B/C, VlsE, and outer membrane glycolipids (e.g., cholesteryl 6-O acyl beta D galactopyranoside). Chromosome-encoded 16S ribosomal RNA and cp32 plasmid-encoded OspE and terminase genes were also detected in the BEVs. Of the 45 Borrelia proteins identified in the urine of a C3H/HeJ murine model of Lyme disease, 14 were associated with BEVs. In human urine samples, 31 of 289 spirochete proteins detected in patients with either acute Lyme disease or persistent borreliosis post-treatment symptoms, including p66 and FlaB, were also BEV-associated. BEV treatment of HMC3 human microglial cells reduced phagocytic activity and triggered aberrant activation of inflammatory and immunometabolic pathways, including upregulation of interferon-alpha (IFN-α), aconitate decarboxylase 1 (Acod1), and Toll-like receptor 2 (TLR2) gene expression. BEVs also induced NRF2 nuclear translocation. In conclusion, these findings support that BEVs can amplify spirochete-induced damage and act as antigenic debris, driving dampened phagocytic activity and dysregulated inflammation, with implications for diagnostics and therapeutics targeting vesicle-mediated pathology. Full article