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Lyme disease, also known as Lyme borreliosis, is a bacterial infection caused by Borrelia burgdorferi. It is transmitted to humans through the bite of infected blacklegged ticks, commonly known as deer ticks. These ticks become carriers when they feed on infected animals, such as rodents. Importantly, Lyme disease does not spread from person to person, nor through food, water, air, pets, or other insects like mosquitoes and flies.

The disease is primarily reported in North America, Europe, and parts of Asia, particularly in wooded and grassy regions during the warmer months. In the United States, it is most prevalent in the northeastern, mid-Atlantic, and upper Midwestern states.

Symptoms and Progression

Lyme disease often begins with a characteristic red, expanding rash called erythema migrans, which may appear in a bull’s-eye pattern. Early symptoms also include fever, chills, fatigue, muscle aches, headache, and swollen lymph nodes. If untreated, it can progress to cause:

• Neurological issues: meningitis, facial palsy (Bell’s palsy), nerve pain, and brain inflammation.
• Cardiovascular problems: irregular heartbeat and heart block.
• Musculoskeletal symptoms: arthritis, joint pain (especially in the knees), and swelling.
• Other effects: dizziness, vision problems, memory issues, and concentration difficulties (often referred to as “brain fog”).

Treatment Protocol

Lyme disease is primarily treated with antibiotics, especially when diagnosed early. Common antibiotics include doxycycline (for adults and children over 8 years), amoxicillin (for younger children and pregnant women), cefuroxime, and azithromycin (for those allergic to other options). The treatment duration varies:

• Localized skin infections: 14 days
• Early disseminated infections: 21 days
• Lyme arthritis: 28 to 60 days
• Severe or neurological cases may require intravenous antibiotics like ceftriaxone

In some cases, symptoms may persist even after treatment, a condition known as Post-Treatment Lyme Disease Syndrome (PTLDS). While the exact cause is unknown, continued antibiotic use does not improve outcomes, and treatment focuses on managing symptoms.

Recent Scientific Breakthrough

In a major scientific advancement, researchers have identified a crucial enzyme—lactate dehydrogenase specific to Borrelia burgdorferi (BbLDH)—which plays a vital role in the bacterium's survival and infectivity. Unlike most organisms that rely on thiamin-dependent metabolism, B. burgdorferi uniquely depends on BbLDH to convert pyruvate to lactate, maintaining its NADH/NAD+ balance.

The research, conducted at Virginia Commonwealth University and published in mBio, demonstrated through genetic, biochemical, and structural analysis that BbLDH is essential for the growth and infection capability of the Lyme disease bacterium. Loss-of-function studies confirmed its indispensability, both in laboratory and in vivo models.

High-throughput screening of chemical compounds led to the identification of several promising BbLDH inhibitors. These inhibitors could form the basis for future, highly targeted treatments against Lyme disease. Moreover, the findings have broader implications for tackling other tick-borne illnesses.