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LDA Grant Award Summary Page 9 of 15 "Borrelia burgdorferi DNA in the Urine of Treated Patients with Chronic Lyme Disease Symptoms. A PCR Study of 97 Cases" M.E. Bayer, MD et al; Infection 24 1996 ; #5 Author affiliation Fox Chase Cancer Center, Philadelphia, P A 19111, USA ABSTRACT "All patients had shown erythema chronica migrans following a deer tick bite. Most of the patients had been antibiotic-treated for extended periods of time Of the 97 patients, 72 74.2% ; were found with positive PCR and the rest with negative PCR. The 62 healthy volunteers were PCR negative. It is proposed that a sizeable group of patients diagnosed on clinical grounds as having chronic Lyme disease may still excrete Borrelia DNA, and may do so in spite of intensive antibiotic treatment." 3 "Absence of Borrelia Burgdorferi-specific immune complexes in chronic fatigue syndrome, " Steven Schutzer, UMDNJ, Neurology, Oct 12, 1999 ABSTRACT Chronic fatigue syndrome CFS ; and Lyme disease often share clinical features, especially fatigue, contributing to concern that Borrelia burgdorferi Bb ; , the cause of Lyme disease, may underlie CFS symptoms. We examined 39 CFS patients and 40 healthy controls with a Bb immune complex test. Patients and controls were nonreactive. Centers for Disease Control and Prevention-defined CFS patients lacking antecedent signs of Lyme disease-erythema migrans, Bell's palsy, or large joint arthritis--are not likely to have laboratory evidence of Bb infection. 4 "Borrelia Burgdorferi--Specific Immune Complexes in Acute Lyme Disease, " Steven Schutzer, UMDNJ, JAMA, Nov. 24, 1999, Vol.282, No.20 ABSTRACT Context Diagnosis of infection with Borrelia burgdorferi, the cause of Lyme disease LD ; , has been impeded by the lack of effective assays to detect active infection. Objective To determine whether B burgdorferi specific immune complexes are detectable during active infection in LD. Design, Setting, and Patients: Cross-sectional analysis of serum samples from 168 patients fulfilling Centers for Disease Control and Prevention surveillance criteria for LD and 145 healthy and other disease controls conducted over 8 years. Tests were performed blinded. Main Outcome Measure Detection of B burgdorferi immune complexes by enzyme-linked immunosorbent assay and Western blot. Results The B burgdorferi immune complexes were found in 25 of patients with early seronegative erythema migrans EM ; LD; 105 of 107 patients with seropositive EM LD; 6 of 10 patients who were seronegative with culture-positive EM; 0 of 12 patients who were treated and recovered from LD; and 13 of 13 patients with neurologic LD without EM. Among 147 controls, B burgdorferi immune complex was found in 0 of healthy individuals; 0 of 40 patients with persistent fatigue; 0 of 7 individuals with frequent tick exposure; and 2 of 50 patients with other diseases. Conclusion These data suggest that B burgdorferi immune complex formation is a common process in active LD. Analysis of the B burgdorferi immune complexes by a simple technique has the potential to support or exclude a diagnosis of early as well as active LD infection Funding Support: This work was supported in part by grants A41518, NS34092, AI31561, and AR40470 from the National Institutes of Health and grant U50 CCU206582 from the Centers for Disease Control and Prevention, and by the Lyme Disease Association of New Jersey. 5 "Repeated Antibiotic Treatment in Chronic Lyme Disease" Brian Fallon, MD, et al, Journal of Spirochetal and Tick-borne Diseases Fall Winter 1999 ABSTRACT Patients with chronic Lyme disease who experience persistent cognitive deficits despite having received the recommended antibiotic treatment pose a therapeutic dilemma. This pilot study was designed to assess whether additional antibiotic therapy is beneficial and estradiol.
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