To identify immune antibodies that appear earlier than current laboratory markers of Lyme disease and assess their potential in diagnosing acute and post-treatment Lyme disease.
Approach:
Study Design: Analyzed blood samples from multiple US Lyme disease cohorts, including patients at diagnosis and those with long-standing post-treatment Lyme disease (PTLD).
Antibody Measurement: Measured antibodies against phospholipids acquired by B. burgdorferi from its host.
Key Findings:
Three antibody types increased during infection; two were elevated at initial presentation with erythema migrans rash.
These markers could complement existing tests during the diagnostic window.
Most patients' antiphospholipid antibody levels declined after treatment, but a subgroup with long-term PTLD showed persistently raised antibodies against phosphatidylserine.
Interpretation:
Limitations:
The study does not establish causation between antibodies and persistent symptoms.
Larger validation studies are needed before clinical implementation.
