Antimicrobial Discovery Center, Department of Biology, Northeastern University, Boston, Massachusetts, USA.
Department of Pediatrics, University of California San Diego, La Jolla, California, USA.
mBio. 2020 Sep 29;11(5):e02310-20. doi: 10.1128/mBio.02310-20.
Lyme disease is the most common vector-borne disease in the United States, with an estimated incidence of 300,000 infections annually. Antibiotic intervention cures Lyme disease in the majority of cases; however, 10 to 20% of patients develop posttreatment Lyme disease syndrome (PTLDS), a debilitating condition characterized by chronic fatigue, pain, and cognitive difficulties. The underlying mechanism responsible for PTLDS symptoms, as well as a reliable diagnostic tool, has remained elusive. We reasoned that the gut microbiome may play an important role in PTLDS given that the symptoms overlap considerably with conditions in which a dysbiotic microbiome has been observed, including mood, cognition, and autoimmune disorders. Analysis of sequencing data from a rigorously curated cohort of patients with PTLDS revealed a gut microbiome signature distinct from that of healthy control subjects, as well as from that of intensive care unit (ICU) patients. Notably, microbiome sequencing data alone were indicative of PTLDS, which presents a potential, novel diagnostic tool for PTLDS. Most patients with acute Lyme disease are cured with antibiotic intervention, but 10 to 20% endure debilitating symptoms such as fatigue, neurological complications, and myalgias after treatment, a condition known as posttreatment Lyme disease syndrome (PTLDS). The etiology of PTLDS is not understood, and objective diagnostic tools are lacking. PTLDS symptoms overlap several diseases in which patients exhibit alterations in their microbiome. We found that patients with PTLDS have a distinct microbiome signature, allowing for an accurate classification of over 80% of analyzed cases. The signature is characterized by an increase in , a decrease in , and other changes. Importantly, this signature supports the validity of PTLDS and is the first potential biological diagnostic tool for the disease.
莱姆病是美国最常见的虫媒传染病，估计每年有 30 万例感染。抗生素干预可治愈大多数莱姆病患者；然而，10%至 20%的患者会出现治疗后莱姆病综合征（PTLDS），这是一种衰弱性疾病，其特征是慢性疲劳、疼痛和认知困难。导致 PTLDS 症状的潜在机制以及可靠的诊断工具仍然难以捉摸。我们推测，鉴于肠道微生物组与观察到的微生物失调相关的疾病（包括情绪、认知和自身免疫性疾病）的症状有很大重叠，肠道微生物组可能在 PTLDS 中发挥重要作用。对严格筛选的 PTLDS 患者队列的测序数据进行分析，发现 PTLDS 患者的肠道微生物组特征与健康对照组以及重症监护病房（ICU）患者的肠道微生物组特征明显不同。值得注意的是，仅微生物组测序数据就可指示 PTLDS，这为 PTLDS 提供了一种潜在的新型诊断工具。大多数急性莱姆病患者经抗生素干预后可治愈，但 10%至 20%的患者在治疗后会出现疲劳、神经并发症和肌痛等衰弱性症状，这种情况称为治疗后莱姆病综合征（PTLDS）。PTLDS 的病因尚不清楚，也缺乏客观的诊断工具。PTLDS 的症状与几种患者表现出微生物组改变的疾病重叠。我们发现，PTLDS 患者具有独特的微生物组特征，可对 80%以上的分析病例进行准确分类。该特征的特点是增加，减少，和其他变化。重要的是，该特征支持 PTLDS 的有效性，是该疾病的第一个潜在生物学诊断工具。
