Lyme Disease

Comparison of the Serodiagnostic Accuracy Tests for Lyme Disease in Adults and Children: A Network Meta-Analysis.

Ma W, Li J, Gao L, Wu X, Ma W, Yang J · Pathogens (Basel, Switzerland) · 2025 · n=32

As direct detection methods of Borrelia burgdorferi are limited, serology plays an important role in diagnosing Lyme disease (LD). There are various types of Lyme serological tests with varying diagnostic accuracy, so it is necessary to compare and rank them. The aim of this study is to compare the accuracy of various serological diagnostic methods for LD using network meta-analysis (NMA). We searched the Cochrane Library and PubMed databases for all serological diagnostic accuracy studies published from the discovery of LD until June 2024. After screening, we assessed the quality of the included studies with QUADAS-C and extracted relevant data. We calculated the Q* index of the receiver operating characteristic curve for each diagnostic test. Meta-disc 2.0 and Stata 15.0 were used to perform traditional meta-analysis and NMA with the gold standard (the comprehensive evaluation) as a reference. We then compared the Q* index values between different methods using two-by-two comparisons

Associations of Atrioventricular Blocks and Other Arrhythmias in Patients with Lyme Carditis: A Systematic Review and Meta-Analysis.

Javed N, Sklyar E, Bella JN · Journal of cardiovascular development and disease · 2024

Lyme disease often leads to cardiac injury and electrophysiological abnormalities. This study aimed to explore links between atrioventricular blocks and additional arrhythmias in Lyme carditis patients. This systematic review and meta-analysis of existing literature was performed from 1990 to 2023, and aimed to identify cases of Lyme carditis through serology or clinical diagnosis with concomitant arrhythmias. Pubmed and Web of Science were searched using appropriate MESH terms. Patients were divided into groups with atrioventricular blocks and other arrhythmias for cardiovascular (CV) outcome assessment. A total of 110 cases were analyzed. The majority (77.3%) were male, with mean age = 39.65 ± 14.80 years. Most patients presented within one week of symptom onset (30.9%). Men were more likely to have first-degree atrioventricular blocks (OR = 1.36 [95% CI 1.12-3.96], p = 0.01); these blocks tended to be reversible in nature (OR = 1.51 [95% CI 1.39-3.92], p = 0.01). Men exhibited

Prevalence of Borrelia burgdorferi in Ixodidae Tick around Asia: A Systematic Review and Meta-Analysis.

Ji Z, Jian M, Yue P, Cao W, Xu X, Zhang Y · Pathogens (Basel, Switzerland) · 2022

Lyme disease (LD) is a common arthropod-borne inflammatory disorder prevalent in the northern hemisphere. LD is caused by a spirochete named Borrelia burgdorferi s.l., which is transmitted to humans by ticks. Climate, environment, and other factors affect land use; recreational-behavior changes affect human contact with infected ticks. Studies in Europe and North America have looked at these aspects, but studies in Asia have not. We searched databases to identify all relevant abstracts published until March 2021. A meta-analysis was undertaken using the standard methods and procedures established by the Cochrane Collaboration. Ninety-one articles were included in our meta-analysis. The literature search identified data from nine countries (China, Japan, Malaysia, Mongolia, Pakistan, Russia Siberia region, South Korea, Thailand and Turkey). Furthermore, 53,003 ticks from six genera (Amblyomma, Dermacentor, Haemaphysalis, Hyalomma, Ixodes and Rhipicephalus) were inspected for infection w

Evidence-Based Clinical Effectiveness of Kundalini Yoga: Systematic Review of RCTs Across Multiple Health Conditions.

Roy S, Biswas AK, Sharma M · Alternative therapies in health and medicine · 2026 · n=1370

Kundalini Yoga (KY) integrates breathwork, meditation, dynamic movement, and chanting, and has gained recognition as a therapeutic intervention. Despite promising results from individual randomized controlled trials (RCTs), to our knowledge, no systematic review has exclusively synthesized RCT evidence on KY across health domains. To critically assess the clinical effectiveness and safety of KY interventions across diverse cognitive, psychological, emotional, sleep-related, and physical health outcomes. PRISMA-guided systematic review of RCTs evaluating KY was conducted from January 2015 to December 2024. Databases included MEDLINE (PubMed), Scopus, CENTRAL (Cochrane Library), Embase, PsycINFO, and CINAHL. Risk of bias was independently assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Studies were conducted worldwide, across multiple sites. Approximately 1370 participants ranging from healthy adults to those diagnosed with conditions such as Mild Cognitive I

An Updated Review on the Spatial Distribution of Borrelia burgdorferi Sensu Lato Across Ticks, Animals and Humans in Northeastern China and Adjacent Regions.

Dong R, Fang R, Yang X, Sun Y, Zhang Y, Li S · Zoonoses and public health · 2024

Lyme disease is a tick-borne zoonotic disease caused by Borrelia burgdorferi sensu lato and is prevalent in northeastern Asia, particularly in the forested area of Northeastern China. However, a lack of systematic data on the spatial distribution of B. burgdorferi in this region hinders the prediction of its transmission risk across the landscape. To provide an updated overview and establish a comprehensive spatial distribution database, we conducted a systematic review of literature published between 2000 and 2022. We collected and compiled relevant data on B. burgdorferi in Northeastern China and its neighbouring regions, outlining its distribution in ticks, wild animals, livestock and humans. Spatial analysis was performed to identify spatial clusters of tick positivity and host infection rates. From a total of 1823 literature, we selected 110 references to compile 626 detection records of B. burgdorferi, including 288 in ticks, 109 in wildlife, 111 in livestock and domestic anima

Historical associations and spatiotemporal changes of pathogen presence in ticks in Canada: A systematic review.

Crandall KE, Millien V, Kerr JT · Zoonoses and public health · 2024

Starting in the early 20th century, ticks and their pathogens have been detected during surveillance efforts in Canada. Since then, the geographic spread of tick vectors and tick-borne pathogens has steadily increased in Canada with the establishment of tick and host populations. Sentinel surveillance in Canada primarily focuses on Ixodes scapularis, which is the main vector of Borrelia burgdorferi, the bacterium causing Lyme disease. Other tick-borne pathogens, such as Anaplasma, Babesia, and Rickettsia species, have lower prevalence in Canada, but they are emerging or re-emerging in tick and host populations. Here, we assessed the historical associations between tick vectors, hosts and pathogens and identified spatiotemporal clusters of pathogen presence in ticks in Canada using data extracted from the literature. Approximately one-third of ticks were infected with a pathogen, and these ticks were feeding primarily on bird and mammal hosts. B. burgdorferi was the most detect

Guidelines for diagnosis and treatment in neurology - Lyme neuroborreliosis.

Rauer S, Kastenbauer S, Dersch R, Hofmann H, Fingerle V, Huppertz HI · German medical science : GMS e-journal · 2025

Lyme disease is the most common tick-borne infectious disease in Europe. Neurological manifestations occur in 3-15% of infections and can present as polyradiculitis, meningitis, and rarely as encephalomyelitis. The disease is treatable with antibiotics. The S3 guideline "Neuroborreliosis" has been updated in accordance with the methodological standards of the "Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. V." (AWMF register number 030/071). Eighteen AWMF member societies, the Robert Koch Institute, the "Paul-Ehrlich-Gesellschaft für Infektionstherapie", the "Schweizerische Neurologische Gesellschaft", the "Österreichische Gesellschaft für Neurologie", the "Deutsche Borreliose-Gesellschaft" and two patient organizations were involved in the update. The guideline aimed at physicians in practice and hospital settings who are involved in the treatment of neuroborreliosis in children and adults. For the first time, there is Class Ia evidence t

Guidelines for Lyme borreliosis: post-treatment Lyme disease syndrome (PTLDS).

Arias P, Gocko X, Roblot F, Hansmann Y, Baux E, Eldin C · Infectious diseases now · 2025

Persistent symptoms following appropriate treatment of confirmed Lyme borreliosis (LB) require a systematic clinical reassessment. The diagnostic approach should verify the accuracy of the initial diagnosis, adherence to and adequacy of antibiotic therapy, and consider potential sequelae or differential diagnoses such as new-onset diseases or comorbidities. When no alternative explanation is found, symptoms may correspond to Post-Treatment Lyme Disease Syndrome (PTLDS), as defined by the French National Authority for Health (HAS). PTLDS is characterized by fatigue, diffuse pain, and cognitive dysfunction lasting more than six months after a documented and adequately treated LB episode. The syndrome significantly impairs daily functioning and quality of life and is not attributable to persistent infection or other identifiable causes. Management relies on long-term, multidisciplinary, and personalized care coordinated between reference centers and primary physicians, focusing on physica

Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis, and Treatment of Lyme Disease.

Lantos PM, Rumbaugh J, Bockenstedt LK, Falck-Ytter YT, Aguero-Rosenfeld ME, Auwaerter PG · Arthritis & rheumatology (Hoboken, N.J.) · 2021

Lyme Disease and Health Care Costs.

Yu H, Fee RM, Campfield BT, Gould LH, Mercadante AR, Chastek B · JAMA network open · 2026 · n=962

Lyme disease (LD) is the most common vector-borne illness in the US. Given the increasing prevalence and expanding geographic bounds of LD, in-depth, up-to-date understanding of costs associated with an LD diagnosis, including patient out-of-pocket (OOP) costs, is needed. To assess health care costs in a broad US population diagnosed with LD, overall and stratified by localized disease vs disseminated disease. This retrospective cohort study identified patients from Optum's deidentified Market Clarity Data (Optum Market Clarity) between December 2, 2014, and January 30, 2023 (study period), with an LD diagnosis between January 1, 2016, and December 31, 2022 (identification period), having at least 14 months of continuous health plan enrollment. Optum Market Clarity is an integrated, multisource medical claims, pharmacy claims, and electronic health records data set. Outpatients had a claim with an LD diagnosis plus relevant antibiotics within 30 days, and inpatients had a claim with

Revolutionizing Lyme disease vaccination: a systematic review and meta-analysis of promising candidates.

Tamanna S, Kim DM · Frontiers in cellular and infection microbiology · 2025

The most prevalent vector-borne diseases in North America and Europe is still Lyme disease, which is caused by the bacterium Borrelia burgdorferi. As incidence rates rise, this poses a serious threat to public health. Since there is presently no vaccine for Lyme disease that is suitable for human use after the LYMErix vaccine was withdrawn in 2002 due to safety issues and insufficient adoption, there is an urgent need for an effective vaccination to protect at-risk populations. Numerous intriguing vaccine candidates have been developed as a result of advances in molecular biology and immunology; nevertheless, it is still unclear which candidate provides the best balance of durability, safety, and efficacy. The purpose of this meta-analysis and systematic review is to assess the safety and effectiveness of many Lyme disease vaccine candidates that are presently undergoing clinical trials. According to PRISMA guideline, the systematic review was performed, and the meta-analysis was perfo

Identification of hub gene and immune infiltration in Lyme disease revealed by weighted gene co-expression network analysis and machine learning.

Dong Y, Liu M, Luo Y, Chen Y, Chen X, Liu X · European journal of medical research · 2025

Lyme disease (LD), caused by the spirochete Borrelia burgdorferi (Bb), is a multisystem disorder with early symptoms such as erythema migrans and late manifestations including arthritis and neuroborreliosis. The molecular mechanisms driving tissue damage and inflammatory dysregulation in LD remain incompletely characterized. Given the central role of peripheral blood mononuclear cells (PBMCs) in orchestrating immune responses, we aimed to identify optimal feature genes (OFGs) within PBMCs associated with LD pathogenesis and delineate their immune infiltration patterns using integrated bioinformatics. Transcriptomic datasets (GSE42606, GSE68765, GSE103481) were retrieved from GEO. Differential expression analysis identified LD-related genes. Weighted Gene Co-expression Network Analysis (WGCNA) screened disease-associated modules. Feature selection was performed via SVM-Recursive Feature Elimination (SVM-RFE), Least absolute shrinkage and selection operator (LASSO) regression, and rando

Gene Regulation and Transcriptomics.

Samuels DS, Lybecker MC, Yang XF, Ouyang Z, Bourret TJ, Boyle WK · Current issues in molecular biology · 2021

Borrelia (Borreliella) burgdorferi, along with closely related species, is the etiologic agent of Lyme disease. The spirochete subsists in an enzootic cycle that encompasses acquisition from a vertebrate host to a tick vector and transmission from a tick vector to a vertebrate host. To adapt to its environment and persist in each phase of its enzootic cycle, B. burgdorferi wields three systems to regulate the expression of genes: the RpoN-RpoS alternative sigma factor cascade, the Hk1/Rrp1 two-component system and its product c-di-GMP, and the stringent response mediated by RelBbu and DksA. These regulatory systems respond to enzootic phase-specific signals and are controlled or fine- tuned by transcription factors, including BosR and BadR, as well as small RNAs, including DsrABb and Bb6S RNA. In addition, several other DNA-binding and RNA-binding proteins have been identified, although their functions have not all been defined. Global changes in gene expression revealed by high-throug

Is there a place for xenodiagnosis in the clinic?

Telford SR 3rd, Hu LT, Marques A · Expert review of anti-infective therapy · 2014

Whether Borrelia burgdorferi, the causative agent of Lyme disease, can persist after antibiotic therapy is an area of ongoing controversy. In animal models, B. burgdorferi DNA can be detected in tissues after antibiotic therapy as well as by using the natural tick vector to acquire the organism through feeding (xenodiagnosis). Vector arthropods have been successfully used in xenodiagnosis to describe the etiology of infections such as malaria, typhus and Chagas disease. Our recent safety trial of xenodiagnosis demonstrates that ticks may be successfully fed on patients and may help determine the biological basis for post-treatment Lyme disease syndrome.

Treatment and prevention of Lyme disease.

Hansmann Y · Current problems in dermatology · 2009

Randomized controlled trials have ascertained the efficiency of antibiotics in treating erythema migrans, the hallmark of early stage Lyme borreliosis. Oral amoxicillin and doxycycline are first-line treatment options, though phenoxymethylpenicillin, cefuroxime axetil and azithromycin are alternative second-line options. Treatments for secondary and tertiary Lyme borreliosis are more poorly documented, and antibiotics are not always effective. This is due to the unique pathophysiology of late Lyme borreliosis, which involves not only bacterial infection, but also immunological response. Since there is no completely reliable method of diagnosis, it is difficult to choose the proper treatment and to evaluate treatment efficacy. However, numerous studies have shown that ceftriaxone and doxycycline are the 2 most efficient antibiotics, particularly in Lyme arthritis and in neuroborreliosis. In late Lyme borreliosis, these antibiotics are less efficient, and different treatment schemes with

Detection of Borrelia Bacteria in Early Stage Lyme Borreliosis Using the T2Lyme Panel

n=18 · NCT03581279 · TERMINATED · TERMINATED

The T2Lyme assay will be compared to Borrelia culture from erythema migrans (EM) biopsy and/or detection of the C6 antigen in serum collected prospectively from patients suspected of early Lyme disease.

The Burden of Lyme Disease (BOLD) in a Pandemic

n=2000 · NCT05312619 · UNKNOWN · UNKNOWN

A cross-sectional descriptive survey of the BOLD for individuals after having been ill with COVID-19 or have taken the COVID-19 vaccine will be compared with that of individuals who have neither been ill with COVID-19 nor taken the COVID-19 vaccine. Individuals who have both been ill and taken the COVID-19 vaccine will be compared to identify any additive risk factors.

STUDY TO EVALUATE THE ROLE OF T CELL-DYSFUNCTION IN SYMPTOMS ASSOCIATED WITH LONG COVID, LYME DISEASE AND MYALGIC ENCEPHALOMYELITIS/CHRONIC FATIGUE SYNDROME USING THE VIRAXIMMUNE FLUOROSPOT T CELL ASSAY

n=160 · NCT06731179 · ACTIVE_NOT_RECRUITING · ACTIVE_NOT_RECRUITING

This is a longitudinal observational study recruiting individuals that have attended three clinical sites with symptoms associated with a diagnosis of long COVID, PTLDS or ME/CFS. The study will be a multi-centre study, with up to 160 male and female participants enrolled. Participants that experience symptoms considered to be associated with a diagnosis of long COVID, PTLDS or ME/CFS will consent to the study, and attend for two study visits (at study entry and 6 months) to complete a questionnaire related to their symptoms, and to have a blood sample taken. Blood samples will be taken either at the clinical site or at the participant's home if they are unable to attend due to the severity of their illness. . Participants will be allocated to one of the following groups: Group 1: Long COVID Group 2: ME/CFS Group 3: PTLDS Group 4: Healthy Control

Lyme disease

Cochrane

The Cochrane Library provides a collection of systematic reviews and meta-analyses related to Lyme disease interventions. It is a prime source for evidence-based healthcare decisions, offering critical appraisals of research.