Lyme Disease Working Group

On August 18, 2013, the Centers for Disease Control and Prevention (CDC) announced its ten-fold increased prevalence estimate of Lyme disease, from 30,000 new infections per year in the U.S. to a preliminary new estimate of 300,000.

Lyme Borreliosis, more commonly known as Lyme disease, is the most frequently reported vector-borne illness in the United States.

Lyme disease affects individuals of all ages and is caused by the bacterium Borrelia burgdorferi, transmitted through the bite of a tick. The disease is thought to be characterized by a signature “bulls-eye” rash around the bite-site in the early localized stage of Lyme disease, although this rash is not always present. Symptoms of headache, fever and fatigue can present soon after infection. Lyme disease can cause worsening symptoms over time during early and later disseminated stages. It is thought to be responsible for devastating effects in the health of humans including serious disease and sequelae in the brain, heart muscle and joint tissue. Meningitis, cranial neuritis, radiculoneuritis, peripheral neuritis, carditis, heart block, migratory musculoskeletal pain, intermittent or chronic arthritis, polyneuropathy, and chronic encephalopathy affecting memory, mood, or sleep have been associated with B. burgdorferi infection.

Consequently, Lyme disease and Lyme-like diseases are often debilitating, but little is known about how this infection can trigger symptoms that in some cases do not resolve even after a course of high dose antibiotics. Developing new methods to diagnose, monitor and treat Lyme disease and other tick-borne diseases (TBD) will allow us to reduce and hopefully eliminate the burden and cost of this prevalent chronic disability.

Fortunately, recently available research findings (e.g., biofilms, spirochete replication and adaptation, metabolic vulnerabilities) are opening a gateway to more enlightened medical understanding. This growing body of evidence offers fresh pathways for innovative research that can help to transcend the scientific debate, and point to better means of TBD diagnosis, treatment and prevention. In the long run, such research may offer a transformative lens through which to view other complex human ailments.

Despite the high occurrence of disease, and disagreements within the medical community about Lyme disease and other tick-borne diseases, evidence from research on this illness is in its infancy. A group of scientists and physicians have formed a Lyme Disease Working Group – a Stanford-based, integrated, interdisciplinary, far-reaching initiative to address the global ravages of Lyme disease. We are now beginning a major fund-raising effort to support research and clinical projects proposed by our Working Group.

Our Lyme Disease Working Group is interested in developing more accurate diagnostic tests, improving medical understanding of the course of illness, evaluating the effectiveness of innovative therapies, expanding clinical services, and building greater knowledge and awareness of how to prevent illness. Participating colleagues represent biochemistry, biomedical informatics, biomaterials and advanced drug delivery, cardiovascular medicine, community ecology of wildlife disease, genetics, infectious disease, pediatrics, pain management, microbiology/immunology, neurology, psychiatry and behavioral sciences, and rheumatology/immunology. Basing this effort at Stanford University will build upon the advantages of working within an institution that strongly supports academic freedom while also encouraging interdisciplinary collaboration.

Such a model is optimal in this context for its potential to produce major breakthroughs in knowledge and improve medical practice—perhaps even more so in the context of Lyme disease where bringing together diverse views is greatly needed to advance the science and inform practice.

We are currently planning to seek academic and development approval for a Phase 1 effort to invest in specific researchers and programmatic targets to alleviate the burden of Lyme disease. With greater funding, we can do even more. A Phase 2 effort will enable us to launch a coordinated interdisciplinary Lyme disease program that focuses on cutting edge research and use the new knowledge that ensues to inform public policy and improve education and clinical care accordingly.