Back to Journals » Infection and Drug Resistance » Volume 11

Better drugs for Lyme disease: focus on the spirochete

Authors Stricker RB , Middelveen MJ 

Received 11 June 2018

Accepted for publication 20 July 2018

Published 7 September 2018 Volume 2018:11 Pages 1437—1439


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Professor Suresh Antony

Video abstract presented by Raphael Stricker.

Views: 622

Raphael B Stricker,1 Marianne J Middelveen2

1Union Square Medical Associates, San Francisco, CA, USA; 2Atkins Veterinary Services, Calgary, AB, Canada

Abstract: Twenty-five years ago, the AIDS epidemic was wreaking havoc around the world. Although “HIV denialists” threatened to undermine research efforts to combat the epidemic, development of targeted antiviral therapy eventually provided effective treatment for the disease. Now the Lyme disease epidemic is wreaking havoc around the world, and “Lyme denialists” are undermining efforts to combat the epidemic. Drawing on our experience with the AIDS epidemic, there is a significant need to develop targeted therapy to control the Lyme disease epidemic.

Keywords: HIV/AIDS, Lyme disease, Borrelia burgdorferi, tick-borne disease, designer drugs


The authors report no conflicts of interest in this work.



Osmond DH. Epidemiology of HIV/AIDS in the United States. HIV InSite Knowledge Base Chapter; 2003. Available from: Accessed August 26, 2018.


Brauchli P, Reuteler I, Bürki B, Saller R. Use of complimentary medical therapies in HIV/AIDS in Switzerland. Schweiz Med Wochenschr. 1996;126(30):1297–1305.


Duesberg PH. AIDS epidemiology: inconsistencies with human immunodeficiency virus and with infectious disease. Proc Natl Acad Sci U S A. 1991;88(4):1575–1579.


Cohen J. AIDS research. Keystone’s blunt message: ‘it’s the virus, stupid’. Science. 1993;260(5106):292–293.


Stone BL, Tourand Y, Brissette CA. Brave new worlds: the expanding universe of Lyme disease. Vector Borne Zoonotic Dis. 2017;17(9):619–629.


Johnson L, Wilcox S, Mankoff J, Stricker RB. Severity of chronic Lyme disease compared to other chronic conditions: a quality of life survey. PeerJ. 2014;2:e322.


Delong AK, Blossom B, Maloney EL, Phillips SE. Antibiotic retreatment of Lyme disease in patients with persistent symptoms: a biostatistical review of randomized, placebo-controlled, clinical trials. Contemp Clin Trials. 2012;33(6):1132–1142.


Stricker RB, Johnson L. Lyme disease: the promise of Big Data, companion diagnostics and precision medicine. Infect Drug Resist. 2016;9:215–219.


Cabello FC, Godfrey HP, Bugrysheva JV, Newman SA. Sleeper cells: the stringent response and persistence in the Borreliella (Borrelia) burgdorferi enzootic cycle. Environ Microbiol. 2017;19(10):3846–3862.


Godfrey HP, Bugrysheva JV, Cabello FC. The role of the stringent response in the pathogenesis of bacterial infections. Trends Microbiol. 2002;10(8):349–351.


Feng J, Shi W, Zhang S, Zhang Y. Persister mechanisms in Borrelia burgdorferi: implications for improved intervention. Emerg Microbes Infect. 2015;4(8):e51.


Sharma B, Brown AV, Matluck NE, Hu LT, Lewis K. Borrelia burgdorferi, the causative agent of Lyme disease, forms drug-tolerant persister cells. Antimicrob Agents Chemother. 2015;59(8):4616–4624.


Stricker RB, Johnson L. Persistent infection in chronic Lyme disease: does form matter? Res J Infect Dis. 2013;1:2.


Middelveen MJ, Sapi E, Burke J, et al. Persistent Borrelia infection in patients with ongoing symptoms of Lyme disease. Healthcare. 2018;6(2):33.


Wormser GP, Shapiro ED, Strle F. Studies that report unexpected positive blood cultures for Lyme Borrelia - are they valid? Diagn Microbiol Infect Dis. 2017;89(3):178–181.


Embers ME, Hasenkampf NR, Jacobs MB, et al. Variable manifestations, diverse seroreactivity and post-treatment persistence in non-human primates exposed to Borrelia burgdorferi by tick feeding. PLoS One. 2017;12(12):e0189071.


Maraspin V, Ogrinc K, Ružić-Sabljić E, Lotrič-Furlan S, Strle F. Isolation of Borrelia burgdorferi sensu lato from blood of adult patients with borrelial lymphocytoma, Lyme neuroborreliosis, Lyme arthritis and acrodermatitis chronica atrophicans. Infection. 2011;39(1):35–40.


Lenormand C, Jaulhac B, Debarbieux S, et al. Expanding the clinicopathological spectrum of late cutaneous Lyme borreliosis (acrodermatitis chronica atrophicans [ACA]): A prospective study of 20 culture- and/or polymerase chain reaction (PCR)-documented cases. J Am Acad Dermatol. 2016;74(4):685–692.


Rudenko N, Golovchenko M, Vancova M, Clark K, Grubhoffer L, Oliver JH. Isolation of live Borrelia burgdorferi sensu lato spirochaetes from patients with undefined disorders and symptoms not typical for Lyme borreliosis. Clin Microbiol Infect. 2016;22(3):267.e9–267.e15.


Clark KL, Leydet B, Hartman S. Lyme borreliosis in human patients in Florida and Georgia, USA. Int J Med Sci. 2013;10(7):915–931.


Sapi E, Pabbati N, Datar A, Davies EM, Rattelle A, Kuo BA. Improved culture conditions for the growth and detection of Borrelia from human serum. Int J Med Sci. 2013;10(4):362–376.


Middelveen MJ, Bandoski C, Burke J, et al. Exploring the association between Morgellons disease and Lyme disease: identification of Borrelia burgdorferi in Morgellons disease patients. BMC Dermatol. 2015;15:1.


Stricker RB, Middelveen MJ. Sexual transmission of Lyme disease: challenging the tickborne disease paradigm. Expert Rev Anti Infect Ther. 2015;13(11):1303–1306.


Radolf JD, Deka RK, Anand A, Šmajs D, Norgard MV, Yang XF. Treponema pallidum, the syphilis spirochete: making a living as a stealth pathogen. Nat Rev Microbiol. 2016;14(12):744–759.


Mestecky J, Moldoveanu Z, Russell MW. Immunologic uniqueness of the genital tract: challenge for vaccine development. Am J Reprod Immunol. 2005;53(5):208–214.


Fischer WA, Wohl DA. Confronting Ebola as a sexually transmitted infection. Clin Infect Dis. 2016;62(10):1272–1276.


Moreira J, Peixoto TM, Siqueira AM, Lamas CC. Sexually acquired Zika virus: a systematic review. Clin Microbiol Infect. 2017;23(5):296–305.


Marks DH. Neurological complications of vaccination with outer surface protein A (OspA). Int J Risk Saf Med. 2011;23(2):89–96.


Stricker RB, Johnson L. Lyme disease vaccination: safety first. Lancet Infect Dis. 2014;14(1):12.


Zhang XC, Yang ZN, Lu B, Ma XF, Zhang CX, Xu HJ. The composition and transmission of microbiome in hard tick, Ixodes persulcatus, during blood meal. Ticks Tick Borne Dis. 2014;5(6):864–870.


Tokarz R, Williams SH, Sameroff S, Sanchez Leon M, Jain K, Lipkin WI. Virome analysis of Amblyomma americanum, Dermacentor variabilis, and Ixodes scapularis ticks reveals novel highly divergent vertebrate and invertebrate viruses. J Virol. 2014;88(19):11480–11492.


Pedroni MJ, Vidadala RS, Choi R, et al. Bumped kinase inhibitor prohibits egression in Babesia bovis. Vet Parasitol. 2016;215:22–28.


Özdener AE, Park TE, Kalabalik J, Gupta R. The future of pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) infection. Expert Rev Anti Infect Ther. 2017;15(5):467–481.


Mayer KH, Jones D, Oldenburg C, et al. Optimal HIV postexposure prophylaxis regimen completion with single tablet daily elvitegravir/cobicistat/tenofovir disoproxil fumarate/emtricitabine compared with more frequent dosing regimens. J Acquir Immune Defic Syndr. 2017;75(5):535–539.

Creative Commons License © 2018 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.