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Review of evidence for immune evasion and persistent infection in Lyme disease

Authors Berndtson K

Received 17 February 2013

Accepted for publication 18 March 2013

Published 23 April 2013 Volume 2013:6 Pages 291—306

DOI https://doi.org/10.2147/IJGM.S44114

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Keith Berndtson

Park Ridge MultiMed, Park Ridge, IL, USA

Abstract: Is chronic illness in patients with Lyme disease caused by persistent infection? Three decades of basic and clinical research have yet to produce a definitive answer to this question. This review describes known and suspected mechanisms by which spirochetes of the Borrelia genus evade host immune defenses and survive antibiotic challenge. Accumulating evidence indicates that Lyme disease spirochetes are adapted to persist in immune competent hosts, and that they are able to remain infective despite aggressive antibiotic challenge. Advancing understanding of the survival mechanisms of the Lyme disease spirochete carry noteworthy implications for ongoing research and clinical practice.

Keywords: Lyme disease, Borrelia, biofilm, bacterial persistence, antibiotic tolerance

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