Causes of Lyme Disease
by Kamau Kokayi, MD
The causal agents of Lyme disease are Borrelia bacteria in North America, carried
by Ixodes scapularis in Eastern North America, or Ixodes pacificus
in the West. Out of the 11 described Borrelia species, three have been identified
as having the capacity to spread Lyme disease: B. burgdorferi, B. afzelii,
and B. garinii. Also considered to be infectious are B. bissetti
and B. valaisiana, but not as significant causal agents of the disease.
In North America, the black-legged tick (Ixodes scapularis), better known
as the deer tick, has been identified as the key vector for spread of the disease.
A different tick species, Amblyomma americanum, or common lone-star tick—named
for the distinctive white dot on the female's back—has been found to carry
the borreliosis spirochete known as B. lonestari, in approximately 2% of
its population. This organism is the putative agent of STARI (Southern tick-associated
rash illness), otherwise known as Southern Lyme, or Masters disease after its discoverer,
Ed Masters. Dr. Masters worked diligently to gain recognition of this illness, which
resembles Lyme clinically, though sufferers rarely test positive for Lyme with currently
available testing methods. Amblyomma americanum has increased in prevalence
in the past 40 years, and its range now includes the Midwest, extending northeastward
to Maine and into the Southeast.
The B. burgdorferi bacterium is a spirochete, a corkscrew-shaped organism
with a complex life cycle that requires ticks, rodents, and deer. The main reservoir
of the spirochete is mice, while the main host of the Ixodes tick is the deer, with
the tick transferring the Borrelia bacteria back and forth between the two. Other
animals, including birds, humans and their pets, among others, may be involved as
alternate hosts or agents of transmission.
The spirochete attaches itself to the gut of the disease-carrying tick. During the
24 to 48 hours after the tick has attached itself to its host, the spirochete multiplies
and moves to the salivary glands of the tick. The spirochete at this point faces
the defenses of the immune system of the host to which the tick is attached. Antibodies,
leukocytes, polymorphonuclear cells, and macrophages are all hostile complements
of the host's immune system that kill most of the invading bacteria.
These particular bacteria, however, possess mechanisms that enable them to evade
detection, to inactivate mechanisms that typically kill them, and to then hide themselves
in less accessible compartments of the body, such as within the extracellular matrix.
One such mechanism involves binding proteins on the surface of the spirochete that
allow it to attach to host proteins, including one associated with collagen. Lupus-like
and arthritic symptoms are explained by this ability, as clinical features in tissues
of chronic Lyme sufferers bear similarities to those of lupus and arthritic conditions.
Once camouflaged with host-like proteins and established in the body the infection,
if untreated with antibiotics, can migrate into the central nervous system and generate
the variety of debilitating, often painful symptoms chronic Lyme disease is known
for. The particular mechanism for entering the central nervous system is unknown
at this time. Disseminating widely through the body, specimens of the spirochetes
have been found in heart muscle, muscle, bone, spleen, liver, retina, and the brain.
In some Lyme sufferers post-infection syndromes remain a severe problem for months
or years after a standard course of antibiotic treatment. Treatment-resistant Lyme
arthritis leaves as many as 10% of Lyme arthritis patients with persistent joint
inflammation long after treatment. It is unclear whether the syndrome is due to
persistent infection of hard-to-reach spirochetes, or to an infection-induced autoimmune
condition. Evidence exists for both possibilities.
Lyme disease diagnosis and treatment have been wrought with controversy and debate
because of the difficulty in pinning down a clear diagnosis caused by this resourceful
microbe. Co-infections with related species or strains, latent Lyme infections,
and a bewildering spectrum of symptoms that appear in much the same way as other
difficult-to-treat diseases make Lyme particularly prone to controversy. Careful
screening and a holistic approach to treatment avoids some of the controversy by
treating the disease from a number of different angles integratively.
Begin Your Healing with Patients Medical
The effects of chronic Lyme disease can significantly affect your health, livelihood, and overall well-being. Conventional antibiotic therapy may provide an initial sense of relief, but if your symptoms should return, continue, or worsen in spite of conventional therapy, as they do in many Lyme sufferers, broadening your therapeutic options is a worthwhile step toward restoring both your health and your sense of well-being.
At Patients Medical we draw upon both modern and ancient healing arts to tackle the oft-times bewildering problems chronic Lyme disease presents in our patients. Our team of Lyme experts can develop a personalized, integrative treatment protocol designed to optimize your long-term health and support you in countering the symptoms and detrimental effects of Lyme disease.
For those that can make the journey, we are happy to welcome new patients to our medical center
in New York City. Call us at
1-212-661-4441.
We are here to listen and to help.
We are located at: Patients Medical PC, 800 Second Avenue, Suite 900 (Between 42nd and 43rd Street), Manhattan, New York, NY 10017.
Causes of Lyme Disease—Citations
and Further Reading
Date of Publication: 09/05/2005
Article Last Updated: 11/17/2011