• Structural requirements for glycosaminoglycan recognition by the Lyme disease spirochete, Borrelia burgdorferi

      Leong, John M.; Robbins, Douglas; Rosenfeld, Louis; Lahiri, Biswajit; Parveen, Nikhat (1998-11-24)
      Borrelia burgdorferi, the Lyme disease agent, binds glycosaminoglycans (GAGs) such as heparin, heparan sulfate, and dermatan sulfate. Heparin or heparan sulfate fractions separated by size or charge were tested for their ability to inhibit attachment of B. burgdorferi to Vero cells. GAG chains of increasing length and/or charge showed increasing inhibitory potency, and detectable heparin inhibition of bacterial binding required a minimum of 16 residues. The ability of a given heparin fraction to inhibit binding to Vero cells was strongly predictive of its ability to inhibit hemagglutination, suggesting that hemagglutination reflects the capacity of B. burgdorferi to bind to GAGs.
    • Treatment trials for post-Lyme disease symptoms revisited

      Klempner, Mark S.; Baker, Phillip J.; Shapiro, Eugene D.; Marques, Adriana; Dattwyler, Raymond J.; Halperin, John J.; Wormser, Gary P. (2013-08-01)
      The authors of 4 National Institutes of Health-sponsored antibiotic treatment trials of patients with persistent unexplained symptoms despite previous antibiotic treatment of Lyme disease determined that retreatment provides little if any benefit and carries significant risk. Two groups recently provided an independent reassessment of these trials and concluded that prolonged courses of antibiotics are likely to be helpful. We have carefully considered the points raised by these groups, along with our own critical review of the treatment trials. On the basis of this analysis, the conclusion that there is a meaningful clinical benefit to be gained from retreatment of such patients with parenteral antibiotic therapy cannot be justified.