Lyme Disease
and
The Lyme Disease Vaccine
Presentation By
Jason Hadrath
What is Lyme Disease?

A multisystem inflammatory disease.
Resulting

from an infection of Borrelia burgdorferi
Characterized by inflammation of:
1. connective
tissueticks
(skin and joints)
Transmitted
by Ixodes
2. nervous tissue
3. cardiac tissue
Symptoms and Stages

Early
Erythema migrans and flu-like
symptoms.

BEST POINT FOR TREATMENT !!
 Arthritis-like joint pain, heart
Middle
arrhythmia,
andasymptomatic
fatigue.
40 % of lyme
cases are
in
the early stages.
 Chronic arthritis, memory loss,
 Late

and dementia.
History
You are here.

100 years of lyme
disease.
New
Britain
Connecticut

First classified in 1975 by Dr. Allen Steere.
 Named after Old Lyme Connecticut.
Old Lyme
Statistics
Lyme disease is the most common tick-transmitted
in number
North America.
 illness
The true
of cases may be significantly higher.

 From 1980 to 1998 112,000 cases have
 Lyme disease costs about $1 billion per
been reported.
year.
The Tick

Ixodes scapularus (dammini )

Ixodes americanum

Ixodes pacificus
Ixodes riciaus
 Ixodes persulcatus

More Ticks
Ixodes americanum
Larvae
Ixodes scapularus
Ixodes pacificus
Life Cycle Year 1

Early Spring

Spring / Summer
Late Summer /
Fall / Winter

Female drops off
deer and lays eggs
 Larvae
hatch and
on
the ground.
attach to white
Larvae
molt to
footed
mice.
nymphs which over
winter in the soil
without feeding.

Life Cycle Year 2

Spring / Summer

Fall

Late Fall / Winter
Nymphs emerge
and attach to mice,
deer,
and people.

Nymphs
molt to
adults and attach to

Adult
ticksand
on
mice,
deer,
deer
making and
people.
carrying eggs.

Borrelia burgdorferi
 Discovered
by  Entire genome is
Willy Burgdorfer1 MB. Consisting
in 1984.
of 1 linear
 Gram negative chromosome and
19 circular
spirochete
plasmids
bacteria.
Borrelia burgdorferi cont..
 One
of the  Has an unusually
plasmids is most
large variety of
likely to code for
surface proteins,
virulence.
which are both
 Is found in theitís strengths and
mid gut of the weaknesses.
tick.
Outer Surface Protein A
Lipoprotein.
Single
polypeptide chain of 257
amino acids.
Lipid
is covalently bonded to
the N terminus.
Interactive
Chain L
Chain H
The Vaccine
 Given
in three doses.
LYMErix.
Two doses, one month
apart and
 Developed
byagain in 12
months.Beecham
SmithKline
Biologicals.
 Consisting of the
complete lipoprotein
 Noninfectious
 Cost $ 8500 per shot.
OspA and aluminum
vaccine.
hydroxide (adjuvant).
The Vaccine cont...
 Expressed in
E.
With
OspA
coli strain AR58.
(a plasmid gene)
as its insert.
 Transformed with
plasmid pOA15.
 The lipid moiety
was added posttranslationaly
Mechanism of Action
 An
injection
of OspA taken
 Antibodies
results in theinformation
of
along
with
Here is anti-OspA
the key ! antibodies.
tickís bloodmeal.
 These antibodies
possess
 B. burgdorferi
bactericidal destruction
activity.
ensues.
Vaccine Efficacy
 76%
effective after all
 10,000 person
three doses.
study.
 After three doses 100%
effective in preventing
 49% effective
asymptomatic
infection.
after two
doses.
Reservations
 OspA contains
a sequence
that
is similar
 Lack of long
term
testing.to the human
protein
LFA-1.
 Is a booster
dose needed?
 This could lead to an
autoimmune disease.
Books
References
Biddle, W. Afield Guide to Germs. New Jeresy: Doubleday Publishing
Groupe,1995.
Ginsberg, H.S. Ecology and Environmental Management of Lyme Disease. New
Jersey: Rutgers University Press, 1993.
Lang, D. Coping with Lyme Disease. New York: Henery Holt and Company, 1993.
Silverstein, A. Lyme Disease the Great Imitator. New Jersey: Avstar Publishing
Corp., 1990.
Journals
ìImmunization Against Lyme Disease - An Important First Step.î The New England
Journal of Medicine July 23,1998: 263-264.
Marwick, C. ìGuarded Endorsement for Lyme Disease Vaccine.î JAMA June 24,
1998: 1937-1938.
Sigal, L.H. ìA vaccine consisting of Recombinant Bb OspA to Prevent Lyme
disease.î The New England Journal of Medicine July 23,1998: 216-221.
References
Journals
Steere, A.C. ìVaccination Against LD with Recombinant Bb OspA
with Adjuvant.î The New England Journal of Medicine July 23,
1998: 209-214.
Telford S.R. ìEfficancy of LD Vaccine Formulations in a Mouse
Model.î The Journal of Infectious Diseases May, 1995: 13681370.
Sanz C. ìSummer of Danger.î Discover May, 1999: 64-71.
Web sites
http://www.lymerix.com SmithKline Beecham Bio.
http://www.aldf.com American Lyme Disease Foundation, Inc.
http://www.uri.edu/ticklab The Tick Research Lab.
hppt://www.ent.iastate.edu/imagega Iowa State Entomolgy Image
Gallery.
References
Web sites
http:www.acponline.org/lyme American Academy of Physicians
http://www.cdc.gov/ncidod/dvbid/lymeinfo.htm Centers for Disease
Control and Prevention.
http://thetick.powertie.org Brandons Tribute to the Tick.
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