Lyme Arthritis: A 50-Year Journey

Author:
Publisher website
Google Scholar
Abstract
Lyme arthritis (LA) was recognized as a separate entity in 1975 because of geographic clustering of children often diagnosed with juvenile rheumatoid arthritis in Lyme, Connecticut. After identification of erythema migrans as a common early feature of the illness, a prospective study of such patients implicated Ixodes scapularis ticks in disease transmission. In 1982, the causative agent, now called Borrelia burgdorferi, was cultured from these ticks and from Lyme disease patients. Subsequently, it was shown that LA could usually be treated successfully with oral antibiotics but sometimes required intravenous antibiotics. Yet, a small percentage of patients developed a dysregulated, proinflammatory immune response leading to persistent postinfectious synovitis with vascular damage, cytotoxic and autoimmune responses, and fibroblast proliferation, a lesion similar to that of rheumatoid arthritis. The message from postinfectious LA for other autoimmune arthritides is that a complex immune response with autoimmune features can begin with a microbial infection.
Funding Information
  • National Institutes of Health
  • National Institute of Allergy and Infectious Diseases (R01-144365))
  • G. Harold and Leila Y. Mathers Foundation
  • Arthritis Foundation
  • Rheumatology Research Foundation
  • Eshe Fund
  • Lyme Disease and Arthritis Research Fund at Massachusetts General Hospital

This publication has 45 references indexed in Scilit: