Finally, a Lyme Disease Prevention Shot Could Be on the Way

Despite all of the problems that Lyme disease creates, there is no human vaccine available. Oral antibiotics were never adequate for Yasso. Blood radiation, a somewhat uncommon Lyme treatment in which doctors syphon some blood, blast it with electromagnetic waves, and then drip it back into the bloodstream, is one of the antimicrobial therapies he’s been prescribed. “I feel better every time I do these treatments. But it’s only for a while,” he says. “It can persist up to three months at times. It can sometimes last a month.”

Yasso’s continuous troubles put him in a unique group: around one in every five persons who catch Lyme develops a chronic illness with persistent symptoms. It’s referred to as “post-treatment Lyme disease syndrome” by the CDC. About two million people in the United States were affected by this illness, which is characterised by fatigue, headaches, attention and memory issues, and severe arthritis as of 2020.

Chronic Lyme disease is another label for these cases of long-term Lyme disease, which has caused controversy and debate in the medical community. Chronic Lyme disease is not recognised as an official diagnosis by the Infectious Diseases Society of America. Chronic Lyme, according to the IDSA, is “a pseudoscientific diagnosis—an ideology rather than a biological reality,” according to Meghan O’Rourke, writing in The Atlantic in 2019.

Lyme disease develops into a never-ending disorder with persistent symptoms in around one out of every five persons who encounter it.

According to Tulane’s Embers, there are two schools of thought: On the one hand, some experts believe that certain patients’ Lyme symptoms would linger even after antibiotic treatment, leading to chronic Lyme. (To put it another way, there is an active infection.) “Persistent Borrelia infection despite antibiotic therapy in patients with persisting Lyme disease symptoms,” according to a 2018 study.) Some medical specialists, on the other hand, say that medicines invariably address Lyme symptoms, and that any residual problems a patient experiences later must be due to something else.

Despite this, research can agree on one thing: avoiding Lyme illness in the first place is the best option. To that goal, some experts have banded together to reverse the script on the Lyme disease. Treating Borrelia in the body is a waste of time. What if you could render it unconscious while it was still inside the tick?

Mark Klempner enters the picture. He’s a physician and infectious-disease scientist at the University of Massachusetts, and he’s working on a study that could change the way Lyme disease is treated. Klempner led the development of a first-of-its-kind antibody injection to prevent Lyme disease. The plan is to administer the injection once a year to protect patients from late spring to early fall.

Klempner, now in his early sixties, is bespectacled and personable, with a soothing air about him. He comes across as insatiably interested, as if he’s spent his entire life attempting to solve medical puzzles.

In 1972, a trip to Nigeria changed the course of his medical career. He treated patients with malaria, measles, and tuberculosis while working in a field hospital. He knew he wanted to research infectious illnesses when he graduated from Cornell University Medical College in 1973. On the advice of the college’s chief resident, Anthony Fauci, he applied for a fellowship at the National Institutes of Health in his third year of medical school. (You may be familiar with his name.) Klempner arrived in 1975 for a three-year assignment, the same year that the first case of juvenile arthritis was reported in Lyme, Connecticut.

He continues, “I spent a lot of time studying the host response to infectious agents, so I understood a lot about how the body battled infections.” “Then there was Lyme illness, and no one understood how your body was going to fight it.”

Klempner studied Lyme disease for many years. In 1990, he even took a summer leave to work with Burgdorfer at Rocky Mountain Laboratories in Montana, where the groundbreaking Borrelia experiments were conducted. Klempner went on to become the CEO of MassBiologics, the country’s first nonprofit vaccine manufacturer with FDA approval. (In July, he moved on to a position focusing on the clinical development of medications in the nonprofit’s pipeline.) After learning how the body fights Lyme, Klempner set his sights on developing a preventative drug in 2014.

The Lyme microorganism is a formidable foe with a broad reach. Lyme disease is caused by 18 different Borrelia species found in North America, Europe, and Asia. It does, however, have a flaw that Klempner hoped to exploit: the bacterium’s exterior is covered in outer surface proteins that regulate its activity. While within the tick, outer surface protein A (OspA) covers the bacterium, helping it to adhere to the gut walls. When a tick bites someone and begins drinking blood, microbes gradually shed OspA in favour of outer surface protein C (OspC), which aids the bacteria’s movement from the gut to the salivary glands and then into the bloodstream, where this new protein jacket further aids the bacteria’s evasion of the human immune system.

Klempner’s plan was straightforward: identify an anti-OspA antibody, spin it up into an injectable solution, and inoculate someone. A team of scientists and physicians from MassBiologics and elsewhere worked on the discovery and development of the drug. The treatment, known as Lyme PREP (for “pre-exposure prophylaxis”), injects a large number of identical Lyme-microbe-fighting antibodies into the bloodstream. (Some COVID-19 patients are being treated with a monoclonal antibody strategy similar to this.) When a tick bites and begins to drink, the antibodies are sucked into the tick’s gut, killing the Borrelia bacteria. “You’re attempting to prevent transmission before the pathogen ever enters your body,” Klempner explains.

Lyme PREP was 100 percent effective in mice and nonhuman primates at the highest dose. (Embers actually assisted Klempner and his crew with nonhuman primate research in Massachusetts.) That isn’t a guarantee of crossover success in people, though. Mice are carriers of Lyme bacteria but do not become ill as a result of the infection. While primates are our closest mammalian relatives, they are only a stepping stone to the main test. Lyme PREP entered its first human clinical trials earlier last year.

A decade ago, 300,000 Americans were infected with Lyme disease each year. Now, with the disease’s prevalence increasing and the difficulty of eradicating it in some people, a successful pre-Lyme treatment might be huge. “It’s widely acknowledged that the longer an infection persists, the more difficult it is to treat,” adds Embers. “It would be a game changer if we could prevent infection.”

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