Abstract
Lyme borreliosis is a zoonotic disease caused by Borrelia burgdorferi sensu lato bacteria transmitted to humans and domestic animals by the bite of an Ixodes spp. tick (deer tick). Despite improvements in diagnostic tests and public awareness of Lyme disease, the reported cases have increased over the past decade to approximately 30,000 per year. Limitations and failed public acceptance of a human vaccine, comprised of the outer surface A (OspA) lipoprotein of B. burgdorferi, led to its demise, yet current research has opened doors to new strategies for protection against Lyme disease. In this review we discuss the enzootic cycle of B. burgdorferi, and the unique opportunities it poses to block infection or transmission at different levels. We present the correlates of protection for this infectious disease, the pros and cons of past vaccination strategies, and new paradigms for future vaccine design that would include elements of both the vector and the pathogen.
Highlights
In the United States, during 2000–2010, a total of 251,720 confirmed cases of Lyme disease were reported to the CDC by health departments in the 50 states, the District of Columbia, and US territories; the annual count increased 101%, from 9908 cases in 1992 to 19,931 cases in 2006 and has approached 30,000 more recently
We present the correlates of protection for this infectious disease, the pros and cons of past vaccination strategies, and new paradigms for future vaccine design that would include elements of both the vector and the pathogen
Several tick molecules with the potential to serve as vaccines to impair feeding and transmission have been identified in the last decade
Summary
In the United States, during 2000–2010, a total of 251,720 confirmed cases of Lyme disease were reported to the CDC by health departments in the 50 states, the District of Columbia, and US territories; the annual count increased 101%, from 9908 cases in 1992 to 19,931 cases in 2006 and has approached 30,000 more recently. Cross-reactivity between anti-Borrelial whole-cell antibodies and host tissue antigens led to emphasis on a subunit vaccine (Aberer et al, 1989; Sigal, 1993; Garcia-Monco et al, 1995). Immunodiagnosis and how this may be affected is another consideration. Two subunit vaccines have progressed to market—one consisting of just the B. burgdorferi outer surface protein A (OspA) subunit, Recombitek®, manufactured by Merial (Conlon et al, 2000), and another combining OspA and OspC subunits (Novibac® Lyme) by Merck Animal Health These subunits will be discussed extensively . Challenge of mice by injection, tissue transplant and tick transmission; challenge of monkeys by tick transmission
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