Microbiome signature in post-treatment Lyme disease syndrome patients

Lyme disease is the most common vector-borne disease in the United States with an estimated incidence of 300,000 infections annually. Antibiotic intervention cures Lyme disease in the majority of cases; however, 10-20% of patients develop post-treatment Lyme disease syndrome (PTLDS), a debilitating condition characterized by chronic fatigue, pain, and cognitive difficulties. The underlying mechanism responsible for PTLDS symptoms, as well as a reliable diagnostic tool, has remained elusive. We reasoned that the gut microbiome may play an important role in PTLDS given that the symptoms overlap considerably with conditions in which a dysbiotic microbiome has been observed, including mood, cognition, and autoimmune disorders. Analysis of sequencing data from a rigorously curated cohort of PTLDS patients revealed a gut microbiome signature distinct from healthy control subjects, as well as from ICU patients being treated with antibiotics. Notably, microbiome sequencing data alone was indicative of PTLDS which presents a potential, novel diagnostic tool for PTLDS.