But a new test can now detect it earlier so treatment can start sooner.
A high school student’s goal to create a better way to diagnose Lyme disease at its earliest stages now helps doctors treat their patients.
It all began six years ago when rising high school senior Temple Douglas was part of George Mason University’s Aspiring Scientists Summer Internship Program.
The teenager from Lucketts, Virginia, had family members who were suffering from the tick-borne disease and wondered if Mason-developed technology could be used to design a more accurate test. Her mentor, Mason researcher Alessandra Luchini, told her to run with it.
Douglas collected the first round of ticks for the initial work on the test in Mason’s Center for Applied Proteomics and Molecular Medicine.
“I lived in the countryside, so whenever people found ticks on their animals or crawling on their pants after they went hiking, I would take them with me to the lab,” says Douglas, who graduated from Princeton University and is now a doctoral student at Virginia Tech working on new cancer detection methods.
And 300 patients later, the idea Douglas brought into the lab that Mason researchers refined is helping patients receive early and accurate diagnoses for Lyme disease.
Sneaky start to a long-term battle
Lyme disease starts with a bacterium called Borrelia burgdorferi, which can be carried by blacklegged ticks. Nymphs―about the size of the period at the end of this sentence―can bite unnoticed until the standard first sign of Lyme disease, a bull’s-eye rash, appears.
Joint and muscle aches, fatigue, fever, chills, headaches, and swollen lymph nodes typically follow, according to the Centers for Disease Control and Prevention.
A dose of antibiotics usually kills the bacteria, but symptoms may persist. Patients return to their doctors months and even years later, convinced they still have Lyme disease, says Lance Liotta, co-director of Mason’s molecular medicine center. Until now, doctors couldn’t test to see whether the disease was still active or not.
Regular blood tests only show if the body has created antibodies to fight the infection, but antibodies remain even after the infection is beaten.
“Everyone measures the antibodies because it’s much easier,” says Luchini, who spearheaded the Lyme test research and is a co-inventor of the technology.
Mason researchers bypass the antibodies and go straight for the tiniest of clues called antigens, which are shed by the Lyme disease bacterium while active. Mason-created technology traps these particles that were once too small to test.
“The antigen is a component of the toxic-causing agent itself,” Luchini says. “Instead of looking at the host response or whatever the human body does to fight the infection, we look at a piece of the infection-causing agent.”
Trapping the proteins
Mason’s nanoparticle technology works much like a lobster trap, Liotta says. It’s an open meshwork with bait inside. The traps look like tiny white balls under the microscope.
“The protein that we want goes in and gets stuck inside,” Liotta says. “It binds to that bait in the trap.”
Mason’s approach can determine if someone has Lyme disease even before antibodies are made.
And it’s those antibodies that can cause problems down the line, Liotta says. Antibodies fight infection and react to the proteins in the bacteria. But antibodies don’t stop with the infection—they move to attack proteins in the nerves, joints, and brain.
Mason licensed its technology to private company Ceres Nanoscience, which has commercialized the urine-based test and brought it into doctor’s offices. Mason researchers are working with Ceres to apply a similar approach to Ebola, malaria, and tuberculosis, among other diseases.
“We’re looking to repeat the story again with these other diseases,” Luchini says.
“Other targets for the new type of test include Chagas disease, which is infectious and caused by a parasite, and toxoplasmosis, another parasite-borne disease.”