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Lyme Disease and The Lyme Disease Vaccine. Presentation By Jason Hadrath. Characterized by inflammation of:. 1. connective tissue (skin and joints). 2. nervous tissue. 3. cardiac tissue. What is Lyme Disease?. A multisystem inflammatory disease.

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Lyme Disease and The Lyme Disease Vaccine

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Lyme disease and the lyme disease vaccine l.jpg

Lyme Disease and The Lyme Disease Vaccine

Presentation By

Jason Hadrath


What is lyme disease l.jpg

  • Characterized by inflammation of:

1. connective tissue (skin and joints)

2. nervous tissue

3. cardiac tissue

What is Lyme Disease?

  • A multisystem inflammatory disease.

  • Resulting from an infection of Borrelia burgdorferi

  • Transmitted by Ixodes ticks


Symptoms and stages l.jpg

Symptoms and Stages

  • Erythema migrans and flu-like symptoms.

  • Early

BEST POINT FOR TREATMENT !!

  • Arthritis-like joint pain, heart arrhythmia, and fatigue.

  • Middle

40 % of lyme cases are asymptomatic in the early stages.

  • Late

  • Chronic arthritis, memory loss, and dementia.


History l.jpg

You are here.

NewBritain

Connecticut

Old Lyme

History

  • 100 years of lyme disease.

  • First classified in 1975by Dr. Allen Steere.

  • Named after Old Lyme Connecticut.


Statistics l.jpg

Statistics

  • Lyme disease is the most common tick-transmitted

  • illness in North America.

  • The true number of cases may be significantly higher.

  • From 1980 to 1998 112,000 cases have

  • been reported.

  • Lyme disease costs about $1 billion per year.


The tick l.jpg

The Tick

  • Ixodes scapularus (dammini )

  • Ixodes americanum

  • Ixodes pacificus

  • Ixodes riciaus

  • Ixodes persulcatus


More ticks l.jpg

Ixodes americanum

Larvae

Ixodesscapularus

Ixodes pacificus

More Ticks


Life cycle year 1 l.jpg

Life Cycle Year 1

  • Early Spring

  • Female drops off deer and lays eggs on the ground.

  • Spring / Summer

  • Larvae hatch and attach to white-footed mice.

  • Late Summer / Fall / Winter

  • Larvae molt to nymphs which over winter in the soil without feeding.


Life cycle year 2 l.jpg

Life Cycle Year 2

  • Nymphs emerge and attach to mice, deer, and people.

  • Spring / Summer

  • Fall

  • Nymphs molt to adults and attach to mice, deer, and people.

  • Late Fall / Winter

  • Adult ticks on deer making and carrying eggs.


Borrelia burgdorferi l.jpg

Borreliaburgdorferi

  • Entire genome is 1 MB. Consisting of 1 linear chromosome and 19 circular plasmids

  • Discovered by Willy Burgdorfer in 1984.

  • Gram negative spirochete bacteria.


Borrelia burgdorferi cont l.jpg

Borreliaburgdorferi cont..

  • Has an unusually large variety of surface proteins, which are both itís strengths and weaknesses.

  • One of the plasmids is most likely to code for virulence.

  • Is found in the mid gut of the tick.


Outer surface protein a l.jpg

Outer Surface Protein A

  • Lipoprotein.

  • Single polypeptide chain of 257 amino acids.

  • Lipid is covalently bonded to the N terminus.


Interactive l.jpg

Chain L

Chain H

Interactive


The vaccine l.jpg

LYMErix.

Developed by SmithKline Beecham Biologicals.

Noninfectious vaccine.

Given in three doses. Two doses, one month apart and again in 12 months.

Consisting of the complete lipoprotein OspA and aluminum hydroxide (adjuvant).

The Vaccine

$ 8500 per shot.

  • Cost


The vaccine cont l.jpg

Expressed in E. coli strain AR58.

Transformed with plasmid pOA15.

With OspA (a plasmid gene) as its insert.

The lipid moiety was added post-translationaly

The Vaccine cont...


Mechanism of action l.jpg

An injection of OspA results in the formation of anti-OspA antibodies.

These antibodies possess bactericidal activity.

Antibodies taken in along with tickís bloodmeal.

B. burgdorferi destruction ensues.

Mechanism of Action

Here is the key !


Vaccine efficacy l.jpg

10,000 person study.

49% effective after two doses.

After three doses 100% effective in preventing asymptomatic infection.

Vaccine Efficacy

  • 76% effective after all three doses.


Reservations l.jpg

Lack of long term testing.

Is a booster dose needed?

OspA contains a sequence that is similar to the human protein LFA-1.

This could lead to an autoimmune disease.

Reservations


References l.jpg

Books

Biddle, W. Afield Guide to Germs. New Jeresy: Doubleday Publishing Groupe,1995.

Ginsberg, H.S. Ecology and Environmental Management of Lyme Disease. New Jersey: Rutgers University Press, 1993.

Lang, D. Coping with Lyme Disease. New York: Henery Holt and Company, 1993.

Silverstein, A. Lyme Disease the Great Imitator. New Jersey: Avstar Publishing Corp., 1990.

Journals

ìImmunization Against Lyme Disease - An Important First Step.î The New England Journal of Medicine July 23,1998: 263-264.

Marwick, C. ìGuarded Endorsement for Lyme Disease Vaccine.î JAMA June 24, 1998: 1937-1938.

Sigal, L.H. ìA vaccine consisting of Recombinant Bb OspA to Prevent Lyme disease.î The New England Journal of Medicine July 23,1998: 216-221.

References


References21 l.jpg

References

Journals

Steere, A.C. ìVaccination Against LD with Recombinant Bb OspA with Adjuvant.î The New England Journal of Medicine July 23, 1998: 209-214.

Telford S.R. ìEfficancy of LD Vaccine Formulations in a Mouse Model.î The Journal of Infectious Diseases May, 1995: 1368-1370.

Sanz C. ìSummer of Danger.î Discover May, 1999: 64-71.

Web sites

http://www.lymerix.com SmithKline Beecham Bio.

http://www.aldf.com American Lyme Disease Foundation, Inc.

http://www.uri.edu/ticklab The Tick Research Lab.

hppt://www.ent.iastate.edu/imagega Iowa State Entomolgy Image Gallery.


References22 l.jpg

References

Web sites

http:www.acponline.org/lyme American Academy of Physicians

http://www.cdc.gov/ncidod/dvbid/lymeinfo.htm Centers for Disease Control and Prevention.

http://thetick.powertie.org Brandons Tribute to the Tick.


If you think education is expensive l.jpg

If you think education is expensive ...

Try Ignorance.

Any questions ?


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