ORIGINAL RESEARCH article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1577936
This article is part of the Research TopicEvolving Strategies in Lyme Borreliosis Treatment and PreventionView all 4 articles
Lyme Disease Biobank: 10 years of 3 month follow-up visits from 2014-2023
Provisionally accepted
Elizabeth J Horn1*
George Dempsey2Anna M Schotthoefer3Matthew McArdle1
Allison F Weber1Cathy DeLuca4
Bobbi S Pritt5Elizabeth L Maloney6- 1Lyme Disease Biobank, Portland, United States
- 2East Hampton Family Medicine, East Hampton, United States
- 3Marshfield Clinic Research Institute, Marshfield, Wisconsin, United States
- 4Stony Brook University, Stony Brook, New York, United States
- 5Mayo Clinic, Rochester, Minnesota, United States
- 6Partnership for Tick-borne Disease Education, Wyoming, United States
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Introduction: Lyme Disease Biobank (LDB) enrolls participants with signs and symptoms of early Lyme disease (LD) from endemic areas and makes samples available to researchers developing more accurate diagnostics. From 2014-23, 466 cases and 367 controls were enrolled on Long Island, NY, and in Central Wisconsin. Methods: This study included 253 LDB participants who provided samples from an initial and a convalescent blood draw. Serologic testing, including a first-tier enzyme immunoassay and IgM and IgG immunoblotting, was performed on all samples; blots were interpreted using CDC criteria. Results: At the first draw, 34% of samples from participants presenting with erythema migrans (EM) > 5 cm were positive by CDC’s standard two-tier testing (STTT) algorithm. IgG seroconversion was rare, only 4% of samples demonstrated seroconversion. While the majority of participants (78%) reported no LD symptoms at the second draw, 22% reported ongoing symptoms; the most common being joint pain, fatigue, and muscle pain. Only 35% of participants with ongoing symptoms reported seeing their provider about their symptoms. Conclusions: These results provide additional evidence that STTT is insensitive in early LD and seroconversion is rare after antibiotics. More than one-fifth of participants initially prescribed antibiotics reported ongoing LD symptoms. Therefore, healthcare professionals treating patients with early LD are encouraged to follow-up with their patients, determine whether they continue to experience symptoms, and consider immediate antibiotic re-treatment as appropriate. Early diagnosis, treatment, and follow-up of early LD patients has the potential to improve outcomes and reduce the burden of LD in the US.
Keywords: Lyme Disease, Serology, seroconversion, biorepository, Biobank, antibiotic treatment
Received: 17 Feb 2025; Accepted: 11 Jun 2025.
Copyright: © 2025 Horn, Dempsey, Schotthoefer, McArdle, Weber, DeLuca, Pritt and Maloney. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Elizabeth J Horn, Lyme Disease Biobank, Portland, United States
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