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Untreated Lyme disease may result in chronic arthritis, which is curable by antibiotics in 90% of cases. New research proposes an explanation for why the other 10% fail to improve and raises concerns about the long-term safety of a new Lyme disease vaccine.
Individuals with treatment-resistant Lyme arthritis are often positive for the HLA-DRB1*0401 histocompatibility class II complex, and their synovial fluid T cells preferentially recognize the outer surface protein A (OspA) of Borrelia burgdorferi, the cause of Lyme disease. Studies using a peptide-binding algorithm and transgenic mice identified the main epitope of OspA that interacts with DRB1*0401. This sequence is closely homologous to the human integrin LFA-1, which also binds to DRB1…