Scientific research into Lyme disease is published in a variety of outlets including the Oxford-based Journal of Infectious Disease, published continuously since 1904. This is a highly regarded publication, although it is now published on behalf of the Infectious Disease Society of America (IDSA), a fact which will cause a number of Lyme disease advocates to approach the research therein with scepticism. Many of the articles found in this journal are written by authors familiar to the Lyme disease community, including Gary Wormser, Eugene Shapiro, Allen C. Steere, and Durland J. Fish (recently releasing research on a new tick-borne bacteria related to the Lyme disease pathogen).
Other peer-reviewed articles may appear online on BioMedCentral’s Infectious Diseases journal which is open-access and tracked by a number of databases. The online-only International Journal of Infectious Diseases (IJID) is published monthly by the International Society for Infectious Diseases and includes clinical and laboratory-based research, reviews, and case reports. The Canadian Journal of Infectious Disease & Medical Microbiology also publishes research into Lyme disease although the low incidence (or recognition) of Lyme disease in Canada means that many of the articles on the infection are brief notes on its presence in the country and the methods that may be incorrectly used to diagnose Lyme disease. A public health warning issued earlier this year admits to the detection of Lyme disease in Alberta, which may increase awareness of the possibility of infection through tick bites and trigger more research in other Canadian provinces and territories.
Lyme Disease Research Politics
Lyme disease research journals are an important source of information for general practitioners looking for guidance on the treatment of patients with Lyme disease and the diagnosis of the condition, along with differential diagnosis of Lyme. The editorial decisions made by staff at these journals is, therefore, important in how patients are eventually treated by doctors and the presence of scientists such as Steere on the advisory board of the very journals in which they are published may give cause for concern.
Selective publishing of research and reviews by journals has the effect of maintaining the conviction that Lyme disease is a treatable infection with few, if any, lasting effects after successful eradication with antibiotics. This means that there is little attraction for researchers to carry out studies which may contradict the status quo, especially when considering the need to attract funding for such studies. Even so, there are 32 clinical trials currently listed in connection with Lyme disease at ClinicalTrials.gov, some of which are actively recruiting, some which are still in planning stages, and some which are completed and pending publication of results. Many of those trials actively recruiting are investigating diagnostic techniques to assess the presence of Lyme disease bacteria in the skin or lesions, others are looking at specific antibiotic treatments for Lyme disease, and still more the general characteristics of the infection and possible persistence of symptoms.
Current and Future Lyme Disease Research
One interesting study (NCT01143558) currently recruiting patients is sponsored by the NIAID and the National Institutes of Health and explores a novel way of detecting persistent Lyme disease infection after antibiotic treatment. This study will use a process of xenodiagnosis where patients with confirmed Lyme disease are treated with antibiotics and then exposed to uninfected larval ticks before these ticks are allowed to turn into nymphs and feed, in turn, on mice with compromised immune systems. Detecting the presence of live active Borrelia bacteria in the mice would then suggest that the infection persisted in the human patient even after antibiotic treatment. Patients with untreated Lyme disease, those recently treated for the infection, and healthy volunteers looking to help further Lyme disease research, are eligible for the study which has centers in Maryland, Connecticut, and Massachusetts. Other studies are also actively recruiting and the more patients come forward to fill Lyme disease research quotas the closer the Lyme disease community will be to a better understanding of the condition.