Lyme disease – time to bite back
Thu, 06 Sep 2012 10:03:00 BST
Dr Richard Bingham’s goal is an accurate test that will mean quick and effective treatment of a tick-borne ailment that can have devastating effects
CAUSED by a bite from an infected tick, the early symptoms of Lyme disease are unpleasant but respond well to antibiotics. However, if diagnosis is delayed or mistaken, the illness can take a serious turn, leading to severe joint pain, brain infection and paralysis.
Now a scientist at the University of Huddersfield is on the trail of an accurate test that will enable quick and accurate detection of Lyme disease.
The British Paralympic archer Mel Clarke (pictured right) has spoken about her devastating experiences after she caught the infection while competing in the UK’s able-bodied archery team in the USA. Doctors were initially baffled, but although Lyme disease was diagnosed, she lost the sight in her right eye and she was paralysed from the waist down. She is now confined to a wheelchair but fought back to fitness and has issued urgent advice not to ignore the early symptoms of the disease.
The incidence of Lyme disease is growing in the UK, but its flu-like early symptoms, including chronic tiredness, are shared with many ailments, so that doctors face diagnostic dilemmas. If treatment begins at a late stage, patients face a gruelling 28-day course of antibiotics – and even after that, symptoms can return.
At the University of Huddersfield, the research carried out by Dr Richard Bingham (pictured left) focuses on the cause of Lyme disease, a spiral-shaped bacteria named Borrelia burgdorferi, which has the capacity to bind itself to human proteins, enabling it to invade various tissues and to camouflage itself against immune systems. Unlike most bacteria, it can even cross the ‘blood-brain barrier’, leading to serious neurological infection.
Ticks attach to the skin
Borrelia is carried by ticks, and in the UK and Europe they lurk in long, damp grass or on the branches of trees.
“When a warm blooded mammal comes along, the ticks attach themselves to the skin and start to feed,” explained Dr Bingham.
“The bacteria is actually inside the gut of the tick and it gets injected into the host through the salivary glands of the tick and once in your bloodstream, it starts to reproduce and can cause a quite nasty infection.”
The first sign is a circular ‘bullseye rash’ as the bacteria spread out from the bite. Then they gain access to the bloodstream and will cause symptoms including a high temperature and tiredness.
“But many people have such flu-like symptoms and they don’t realise they have got this bacterial infection, so they don’t go to the doctors and therefore miss these classic signs of Lyme disease,” said Dr Bingham.
Diagnosis and antibiotic treatment at this early stage is vital in order to avoid the stage of infection known as late-borreliosis.
“Your immune system is able to clear the Borrelia from the blood, but it invades other parts of the body,” said Dr Bingham. “It can go into joints such as knees, elbows, the eyes and spinal fluid, and it can gain access to the brain.”
Greater understanding of Borrelia
Meanwhile, doctors are confronted by symptoms that are shared by a number of diseases and conditions, making diagnosis difficult.
Ideally, when people are bitten by a tick they should remove it and keep it so that it can be tested for the presence of bacteria.
Now, assisted by two PhD students and an undergraduate researcher, Dr Bingham is using techniques including X-ray diffraction, small angle X-ray scattering and circular dichroism spectroscopy in order to reproduce the bacterial proteins that lead to Lyme disease. He will be aided by a major programme of investment in laboratory facilities at the chemistry department of the University’s School of Applied Sciences.
The research will result in greater understanding of the molecular structure of Borrelia, which could lead to new treatments. Also, the pharmaceutical industry could develop new diagnostic tools so that Lyme disease can conclusively be detected at an early stage.
In the UK the number of cases of Lyme disease confirmed by blood testing rose from 346 in 2003 to 1, 578 in 2009. But the real rate of infection is almost certainly much higher.
The Health Protection Agency estimates that there could be up to 3,000 new cases in the UK every year. Many victims do not fully recover, so the total number of people affected is accumulating, according to the charity Lyme Disease Action (LDA), which is calling for research in the field. Dr Bingham has recently delivered a paper on his research at a two-day conference convened by the LDA.
He has also authored and co-authored several journal articles. Dr Bingham was one of the authors of an article that was selected by a panel of judges as open of the 20 best – out of 4,000 – that had appeared in the Journal of Biological Chemistry during 2011.