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Lyme Disease and The Lyme Disease Vaccine

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Title: Lyme Disease and The Lyme Disease Vaccine


1
Lyme Disease and The Lyme Disease Vaccine
  • Presentation By
  • Jason Hadrath

2
What is Lyme Disease?
  • A multisystem inflammatory disease.
  • Resulting from an infection of Borrelia
    burgdorferi
  • Transmitted by Ixodes ticks


3
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.

4
History
  • 100 years of lyme disease.
  • First classified in 1975 by Dr. Allen Steere.
  • Named after Old Lyme Connecticut.

5
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.

6
The Tick
  • Ixodes scapularus (dammini )
  • Ixodes americanum
  • Ixodes pacificus
  • Ixodes riciaus
  • Ixodes persulcatus

7
More Ticks
8
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.

9
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.

10
(No Transcript)
11
Borrelia burgdorferi
  • Discovered by Willy Burgdorfer in 1984.
  • Gram negative spirochete bacteria.
  • Entire genome is 1 MB. Consisting of 1 linear
    chromosome and 19 circular plasmids

12
Borrelia burgdorferi cont..
  • One of the plasmids is most likely to code for
    virulence.
  • Is found in the mid gut of the tick.
  • Has an unusually large variety of surface
    proteins, which are both itís strengths and
    weaknesses.

13
Outer Surface Protein A
  • Lipoprotein.
  • Single polypeptide chain of 257 amino acids.
  • Lipid is covalently bonded to the N terminus.

14
Interactive
15
The 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).
  • LYMErix.
  • Developed by SmithKline Beecham Biologicals.
  • Noninfectious vaccine.

8500 per shot.
  • Cost

16
The Vaccine cont...
  • 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

17
Mechanism of Action
  • 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.

Here is the key !
18
Vaccine Efficacy
  • 76 effective after all three doses.
  • 10,000 person study.
  • 49 effective after two doses.
  • After three doses 100 effective in preventing
    asymptomatic infection.

19
Reservations
  • OspA contains a sequence that is similar to the
    human protein LFA-1.
  • This could lead to an autoimmune disease.
  • Lack of long term testing.
  • Is a booster dose needed?

20
References
  • 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.

21
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.

22
References
  • Web sites
  • httpwww.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.

23
If you think education is expensive ...
Try Ignorance.
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