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Sci Transl Med. 2017 Aug 16;9(403). pii: eaal2717. doi: 10.1126/scitranslmed.aal2717.

Metabolic differentiation of early Lyme disease from southern tick-associated rash illness (STARI).

Author information

1
Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO 80521, USA.
2
Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO 80523, USA.
3
Division of Infectious Diseases,Department of Medicine, New York Medical College, Valhalla, NY 10595, USA.
4
Department of Statistics, Colorado State University, Fort Collins, CO 80523, USA.
5
Division of Immunology and Pathogenesis, Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL 32816, USA.
6
Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO 80523, USA. john.belisle@colostate.edu.

Abstract

Lyme disease, the most commonly reported vector-borne disease in the United States, results from infection with Borrelia burgdorferi. Early clinical diagnosis of this disease is largely based on the presence of an erythematous skin lesion for individuals in high-risk regions. This, however, can be confused with other illnesses including southern tick-associated rash illness (STARI), an illness that lacks a defined etiological agent or laboratory diagnostic test, and is coprevalent with Lyme disease in portions of the eastern United States. By applying an unbiased metabolomics approach with sera retrospectively obtained from well-characterized patients, we defined biochemical and diagnostic differences between early Lyme disease and STARI. Specifically, a metabolic biosignature consisting of 261 molecular features (MFs) revealed that altered N-acyl ethanolamine and primary fatty acid amide metabolism discriminated early Lyme disease from STARI. Development of classification models with the 261-MF biosignature and testing against validation samples differentiated early Lyme disease from STARI with an accuracy of 85 to 98%. These findings revealed metabolic dissimilarity between early Lyme disease and STARI, and provide a powerful and new approach to inform patient management by objectively distinguishing early Lyme disease from an illness with nearly identical symptoms.

PMID:
28814545
PMCID:
PMC5773101
DOI:
10.1126/scitranslmed.aal2717
[Indexed for MEDLINE]
Free PMC Article

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