Metabolic Differentiation Of Early Lyme Disease From Southern Tickassociated Rash Illness (Stari)

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 unbiasedmetabolomics 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.

Publication Date

8-16-2017

Publication Title

Science Translational Medicine

Volume

9

Issue

403

Document Type

Article

Personal Identifier

scopus

DOI Link

https://doi.org/10.1126/scitranslmed.aal2717

Socpus ID

85027685062 (Scopus)

Source API URL

https://api.elsevier.com/content/abstract/scopus_id/85027685062

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