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Vaccination against Lyme disease: past, present, and future.

Embers ME, Narasimhan S - Front Cell Infect Microbiol (2013)

Bottom Line: Lyme borreliosis is a zoonotic disease caused by Borrelia burgdorferi sensu lato bacteria transmitted to humans and domestic animals by the bite of an Ixodes spp. tick (deer tick).In this review we discuss the enzootic cycle of B. burgdorferi, and the unique opportunities it poses to block infection or transmission at different levels.We present the correlates of protection for this infectious disease, the pros and cons of past vaccination strategies, and new paradigms for future vaccine design that would include elements of both the vector and the pathogen.

View Article: PubMed Central - PubMed

Affiliation: Division of Bacteriology and Parasitology, Tulane National Primate Research Center, Covington, LA, USA. members@tulane.edu

ABSTRACT
Lyme borreliosis is a zoonotic disease caused by Borrelia burgdorferi sensu lato bacteria transmitted to humans and domestic animals by the bite of an Ixodes spp. tick (deer tick). Despite improvements in diagnostic tests and public awareness of Lyme disease, the reported cases have increased over the past decade to approximately 30,000 per year. Limitations and failed public acceptance of a human vaccine, comprised of the outer surface A (OspA) lipoprotein of B. burgdorferi, led to its demise, yet current research has opened doors to new strategies for protection against Lyme disease. In this review we discuss the enzootic cycle of B. burgdorferi, and the unique opportunities it poses to block infection or transmission at different levels. We present the correlates of protection for this infectious disease, the pros and cons of past vaccination strategies, and new paradigms for future vaccine design that would include elements of both the vector and the pathogen.

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Points at which interruption of B. burgdorferi transmission to humans can be achieved through vaccination.
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Figure 1: Points at which interruption of B. burgdorferi transmission to humans can be achieved through vaccination.

Mentions: Vaccination against infection is a highly effective means to control the spread of disease in a population. In general, vaccines in common use protect against highly transmissible diseases and effectiveness is largely based on the generation of herd immunity. In this review, we discuss vaccination with regard to protection against Lyme disease—a disease that is not readily transmitted from person to person, but one that is both vector-borne and one whose risk is largely influenced by geography. Despite these limits of contagion, Lyme disease has become a serious and expensive public health problem. The impetus for development of a vaccine gained momentum in the 1990's and led to the approval of the first Lyme disease vaccine for human use. Only on the market for 4 years, several factors led to its failure and enthusiasm for a subsequent product may be founded more in basic science than in the pharmaceutical industry. Prominent scientists have, however, called for renewed interest in a Lyme disease vaccine (Plotkin, 2011; Poland, 2011). Among them, renowned vaccinologist Stanley Plotkin published an article calling the removal of the Lyme vaccine a “public health fiasco (Plotkin, 2011).” Notwithstanding, the possible avenues to protect against Lyme disease include interruption of transmission and infection at multiple points (Figure 1). Current research extends potential well beyond simple vaccination of humans and here we highlight specific approaches, with emphasis on vaccination against the tick vector.


Vaccination against Lyme disease: past, present, and future.

Embers ME, Narasimhan S - Front Cell Infect Microbiol (2013)

Points at which interruption of B. burgdorferi transmission to humans can be achieved through vaccination.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3569838&req=5

Figure 1: Points at which interruption of B. burgdorferi transmission to humans can be achieved through vaccination.
Mentions: Vaccination against infection is a highly effective means to control the spread of disease in a population. In general, vaccines in common use protect against highly transmissible diseases and effectiveness is largely based on the generation of herd immunity. In this review, we discuss vaccination with regard to protection against Lyme disease—a disease that is not readily transmitted from person to person, but one that is both vector-borne and one whose risk is largely influenced by geography. Despite these limits of contagion, Lyme disease has become a serious and expensive public health problem. The impetus for development of a vaccine gained momentum in the 1990's and led to the approval of the first Lyme disease vaccine for human use. Only on the market for 4 years, several factors led to its failure and enthusiasm for a subsequent product may be founded more in basic science than in the pharmaceutical industry. Prominent scientists have, however, called for renewed interest in a Lyme disease vaccine (Plotkin, 2011; Poland, 2011). Among them, renowned vaccinologist Stanley Plotkin published an article calling the removal of the Lyme vaccine a “public health fiasco (Plotkin, 2011).” Notwithstanding, the possible avenues to protect against Lyme disease include interruption of transmission and infection at multiple points (Figure 1). Current research extends potential well beyond simple vaccination of humans and here we highlight specific approaches, with emphasis on vaccination against the tick vector.

Bottom Line: Lyme borreliosis is a zoonotic disease caused by Borrelia burgdorferi sensu lato bacteria transmitted to humans and domestic animals by the bite of an Ixodes spp. tick (deer tick).In this review we discuss the enzootic cycle of B. burgdorferi, and the unique opportunities it poses to block infection or transmission at different levels.We present the correlates of protection for this infectious disease, the pros and cons of past vaccination strategies, and new paradigms for future vaccine design that would include elements of both the vector and the pathogen.

View Article: PubMed Central - PubMed

Affiliation: Division of Bacteriology and Parasitology, Tulane National Primate Research Center, Covington, LA, USA. members@tulane.edu

ABSTRACT
Lyme borreliosis is a zoonotic disease caused by Borrelia burgdorferi sensu lato bacteria transmitted to humans and domestic animals by the bite of an Ixodes spp. tick (deer tick). Despite improvements in diagnostic tests and public awareness of Lyme disease, the reported cases have increased over the past decade to approximately 30,000 per year. Limitations and failed public acceptance of a human vaccine, comprised of the outer surface A (OspA) lipoprotein of B. burgdorferi, led to its demise, yet current research has opened doors to new strategies for protection against Lyme disease. In this review we discuss the enzootic cycle of B. burgdorferi, and the unique opportunities it poses to block infection or transmission at different levels. We present the correlates of protection for this infectious disease, the pros and cons of past vaccination strategies, and new paradigms for future vaccine design that would include elements of both the vector and the pathogen.

Show MeSH
Related in: MedlinePlus