New Paths for Diagnosing and Treating Lyme Disease with Brandon Jutras, PhD

“Folks that have been experiencing long-term complications associated with Lyme disease, they're the original long COVID …  I think it is shaping how physicians and basic scientists like me think about these types of post-infectious sequelae or post-acute infectious sequelae and how they can shape the immune system, be it positive and obviously negative. It's my hope that we'll continue to think outside the box in terms of our understanding of these systems and allow us to put aside what we think and ask the fundamental basic science questions.” 

— Brandon Jutras, PhD 

• Associate Professor of Microbiology-Immunology

Recent studies from the Jutras lab could lead to better diagnosis and treatment of Lyme disease and shed light on why some people experience more severe symptoms. 

• Lyme disease can often be resolved with a short course of antibiotics, but in other cases, symptoms such as fatigue, inflammation, pain, sleep problems, depressed mood and clouded thinking can persist for months or even years. 
• Jutras explains why Lyme disease is so difficult to diagnose and treat compared to other bacterial infections. He says the bacteria disseminate quickly throughout the body, never reaching high concentrations in tissues, which makes it very hard to culture in a laboratory setting. Current diagnostic tests rely on detecting the body’s immune response rather than the infection itself, which can take weeks to develop and may fail entirely in immunocompromised patients. This leaves open a critical gap during the most important treatment window, which is six to eight weeks after being bit by an infected tick. 
• His interest in unusual organisms led him to study the bacterium that causes Lyme disease and has evolved to focus on the microbes ticks carry and how those pathogens cause disease. While he is a basic scientist, one of his goals at Feinberg is to work closely with physicians treating Lyme disease and their patients to better understand, detect and treat the disease.   
• Currently, he says physicians look for a bullseye rash on a patient’s body or rely on patient symptoms and exposure history to prescribe antibiotics before diagnostic confirmation is possible. The standard treatment is a high-dose of the antibiotic doxycycline, taken over an extended period. This route can be effective when administered early, but it also disrupts the gut microbiome and may affect human cells. 
• In some people who have been treated for Lyme disease, severe symptoms persist such as joint swelling, fatigue and inflammation for months or years. This phenomenon affects an estimated 10 to 15 percent of patients after appropriate antibiotic therapy.  
• Jutras describes his lab’s discovery of a bacterial cell wall molecule, peptidoglycan, that can persist in joint fluid long after infection. Unique chemical properties of the Lyme bacterium’s peptidoglycan appear to drive chronic inflammation, offering a possible explanation for ongoing symptoms even when active infection is no longer detectable. 
• His two recent preclinical studies, published in Science Translational Medicine, point toward new therapeutic and diagnostic directions.  
• His team identified the antibiotic piperacillin as a highly effective treatment that clears Lyme bacteria at dramatically lower doses than doxycycline, minimizing damage to the microbiome.  
• The lab also found that Lyme disease peptidoglycan triggers a distinct immune response linked to energy metabolism and inflammation, with similarities to other post-infectious conditions like long COVID. These findings suggest that individual genetic responses may influence who develops persistent symptoms and raises the possibility of future tests to identify at-risk patients and tailor treatment accordingly. 

Additional reading:

• Read more about a drug identified to treat Lyme disease in Science Translational Medicine.
• Learn about the companion study that identified a new type of peptidoglycan.
• Jutras won a prize from the Global Lyme Alliance. Read the story here.