Brunkow, M. E. | bioRxiv Science

bioRxiv2025

Multiomics Reveals Compartmentalized Immune Responses and Tissue-Vascular Signatures in Lyme Disease

Lyme disease (LD) is growing in incidence, with nearly 500,000 cases diagnosed annually in the United States. Despite treatment, some patients experience persistent symptoms. The immune mechanisms underlying LD remain poorly understood. We conducted a multiomic longitudinal analysis of 49 LD patients and matched controls, integrating plasma proteomics, metabolomics, PBMC immunophenotyping, and a meta-analysis of skin lesions. We identified compartmentalized immune responses in acute LD, with coordinated alterations in circulating plasma proteins and metabolites linked to endothelial barrier stability, metabolic reprogramming, and symptom severity, predominantly traced to tissue and vascular immune processes at the site of infection. In contrast, PBMCs remained largely quiescent, revealing a disconnect between localized tissue responses and systemic immunity. These findings provide novel insights into LD pathophysiology and highlight the potential for diagnostics leveraging tissue and vascular immune markers detectable in blood. They also provide a resource for biomarker discovery and predictive modeling to improve LD management.

immunology↗

bioRxiv2019

Measurement of organ-specific and acute-phase blood protein levels in early Lyme disease

Lyme disease results from infection of humans with the spirochete Borrelia burgdorferi. The first and most common clinical manifestation is the circular, inflamed skin lesion referred to as erythema migrans; later manifestations result from infections of other body sites. Laboratory diagnosis of Lyme disease can be challenging in patients with erythema migrans because of the time delay in the development of specific diagnostic antibodies against Borrelia. Reliable blood biomarkers for the early diagnosis of Lyme disease in patients with erythema migrans are needed. Here, we performed selected reaction monitoring, a targeted mass spectrometry-based approach, to measure selected proteins that 1) are known to be predominantly expressed in one organ (i.e., organ-specific blood proteins) and whose blood concentrations may change as a result of Lyme disease, or 2) are involved in acute immune responses. In a longitudinal cohort of 40 Lyme disease patients and 20 healthy controls, we identified 10 proteins with significantly altered serum levels in patients at the time of diagnosis, and we also developed a 10-protein panel identified through multivariate analysis. In an independent cohort of patients with erythema migrans, six of these proteins, APOA4, C9, CRP, CST6, PGLYRP2 and S100A9, were confirmed to show significantly altered serum levels in patients at time of presentation. Nine of the 10 proteins from the multivariate panel were also verified in the second cohort. These proteins, primarily innate immune response proteins or proteins specific to liver, skin or white blood cells, may serve as candidate blood biomarkers requiring further validation to aid in the laboratory diagnosis of early Lyme disease.

systems biology↗