2019 Jan;68(1):7-17. doi: 10.1007/s00011-018-1180-5. Epub 2018 Aug 18.

Metabolites of prostaglandin synthases as potential biomarkers of Lyme disease severity and symptom resolution.



Lyme disease or Lyme borreliosis (LB) is the commonest vector-borne disease in the North America. It is an inflammatory disease caused by the bacterium Borrelia burgdorferi. The role of the inflammatory processes mediated by prostaglandins (PGs), thromboxanes and leukotrienes (LTs) in LB severity and symptoms resolution is yet to be elucidated.


We aim to systematically review and evaluate the role of PGs and related lipid mediators in the induction and resolution of inflammation in LB.


We conducted a comprehensive search in PubMed, Ovid MEDLINE(R), Embase and Embase Classic to identify cell-culture, animal and human studies reporting the changes in PGs and related lipid mediators of inflammation during the course of LB.


We identified 18 studies to be included into this systematic review. The selected reports consisted of seven cell-culture studies, seven animal studies, and four human studies (from three patient populations). Results from cell-culture and animal studies suggest that PGs and other lipid mediators of inflammation are elevated in LB and may contribute to disease development. The limited number of human studies showed that subjects with Lyme meningitis, Lyme arthritis (LA) and antibiotic-refractory LA had increased levels of an array of PGs and lipid mediators (e.g., LTB4, 8-isoPGF, and phospholipases A2 activity). Levels of these markers were significantly reduced following the treatment with antibiotics or non-steroidal anti-inflammatory drugs.


Dysregulation of prostaglandins and related lipid mediators may play a role in the etiology of LB and persistence of inflammation that may lead to long-term complications. Further investigation into the precise levels of a wide range of PGs and related factors is critical as it may propose novel markers that can be used for early diagnosis.



Systematic reviews are only as good as the studies they utilize. The area of Lyme research is notoriously controlled by “The Cabal,” a highly vested group of individuals rife with conflicts of interests.

The “limited” number of human studies is two-fold: 1) the entrance parameters into studies requires a positive on the CDC-two tiered testing (which misses half of all cases & leaves out a huge subset of patients) as well as having the EM rash which is highly variable with patients (studies show 25-80% get it, and some not at all), and 2) anyone who doesn’t agree with the long-held CDC/IDSA narrative that Lyme is hard to catch and easy to treat and doesn’t persist, struggles to be heard and published:  Numerous researchers have told the same sordid tale:

Christian Perronne, physician on the infectious diseases faculty at the University of Versailles-St Quentin, France, states,

“If you try to publish a little bit different from the guidelines, it’s anti-science.”

What researcher in their right mind wants to swim up this stream? Only a few and we are so thankful to have them!

I find it interesting that although patients improve with antibiotics (as clearly stated right here in this article) authorities state antibiotics don’t help. Their studies are rigged for a preconceived outcome. I would not be writing today without numerous long-term antibiotics used judiciously. I can say the same for many other patients. Antimicrobials, of course, are only one prong of treatment and it’s a holistic venture requiring many modalities, experience, and a lot of savvy.

The polarization continues.
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