https://www.frontiersin.org/articles/10.3389/fmed.2021.666554/full

REVIEW article
Front. Med., 18 August 2021 | https://doi.org/10.3389/fmed.2021.666554

Recent Progress in Lyme Disease and Remaining Challenges

Jason R. Bobe1*, Brandon L. Jutras2, Elizabeth J. Horn3, Monica E. Embers4, Allison Bailey1, Robert L. Moritz5, Ying Zhang6, Mark J. Soloski7, Richard S. Ostfeld8, Richard T. Marconi9, John Aucott7, Avi Ma’ayan1, Felicia Keesing10, Kim Lewis11, Choukri Ben Mamoun12, Alison W. Rebman7, Mecaila E. McClune2, Edward B. Breitschwerdt13, Panga Jaipal Reddy5, Ricardo Maggi13, Frank Yang14, Bennett Nemser15, Aydogan Ozcan16, Omai Garner16, Dino Di Carlo16, Zachary Ballard16, Hyou-Arm Joung16, Albert Garcia-Romeu17, Roland R. Griffiths17, Nicole Baumgarth18 and Brian A. Fallon19

Lyme disease (also known as Lyme borreliosis) is the most common vector-borne disease in the United States with an estimated 476,000 cases per year. While historically, the long-term impact of Lyme disease on patients has been controversial, mounting evidence supports the idea that a substantial number of patients experience persistent symptoms following treatment. The research community has largely lacked the necessary funding to properly advance the scientific and clinical understanding of the disease, or to develop and evaluate innovative approaches for prevention, diagnosis, and treatment. Given the many outstanding questions raised into the diagnosis, clinical presentation and treatment of Lyme disease, and the underlying molecular mechanisms that trigger persistent disease, there is an urgent need for more support. This review article summarizes progress over the past 5 years in our understanding of Lyme and tick-borne diseases in the United States and highlights remaining challenges.