The antibody acts as an opsonin and an activator of both the alternative and classic complement pathways. IgM levels may persist long after the patient has been cured. Finally, T-cells acquire cytotoxic activity after exposure to Bb and have the ability to produce cytokines. The spirochete can be isolated from serum taken from the site of inflammation. However, it is also thought that circulating cytokines, of the Th1 subset, are also responsible for some of the symptoms, such as the non-inflammatory joint disease.
Antibiotics are the main means of treatment for the disease.
If detected early enough, oral penicillin or tetracycline is usually adequate. When the symptoms have progressed to the long-standing or disseminated disease, intravenous antibiotics may be necessary to treat the infection of several organ systems.