Duration of Antibiotic Therapy for Lyme Disease
Authors: Raphael B. Stricker, Edward L. McNeil
Journal: Annals of Internal Medicine (2004)

Letters17 February 2004Duration of Antibiotic Therapy for Lyme DiseaseRaphael B. Stricker, MD and Edward L. McNeil, MDRaphael B. Stricker, MDFrom California Pacific Medical Center, San Francisco, CA 94108; and Bowen Microbiology Research Institute, Palm Harbor, FL 34684.Search for more papers by this author and Edward L. McNeil, MDFrom California Pacific Medical Center, San Francisco, CA 94108; and Bowen Microbiology Research Institute, Palm Harbor, FL 34684.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-4-200402170-00027-w1 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In his editorial on the duration of antibiotic therapy for Lyme disease, Allen Steere discussed the pathogenesis of chronic Lyme disease symptoms (1). Steere attributed these symptoms to a “postinfectious” autoimmune syndrome that is triggered by Borrelia burgdorferi infection and cited human leukocyte function-associated antigen-1 (also known as human leukocyte function antigen type 1, or LFA-1) as a possible target autoantigen in chronic Lyme arthritis. This view is puzzling and surprising, because recent studies by Steere himself (2) and others (3) have discounted LFA-1 as a “relevant” autoantigen in chronic Lyme disease. Consequently, the role of autoimmunity ...References1. Steere AC. Duration of antibiotic therapy for Lyme disease [Editorial]. Ann Intern Med. 2003;138:761-2. [PMID: 12729432] LinkGoogle Scholar2. Steere AC, Falk B, Drouin EE, Baxter-Lowe LA, Hammer J, Nepom GT. Binding of outer surface protein A and human lymphocyte function-associated antigen 1 peptides to HLA-DR molecules associated with antibiotic treatment-resistant Lyme arthritis. Arthritis Rheum. 2003;48:534-40. [PMID: 12571864] CrossrefMedlineGoogle Scholar3. Kalish RS, Wood JA, Golde W, Bernard R, Davis LE, Grimson RC, et al . Human T lymphocyte response to Borrelia burgdorferi infection: no correlation between human leukocyte function antigen type 1 peptide response and clinical status. J Infect Dis. 2003;187:102-8. [PMID: 12508152] CrossrefMedlineGoogle Scholar4. Phillips SE, Bransfield R, Sherr VT, Brand S, Smith HA, Dickson K, et al. Evaluation of antibiotic treatment in patients with persistent symptoms of Lyme disease: an ILADS position paper. Accessed at www.ilads.org/stricker.htm on 10 May 2003. Google Scholar5. Lautin A, McNeil EL, Liegner KB, Stricker ZB, Sigel LH. Lyme disease controversy: use and misuse of language [Letter]. Ann Intern Med. 2002;137:775-7. [PMID: 12416964] LinkGoogle Scholar6. Harvey WT, Salvato P. ‘Lyme disease’: ancient engine of an unrecognized borreliosis pandemic? Med Hypotheses. 2003;60:742-59. [PMID: 12710914] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From California Pacific Medical Center, San Francisco, CA 94108; and Bowen Microbiology Research Institute, Palm Harbor, FL 34684. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoLyme Disease Controversy: Use and Misuse of Language Andrew Lautin Lyme Disease Controversy: Use and Misuse of Language Edward L. McNeil Lyme Disease Controversy: Use and Misuse of Language Kenneth B. Liegner Lyme Disease Controversy: Use and Misuse of Language Raphael B. Stricker Lyme Disease Controversy: Use and Misuse of Language Leonard H. Sigal Duration of Antibiotic Therapy for Lyme Disease Allen C. Steere Duration of Antibiotic Therapy for Lyme Disease Allen C. Steere Metrics Cited byCounterpoint: Long-Term Antibiotic Therapy Improves Persistent Symptoms Associated with Lyme DiseaseChronic infection in ‘post-Lyme borreliosis syndrome’Lyme disease: point/counterpoint 17 February 2004Volume 140, Issue 4Page: W-6KeywordsAntibioticsAntigensAutoantigenAutoimmunityInfectious diseasesLyme diseasePathogenesisPatients ePublished: 17 February 2004 Issue Published: 17 February 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...