Could slowing Lyme spirochete movement improve treatment?

Spirochete movement affects infection behavior
Motility may influence virulence and tissue spread
Laboratory studies suggest slowing movement could alter survival

Lyme spirochete movement may play an important role in how Borrelia burgdorferi spreads through tissues, avoids immune defenses, and contributes to infection. Researchers have examined whether slowing spirochete motility could reduce virulence or improve bacterial clearance.

The Lyme disease bacterium moves in an undulating corkscrew-like pattern throughout the body. “The flagella reside within the periplasm, the space between the bacterial cell wall and the outer membrane,” according to Harman from the Department of Molecular and Cellular Biology at the University of Arizona. [1]

“Rotation of the flagella within the periplasm causes the waveform to propagate, leading to a traveling wave undulation of the entire body.” [1]

Understanding how spirochetes move may help explain tissue invasion, dissemination, and why motility is often discussed as a potential treatment target.

Motility may represent one component of the broader biologic pathways discussed in persistent Lyme disease mechanisms.

How do Lyme spirochetes move?

Borrelia burgdorferi uses internal flagella that sit beneath the outer membrane rather than projecting outside the bacterium.

This internal arrangement gives Lyme spirochetes their characteristic corkscrew movement and may help them move through connective tissue, extracellular matrices, and narrow tissue spaces.

The researchers’ earlier mathematical modeling predicted that the shape of the Lyme disease spirochete itself might affect pathogenesis.

“It is likely that the specific shape of B. burgdorferi is important in its ability to infect mammals,” Harman explains. “Consequently, altering the shape and/or stiffness of the bacterium could affect pathogenesis.” [1]

Can slowing spirochete movement affect treatment?

Several antibiotics are known to affect bacterial cell wall synthesis.

“Although doxycycline acts through inhibition of protein synthesis, amoxicillin and cefuroxime axetil both interfere with cell wall synthesis.” According to Harman, “Disruption of either the cell wall itself or of the proteins that are involved in synthesizing it eventually leads to cell lysis.” [1]

For additional treatment discussions see persistent Lyme disease and Lyme persister cells.

These findings raise a broader question: if motility influences virulence, could altering bacterial movement become another way to weaken infection behavior?

The researchers chose vancomycin to examine the effects of antibiotics on cell wall synthesis.

Vancomycin “has previously been shown to be active against B. burgdorferi in vitro” in two studies cited by the authors. [2,3]

The researchers were also able to alter both shape and swimming speed of Lyme spirochetes in laboratory experiments.

What happened when researchers slowed Lyme spirochete motility?

Vancomycin reduced swimming speed by approximately 15% through reducing cell wall stiffness.

The authors concluded that “since motility is crucial to the virulence of B. burgdorferi, the results suggest that sublethal doses of antibiotics could negatively impact spirochete survival by impeding their swim speed, thereby enabling their capture and elimination by phagocytes.” [1]

These findings support the idea that bacterial movement itself may influence survival and immune clearance.

Important limitations of this research

The conclusions are based entirely on laboratory data.

It remains unclear whether findings from controlled in vitro environments translate into human disease.

It is also uncertain whether vancomycin itself will be studied clinically for this purpose, as use of the medication is generally reserved for severe infections such as MRSA and resistant organisms. [4]

Why spirochete movement may affect Lyme disease severity

Spirochete movement may influence:

• Tissue penetration
• Immune evasion
• Dissemination through the body
• Virulence
• Response to environmental stressors

Understanding how Lyme spirochetes move may help researchers better understand infection behavior and identify future treatment targets.

Frequently Asked Questions

How do Lyme spirochetes move?

Lyme spirochetes move using internal flagella located within the periplasmic space, producing a corkscrew-like motion that may help tissue penetration.

Can slowing spirochete movement improve Lyme treatment?

Laboratory studies suggest slowing motility may affect bacterial survival, but this has not been proven to improve outcomes in humans.

What is corkscrew motility in Lyme disease?

Corkscrew motility refers to the characteristic twisting movement of spirochetes that helps them navigate tissue spaces.

Does vancomycin treat Lyme disease?

This study examined vancomycin in laboratory conditions. The findings should not be interpreted as evidence supporting routine use for Lyme disease treatment.

Why is spirochete movement important?

Motility may contribute to dissemination, virulence, tissue penetration, and survival within the host.

Clinical Takeaway

Laboratory studies suggest that Lyme spirochete movement may contribute to bacterial survival and virulence.

Research into motility raises important questions about whether slowing bacterial movement could influence treatment response or immune clearance.

For now, Lyme spirochete motility remains an important biologic mechanism under investigation rather than an established treatment target.

Related Articles

Neurologic Lyme disease
Lyme disease symptoms guide
Recovery from Lyme disease
Biofilms in Lyme disease

References

1. Harman MW, Hamby AE, Boltyanskiy R, Belperron AA, Bockenstedt LK, Kress H, Dufresne ER, Wolgemuth CW. Vancomycin Reduces Cell Wall Stiffness and Slows Swim Speed of the Lyme Disease Bacterium. Biophys J. 2017;112(4):746-754.
2. Dever LL, Jorgensen JH, Barbour AG. In vitro activity of vancomycin against the spirochete Borrelia burgdorferi. Antimicrob Agents Chemother. 1993;37(5):1115-1121.
3. Hunfeld KP, Weigand J, Wichelhaus TA, Kekoukh E, Kraiczy P, Brade V. In vitro activity of mezlocillin, meropenem, aztreonam, vancomycin, teicoplanin, ribostamycin and fusidic acid against Borrelia burgdorferi. Int J Antimicrob Agents. 2001;17(3):203-208.
4. Bruniera FR, Ferreira FM, Saviolli LR, Bacci MR, Feder D, da Luz Goncalves Pedreira M, Sorgini Peterlini MA, Azzalis LA, Campos Junqueira VB, Fonseca FL. The use of vancomycin with its therapeutic and adverse effects: a review. Eur Rev Med Pharmacol Sci. 2015;19(4):694-700.

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Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.

Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention