Could Borrelia DNA Persistence Explain Ongoing Lyme Symptoms?
Borrelia DNA persistence may help explain why some patients continue to experience symptoms even after standard Lyme disease treatment.
In the article “Doctor Says You Are Cured, But You Still Feel the Pain,” Cervantes explores how persistent bacterial DNA may contribute to ongoing illness.
This research challenges common Lyme disease misconceptions about recovery and highlights the complexity of Lyme disease symptoms.
Borrelia DNA Found After Treatment
Studies have identified Borrelia DNA in both animal models and human patients after antibiotic therapy.
Persistent DNA has been detected in joint fluid, cardiac tissue, and urine months after treatment.
These findings raise important questions about whether lingering bacterial material may continue to affect the immune system.
How Borrelia DNA Persistence May Drive Symptoms
Borrelia DNA persistence may contribute to symptoms through immune activation.
Bacterial DNA can activate Toll-like receptor 9 (TLR9), an innate immune pathway that leads to type-I interferon production.
This immune response may produce symptoms such as fatigue, pain, and cognitive difficulties commonly seen in post-treatment Lyme disease syndrome (PTLDS).
These findings suggest that symptoms may persist even in the absence of detectable active infection.
Where Might Borrelia Persist?
Cervantes raises the question of where Borrelia may evade immune detection.
The organism can adapt its structure and move through fibrous tissues such as cartilage.
Because cartilage lacks blood vessels, it may serve as a protected environment where bacterial material can persist outside the reach of immune cells.
Implications for Treatment
The author discusses the potential role of antimicrobial peptides (AMPs) in addressing persistent bacterial DNA.
These peptides may help the immune system clear extracellular DNA and reduce ongoing immune activation.
Further research is needed to better understand their role in clinical care.
Clinical Perspective
Borrelia DNA persistence provides a biologic framework for understanding ongoing symptoms after Lyme disease treatment.
Whether persistent DNA represents inactive debris or ongoing infection remains unclear.
However, continued immune activation may explain why patients experience fatigue, pain, and cognitive symptoms despite prior therapy.
Clinical Takeaway
Borrelia DNA persistence may contribute to ongoing symptoms by activating immune pathways even after treatment.
Recognizing this mechanism may help explain persistent illness and guide future research and treatment strategies.
Frequently Asked Questions
Can Borrelia DNA persist after antibiotic treatment?
Yes. Studies have identified Borrelia DNA in joint fluid, heart tissue, and urine months after treatment.
Does persistent DNA mean infection is still active?
Not necessarily. Persistent DNA may represent residual material or low-level infection. Current tests cannot reliably distinguish between these possibilities.
How can persistent DNA cause symptoms?
Bacterial DNA may activate immune receptors such as TLR9, leading to inflammation and symptoms including fatigue, pain, and cognitive dysfunction.
Related Reading
- Lyme Disease Symptoms: What Patients Need to Know
- Chronic Pain in Lyme Disease
- Lyme Joint Pain and Infection
- Post-Treatment Lyme Disease Syndrome (PTLDS)
- PTLDS and Lyme Disease Recovery
- Lyme Disease Misconceptions
References
- Cervantes J. Doctor says you are cured, but you still feel the pain. Borrelia DNA persistence in Lyme disease. Microbes Infect. 2017;19(12):574–577.
- Bechtold KT, Rebman AW, Crowder LA, Johnson-Greene D, Aucott JN. Standardized symptom measurement of individuals with early Lyme disease over time. Arch Clin Neuropsychol. 2017;32(2):129–141.
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
Thank you Dr. Cameron for that thought. My experience tells me that persistance lives and damage often stays along years of recovery.
Dr. Cameron, I’m so glad that my uncle told me about you and your website.
I live in Clinton Ct, I had an awful experience with Lyme disease in 1989 a very long story. Basically most of the doctors that I saw were still pretty clueless and it took almost a year to figure out what it actually was. By then one Doc called it acute Lyme disease. They had set up a Lyme disease clinic at the UCONN health center and that’s where I ended up going, I saw numerous infectious disease doctors and neurologists. I’m still trying to find out if all the symptoms I still suffer from are the residual effects of the disease or just normal aging (aches & pains)ect… I want to know if there are any blood tests that I can have after all these years that will show any new results or diagnoses.
Lyme never showed in any of my blood tests but it did show up in my spinal fluid. Thank you
Your story is all to common. The tests still remain problematic. Doctors often have to use their clinical judgment.
There is really trouble about the find an ideal tests for diagnosing chronic/prolonged Lyme infections. ELİSPOT or LTT BORRELİA tests May be an alternative tests and DARK FİELD MİCROSCOPY For Borrelia May be a very good option to detect spirochetal and cystic forms of Borrelia bacterias in blood ( and in CSF).
I have chronic Lyme, the whole common story, symptoms, a bite but 2 negative tests. Nine years later finally got a positive result, was given three weeks of antibiotic and was told I was better in spite of worsening symptoms. I realize I will never be well. It’s so sad.
I would encourage you to seek a second opinion with a doctor experienced in treating tick borne illnesses to review your treatment options.
My daughter will be 16 in a few days, she has been diagnosed twice with lyme. The first time being around the age of 13 and the second time was at the age of 15. Her doctor is telling me the symptoms she is having are not from her history of lyme. About a year and a half ago she was severely depressed, to the point of feeling suicidal. I put her in counseling and when that wasn’t helping we put her on a low dose of antidepressants and is doing better but she is still depressed because of how she feels, she is suffering with terrible body aches, mostly muscular but she does have arthritis too. She has terrible night sweats and sometimes chills. She also gets stabbing pains in her lower back, she’s getting bad headaches and sometimes dull ones. Her school work has gone way down, all she wants to do is sleep. Her menstrual cycle is all messed up too. I need some help so my daughter can feel somewhat normal. She just keeps asking me, “why can’t I be normal mom”
I often have patients in practice with the same story. I typically look again for evidence of tick infection or co-infection in addition looking solely at other conditions. Call my office at 914 666 4665 if you have any questions.
I was diagnosed with lyme six weeks ago, I’m on my second round of amoxicillin, two weeks each round, I did have bullseye rash, I’m allergic to doxicyclene so they amped up the amoxicillin, 82 500mg pills in two weeks, twice. And now I almost can’t walk. Lancaster orthopedic group pulled two and a half tubes of fluid off my right knee Last week and my left foot is swelled up on the bottom. Terrible calf pain in both legs. Headache and dizziness, glands in head and neck and chest completely swelled up, was ct scanned with contrast so they saw that, am I going to live? My dr said I’ve been treated. Help!
There are other treatment options. Call my office at 914-666-4665 if you have any questions.