Sanger Sequencing of Borrelia burgdorferi flaB Paralogs Detected Spirochetemia at the Early Localized Stage of Lyme Disease

Background: The general assumption that spirochetemia does not occur at the early localized stage of Lyme disease is due to a lack of sensitive and specific methods for molecular diagnosis. Methods: During a Lym...

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Main Author: Sin Hang Lee
Format: Article
Language:English
Published: IMR Press 2025-06-01
Series:Frontiers in Bioscience-Scholar
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Online Access:https://www.imrpress.com/journal/FBS/17/2/10.31083/FBS31280
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author Sin Hang Lee
author_facet Sin Hang Lee
author_sort Sin Hang Lee
collection DOAJ
description Background: The general assumption that spirochetemia does not occur at the early localized stage of Lyme disease is due to a lack of sensitive and specific methods for molecular diagnosis. Methods: During a Lyme disease season in 2023, the platelet-rich plasma specimens of 145 people residing in Lyme disease-endemic areas in the United States were immediately separated from the blood cells following venous blood collection to prevent the spirochetes, if any, from invading the lymphocytes in the test tube. The entire DNA content was extracted from the platelet pellet and used for split sample polymerase chain reaction (PCR) amplification; Sanger sequencing was performed on the nested PCR products to detect the Borrelia burgdorferi flaB and 16S rRNA genes. Results: In 98 of the people who were clinically suspected of having early localized Lyme disease irrespective of the presence or absence of a skin lesion, 33 of their blood specimens (33.7%) were positive for Borrelia burgdorferi (B. burgdorferi), including 17 positive for flaB gene only, 15 positive for both the flaB and 16S rRNA genes, and one positive for 16S rRNA gene only. Eight (17.0%) of the 47 asymptomatic resident controls were positive for flaB PCR only. Conclusions: The flaB gene is a more sensitive chromosomal target than the 16S rRNA gene for molecular detection of one to three B. burgdorferi cells due to spirochetes gaining or retaining flaB paralogs at the early localized stage of Lyme disease.
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spelling doaj-art-261c92df91c0429789d039000bc7d9d92025-08-20T03:29:39ZengIMR PressFrontiers in Bioscience-Scholar1945-05162025-06-011723128010.31083/FBS31280S1945-0516(25)00136-4Sanger Sequencing of Borrelia burgdorferi flaB Paralogs Detected Spirochetemia at the Early Localized Stage of Lyme DiseaseSin Hang Lee0Milford Molecular Diagnostics Laboratory, Milford, CT 06460, USABackground: The general assumption that spirochetemia does not occur at the early localized stage of Lyme disease is due to a lack of sensitive and specific methods for molecular diagnosis. Methods: During a Lyme disease season in 2023, the platelet-rich plasma specimens of 145 people residing in Lyme disease-endemic areas in the United States were immediately separated from the blood cells following venous blood collection to prevent the spirochetes, if any, from invading the lymphocytes in the test tube. The entire DNA content was extracted from the platelet pellet and used for split sample polymerase chain reaction (PCR) amplification; Sanger sequencing was performed on the nested PCR products to detect the Borrelia burgdorferi flaB and 16S rRNA genes. Results: In 98 of the people who were clinically suspected of having early localized Lyme disease irrespective of the presence or absence of a skin lesion, 33 of their blood specimens (33.7%) were positive for Borrelia burgdorferi (B. burgdorferi), including 17 positive for flaB gene only, 15 positive for both the flaB and 16S rRNA genes, and one positive for 16S rRNA gene only. Eight (17.0%) of the 47 asymptomatic resident controls were positive for flaB PCR only. Conclusions: The flaB gene is a more sensitive chromosomal target than the 16S rRNA gene for molecular detection of one to three B. burgdorferi cells due to spirochetes gaining or retaining flaB paralogs at the early localized stage of Lyme disease.https://www.imrpress.com/journal/FBS/17/2/10.31083/FBS31280sanger sequencingspirochetemianested pcrearly localized lyme diseaseflab paralogssnp in flab genesingle borrelia burgdorferi cellplatelet-rich plasma
spellingShingle Sin Hang Lee
Sanger Sequencing of Borrelia burgdorferi flaB Paralogs Detected Spirochetemia at the Early Localized Stage of Lyme Disease
Frontiers in Bioscience-Scholar
sanger sequencing
spirochetemia
nested pcr
early localized lyme disease
flab paralogs
snp in flab gene
single borrelia burgdorferi cell
platelet-rich plasma
title Sanger Sequencing of Borrelia burgdorferi flaB Paralogs Detected Spirochetemia at the Early Localized Stage of Lyme Disease
title_full Sanger Sequencing of Borrelia burgdorferi flaB Paralogs Detected Spirochetemia at the Early Localized Stage of Lyme Disease
title_fullStr Sanger Sequencing of Borrelia burgdorferi flaB Paralogs Detected Spirochetemia at the Early Localized Stage of Lyme Disease
title_full_unstemmed Sanger Sequencing of Borrelia burgdorferi flaB Paralogs Detected Spirochetemia at the Early Localized Stage of Lyme Disease
title_short Sanger Sequencing of Borrelia burgdorferi flaB Paralogs Detected Spirochetemia at the Early Localized Stage of Lyme Disease
title_sort sanger sequencing of borrelia burgdorferi flab paralogs detected spirochetemia at the early localized stage of lyme disease
topic sanger sequencing
spirochetemia
nested pcr
early localized lyme disease
flab paralogs
snp in flab gene
single borrelia burgdorferi cell
platelet-rich plasma
url https://www.imrpress.com/journal/FBS/17/2/10.31083/FBS31280
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