Bacteria that are able to persist in hosts to cause long term infections are, by definition, able to evade host immune defenses. While establishment of persistent infection can benefit the bacteria, in certain cases where the bacteria itself causes little damage, allowing the establishment of prolonged infection may be more beneficial to the host than continued attack by the immune system. Borrelia burgdorferi, the causative agent of Lyme disease, produces no toxins or other virulence factors thought to damage the host. Instead, most of the manifestations of Lyme disease are thought to be the result of the immune response to the organism. In its natural Peromyscus mouse host, little or no reaction to the organism is typically seen despite the fact that, once infected, the organism persists for the life of the animal. In humans and inbred mice (which do develop immune responses to the organism), inflammation is thought to be initiated by receptors of the innate immune system. In vitro, loss of receptors of the innate immune system that recognize B. burgdorferi such as toll-like receptor 2 (TLR2) or Nod2 results in a decrease inflammatory response. However, in vivo studies of animals deficient in these receptors or their adaptor molecules have not reduced inflammation and in many cases, have actually resulted in increased inflammation. We hypothesize that the host has evolved methods for dampening the immune response over time and that during the course of prolonged exposure, these receptors play a more important role in triggering innate immune tolerance, rather than activating acute inflammatory pathways. In preliminary studies, we have shown that exposure of macrophages to B. burgdorferi can reduce release of inflammatory cytokines and increase release of anti-inflammatory cytokines upon re-exposure to the organism. In this proposal, we will first identify pathways and mechanisms involved in mediating innate immune tolerance to B. burgdorferi. We will study both pathways that have been identified in playing a role in tolerance to other agents (e.g. lipopolysaccharide) as well as perform unbiased studies to identify new mechanisms.
In Aim 2, we will develop animal models to study the importance of innate immune tolerance in Lyme disease. We will test both ex vivo and in vivo systems for isolating the role of different pathways during B. burgdorferi infection. Successful completion of these experiments will provide proof of principle for a new strategy of host defense (mutualism or ?benign neglect?) against organisms that are considered pathogens and establish a rationale for the existence of innate immune tolerance.

Public Health Relevance

Host immune systems are a double edged sword?both protecting the host, but also bringing to bear dangerous weapons that cause self-inflicted damage. For bacteria that can infect a host without causing significant damage, it may be important to control the immune response to limit self-inflicted damage. We believe that the development of tolerance to repeated stimulation by organisms that cause long term infection such that, over time, activation of the immune system is diminished despite the continued presence of the organism, is an import mechanism for self-preservation in infections such as Lyme disease.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
Exploratory/Developmental Grants (R21)
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Special Emphasis Panel (ZRG1-IDM-R (02)M)
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Ilias, Maliha R
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Tufts University
Schools of Medicine
United States
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Killpack, Tess L; Ballesteros, Maria; Bunnell, Stephen C et al. (2017) Phagocytic Receptors Activate Syk and Src Signaling during Borrelia burgdorferi Phagocytosis. Infect Immun 85:
Steere, Allen C; Strle, Franc; Wormser, Gary P et al. (2016) Lyme borreliosis. Nat Rev Dis Primers 2:16090