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Scientists have identified a group of immune molecules that could help doctors catch Lyme disease earlier and identify patients whose symptoms linger long after treatment ends.
The findings, led by Tufts University School of Medicine, could pave the way for better tests that catch Lyme disease in its earliest stages, when antibiotics work best, and help doctors identify patients still struggling with symptoms after treatment.
Why Current Tests Fall Short
Lyme disease is easiest to treat soon after infection, but existing tests often miss cases during that narrow window.
Standard tests look for antibodies the immune system makes in response to the bacterium Borrelia burgdorferi. These antibodies can take weeks to show up, and they often stay detectable for years after the infection is gone. That makes it hard to tell whether someone has an active infection or is dealing with the aftereffects of one cleared long ago.
Earlier work by the study’s senior author, Peter Gwynne, part of the Tufts University Lyme Disease Initiative, found that Lyme bacteria trigger antibodies against certain lipids, or fats, that the bacteria take from their human hosts. Unlike the antibodies used in current tests, these anti-lipid antibodies appear early in infection and drop off after successful treatment.
What the New Study Found
Building on that earlier work, researchers analyzed blood samples from 199 people diagnosed with Lyme disease, including some with symptoms that persisted for months or years after treatment. They tracked anti-lipid antibody levels over time and compared them with samples from healthy volunteers and people with conditions that can look similar to post-treatment Lyme disease syndrome, such as lupus, multiple sclerosis, fibromyalgia, long COVID and chronic fatigue syndrome.
Three anti-lipid antibodies turned up at higher levels during Lyme disease infection. Two of them, anti-phosphatidic acid (αPA) and anti-phosphatidylserine (αPS), were elevated at diagnosis, even in some patients who had not yet tested positive on standard tests. That suggests the antibodies could help flag infections earlier. Patients with lingering symptoms after treatment were also more likely to have elevated αPS levels months later.
Researchers say a temporary rise in these antibodies may point to a new infection, while persistent elevation of αPS is linked to ongoing symptoms in some patients. Notably, elevated αPS levels were common among many patients with persistent symptoms but largely absent in those with other autoimmune and chronic conditions that can mimic post-treatment Lyme disease syndrome.
Gwynne told Newsweek: “Existing tests for Lyme disease are nowhere near where they should be in some important areas: detecting infections early, providing proof of cure, differentiating new from historic infections, and testing for chronic disease. We wanted to see if our alternative antibodies could help any of those areas, so we had to get samples covering a wide timeline, from the day of infection to several decades later. We had a lot of help from a lot of people (the author list) to assemble that sample bank.”
He added: “We found that the anti-lipid antibodies come up earlier than the traditional diagnostic antibodies, so they might be useful for diagnosing people in the first few weeks of infection. Their levels also rise and fall more dynamically than the current tests, so could be more responsive to treatment and able to track people getting sick and then getting better.”
What Comes Next
The researchers caution the findings do not yet support a new clinical test. Larger studies are needed to confirm how accurately the markers detect infection and predict long-term symptoms.
To answer those questions, Gwynne and co-author Linden Hu are turning to a large multi-institution study led by Tufts that follows patients for up to 15 months after diagnosis. Using samples from that trial, the team plans to test whether anti-lipid antibodies can reliably identify early infections and predict which patients go on to develop prolonged symptoms.
“If confirmed by further studies like the clinical trial, those differences could point researchers toward new therapies for people experiencing long-lasting symptoms despite being treated for Lyme disease,” Gwynne said.
The researchers’ work was supported by the NIH, Department of Defense, and the Bay Area Lyme Foundation.
Reference
Gwynne, P., Hu L., et al. (2026), Antiphospholipid antibodies in acute and post-treatment Lyme disease. American Society for Microbiology journal ‘Infection and Immunity.’ https://journals.asm.org/doi/10.1128/iai.00192-26
Contact Newsweek editors on this story: Kara Dolman and Emma Lee-Sang
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