Annexin A2 antibodies in post-treatment Lyme disease

John B Miller; Alison W Rebman; Marcia Daniela Villegas de Flores; Hong Wang; Erika Darrah; John N Aucott

doi:10.1177/20499361241242971

Annexin A2 antibodies in post-treatment Lyme disease

Ther Adv Infect Dis. 2024 Mar 30:11:20499361241242971. doi: 10.1177/20499361241242971. eCollection 2024 Jan-Dec.

Authors

John B Miller¹, Alison W Rebman², Marcia Daniela Villegas de Flores², Hong Wang², Erika Darrah², John N Aucott²

Affiliations

¹ Division of Rheumatology, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Mason F Lord Building Center Tower, Suite 4100, Baltimore, MD 21224, USA.
² Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Abstract

Background: Anti-annexin A2 (AA2) antibodies have been described in Lyme arthritis and erythema migrans, although they have not been described in post-treatment Lyme disease (PTLD).

Objectives: Determine whether anti-AA2 antibodies are present among patients with PTLD and determine the clinical relevance of these antibodies.

Design and methods: Anti-AA2 levels were tested serially in a longitudinal cohort of 44 patients with acute Lyme disease, 22 with a return to health (EM RTH), and 22 with PTLD. Anti-AA2 antibodies were also assessed in a cross-sectional group of 281 patients with PTLD.

Results: Anti-AA2 antibodies were highest after antimicrobial therapy in both the EM RTH and PTLD cohorts. By 6 months, there was no difference between EM RTH and healthy controls. Anti-AA2 antibodies were higher in the cross-sectional PTLD group (79.69 versus 48.22 units, p < 0.0001), though with no difference in total symptom burden.

Conclusion: Anti-AA2 persists in PTLD, though did not identify a clinical phenotype.

Keywords: Lyme disease; anti-Annexin A2; autoantibodies.