PROSSECO

PROSSECO: Understanding Recovery from Lyme Disease

Prospective Study of Symptoms, Events, and Clinical Outcomes with Lyme Disease

What We’re Studying

The PROSSECO study, funded by the National Institutes of Health (NIH), follows people from the moment they’re diagnosed with Lyme disease. By following participants from day one, we’re learning what is associated with faster recovery from the infection.

Why This Matters

Most people feel better within months after antibiotic treatment. But for an estimated 10-15% of patients (range 5-35%), symptoms like fatigue, pain, or brain fog can linger for greater than 6 months or even years. This condition is sometimes called “Chronic Lyme Disease,” though doctors use the medical term Post-Treatment Lyme Disease Syndrome (PTLDS).

Why does this happen? We don’t know. Possibilities that have been raised include:

Residual bacteria or bacterial components that keep the immune system activated
Reactivation of dormant viruses
Changes in the body’s microbiome
Autoimmune responses
Differences in bacterial strains or human genetics

How the Study Works

We enroll patients at their earliest sign of Lyme disease – usually when the telltale erythema migrans rash appears. This timing is crucial because it helps us track symptoms that are linked to the development of Lyme disease, and not other conditions with similar symptoms like Long COVID.

What we collect:

Skin, blood, urine, and stool samples

Samples are collected multiple times over 15 months

Information about patient’s symptoms and course to recovery

What we’re looking for:

Differences between people who recover quickly and those who don’t including but not limited to the following areas:

Genetic and functional differences between infecting strains of bacteria

Presence of the Lyme bacteria or their components

Co-infections with other bacteria, viruses and parasites

Markers of inflammation and immune activation

Genetic encoded differences in how individuals respond to infection

Autoimmune markers such as autoantibody production and development of autoreactive immune cells

Microbiome composition

Beyond Acute Lyme Disease: Cross-Sectional Community Cohort

PROSSECO also includes a Cross-Sectional Community Cohort-a study of people living in Lyme-endemic areas who provide samples at a single point in time. This Community Cohort includes people who may have:

A history of Lyme disease with ongoing symptoms (PTLDS)

Suspected past Lyme exposure

No previous Lyme disease (for comparison)

By comparing samples from the Community Cohort with our acute Lyme disease participants, we hope to develop diagnostic tests that can identify PTLDS and predict recovery outcomes, even for people who weren’t followed from their initial infection.

Our Teams

PROSSECO is a collaboration between: • Tufts University School of Medicine • Tufts Medicine • Mass General Brigham • MaineHealth Our goal is to enroll up to 1,200 patients with acute Lyme disease and 2,500 people in the Community Cohort across approximately 20 sites in New England over the next 5 years.