Resistance and rational actions as effective counter- measures in the struggle against Lyme disease

Abstract

Recent years have witnessed a growing interest in Lyme borreliosis, a diseases transmitted by ticks, which occurs in Poland and many other countries across world. Previously, foresters, hunters, and farmers were considered a high-risk group, however, the increasing physical activity in woodland areas means athletes are also at risk of contracting the disease. The aim of this study is a general review on the possibilities of counteracting Lyme disease, and efforts to combat the disease in the light of recent scientific findings. Fundamental survival strategies of living organisms include mutual interaction, independent of the elements that form it, cell structure complexity, size, or mass, as well as the ability to select the right countermeasures to vector-borne diseases. This paper specifically presents the issues of dependence and interrelationships between humans, ticks, and Lyme spirochete through a detailed presentation of the problem of Lyme disease in athletes. Furthermore, this article presents strategies used by the Lyme spirochete to infect the host's organism, strategies used by the arachnid to cause infection and its preferences in choosing a host, and principles of modern microbiolog-ical diagnostics and prophylaxis as a tool in the fight against a tick infected with B. burgdorferi.

Full text

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VOLUME 16
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HEALTH PROMOTION AND PREVENTION
is is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (http://creativecommons.org/licenses/by-nc/4.0),
which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non-commercial and is otherwise in compliance with the license.
Resistance and rational actions as effective counter-
measures in the struggle against Lyme disease
Marcin Weiner1ABCDE, Patrycja Teodorowicz2ABCD, Ewelina Niźnikowska1ABCD
1 Faculty of Health Sciences, Pope John Paul II State School of Higher Education in Biała Podlaska, Biała Podlaska,
Poland
2
Medical Laboratory, Innovation Research Center, Pope John Paul II State School of Higher Education in Biała Podlaska,
Biała Podlaska, Poland
Received: 23 March 2020; Accepted: 01 June 2020; Published online: 13 July 2020
AoBID: 13924
Abstract
 RecentyearshavewitnessedagrowinginterestinLymeborreliosis,adiseasestransmiedbycks,whichoc-
curs in Poland and many other countries across world. Previously, foresters, hunters, and farmers were con-
sideredahigh-riskgroup,however,theincreasingphysicalacvityinwoodlandareasmeansathletesarealso
atriskofcontracngthedisease.Theaimofthisstudyisageneralreviewonthepossibiliesofcounteract-
ingLymedisease,andeortstocombatthediseaseinthelightofrecentsciencndings.
  Fundamentalsurvivalstrategiesoflivingorganismsincludemutualinteracon,independentoftheelements
thatformit,cellstructurecomplexity,size,ormass,aswellastheabilitytoselecttherightcountermeasures
to vector-borne diseases.
  Thispaperspecicallypresentstheissuesofdependenceandinterrelaonshipsbetweenhumans,cks,and
Lymespirochetethrougha detailedpresentaonofthe problemofLymediseaseinathletes.Furthermore,
thisarclepresentsstrategiesusedbytheLymespirochetetoinfectthehost’sorganism,strategiesusedby
thearachnidtocauseinfeconanditspreferencesinchoosingahost,andprinciplesofmodernmicrobiolog-
icaldiagnoscsandprophylaxisasatoolintheghtagainstackinfectedwithB. burgdorferi.
Keywords:
 agonology•borreliosis•combatstrategies•interacons•interrelaonships•cks
Copyright:
© 2020, the Authors. Published by Archives of Budo
Conflict of interest:
 Authorshavedeclaredthatnocompenginterestexists
Ethical approval:
 ThestudywasapprovedbythelocalEthicsCommiee
Provenance & peer review:
 Notcommissioned;externallypeer-reviewed
Source of support:
 ThepaperwaspreparedasapartoftheprojectNo.PB/25/2020“Molecularbiologyresearchaimedatck-
bornepathogens”nancedbytheScienceDevelopmentFundofPopeJohnPaulIIStateSchool ofHigher
EducaoninBialaPodlaska,Poland
Author’s address:
 MarcinWeiner,FacultyofHealthSciences,PopeJohnPaulIIStateSchoolofHigherEducaoninBiałaPodlaska,
SidorskaStr.105,21-500BiałaPodlaska,Poland;e-mail:m.weiner@pswbp.pl
Authors’ Contribution:
A Study Design
B Data Collection
C Statistical Analysis
D Manuscript Preparation
EFunds Collection

ORIGINAL ARTICLE

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Original Article
INTRODUCTION
For several years, there has been a growing inter-
estinck-bornediseases–especiallyLymebor-
reliosis, which is currently one of the common
diseasestransmiedbycks,bothinPolandand
acrossthe world. Laboratoriesperformdozens
orevenhundredsoftestsperweektodiagnose
Lymedisease.Formerly,ckswerefearedmainly
in the summer and autumn, but nowadays, due to
globalwarming,contactwithcksispossibleeven
duringwinter.Everyyear,thereisalargeincrease
in the number of Lyme disease cases, as well as
agreaternumberofcksintheurbanenviron-
ment. Previously, foresters, hunters, and farmers,
i.e.,peopleassociatedwithbeinginthesameenvi-
ronmentascksinfectedwithB. burgdorferi, were
consideredahigh-riskgroup.However,increas-
ingphysicalacvityoutdoors,exercisinginwoods,
parks,andmeadows,meansathletesarealsovul-
nerabletothisdisease(butalsoocersofthebor-
der guard, because the forested areas of countries
between, which run through the closed borders
areaconvenientplaceforincreasedsmuggling
acvityandothercriminalacts).Asaresult,for
manypeoplethe“ckenvironment”isnotonly
aplaceindividual’scarryoutwork-relatedacvi-
esbutwheretheypursuetheirpassionsorpre-
venvehealthcare,andareatriskoffallingill.
Lymediseaseisaninfecousbacterialdiseasethat
aectsalltypesofssuesinthehumanbody.It
has several stages, may be mild, or chronic and
verydestrucve[1].Females,males,children,ado-
lescents,adults,theelderly,pets,andwildanimals
canbeinfectedwithLymeborreliosis.Thisdisease
mayshowsymptomsfortherstmeafewdays
aerackbite,butsomemesitcannotbediag-
nosedunlyearslater.Furthermore,thesymp-
tomsofLymediseaseareextremelydiverseand
similartootherillnesses.Duringthediagnosc
stage,thereareoenfalse-posiveorfalse-neg-
averesults.Whatisthedicultyofdetecng
thisdisease?Theanswerliesinthemicrobiology
oftheeologicalfactorcausingLymedisease–
in bacteria, B. burgdorferi spirochete.Mostofthe
spirocheteillnesseshaverecurrentnature.Lyme
diseaseowesits“cunning”togram-negavebac-
teria,whichhavetheappropriatemorphological
featuresbutalsoapplymolecularsurvivalstrate-
gies.Itcan“anestheze”thehost’simmunesys-
temalertnessandaackataconvenientme[2].
Inthiscase,cksarethevectorofinfecon,but
they also have their methods that facilitate reach-
ingthehost.Moreover,ckshaveindividualpref
-
erences,whichguidetheirseleconofthehosts.
In recent year cases of Lyme infecons have
increased.Thereforeitcouldbeconsideredthat
apersistent“ght”betweenB. burgdorferi spi-
rochete(constantlysearchingforimprovement
initsmethodsofinvadingthehost’sorganism),
andhumans’tryingtopreventit,bysimplemeth-
ods as well as using their immune system, and by
thelatestdiagnosctoolsandthecapabiliesof
molecular biology.
Jarosław Rudniański,the founder of the the-
oryofanunarmedstruggleandthespecicthe-
oryofcompromise,denedtheghtinamore
extensive way than his predecessor,Tadeusz
Kotarbiński, founderof the general theory of
struggle,knownasagonology.Theword“ght”
isusedinnumerouscontexts:forexamplepopu-
larnowadays“ghtwiththepandemic”,or“ght
withtheelements”,“ghtwithre”,“ghtwith
tuberculosis”, but also, due to its increasingly
commonoccurrence,“theghtagainstLymedis-
ease”.Rudniańskistatedthattheaconscalled
aght,inwhichthemostspecicfeatureisreck-
oningwiththeopponent’scountermeasures,fall
withinaverybroadclassofacons.Thisclassof
aconsischaracterizedas“areckoningthrough-
outthewholeaconwithstrongandvariedresis
-
tance,locatedinaconstantandindependentof
theperformingentyofmovementormaterial,
ortheenvironment,oraltogether”.Thismutual
interacon,independent oftheelementsthat
create them, is one of the basic elements of the
survivalstrategyoflivingorganisms.Itmustbe
notedthatitis not the complexityofthe cell
structure,size,ormassthatmaers,buttheabil-
itytoselecttheappropriatecountermeasuresto
theaconofthisspecic“opponent”.Rudniański
formulatesarule–asheclaims–ofthehighest
extentofgenerality:“(…)inanaconinwhich
the material or the environmentis in moon
independentoftheperformerduringtheenre
meoftheaconwhilecreangstrongandvar-
ied resistance, acts in such a way, that you can
changeboththeaconplananditsmethodat
anymoment”[3].
Theaimofthisstudyisageneralreviewonthe
possibilies of combang Lyme diseasewith
wideruseofsciencunderstanding.
Lyme disease in athletes
Theoccurrence ofLymediseaseinathletesis
ararelydiscussedissue,both bythescienc
community in Poland and internaonally [4].
However, some studies have researched the
Physical acvity – noun
exercise and general
movement that a person
carries out as part of their
day [39].
Physical training – noun same
as physical educaon [39].
Contact sport – noun any
sport in which physical contact
between players is an integral
part of the game, e.g. Boxing,
rugby or taekwondo [39].
Chronic – adjecve 1. used
for describing a disease or
condion that lasts for a long
me. Compare acute 2. used
for describing severe pain [39].
Prevenve – adjecve used
for describing an acon taken
to stop something happening,
especially to stop a disease or
infecon from spreading [39].
Combat sport – noun a sport
in which one person ghts
another, e.g. wrestling, boxing
and the maral arts [39].
Maral arts – plural noun
any of various systems of
combat and self-defence, e.g.
judo or karate, developed
especially in Japan and Korea
and now usually pracsed as
a sport [39].

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epidemiology of Lyme disease, clinical symp-
toms,diagnosis,treatment,and prevenonof
Lymeborreliosis[5].
Athleteswhotrainorcompete in thewoodland
areas of the endemic regions are at an increased
riskofgenginfectedbyLymedisease.Variable
clinicalsymptomsandlimitaonsintesngmay
lead to misdiagnosis. Early diagnosis and treat-
mentcancompletelycuremostoftheathleteswith
Lymedisease;however,symptomsmayappearfor
monthsoryears,parcularlywhenthediagnosis
isdelayed[6].Europeanstudiesshowastascal
dependencebetweendoingoutdoorsportsinthe
ck-infectedforestsandcatchingtheck-borne
infecon[7].Ontheotherhand,earlycasestud-
iesintheUnitedStatesdidnotshowasignicant
increaseintheriskassociatedwithpraccingout-
doorsports,yetastudybySmithetal.[8]revealed
thatpeoplewhospentmorethan30hoursaweek
training outdoors in the endemic areas, were tested
posive for Lyme disease even2.5 mes more
oen.BasedonresearchconductedbyVellard[9],
itwasfoundthattheriskofcontracngwithLyme
diseaseishigherby6.3%inthoseathletes,who
train in the forested environments.
Theriskofsporngacvityforinfectedpeople
variessignicantlydependingonthelocaonof
theinfecon,itsdegree,andmicrobialcause,as
wellastheintensityandatypeofsportsdiscipline.
Intensivephysicaltraining,andevenmentalstress,
mayreducetheorganism’sdefensiveresponse
againsttheinfecon,andaggravatetheinfecon.
Whatismore,anasymptomaccomplicaonofan
infecon,suchasmyocardis,aggravatesbyvig-
orousexercises.Theriskfactorisgenerallyhigher
foratrainedathlete,especiallyatahighlyskilled
levelthanforanordinaryathlete.Physicaleort
inathletessmulatestheimmunesystemwhich
enhance defensive mechanism against the infec-
on.Anathletewhobeginstoexercisesystemat-
ically, gradually strengthens his immune system
funcons,thusreducesitsvulnerabilitytoinfec-
ons.Intensiveendurancetraining,suchasjogging
foratleastanhour,iniallyprovidesastrongsm-
ulaonoftheimmunesystem,whichlaterchanges
totheopposite.Predominantly,theperiodoftem-
poraryweakeningoftheimmunefunconoccurs
aertrainingorcompeon,whichtemporarily
heightensthesuscepbilitytoinfecons[4].
Athletes parcipang in outdoor training in
endemicregionsare at increasedriskof con-
tracng Lyme disease. Diagnosis should be
based on results of clinical and serological tests.
However,thiscanbecomplicatedduetonon-
specicsymptoms,which arecommonin the
sportspopulaon,andthelimitaonsoflabo-
ratorytesng.Clinicalsignsincludeskinlesions
(especiallyerythemamigrans),neurologicaldis-
orders,musculoskeletalsymptoms,andarrhyth-
mias.Theincidencerateofinfeconsappears
to be increasing in Great Britain and the rest of
Europe.Inaddiontothecommonsymptomsof
Lymedisease–fague,jointpain,necksness,
andbrainfog–ChrisneGreensays,thatsome
athlete-specic symptoms mayindicate Lyme
disease:“Youmaynocelongerrecoveryme
ormoreprominentsymptomsofdelayedonset
musclesoreness(DOMS)”,saysGreen.“Strained
muscleswith prolonged healing meare also
somethingthatisoenmistakenasanormalpart
ofthetraining,butcouldimplysomethingelse”.
Theoccurrenceofinjuriesinathletes,e.g.during
contactghts(especiallyincontactsports),can
leadtovarioustypesofjointdamageorneurolog-
ical disorders, which the coach or doctor does not
considerasasymptomofLymedisease.
Thesoonerthetreatmentforck-bornedisease
starts,thebeerforthepaent,andtheworse
forthemicrobes.Only50%to68%ofpaents
haveapronouncederythemamigransrash,and
only26%nocesackthatcauses Lymedis-
ease.Unfortunately,themajorityofathletesdo
notknowthattheuinlatespring,summer,or
earlyfallcanbeasignofLymeborreliosis.Inthe
treatment of Lyme disease, properly selected
physiotherapeuctechniquescancauseafavor-
ableeectonthehealthandwell-beingofan
athlete.Theycaneecvelyrelaxthemuscles,
relievingthecondion.JosephBurrascano[11]
emphasizesthatapaentwithLymediseasewill
notrecoverwithoutphysicalacvity,because
duringexercise,Tcellsareproduced,previously
destroyedbytheborreliosis.Therefore,tomain-
taintheeectsofpharmacologicaltreatmentand
thediet,itisnecessarytoperformasetofexer-
cisesappropriatelyselected totheneeds and
capabiliesofthepaent.ThetraininginLyme
diseasecannotbeanaerobic,theworkoutcannot
bedoneeverydayeither.However,itisimportant
toachievetherapeucgoalssuchasanenhance-
mentofmusclestrength,andalsoimprovement
andmaintenanceoffunconalrangesofmoon
inthejoints.Theimplementaonofanappropri-
atesetofexercisesnotonlyimprovesthegen-
eralhealthofthepaentbutalsocontributesto
theremovalofexcesslymph.InLymedisease,

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Original Article
theowoflymphissignicantlyimpededdueto
itsenormousamountsproducedbytheimmune
systemtogetridoftheexcessiveamountoftox-
ins and dead bacteria.
Tools used to combat B. burgdorferi
B. burgdorferihasaspiral,irregularshapeandis
oneofthelargestspirochetes.Itbelongstothe
groupofgram-negavebacteria,althoughitalso
hastheabilitytostain,whichischaracteriscof
gram-posivebacteria[12].B. burgdorferi, due to
itscilia,hasagreatmolity,whichisanadvan-
tageinthecontextofmovementintheblood-
streamand ssues. Lymedisease spirochetes
have a triple cell wall, and it is disnguished
amongotherbacteriaofthistypebyhavingan
addionalmucosamadeofproteoglycansonits
surface.Ithasaprotecvefuncon,providing
“acamouage”from the humanimmune sys-
tem[2,13].Thecellwallgivesshapetothecell.It
turns out that B. burgdorferi can change the struc-
tureofthecellwallbytheexclusionofthegenes
thatformit.Then,thespirochetetakestheshape
ofasphere–alsocalled the L-form.Itcauses
majordiculesfordoctorsandmicrobiologists
indiagnosis[2].
Ofallknownbacteria,B. burgdorferi has the most
complicated genome. Molecular studies have
allowedresearcherstodisnguishabout20ofits
genospecies.Thegenomesizeisrelavelysmall,
only1x5Mb.Themainelementofthegenome
is the linear chromosome, on which most genes
arelocatedanditssizeisabout1Mb.Besides,
asmanyas21plasmidscanbedisnguishedin
the genome, which is the largest number among
otherbacterialgenomes[14].Thegenecmate-
rialofthe Lymespirocheteisalso distributed
dierently–alongthecellwallline,sonofree-
oang chromosomes in the cytoplasm are
observed.AnotherfeaturethatdisnguishesB.
burgdorferi and irritates the human immune sys-
temisitsformaonofstructurescalledvesicles.
Thespirocheteduplicatesthegenesand then
placestheminthecellwall.Thisparcularfrag-
mentofthecellwall,aerexocytosis,istrans-
ferred to the human body along with the vesicle.
Thecelldivisionofpathogensisusuallyrapid.It
lastsabout20minutes.ItisnotthecaseforB.
burgdorferi, which has the ability of division from
12upto24hours.Thisisimportantduringanbi-
octherapy,whichusesbacteriadivisiontoght
them and destroy the newly formed cell walls. No
anbioccanbeeecvewhenthebacteriaare
dormant(betweendivisions)[2,15].
B. burgdorferi vs. human – strategies used
by Lyme spirochete to infect a host
TheprocessesthatenableB. burgdorferi to sur-
vive in the host organisms occurs at the molec-
ularlevel.Thespirocheteproteinsareencoded
byaseriesofplasmidsandchromosomalgenes,
andtheregulaonoftheirexpressionisinially
assistedbytheckenvironment,and laterby
thehost–vertebrate.Surfacelipoproteins(Osp)
–mainlyOspA–playanimportantroleinthe
colonizaonoftheckintesne.Inthebegin-
ning, B. burgdorferihastomovefromtheck’s
intesnetoitssalivaryglandsinordertoenter
thehost.Bacterialmigraonoccursbythereduc-
on of regulaon of OspA, and the incense-
mentofregulaonoftheOspClipoprotein.The
interaconbetweenahumansandB. burgdor-
feribeginswithackbite.Then,Lymedisease
spirocheteencounterstherstlineofdefenseof
thehumanimmunesystem,whichreleasesan-
bodiesandchemokines,beginstheimmediate
produconofreacveoxygenspecies,andac-
vatesthecomplementsystemcascades(C3).B.
burgdorferisuppresses the immunesystemby
acquiringappropriatesurfaceproteins(CRASP)
andErpproteinstogetherwithHorFHLfac-
tor(factor-H-like).FactorHaectstheregula-
on of the complement system, while factor
FHL,asacofactorofC3convertase,facilitates
itscleavageandbindsOspEproteins.B. burgdor-
ferireceiveshelpfromtheinfeconvectoritself,
i.e.theck,which,duetotheSALP15salivary
protein,playsanimportantroleinexterminat-
ingthehost’sdefensemechanisms.TheSALP15
proteininhibitstheacvityofTlymphocytesand
thebindingoftheOspCsurfaceprotein,which
makesB. burgdorferiimpossibletoannihilate[1,
16].AnothersalivaryproteinincksisSalp25D,
involvedintheneutralizaonofreacveoxygen
speciesproducedbyneutrophils.Theseprocesses
allowtheLymespirochetetotransmitandini-
atetheinfecon.OnceB. burgdorferi reaches the
insideofthehost’sorganism,bacteria’simpor-
tantfeaturereveals,whichpermitstodeceive
andmanipulatethehumanimmunesystem.Itis
theabilityofLymespirochetetopolymorphism.
Asaresult,duringtheperiodofdivision,B. burg
-
dorferihastheabilitytochangesurfaceangens,
sequencesofcodinggenes,e.g.OspC,andalsoto
changethestructureofthecellwall,whichul-
matelycausesgenomicchanges,makingitmore
dicult to locate the bacteria as an intruder.
Therefore,Lymediseasespirochetegainsmeto
hide in the host and wait for the immune system
tostopsearchingforit[17].Whentheimmune

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system encounters a foreign body, it is absorbed
bythemacrophagetotransmitandstoreinfor-
maonaboutthecell.Theimmunesystemalso
triestodetectanangenonthesurfaceofan
intruder’scelltoproduceanaackinganbody.
InthecaseoftheLymespirochete,thesituaon
iscomplicatedbecauseithidesitsangensinthe
innermembrane,whichmakesitinvisibletothe
humanimmunesystemandpreventstheimmune
response.Duetotheabilitytochangesurface
angens, B. burgdorferi distracts the immune sys-
tem,forcingtheproduconofnewanbodies
whentheinfeconconnuesandthebacteria
hidebeerandbeer[2,14].Anothersurvival
strategyforLymespirocheteisgenecrecombi-
naon,whichtakesplaceatthemajorsequence
proteingenelocus(vls).Expressiontakesplace
inViSE(vlsexpressionsite)andcausesthefor-
maonofnewangenicvariantsandchanges
inDNAsequences[18].ThesuccessofB. burg-
dorferipathogenesisisalsoinuencedbylateral
genetransferwiththeusageofbacteriophages.
IthasbeenproventhataphagetransfersDNA
fromonespirochetetoanother.Moreover,fre-
quenttransfersofOspCgeneswithinspecies
and between B. burgdorferi sensu stricto, B. gari-
nii, and B. afzeliihavebeenreported.Thehighfre-
quencyofgeneexchangebetweenspirochetes
enablesthemtorespondeecvelytothepres-
sureofseleconintheenvironment[19].
Tick vs. humans – bite strategies used by ck
arachnids and preferences in host selecon
Nowadays, cks are well-known vectors of
humanandanimalpathogens.Amongthearthro-
pods,theyarecharacterizedbythegreatestvari-
etyof transmied infecousorganisms,such
asprotozoa,viruses, bacteria, and fungi. The
pathogenstransmiedbyckscauseaseriesof
ck-bornediseases:babesiosis,anaplasmosis,
Qfever,tularemia,butthehighestpercentage
of cases in humans is noted due to Lyme dis-
ease[20].Theacvity,reproducon,abundance
aswellasthesurvivaloftheckdependson
manybiocfactors.Temperature,humidity,and
photoperiodhaveasignicanteectonarach-
nidsfromthisgroup.Currentclimatechangesare
thedrivingforcebehindtheexpansionofcks
aroundtheworld[21].
Whenchoosingahost,cksareguidedbycer-
taindisnguishing featuresthatsuggestthem
host’squalies.Ticksare primarily smulated
bysmells,radiantheat,vibraons,andbreath.
Theodoraractantsincludeammoniainurine,
animalwaste,aswellasbutyricacidandlacc
acid,whichcanbefoundinsweat.Thesearchfor
ahostisaddionallytriggeredbysmuliinclud-
ingvibraons,sounds,andtouch.Thevibraon
ofthegrassimmediatelytriggersthearachnid’s
reacon[22].Studieshaveshownthatthecks
arealsosmulatedbytheelectromagnecwaves
ata frequency of 800-900Hz, typical forTV
antennasorsmartphones[23].TheIxodes genus
ckscancrawlaroundthehostevenforseveral
hourstondasuitablefeedingplace.Thisselec-
onprocessissupportedbytheheatandsmell
thatarereleasedbyapotenalhosts.Ongoing
researchiscarriedoutdeterminethepreferences
ofcksforbloodgroupofapotenalhost;for
example in 2018, in Czechia, an experiment
invesgangthistookplace.Theresultsshowed
stascalpreferenceforparcularbloodgroups
amongckswasA>0>AB>B.However,theseare
onlyinialndingsthatrequirefurtherinves-
gaon[24].Fromthemomentofpenetraonof
theskin,theckbeginstoghtforsurvival,and
forthepossibilityofstarngabloodmeal[25].
Immediatelyaeraachment,mostarachnids
secreteasubstancethathelpsthemtosecure
inthewound.Next,thecksalivatesandsucks
bloodfromthe exactplaceofthe hematoma,
whichstartstodevelopaeritsbite.Inthesaliva,
ckshavenumerousancoagulantandanhis-
taminecompoundsthatcausessue lysisand
aconstantowofuid.Thesuccessofthemeal
dependson the secreon ofan-hemostac,
an-inammatory,andimmunemodulangpro-
teinsintheck’ssaliva,whichinhibitthehost’s
responsesthatmayotherwiserejecttheintruder.
Manyspeciesofthesearachnidssecreteproper
proteinsregulangplateletaggregaonandpro-
teinsthatdegradethemediatorsofpain,itching,
inammaon,especiallyhistamineandserotonin.
Theproperesandaconofcksputumsuggest
itsacveparcipaoninthetransmissionofan
infecousorganismbetweeninfectedandunin-
fectedarthropodslivingonthesamehost.This
processcontributestothefurtherdevelopment
oftheinfecon[25,26].
Modern microbiological diagnoscs and
prevenon as a tool in the struggle against
cks infected with
B. burgdorferi
ManymethodsareusedtodiagnoseLymedis-
ease. Among them, microbiological, serological,
andmolecular biologymethodscanbedisn-
guished.Serologicaltestsfocusontheresponse
oftheimmunesystem.Theirprincipleofopera-
onistorecognizetheappropriateanbodies

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VOLUME 16 | 2020 www.archbudo.com
Original Article
inthepaent’sserum.Inmicrobiologicalmeth-
ods, bacteria are grown in vitro on substratum
thatprovidesthemwithappropriategrowthcon-
dions.Themethodsofmolecularbiologyare
thetechniquesmainlybasedonthePCRreac-
on(polymerasechainreacon)anditsvariants,
which allow for the amplicaonof bacterial
genec material [1, 27]. Therefore, if a Lyme
infeconissuspected,itwould seemthatthe
paent has a lot of diagnosc possibilies.
Unfortunately,contrarytoappearances,thisdis-
ease is not so unambiguous when it comes to
makinganaccuratediagnosis.
Accordingto the recommendaons,the two-
stageserologicaldiagnosisprocedureisadvised.
Therststepistoperforman enzyme-linked
immunosorbentassay(ELISA).Itstaskistodetect
anbodiesagainstB. burgdorferi and then assign
themtotheIgMorIgGclass.Thisexaminaon
selectspaentswhorequirefurtherdiagnosis.
TheELISAdoesnotconrmLymedisease,itonly
conrmsthepresenceofaspecicclassofan-
bodiestospirochetes[1,28].
Thesecondstageoftheserologicaldiagnoscsis
theWesternblong,whichisusedtoverifythe
resultofthescreeningtest.Itclassiesanbod-
iesbysizeandweight.Whenanbodiesbindto
the B. burgdorferiangens,characteriscbands
are formed, which indicatesa posive result.
Eachband corresponds to adisnct bacterial
protein.Themostfrequentlydetectedangens
areVIsE–cellwalllipoprotein(B. afzelii, B. burg-
dorferi, B. garinii),p83–cellwall-relatedprotein,
agellin–p41,Borreliellap39/BmpA,p31/OspA,
p30,p25/OspC,p21,p19,p17/Dbpa[1,29].
Bothtestsarebasedonthehost’sabilitytopro-
duceanbodiesagainstB. burgodrferi.However,
there are challenges using this diagnosis method.
Lymediseasespirochetes,havinganaddional
mucosa and the capacity to change surface
angens,eecvelyavoidtheimmunesystem
response.Thistypeoftestcanonlydetectfree
anbodiesthatarenotboundtothe angen.
Immune syndromes are beyondthe scope of
ELISAandWesternblot[18].
Intheearlystagesofthedisease,theserologi-
caltestresultsmaybefalse-negaveduetothe
inabilitytodetectlowlevelsofIgManbodies.
Ontheotherhand, false-posive resultsmay
appearwhenotherviralinfeconsandautoim-
munediseasescoexist,e.g.EBV[1,30].Inthe
caseoftheserologicaltests,itisimpossibleto
disnguishbetweenthepastandcurrentinfec-
on.Evenifasinglebacterialcellsurvivesaer
theanbioctreatment,itmaycausetherecur-
renceofdisease[2].
Advancesin molecular biology haveprovided
enormousdiagnoscpossibilies.Theycanbe
usedtoconrmLymedisease,typifyandiden-
fyspirochetes,idenfyco-infeconsbetween
dierentspeciesofBorreliella, as well as other
ck-bornepathogens.The arachnid itselfcan
alsobematerialformolecularstudies.Modern
techniquesallowtheanalysisofthe infecon
ofackbyapathogen.Molecularmethodssig-
nicantlyshortenedthemeofDNAanalysis
of Borreliellaspirochetes,andincomparisonto
othermethods,theyarecharacterizedbyhigh
sensivity, easy standardizaon, and require
anegligibleamountofgenecmaterialforthe
research[1].
100% protecon against a ck bite does not
exist.Thereare,however,afewbasicwaysto
limit contact with these arachnids. The pre-
venonincludes avoiding forestedandgrassy
areas,whereckspaentlywaitforthearrival
ofahost.Duringtripstonature,itisnecessary
towearappropriatelight-coloredclothingwith
long sleeves covering as much of the body sur-
faceaspossible.Thelightcoloroftheclothes
willmakeanyintruderimmediatelyvisible, so
itcanbeeasilyremovedbeforeitndsafeed-
ingplace.Forbasicprophylaxis,therearealso
variousckrepellantsavailableonthemarket
–preparaonswithDEET(N,N-Diethyl-meta-
toluamide).Aerreturningfromtheareaswhere
contactwitharachnidswaspossible,itisneces-
sarytocarefullyexamineyourbodyandevalu-
atewhetheranyofthemgotbeyondtherstline
ofhumandefense[31].Ackbiteisnotsyn-
onymouswithgengsick,asnoteveryckis
infected with the pathogen.The second line
of human defense is triggered in the moment
of contact with the arachnid and is associated
withthehost’simmuneresponse.Inially,the
infecon causes a non-specic, innate reac-
on.Overme,theimmunesystemwidensthe
host’sresponses.Aer2-3weeks,asaresultof
thehumoralresponse,theearlyIgManbod-
iesappear.Onaverage,in 2 months from the
momentofinfecon,theyachievetheirhighest
value.Whentheirterstartstodrop,theimmune
systembeginstoproducelateanbodies–IgG,
whichpersistevenforseveralyears[1].

Weiner M et al. – Resistance and rational actions...
© ARCHIVES OF BUDO
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HEALTH PROMOTION AND PREVENTION 2020
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VOLUME 16
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179
Thereisno“goldenmean”inaperson’sght
againstLymedisease.Simpleandbasicpreven-
on,includingavoidingthehabitatsofcks,
especially at the peak of their occurrence,
appropriateclothing,andtheuseofrepellent
preparaons,aretheonlyaconsthataper-
soncantakelestcatchingck-bornediseases.
Whenaninfecondevelops,theimmunesys-
temrespondstothepathogen,tryingtoneu-
tralizeitnaturally.Peoplebegantousenew
technologies, alongside the development in
many elds of biology and medicine, to be
abletowin againstthepathogenbygeng
to know its structure, genome, and genes.
Understandingthe properesand funcons
of the infecous organism,cks, which are
thevectorofinfeconwhichofB. burgdorferi,
allowsfortheconstantimprovementofdiag-
noscmethodsandthedevelopmentofeec-
vemeansofproteconagainstarachnidbites
andLymeinfecon.
Athletes constute a high-risk groupdue to
their increased exposureto dierent people
andenvironments,andsomemestotheirlife-
stylebehavior.Primaryprophylaxiscanbepro-
motedthroughappropriatevaccinaon,good
hygienepracces,andamodicaonofbehav-
iorstominimizehigh-riskacvies.Secondary
prevenoncanbeachievedthroughvigilantsur-
veillanceofreporteddiseases,adequateeduca-
on,andalimitaonofcontainmentincaseof
occurrence of disease.
CONCLUSIONS
Ademandingreadermayaskthereasonableques-
onaboutthelegimacyofpublishingthiswork
inajournaldedicatedtothebroadlyunderstood
prophylaxis,healththerapy,andpersonalsafety
withtheuseofmaralartsandcombatsports.
According to Jarosław Rudniański’s theory of
unarmedstruggle,especiallytothegeneralruleof
acontrolledenvironment,providesaparalexpla-
naon[3].However,thekeyargumentisassoci-
atedwiththefactthatsince2011[32],thejournal
ArchivesofBudohasbeenpopularizingscienceas
auniqueknowledgeaboutinnovaveagonology
(detailedscienceofstruggle)intheglobalspace.
Theunderesmatedvalueofthisscience(starng
with the general theory of struggle, agonology by
TadeuszKotarbiński[33])aretheoremsthatcan
beconnotedonthevergeofvarioussciences–
evenasdistantascon[32,34],orsportssci-
ence[35,36].Inouropinion,theprimarycriterion
oftheapplicaonofinnovaveagonologywith
othersciencdisciplinesisarealsuccessincoun-
teracnghealthorlife-threateningsituaonsfrom
the micro to the macro scale (from an individual to
thehumanpopulaon),regardlessofwhetherthe
opponent(theenemy)isaman,ananimal,aforce
ofnature,lackofpsychomotorcompetenciesofan
individualoperangundercertaincircumstances,
unreliable technology, or bacteria and microbes
invisibletothenakedeye[37].Inthisthesis,we
merely indicate the issue of the rule of a controlled
environment,whichissouniversalthat–apart
fromthesourceofthethreat–canbeusedby
anyentythatresiststhethreatraonally[38].
REFERENCES
1.
TeodorowiczP,WeinerM.Currentmethods
usedtoidenfyandgenotypespirochaetes
Borreliellaburgdorferi.HealthProbCivil2020;
14(2):71-82
2. GrierTM.ThecomplexiesofLymeDisease.
In:LymeDiseaseSurvivalManual.Duluth:
Pedagogue Press; 2000
3. RudniańskiJ.Kompromisiwalka.Sprawność
ietykakooperacjipozytywnejinegatywnej
wgęstymotoczeniuspołecznym.Warszawa:
InstytutWydawniczyPax1989[inPolish]
4.
RønsenO.Prevenonandmanagementof
respiratorytractinfeconsinathletes.New
StudiesinAthletes2005;20:49-56
5.
LantosPM.ChronicLymeDisease:The
ControversiesandtheScience.ExpertRev
AnInfectTher2011;9(7):787-797
6.
DuPreyKM.LymeDiseaseinAthletes.Cur
SportsMedReports2015;14(1):51-55
7.
SumiloD,BormaneA,AsoklieneLetal.Socio-
economicfactorsinthedierenalupsurgeof
ck-borneencephalisinCentarlandEastern
Europe.RevMedVirol2008;18(2):81-95
8. SmithP,BenachJ,WhiteDetal.Occupaonal
riskofLymediseaseinendemicareasofNewYork
State.AnnNYAcadSci1988;539(1):289-301
9.
VellardN.Forestsport:environmentalrisk
ofinfecon,prevenonandadvice:example
ofLymedisease.SciPharm2018
10.BrishInfeconAssociaon.Theepidemiol-
ogy,prevenon,invesgaonandtreatmentof
LymeborreliosisinUnitedKingdompaents:
aposionstatementbytheBrishInfecon
Associaon.JInfect2011;62:329-338
11.
BurrascanoJJ.AdvancedTopicsinLyme
Disease.Diagnoschintsandtreatmentguide-
linesforLymeandotherckborneillnesses.
Managinglymedisease.16thed.2008:35
12.
WłodarekJ,ŻurawA,WalczakRetal.Borelioza
zLyme–najczęstszachorobaodkleszczowa
ludziizwierząt.MedWet2013;69(6):342
13.AslamB,NisarMA,KhursidMetal.Immune
escapestrategiesofBorreliaburgdorferi.Future
Microbiol2017;12(13):1219-1237
14.
BrissonD,DrecktrahD,EggersCHetal.
GenecsofBorreliaburgdorferi.AnnuRev
Genet2012;46:515-536
15.
EmbersME,RamamoorthyR,PhilippMT.
SurvivalstrategiesofBorreliaburgdorferi,
theeologicagentofLymedisease.Microbes
Infect2004;6:312-318

180
|
VOLUME 16 | 2020 www.archbudo.com
Original Article
16.
RegoROM,TrentelmanJJA,AnguitaJet
al.Counteraackingtheckbite:towards
araonaldesignofan-ckvaccinestarget-
ingpathogentransmission.ParasitVectors
2019;12(1):229
17.
SinghSK,GirschickHJ.Molecualarsurvival
strategiesoftheLymediseasespirochete
Borreliaburgdorferi.LancetInfectDis2004;
4(9):575-583
18.
Pedrycz-WieczorskaA.Analysisofthemeth-
odsfordiagnosingborreliosis−Lymedisease.
HealthProbCivil2017;11(2):80-86
19.
QiuWG,SchutzerSE,BrunoJFetal.Genec
exchangeandplasmidtransfersinBorrelia
burgdorferi sensu stricto revealed by three-
waygenomecomparisonsandmultilocus
sequencetyping.PNATLAcadSciUSA2004;
101(39):14150-14155
20. NicholsonWL,SonenshineDE,NodenBEet
al.Ticks(Ixodida).In:MullenGR,DurdenLA,
editors.Medicalandveterinaryentomology;
SanDiego:AcademicPress;2019:603-672
21.
Dantas-TorresF.Climatechange,biodiver-
sity,cksandckbornediseases:Thebuer-
yeect.IntJParasitol2015;4(3):452-461
22.
WalladeSM,RiceMJ.Thesensorybasisof
ckfeedingbehaviour.In:ObenchainFD,
GalunR,editors.Physiologyofcks.Oxford:
PergamonPress;1982:71-118
23.
FrątczakM,VargováB,TryjanowskiPetal.
InfectedIxodesricinuscksarearactedby
electromagnecradiaonof900MHz.Ticks
Tick-BorneDis2020;11(4):101416
24.
ŽákovskáA,JanečekJ,NejezchlebováHetal.
PilotstudyofIxodesricinusckspreference
forhumanABObloodgroupsusingasim-
pleinvitromethod.AnnAgrEnvMed2018;
25(2):326-328
25.
LewandowskiD,UrbanowiczA,FiglerowiczM.
Molekularnepodłożeoddziaływańpomiędzy
borreliaburgdorferi,kleszczemikręgowcem.
PostMikrob2013;52(1):13-16
26.
KurokawaC,LynnGE,PedraJHFetal.
InteraconsbetweenBorreliaburgdorferi
andcks.NatRevMicrobiol2020;18(10):
587-600
27.
ChmielewskiT,DunajJ,Gołąb Eetal.
Laboratorydiagnosticsoftick-bornedis-
eases.RecommendationsoftheWorking
Group.Warszawa:KrajowaIzbaDiagnostów
Laboratoryjnych;2014
28.
SchutzerSE,BodyBA,BoyleJetal.Direct
DiagnoscTestsforLymeDisease.ClinInfect
Dis2019;68(6):1052-1057
29.
JohnTM,TaegeAJ.Appropriatelaboratory
tesnginLymedisease.ClevClinJMed2019;
86(11):751
30.
KmieciakW,CiszewskiM,Szewczyk
EM.ChorobyodkleszczowewPolsce–
występowanieitrudnościdiagnostyczne.
MedPr2016;67(1):73-87
31.
SarwarMH,SarwarM.Medicalimportanceof
cksbiteanddiseasestransmissionbymeans
ofitaecnghumans.BiomedHealthInform
2016;1(2):44-51
32.KrzemienieckiLA,KalinaRM.Agon–aterm
connecngthetheoryofstrugglewithbelles-
leres.Aperspecveofinter-disciplinary
research.ArchBudo2011;7(4):255-265
33.
KotarbińskiT.Zzagadnieńogólnejteoriiwalki.
Warszawa:SekcjaPsychologicznaTowarzystwa
WiedzyWojskowej;1938[inPolish]
34.
KrzemienieckiLA.Literackiagonwświetle
teoriiwalki(E.HemingwayStaryczłowiek
imorze).Biblioterapeuta:BiuletynInformacyjny
PolskiegoTowarzystwaBiblioterapeutycznego
2010;3(52):1-6[inPolish]
35.
KalinaRM.Agonologyasadeeplyesoteric
science–anintroducontomaralartsther-
apyonaglobalscale.ProcediaMan2015;3:
1195-1202
36.
KalinaRM,BarczyńskiBJ.Mixedassessments
asmentalandpedagogicbasisofinnovave
self-defence.ArchBudo2017;13:187-194
37.
KalinaRM.Innovaveagonologyasasyno-
nymforprophylaccandtherapeucago-
nology–thenalimpulse.ArchBudo2016;
12:329-344
38.
KalinaRM,BarczyńskiBJ.Anovelapproach
tocounteraconofthreats:Inspiraonfor
all.ArchBudoSciMaralArtExtremeSport
2019;15:159-163
39.
DiconaryofSportandExerciseScience.
Over5,000TermsClearlyDened.London:
A&BBlack;2006
Cite this arcle as: WeinerM,TeodorowiczP,NiźnikowskaE.ResistanceandraonalaconsaseecvecountermeasuresinthestruggleagainstLyme
disease.ArchBudo2020;16:173-180