{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T14:43:53Z","timestamp":1787582633629,"version":"build-2736575974"},"reference-count":53,"publisher":"Rockefeller University Press","issue":"9","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health\/National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01 AI157007"],"award-info":[{"award-number":["R01 AI157007"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health\/National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["5T35 OD024982"],"award-info":[{"award-number":["5T35 OD024982"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health\/National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["T32OD011089"],"award-info":[{"award-number":["T32OD011089"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health\/National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["F32AI161850"],"award-info":[{"award-number":["F32AI161850"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000090","name":"Congressionally Directed Medical Research Programs","doi-asserted-by":"publisher","award":["TB220074"],"award-info":[{"award-number":["TB220074"]}],"id":[{"id":"10.13039\/100000090","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016230","name":"Steven and Alexandra Cohen Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016230","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014731","name":"Global Lyme Alliance","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014731","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013479","name":"Bay Area Lyme Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013479","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["rupress.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10,5]]},"abstract":"<jats:p>Lyme disease, an emerging tickborne disease caused by Borrelia burgdorferi (Bb), can result in myriad symptoms of unknown causes in humans. Here, we show that Bb rapidly disrupts the gastrointestinal immune barrier in infected mice, inducing a \u201cleaky gut\u201d syndrome, characterized by increased gut permeability, systemic endotoxemia, elevated LPS binding protein and intestinal fatty acid binding protein, and altered blood leukocyte profiles. Patients with acute Lyme disease showed similar blood changes that correlated with disease symptoms and liver function measurements and largely resolved after antibiotic treatment. Mechanistically, Bb infection triggered mild early inflammation in the small intestine and suppressed humoral immunity to the microbiota, resulting in reduced IgA coating of fecal microbes and decreased antimicrobial serum IgG, despite the increased gut permeability. These defects preceded shifts in later observed gut bacterial composition and short-chain fatty acid production. Together, our findings identify mucosal barrier dysfunction and impaired antimicrobial humoral immunity as potential drivers of Bb-induced disease.<\/jats:p>","DOI":"10.1084\/jem.20252380","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T06:20:49Z","timestamp":1785478849000},"update-policy":"https:\/\/doi.org\/10.1084\/jem.crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["<i>Borrelia burgdorferi<\/i>\n                    disrupts gut barrier functions and microbiota\u2013antibody interactions"],"prefix":"10.1084","volume":"223","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9809-4766","authenticated-orcid":true,"given":"Shilpa","family":"Sachan","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Lyme and Tickborne Diseases Research and Education Institute, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University 1 W. Harry Feinstone Department of Molecular Microbiology and Immunology, , Baltimore, MD,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0993-1672","authenticated-orcid":true,"given":"Giang Vu Vi","family":"Tran","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05rrcem69","id-type":"ROR","asserted-by":"publisher"}],"name":"School of Veterinary Medicine, University of California 2 Center for Immunology and Infectious Diseases and Department of Pathology, Microbiology and Immunology, , Davis, CA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8085-3576","authenticated-orcid":true,"given":"Kimberly J.","family":"Olsen","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05rrcem69","id-type":"ROR","asserted-by":"publisher"}],"name":"School of Veterinary Medicine, University of California 2 Center for Immunology and Infectious Diseases and Department of Pathology, Microbiology and Immunology, , Davis, CA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5110-8361","authenticated-orcid":true,"given":"Heather","family":"Kulaga","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Lyme and Tickborne Diseases Research and Education Institute, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University 1 W. Harry Feinstone Department of Molecular Microbiology and Immunology, , Baltimore, MD,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1330-3138","authenticated-orcid":true,"given":"Anne","family":"Day","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Lyme and Tickborne Diseases Research and Education Institute, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University 1 W. Harry Feinstone Department of Molecular Microbiology and Immunology, , Baltimore, MD,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1057-7239","authenticated-orcid":true,"given":"Hannah P.","family":"Savage","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05rrcem69","id-type":"ROR","asserted-by":"publisher"}],"name":"School of Medicine, University of California 3 Department of Microbiology and Immunology, , Davis, CA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7240-7158","authenticated-orcid":true,"given":"Alison W.","family":"Rebman","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Johns Hopkins University School of Medicine 4 Lyme Disease Research Center, Division of Rheumatology, Department of Medicine, , Baltimore, MD,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2648-0896","authenticated-orcid":true,"given":"John N.","family":"Aucott","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Johns Hopkins University School of Medicine 4 Lyme Disease Research Center, Division of Rheumatology, Department of Medicine, , Baltimore, MD,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5384-7809","authenticated-orcid":true,"given":"Isabel A.","family":"Jimenez","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Lyme and Tickborne Diseases Research and Education Institute, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University 1 W. Harry Feinstone Department of Molecular Microbiology and Immunology, , Baltimore, MD,","place":["USA"]},{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Johns Hopkins University School of Medicine 5 Department of Molecular and Comparative Pathobiology, , Baltimore, MD,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6666-6548","authenticated-orcid":true,"given":"Cory F.","family":"Brayton","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Johns Hopkins University School of Medicine 5 Department of Molecular and Comparative Pathobiology, , Baltimore, MD,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2891-4483","authenticated-orcid":true,"given":"Nicole","family":"Baumgarth","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Lyme and Tickborne Diseases Research and Education Institute, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University 1 W. Harry Feinstone Department of Molecular Microbiology and Immunology, , Baltimore, MD,","place":["USA"]},{"id":[{"id":"https:\/\/ror.org\/05rrcem69","id-type":"ROR","asserted-by":"publisher"}],"name":"School of Veterinary Medicine, University of California 2 Center for Immunology and Infectious Diseases and Department of Pathology, Microbiology and Immunology, , Davis, CA,","place":["USA"]},{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Johns Hopkins University School of Medicine 5 Department of Molecular and Comparative Pathobiology, , Baltimore, MD,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"291","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"2026082410094344800_bib1","doi-asserted-by":"publisher","first-page":"2436","DOI":"10.3390\/cells11152436","article-title":"Role of intestinal dysbiosis and nutrition in rheumatoid arthritis","volume":"11","author":"Attur","year":"2022","journal-title":"Cells"},{"key":"2026082410094344800_bib2","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1016\/j.ijid.2022.01.033","article-title":"Risk of post-treatment Lyme disease in patients with ideally-treated early Lyme disease: A prospective cohort study","volume":"116","author":"Aucott","year":"2022","journal-title":"Int. J. Infect. Dis."},{"key":"2026082410094344800_bib3","doi-asserted-by":"publisher","first-page":"1327","DOI":"10.1093\/ibd\/izad024","article-title":"The underappreciated role of secretory IgA in IBD","volume":"29","author":"Bamias","year":"2023","journal-title":"Inflamm. Bowel Dis."},{"key":"2026082410094344800_bib4","doi-asserted-by":"publisher","first-page":"1634","DOI":"10.3389\/fimmu.2018.01634","article-title":"Robust B cell responses predict rapid resolution of Lyme disease","volume":"9","author":"Blum","year":"2018","journal-title":"Front. Immunol."},{"key":"2026082410094344800_bib5","doi-asserted-by":"publisher","first-page":"666554","DOI":"10.3389\/fmed.2021.666554","article-title":"Recent progress in Lyme disease and remaining challenges","volume":"8","author":"Bobe","year":"2021","journal-title":"Front. Med. (Lausanne)"},{"key":"2026082410094344800_bib6","doi-asserted-by":"publisher","first-page":"850","DOI":"10.1097\/MCG.0b013e31824b2277","article-title":"Immunoglobulin A deficiency in celiac disease","volume":"46","author":"Chow","year":"2012","journal-title":"J. Clin. Gastroenterol."},{"key":"2026082410094344800_bib7","doi-asserted-by":"publisher","first-page":"946248","DOI":"10.3389\/fimmu.2022.946248","article-title":"Gut microbiota, leaky gut, and autoimmune diseases","volume":"13","author":"Christovich","year":"2022","journal-title":"Front. Immunol."},{"key":"2026082410094344800_bib8","doi-asserted-by":"publisher","first-page":"185","DOI":"10.3389\/fimmu.2013.00185","article-title":"Multi-faceted functions of secretory IgA at mucosal surfaces","volume":"4","author":"Corth\u00e9sy","year":"2013","journal-title":"Front. Immunol."},{"key":"2026082410094344800_bib9","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1016\/j.immuni.2013.10.001","article-title":"Systemic effects of inflammation on health during chronic HIV infection","volume":"39","author":"Deeks","year":"2013","journal-title":"Immunity"},{"key":"2026082410094344800_bib10","doi-asserted-by":"publisher","first-page":"1635","DOI":"10.1007\/s11739-023-03329-1","article-title":"Role of mucosal immunity and epithelial\u2013vascular barrier in modulating gut homeostasis","volume":"18","author":"Di Sabatino","year":"2023","journal-title":"Intern. Emerg. Med."},{"key":"2026082410094344800_bib11","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1016\/j.chom.2015.05.001","article-title":"IgG \u201cdetoxes\u201d the intestinal mucosa","volume":"17","author":"Eckmann","year":"2015","journal-title":"Cell Host Microbe"},{"key":"2026082410094344800_bib12","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1004976","article-title":"Suppression of long-lived humoral immunity following Borrelia burgdorferi infection","volume":"11","author":"Elsner","year":"2015","journal-title":"PLoS Pathog."},{"key":"2026082410094344800_bib13","first-page":"4557","article-title":"A guide to histomorphological evaluation of intestinal inflammation in mouse models","volume":"7","author":"Erben","year":"2014","journal-title":"Int. J. Clin. Exp. Pathol."},{"key":"2026082410094344800_bib14","doi-asserted-by":"publisher","first-page":"e2342","DOI":"10.1093\/cid\/ciaa1455","article-title":"Metabolic response in patients with post-treatment Lyme disease symptoms\/syndrome","volume":"73","author":"Fitzgerald","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"2026082410094344800_bib15","doi-asserted-by":"publisher","first-page":"5612","DOI":"10.4049\/jimmunol.1103735","article-title":"Delays and diversions mark the development of B cell responses to Borrelia burgdorferi infection","volume":"188","author":"Hastey","year":"2012","journal-title":"J. Immunol."},{"key":"2026082410094344800_bib16","doi-asserted-by":"publisher","first-page":"114","DOI":"10.3389\/fimmu.2017.00114","article-title":"Borrelia burgdorferi keeps moving and carries on: A review of borrelial dissemination and invasion","volume":"8","author":"Hyde","year":"2017","journal-title":"Front. Immunol."},{"key":"2026082410094344800_bib54","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/B978-0-12-818708-1.00017-8","volume-title":"Avian Immunology","author":"Kogut","year":"2022","edition":"Third"},{"key":"2026082410094344800_bib18","doi-asserted-by":"publisher","first-page":"628741","DOI":"10.3389\/fimmu.2021.628741","article-title":"The gut microbiome in myalgic encephalomyelitis (ME)\/chronic fatigue syndrome (CFS)","volume":"12","author":"K\u00f6nig","year":"2022","journal-title":"Front. Immunol."},{"key":"2026082410094344800_bib19","doi-asserted-by":"publisher","first-page":"5112","DOI":"10.1128\/AEM.01043-13","article-title":"Development of a dual-index sequencing strategy and curation pipeline for analyzing amplicon sequence data on the MiSeq Illumina sequencing platform","volume":"79","author":"Kozich","year":"2013","journal-title":"Appl. Environ Microbiol."},{"key":"2026082410094344800_bib20","doi-asserted-by":"publisher","first-page":"5405","DOI":"10.1016\/j.cell.2021.09.011","article-title":"A selective antibiotic for Lyme disease","volume":"184","author":"Leimer","year":"2021","journal-title":"Cell"},{"key":"2026082410094344800_bib21","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.00217-18","article-title":"Short-chain fatty acids alter metabolic and virulence attributes of Borrelia burgdorferi","volume":"86","author":"Lin","year":"2018","journal-title":"Infect. Immun."},{"key":"2026082410094344800_bib22","doi-asserted-by":"crossref","first-page":"284","DOI":"10.4049\/jimmunol.114.1_Part_2.284","article-title":"Increased risistance of immunoglobulin A dimers to proteolytic degradation after binding of secretory component","volume":"114","author":"Lindh","year":"1975","journal-title":"J. Immunol."},{"key":"2026082410094344800_bib23","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1038\/mi.2011.41","article-title":"Secretory IgA's complex roles in immunity and mucosal homeostasis in the gut","volume":"4","author":"Mantis","year":"2011","journal-title":"Mucosal Immunol"},{"key":"2026082410094344800_bib24","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1172\/JCI76304","article-title":"Gut\/brain axis and the microbiota","volume":"125","author":"Mayer","year":"2015","journal-title":"J. Clin. Invest."},{"key":"2026082410094344800_bib25","doi-asserted-by":"publisher","first-page":"1567","DOI":"10.1128\/AAC.38.7.1567","article-title":"Effectiveness of antimicrobial treatment against Borrelia burgdorferi infection in mice","volume":"38","author":"Moody","year":"1994","journal-title":"Antimicrob. Agents Chemother."},{"key":"2026082410094344800_bib26","doi-asserted-by":"publisher","first-page":"14822","DOI":"10.3390\/ijms241914822","article-title":"Dynamics of the microbiota and its relationship with post-COVID-19 syndrome","volume":"24","author":"Moreno-Corona","year":"2023","journal-title":"Int. J. Mol. Sci."},{"key":"2026082410094344800_bib27","doi-asserted-by":"publisher","DOI":"10.1128\/mbio.02310-02320","article-title":"A distinct microbiome signature in posttreatment Lyme disease patients","volume":"11","author":"Morrissette","year":"2020","journal-title":"mBio"},{"key":"2026082410094344800_bib28","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1038\/s41564-024-01887-4","article-title":"Metagenomic immunoglobulin sequencing reveals IgA coating of microbial strains in the healthy human gut","volume":"10","author":"Olm","year":"2025","journal-title":"Nat. Microbiol."},{"key":"2026082410094344800_bib29","doi-asserted-by":"publisher","DOI":"10.1002\/cpz1.1127","article-title":"Mouse models for the study of Borrelia burgdorferi infection","volume":"4","author":"Olsen","year":"2024","journal-title":"Curr. Protoc."},{"key":"2026082410094344800_bib30","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1016\/j.cgh.2018.10.002","article-title":"The gut\u2013brain axis and the microbiome: Mechanisms and clinical implications","volume":"17","author":"Osadchiy","year":"2019","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"2026082410094344800_bib31","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1038\/s41385-019-0227-4","article-title":"IgA and the intestinal microbiota: The importance of being specific","volume":"13","author":"Pabst","year":"2020","journal-title":"Mucosal Immunol."},{"key":"2026082410094344800_bib32","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1111\/imr.12567","article-title":"Gut microbiota: Role in pathogen colonization, immune responses, and inflammatory disease","volume":"279","author":"Pickard","year":"2017","journal-title":"Immunol. Rev."},{"key":"2026082410094344800_bib33","doi-asserted-by":"publisher","first-page":"4043","DOI":"10.1128\/iai.65.10.4043-4047.1997","article-title":"Duration of immunity to reinfection with tick-transmitted Borrelia burgdorferi in naturally infected mice","volume":"65","author":"Piesman","year":"1997","journal-title":"Infect. Immun."},{"key":"2026082410094344800_bib34","doi-asserted-by":"publisher","first-page":"S191","DOI":"10.1017\/s0031182003004694","article-title":"Lyme borreliosis in Europe and North America","volume":"129","author":"Piesman","year":"2004","journal-title":"Parasitology"},{"key":"2026082410094344800_bib35","doi-asserted-by":"publisher","first-page":"392","DOI":"10.3390\/antibiotics13050392","article-title":"The role of gut microbiota in the etiopathogenesis of multiple chronic diseases","volume":"13","author":"Pires","year":"2024","journal-title":"Antibiotics"},{"key":"2026082410094344800_bib36","doi-asserted-by":"publisher","first-page":"57","DOI":"10.3389\/fmed.2020.00057","article-title":"Post-treatment Lyme disease as a model for persistent symptoms in Lyme disease","volume":"7","author":"Rebman","year":"2020","journal-title":"Front. Med."},{"key":"2026082410094344800_bib37","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1007\/s15010-021-01590-0","article-title":"The presenting characteristics of erythema migrans vary by age, sex, duration, and body location","volume":"49","author":"Rebman","year":"2021","journal-title":"Infection"},{"key":"2026082410094344800_bib38","doi-asserted-by":"publisher","first-page":"1454858","DOI":"10.3389\/fmed.2024.1454858","article-title":"A sex-based analysis of complete blood count features during acute, untreated Lyme disease","volume":"11","author":"Rebman","year":"2024","journal-title":"Front. Med."},{"key":"2026082410094344800_bib39","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.1016\/j.chom.2024.05.008","article-title":"Epithelial hypoxia maintains colonization resistance against Candida albicans","volume":"32","author":"Savage","year":"2024","journal-title":"Cell Host Microbe"},{"key":"2026082410094344800_bib55","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1007\/s00281-021-00879-4","article-title":"The immune landscape of IgA induction in the gut","volume":"43","author":"Seikrit","year":"2021","journal-title":"Semin. Immunopathol."},{"key":"2026082410094344800_bib41","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1159\/000213070","article-title":"Clinical manifestations and diagnosis of Lyme borreliosis","volume":"37","author":"Strle","year":"2009","journal-title":"Curr. Probl. Dermatol."},{"key":"2026082410094344800_bib42","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/s0176-6724(86)80123-7","article-title":"Clinical manifestations of Lyme disease","volume":"263","author":"Steere","year":"1986","journal-title":"Zentralbl. Bakteriol. Mikrobiol. Hyg. A"},{"key":"2026082410094344800_bib43","doi-asserted-by":"publisher","DOI":"10.1080\/21688370.2017.1373208","article-title":"Intestinal barrier and gut microbiota: Shaping our immune responses throughout life","volume":"5","author":"Takiishi","year":"2017","journal-title":"Tissue Barriers"},{"key":"2026082410094344800_bib44","doi-asserted-by":"publisher","first-page":"116","DOI":"10.3389\/fimmu.2017.00116","article-title":"Borrelia burgdorferi manipulates innate and adaptive immunity to establish persistence in rodent reservoir hosts","volume":"8","author":"Tracy","year":"2017","journal-title":"Front. Immunol."},{"key":"2026082410094344800_bib45","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1002066","article-title":"Lymphoadenopathy during lyme borreliosis is caused by spirochete migration-induced specific B cell activation","volume":"7","author":"Tunev","year":"2011","journal-title":"Plos Pathog."},{"key":"2026082410094344800_bib46","doi-asserted-by":"publisher","first-page":"1399","DOI":"10.1093\/cid\/ciw599","article-title":"Expression of C-reactive protein and serum amyloid A in early to late manifestations of Lyme disease","volume":"63","author":"Uhde","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"2026082410094344800_bib47","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.biochi.2018.06.014","article-title":"Experimental human endotoxemia as a model of systemic inflammation","volume":"159","author":"van Lier","year":"2019","journal-title":"Biochimie"},{"key":"2026082410094344800_bib48","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1080\/17474124.2017.1343143","article-title":"The intestinal barrier: A fundamental role in health and disease","volume":"11","author":"Vancamelbeke","year":"2017","journal-title":"Expert Rev. Gastroenterol. Hepatol."},{"key":"2026082410094344800_bib49","doi-asserted-by":"publisher","first-page":"e0001824","DOI":"10.1128\/iai.00018-24","article-title":"Suppression of host humoral immunity by Borrelia burgdorferi varies over the course of infection","volume":"92","author":"Williams","year":"2024","journal-title":"Infect. Immun."},{"key":"2026082410094344800_bib50","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1080\/23744235.2021.1924397","article-title":"Long COVID or post-COVID-19 syndrome: Putative pathophysiology, risk factors, and treatments","volume":"53","author":"Yong","year":"2021","journal-title":"Infect. Dis."},{"key":"2026082410094344800_bib51","doi-asserted-by":"publisher","first-page":"1587","DOI":"10.3390\/microorganisms8101587","article-title":"Gut microbiota and immune system interactions","volume":"8","author":"Yoo","year":"2020","journal-title":"Microorganisms"},{"key":"2026082410094344800_bib52","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1002\/JLB.1MR0321-660R","article-title":"Gut microbiota shape B cell in health and disease settings","volume":"110","author":"Yu","year":"2021","journal-title":"J. Leukoc. Biol."},{"key":"2026082410094344800_bib53","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1021\/acs.jproteome.9b00569","article-title":"Measurement of organ-specific and acute-phase blood protein levels in early Lyme disease","volume":"19","author":"Zhou","year":"2019","journal-title":"J. Proteome Res."}],"container-title":["Journal of Experimental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/rupress.org\/jem\/article-pdf\/doi\/10.1084\/jem.20252380\/2040083\/jem_20252380.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/rupress.org\/jem\/article-pdf\/doi\/10.1084\/jem.20252380\/2040083\/jem_20252380.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T14:09:55Z","timestamp":1787580595000},"score":1,"resource":{"primary":{"URL":"https:\/\/rupress.org\/jem\/article\/223\/9\/e20252380\/282969\/Borrelia-burgdorferi-disrupts-gut-barrier"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,24]]},"references-count":53,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,10,5]]}},"URL":"https:\/\/doi.org\/10.1084\/jem.20252380","relation":{},"ISSN":["0022-1007","1540-9538"],"issn-type":[{"value":"0022-1007","type":"print"},{"value":"1540-9538","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,24]]},"article-number":"e20252380"}}