{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T16:09:26Z","timestamp":1778256566767,"version":"3.51.4"},"posted":{"date-parts":[[2026,5,6]]},"group-title":"Infectious Diseases (except HIV\/AIDS)","reference-count":40,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,5,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:p>\n                  Lyme disease is a growing and prominent human health problem caused by a group of spirochaetal bacteria that belong to the\n                  <jats:italic>Borrelia<\/jats:italic>\n                  genus. Persistent Lyme disease infection produces a multi-system disorder that may result in severe arthritis, carditis, neurological problems, and even death. Preventing severe disease requires immediate treatment, but current approaches to diagnose Lyme disease are indirect, serology-based assays that may fail early in infection. All Lyme disease-causing\n                  <jats:italic>Borrelia<\/jats:italic>\n                  species shed distinct and unique fragments of their peptidoglycan cell wall during growth. We exploited this fundamental biological process to develop an acute, urine-based diagnostic test. Using a cocktail of unique and highly specific monoclonal antibodies, our ELISA-mediated approach accurately reports on the status of an active, acute infection, in a laboratory animal model of Lyme disease, as well as humans. This rapid, simple, and innovative approach detects an active infection in as few as 3 days of transmission and in 88% of human patients yet to seroconvert\u2014more than \u223c2 weeks before serology would be positive.\n                <\/jats:p>","DOI":"10.64898\/2026.05.05.26352475","type":"posted-content","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T23:40:13Z","timestamp":1778110813000},"source":"Crossref","is-referenced-by-count":0,"title":["A direct, urine-based test to diagnose acute Lyme disease using actively secreted peptidoglycan as a biomarker"],"prefix":"10.64898","author":[{"given":"Osamudiamen","family":"Ebohon","sequence":"first","affiliation":[{"name":"Department of Microbiology-Immunology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA"},{"name":"Center for Human Immunobiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA"},{"name":"Department of Biochemistry, College of Agriculture and Life Sciences, Virginia Tech, Blacksburg, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saadman S.","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Microbiology-Immunology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jules","family":"Dressler","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, College of Agriculture and Life Sciences, Virginia Tech, Blacksburg, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenda Y.","family":"Rosario Perez","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology and Microbiology, Tufts University School of Medicine, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl L.","family":"Ocius","sequence":"additional","affiliation":[{"name":"Department of Chemistry, University of Virginia, Charlottesville, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcos M.","family":"Pires","sequence":"additional","affiliation":[{"name":"Department of Chemistry, University of Virginia, Charlottesville, VA, USA"},{"name":"Department of Microbiology, Immunology, and Cancer, University of Virginia, Charlottesville, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6369-3997","authenticated-orcid":false,"given":"Lise E.","family":"Nigrovic","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7989-1031","authenticated-orcid":false,"given":"Brandon L.","family":"Jutras","sequence":"additional","affiliation":[{"name":"Department of Microbiology-Immunology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA"},{"name":"Center for Human Immunobiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA"},{"name":"Department of Biochemistry, College of Agriculture and Life Sciences, Virginia Tech, Blacksburg, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2026050808101684000_2026.05.05.26352475v1.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2015.02.010"},{"key":"2026050808101684000_2026.05.05.26352475v1.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03492.x"},{"issue":"4","key":"2026050808101684000_2026.05.05.26352475v1.3","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1097\/INF.0000000000000248","article-title":"Lyme Borreliosis","volume":"33","year":"2014","journal-title":"Pediatr Infect Dis J"},{"key":"2026050808101684000_2026.05.05.26352475v1.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp061181"},{"key":"2026050808101684000_2026.05.05.26352475v1.5","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00044-19"},{"issue":"31","key":"2026050808101684000_2026.05.05.26352475v1.6","first-page":"590","volume":"44","author":"Centers for Disease Control and Prevention (CDC)","year":"1995","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026050808101684000_2026.05.05.26352475v1.7","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.34.1.1-9.1996"},{"key":"2026050808101684000_2026.05.05.26352475v1.8","doi-asserted-by":"crossref","unstructured":"Horn EJ , Menefee B , Schotthoefer AM , Dempsey G , Mcardle M , Weber AF , et al. 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