Because we are aware that most readers of this book will not have medical training, we have included a glossary at the end of this book. However, as an initial introduction to this topic, readers should understand the commonly used terms, listed below.
Antibody (also known as immunoglobulin) and antigen: A protein produced by the immune system to defend against microbes such as spirochetes, other bacteria, and viruses. The antibody binds to a protein (called an “antigen”) on the microbe (for example, on the outer surface of the spirochete) to facilitate killing of the microbe. The smaller piece of this antigen that is the precise site for antibody binding is called an “epitope.”
Borrelia burgdorferi (B. burgdorferi): the bacterial microbe (a spirochete) that causes Lyme disease.
Centers for Disease Control and Prevention (CDC): A U.S. government agency mandated to improve public health through health promotion, disease surveillance, and prevention.
Cerebrospinal fluid: The continuously produced watery fluid that flows in the ventricles and around the surface of the brain and spinal cord. A lumbar puncture (“spinal tap”) is used to collect cerebrospinal fluid to detect signs of disease or infection.
Chemokine: A type of cytokine that guides white blood cells to sites of infection.
Cytokine: A hormone-like cell-signaling molecule that aids cell-to-cell communication and stimulates other cells to move toward sites of inflammation, infection, and trauma. Examples include interferon, interleukin, and tumor necrosis factor.
Enzyme-linked immunosorbent assay (ELISA): A method of detecting and quantifying substances, such as antibodies in the blood or cerebrospinal fluid. Also referred to as enzyme immunoassay (EIA), this is often the first test for Lyme disease.
Ixodes ticks: Hard-bodied ticks that carry microbes (for example, viruses, bacteria, and protozoan parasites), some of which can be transmitted by the bite of a tick to humans to cause disease. These are considered “vectors” because they transmit infection.
Lyme borreliosis: Another term for Lyme disease, commonly used outside of the United States.
Neuropathy: Damage or malfunction of the nerves of the body. One common type affects the peripheral nervous system, causing symptoms such as tingling, intense pain, or weakness.
Polymerase chain reaction (PCR): A test that detects genetic material (DNA or RNA) and is often considered a marker of current or recent infection or of remnant particles of infection.
Serologic test: A blood test that detects antibodies against microbes.
Western blot: A specific type of immunoblot that detects antibodies present in a serum sample. Often ordered as the second test after the ELISA for Lyme disease.