Through the support of Time for Lyme, Inc, an affiliate of the Lyme Disease Association, a national non-profit corporation, and of the Lyme Disease Association itself and of private donors and foundations, Columbia University is expected to establish the first Lyme Disease Research Center in the United States. The Lyme Disease Research Center will focus on the problem of chronic Lyme disease, including the search for better diagnostic tests and treatments, drawing upon the vast resources of the Columbia University Medical Center.

Background

Lyme disease, a major health threat to our nation, has increased in incidence dramatically over the past 15 years. The states in closest proximity to Columbia University (New York State, New Jersey, Rhode Island, Pennsylvania, and Connecticut) have reported the most cases of Lyme disease to the CDC. Lyme disease is not limited however to the Northeast. It has been reported across the United States, with areas of heavy intensity in the upper Midwest and the Pacific Coastal states, and in many countries throughout the world. In addition to well-documented Lyme disease, Lyme-like diseases have been reported in the Southern States (Master's Disease or STARI) as well. In some highly endemic areas, as many as one in four households have had a member affected by Lyme disease. . Although Lyme disease responds well when diagnosed and treated early, patients unfortunately do not always see the tick bite or rash. These patients are at risk of developing a chronic form of Lyme disease, which may affect the joints, the heart, and/or the central or peripheral nervous system. Little is known about how best to treat patients with the later stages of the disease. These, and other challenging questions about Lyme disease and other vector-borne diseases, can only be answered with state of the art research studies. The Lyme Disease Research Center will bring together basic scientists and clinical leaders to examine these questions. Leadership

Dr. Brian Fallon, Associate Professor in the Department of Psychiatry at Columbia University College of Physicians and Surgeons, will direct the Lyme Disease Research Center. Dr. Fallon is a leading expert on the neuropsychiatric aspects of this disease and publishes widely on the topic.

Since 1991, Dr. Fallon has studied the neurologic and psychiatric manifestations of Lyme disease. This research has been supported by individuals, private foundations and national organizations, including the American Suicide Foundation, the Lyme Disease Association, and the National Institutes of Health. Based on provocative pilot data on brain imaging and treatment, in 1999 Dr. Fallon was awarded a four-year $4.7 million grant from the National Institutes of Neurological Disorders and Stroke to answer basic questions about the neurobiology and treatment of patients with persistent memory and attention problems related to chronic Lyme disease. This represents one of the largest NIH grants ever awarded to study Lyme disease in the United States. The funding of this grant represents an acknowledgment by the NIH that chronic Lyme disease has become a major public health problem that requires closer study. Primary Goals

This Research Center will address critical basic science and clinical issues as they emerge.

Areas of particular basic science interest include, but are not limited to, studies addressing the following areas: improved diagnostic assays; exploration for the presence of comorbid infections in ticks and comorbid diseases in the chronically ill patient; improved understanding of the pathophysiologic mechanism of disease, particularly as it relates to chronic Lyme disease; genetic studies to identify vulnerability factors within families. Areas of particular clinical interest include: use of proteomics to help identify diagnostic markers of infection; application of the power of neuroimaging to better understand the brain mechanisms of disease; treatment trials to examine the efficacy of a wide range of therapeutic interventions, including for example antimicrobials, immunomodulatory agents, and drugs that target neurotransmitters thought to be dysregulated among patients with persistent pain and cognitive problems; further study of the neurologic and neuropsychiatric manifestations of Lyme disease. The Center will continue to provide an evaluation and diagnostic facility where chronically ill children and adults with Lyme disease and other difficult-to-diagnose or difficult-to-manage neurologic or neuropsychiatric conditions can come for a comprehensive evaluation and treatment. In an effort to use some of the funds that have already been raised for the Center establishment, a Research Fund has been launched to help support the funding of pilot studies from academic centers throughout the country, allowing for novel research ideas to be pursued; as of July 2005, over $120,000 has been awarded to investigators outside of Columbia. The Center will also provide an invaluable educational resource through the sponsorship of an annual national scientific research conference (conducted collaboratively over the last several years with the Lyme Disease Association), through regular scientific lectures at the Columbia Presbyterian Medical Center, and through fellowship training of medical students and post-residency Family Medicine physicians. The three main arms of this Center - basic science, clinical research and evaluation, and education - promise to help bring major advances in our understanding, diagnosis, and treatment of Lyme disease.

Why Columbia University?

The Columbia University Medical and Health Sciences Center - a Medical Center with an international reputation for excellence - is situated within northern New York City and within easy access to many heavily Lyme endemic states. Dr. Fallon and his research team have a long-standing commitment to investigating the puzzles of chronic Lyme Disease using rigorous scientific research. This Center with its location within the domain of the Columbia University Health Sciences Center campus will allow for ease of multi-disciplinary collaboration. Collaborations and major research thrusts are being established with experts in the public health field of epidemiology and biostatistics, the basic science domains of genetics, immunology, pathology, microbiology, and neurobiology, and the clinical domains of neurology, rheumatology, pediatrics, and emerging infectious diseases. As an example, the neuroscience and basic science research power of the Columbia University Medical Center - recognized world-wide with two current Nobel laureates - will be used to help understand why some patients with Lyme disease experience such profound neurologic and neurocognitive problems.

FUNDING NEEDS