Biological sex should be included in Lyme disease research, according to a study published online June 17 in the International Journal of General Medicine.
Lorraine Johnson, from MyLymeData in San Ramon, California, and colleagues examined sex-based differences in Lyme disease patients who were clinically diagnosed and reported remaining ill for six or more months after receiving antibiotic treatment. Self-reported clinical data were analyzed for 2,170 patients in the MyLymeData patient registry. In addition, previous Lyme disease studies were reviewed for distribution of patients by biological sex.
The researchers found that compared with men, women reported more tickborne coinfections, worse symptoms, longer diagnostic delays, more misdiagnoses, and worse functional impairment in MyLymeData. Antibiotic treatment response and side effects did not differ. In a review of clinical research trials and data sources, a smaller percentage of women was identified in studies of acute Lyme disease and a larger percentage was identified in studies of persistent illness. A higher percentage of women was seen in samples and data sources that were more reflective of patients seen in clinical practice than in randomized controlled trials and posttreatment Lyme disease studies.
“Basic and medical research should include biological sex as one of the variables in study design,” the authors write. “Biological sex can directly impact initial response to pathogens as well as the course of disease progression through different genetic pathways (including the role of X and Y chromosomes), anatomic niches, immunological profiles, and hormonal environments.” Johnson and colleagues wrote.
