W207 - Lyme Disease Increases Risk for Multiple Gynecological Conditions with Age

Abstract Text: Lyme disease (LD) is an illness caused by the spirochete Borrelia burgdorferi (Bb). Bb disseminates through organs, including skin, joints, spinal cord, bladder, and heart, leading to Lyme arthritis, neuroborreliosis, and Lyme carditis. While previous studies have investigated the impact of LD on pregnancy in both mice and humans and have found the presence of Bb in the uterus of mice, we studied the impact of LD on the non-pregnant female reproductive tract (FRT). We use a LD mouse model and find an ongoing and severe infection of the FRT, which persists up to 15-months post-inoculation. This infection results in uterine glandular cysts, endometrial hyperplasia, and interspersed endometrial stromal cells as well as vaginal epithelial thickening, polymorphonuclear and mononuclear cell epithelial infiltration, and canal lumen epithelial desquamation. Even in C57BL/6 mice, long thought to be asymptomatic for LD, we detect FRTs infected with Bb after 8-weeks of infection, and ongoing infection throughout the next 12-months in n=5/6 individuals. Additionally, we find that age has an impact on the extent of gynepathology such that aged mice (1-year old) that are reproductively senescent have more gynepathology with infection compared to young mice (15-weeks old) when infected for the same length of time. Using large-scale electronic healthcare record data, we report that LD additionally results in increased infection-associated risk of menorrhagia, miscarriage, uterine fibroids), and endometriosis. This work suggests that further study of the FRT and the effects of Bb infection therein will help clarify and expand our knowledge of LD outcomes.