Role of the VlsE Lipoprotein in Immune Avoidance by the Lyme Disease Spirochete Borrelia burgdorferi.

Borrelia burgdorferi is the causative bacterial agent of Lyme disease, the most prevalent tick-borne infection in North America. The ability of B. burgdorferi to cause disease is highly dependent on its capacity to evade the immune response during infection of the mammalian host. One of the ways in which B. burgdorferi is known to evade the immune response is antigenic variation of the variable major protein (VMP)-like sequence (Vls) E lipoprotein. Past research involving the B. burgdorferi antigenic variation system has implicated a gene-conversion mechanism for vlsE recombination, analyzed the long-term dynamic changes occurring within VlsE, and established the critical importance of antigenic variation for persistent infection of the mammalian host. However, a role for the VlsE protein other than providing an antigenic disguise is currently unknown, but it has been proposed that the protein may function in other forms of immune evasion. Although a substantial number of additional proteins reside on the bacterial surface, VlsE is the only known antigen that exhibits ongoing variation of its surface epitopes. This suggests that B. burgdorferi may use a VlsE-mediated system for immune avoidance of its surface antigens. Several recent experimental studies involving host reinfection, superinfection, and the importance of VlsE antigenic variation during the pathogen's enzootic cycle have been used to address this question. Here, the cumulative results from these studies are reviewed, and the knowledge gaps that remain regarding the role of VlsE for immune avoidance are discussed.