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However, this group may represent an interesting, intermediate clinical phenotype between archetypal Lyme disease and PTLD, as these types of presentations may occur before the onset of late Lyme arthritis, during which time objective manifestations may be transient ( Finally, given the lack of an available biomarker, there will always be a subset of patients with missed diagnoses of other diseases and conditions with similar symptoms, who initially seek evaluation for CLD with non-specific symptoms (90, 91)

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EA and MDSA are effective at inhibiting ME2 activity at submicromolar concentrations, but cells require micromolar concentrations to prevent ME2-driven pyruvate and energy metabolism