GameChanger: Nicole Baumgarth

Nicole Baumgarth was first bitten by the tick bug (metaphorically speaking) at the University of California, Davis, back in the early 2000s. At the time, she knew nothing about the parasitic insect, or the increasingly prevalent Lyme disease associated with its bites, but a colleague was conducting early research and finding unusual results. “I had been studying influenza, so I thought, how hard can this be?” says the immunologist, who grew up in Germany. “But it was actually really difficult.” It turned out ticks were a complex area of study, and she was hooked.

Fast-forward to 2022, when Baumgarth, now a leading expert, was named inaugural director of Johns Hopkins University’s new Lyme and Tickborne Diseases Research and Education Institute, where her work aims to address this rising public health issue, which includes other illnesses like Rocky Mountain Spotted Fever and alpha-gal syndrome, which causes a red meat allergy. “If we do this right,” says Baumgarth, “we could really make an impact.”

What is the institute’s mission?
We hope to be the basic research arm of the work surrounding tick-borne diseases at Hopkins. We are focusing on the fundamental research that is so critical, and so lacking, when it comes to understanding ticks, the pathogens, such as Borrelia burgdorferi, and the host’s response to infection.

Why is research lacking?
Lyme disease and other tick-borne illnesses have been quickly on the rise. That’s a combination of factors: It’s the changing climate, it’s humans moving into areas that were not previously inhabited. It’s also really complicated, and there are just not that many people who know anything about ticks. Lyme disease was discovered in the 1980s. That’s a blink of an eye. So one important thing we want to do is increase the number of students and researchers who are excited about working on this.

What are your main areas of focus?
One is the tick itself—we need to understand its biology. And then the tick’s ecology, or the environment in which the tick is in, and how they interact with one another. The third is, of course, the pathogen. And then the last piece is the immune response—the host, and how the host responds, which is an area I’m working in, mainly with mouse models, the normal natural host, but having the proximity to the Lyme Disease Research Center [at Hopkins’ School of Medicine] will allow us to also start looking at human samples to understand where there are similarities and differences.

Why is the pathogen difficult to study?
In order to understand how a pathogen works, how it interacts with the host—and by host, I mean humans or rodents or ticks, really—what researchers usually do is they knock out certain genes and learn what parts of the pathogen are causing disease. But Borrelia has a very unusual genetic structure, which makes it hard to do that. Only a handful of people know how to manipulate the genome, and even then, when you do it successfully, it’s not perfect. That really restricts how fast we can make progress in understanding the pathogen, what it does, and how it works.

There is currently no vaccine for Lyme disease. Is that a goal of your research?
The long-term goal is to make a [Lyme] vaccine. I don’t think that it is a problem that cannot be solved. But I’m even more excited about the prospect of some work going at Yale University, thinking along the lines of making an anti-tick vaccine rather than a pathogen-specific vaccine. While everyone talks about Lyme, we want to be prepared for a novel pathogen that we may not even be thinking about yet.

If we could actually stop the tick from efficiently and effectively biting us and transmitting a pathogen, then we are protecting ourselves from multiple pathogens—not just one. And just like with every vaccine, not everybody will want it or be successfully vaccinated, so you always need to find new therapeutic approaches. Antibiotics are very important in the treatment of Lyme disease; the earlier you take them, the higher your chances are that you’ll be fully cured after the infection. But there are also people who take the course of antibiotics and still have lingering symptoms, similar to what is now sort of described as long COVID, so that’s why we really need to understand the immune response to the pathogen first.

How is climate change impacting all of this—milder winters mean more ticks?
Right. The factors that are affecting ticks are humidity and temperature. So in warmer climates, it is very clear that you can get more spread of ticks in areas that previously were too cold for them to live. That’s an obvious one. We’re also having changing weather patterns and changing rainfalls, and with humidity being so important for them [needing a certain level of moisture in their environment to survive], it will change where the ticks lives.

If you had a message for the public, what would it be?
I don’t think anybody should panic. And while it’s wonderful to go out into nature, just make sure that you protect yourself, either by wearing long trousers or long sleeves, and check yourself afterwards. Ticks are very, very small, so they can easily be overlooked.