Conversely, Zychowski et al. (2024) (Zychowski et al., 2024a) found no significant association between other tick-borne diseases and chronic musculoskeletal symptoms in a North Carolina cohort, although they observed a correlation between elevated α-gal IgE levels and knee pain, emphasizing the variability in the impact of tick-borne illnesses on musculoskeletal health. The gene discussed is IGHE; the disease is tick-borne infectious disease.