All Posts Tagged With: "Lyme borreliosis"

Full article: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=20595179&retmode=ref&cmd=prlinks

Excerpt:

Results
27 different non-specific bands were detected in both groups. Six
of 27 (22%) of the non-specific bands were detected significantly
more in the western blot positive patients compared to the
western blot negative patients (20 kDa, p<0.0001; 28 kDa,
p<0.002; 36 kDa, p<0.002; 37 kDa, p<0.007; 48 kDa, p<0.023; 56
kDa, p<0.028; two-tailed F test). 

Conclusion
Results suggest that the 20, 28 and 48 kDa bands should be
regarded as specific.

Full article: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=20407371&retmode=ref&cmd=prlinks

Excerpt:

PURPOSE OF REVIEW: Lyme borreliosis is the most common
vector-borne bacterial infection in temperate areas of the
northern hemisphere. It has been perceived as difficult to
diagnose and treat, but much is now known about its clinical
presentations, which largely fall into well defined categories in
both adults and children. This review features recent
publications on clinical diagnosis and management. 

RECENT FINDINGS: The reported incidence of Lyme borreliosis has
increased markedly in many countries. Many recent publications
have focused on clinical and laboratory aspects of paediatric and
adult neuroborreliosis, and there is now strong evidence for the
efficacy of oral doxycycline for most presentations of
neuroborreliosis. Serological tests have improved significantly.
Several studies have confirmed that patients treated for early
Lyme borreliosis have good overall long-term outcomes. Studies of
patients with persistent symptoms following treatment have not
shown evidence for active infection or for sustained benefit from
prolonged antibiotic treatment. 

Full article: http://sci.tech-archive.net/Archive/sci.med.diseases.lyme/2008-06/msg00078.html

Excerpt:

IDSA knows that chronic Lyme exists

The IDSA is aware that chronic Lyme exists. We know this because
members of the 2000 and 2006 Lyme disease guideline panels wrote, in
research articles and patents, that chronic Lyme exists.

Evidence about the existence of chronic Lyme borreliosis has increased
since the 2006 LD guidelines were published.

Scientists in California recently reported that not only can Bb persist
in mice despite treatment with ceftriaxone, but the Borrelia can also
infect other ticks and mice. (1) This study buttresses previous
studies that showed that Borrelia can persist in mice (2, 3), dogs (4,
5, 6), and ponies (7).

Studies have also shown that Bb can persist despite antibiotic
treatment in the following human cells, tissues, organs, and body
fluids:

* Fibroblasts (8; Mark Klempner, an IDSA LD guideline panel member in
2006, is an author of this study)

Excerpt:

Results

We demonstrate that B. garinii OspA serotype 4 (ST4) PBi resist complement-mediated killing by binding of FHL-1. To identify the primary ligands of FHL-1 four CspA orthologs from B. garinii ST4 PBi were cloned and tested for binding to human CFH and FHL-1. Orthologs BGA66 and BGA71 were found to be able to bind both complement regulators but with different intensities. In addition, all CspA orthologs were tested for binding to mammalian and avian CFH. Distinct orthologs were able to bind to CFH of different animal origins.

Conclusions

B. garinii ST4 PBi is able to evade complement killing and it can bind FHL-1 to membrane expressed proteins. Recombinant proteins BGA66 can bind FHL-1 and human CFH, while BGA71 can bind only FHL-1. All recombinant CspA orthologs from B. garinii ST4 PBi can bind CFH from different animal origins. This partly explains the wide variety of animals that can be infected by B. garinii

Full article: http://www.emedicine.com/derm/topic4.htm

Excerpt:

Acrodermatitis chronica atrophicans (ACA) is the third or late stage of European Lyme borreliosis (LB). This unusual, progressive, fibrosing skin process is due to the effect of continuing active infection with Borrelia afzelii. Buchwald first delineated it in 1883; Herxheimer and Hartmann described it in 1902 as a tissue paper–like cutaneous atrophy. It is evident on the extremities, particularly on the extensor surfaces, beginning with an inflammatory stage with bluish red discoloration and cutaneous swelling and concluding several months or years later with an atrophic phase. Sclerotic skin plaques may also develop. Physicians should use serologic and histologic examination to confirm this diagnosis.

Pathophysiology: B afzelii is the predominant, but may not be the exclusive, etiologic agent of ACA. Another genospecies of the Borrelia burgdorferi sensu lato complex, Borrelia garinii, has also been detected.

ACA is the only form of LB in which no spontaneous remission occurs. Its pathophysiology is not yet fully understood. ACA appears to be associated with long-term persistence of Borrelia organisms in the skin; several nonspecific reactions together with a specific immune response may contribute to its manifestations.

The persistence of the spirochetes despite a marked cutaneous T-cell infiltration and high serum antibody titers may be connected with resistance of the pathogen to the complement system; the ability to escape to immunologically protected sites (eg, endothelial cells, fibroblasts); and the ability to change antigens, which may lead to an inappropriate immune response. Lack of protective antibodies, with a narrow antibody spectrum and a weak cellular response with down-regulation of major histocompatibility system class II molecules on Langerhans cells, has been observed in patients with LB.

Full article: www.emedicine.com/DERM/topic381.htm 

Excerpt:

BACKGROUND: Sarcoidosis is a multisystemic granulomatous disease of unknown etiology, while Lyme borreliosis is a multisystemic disorder caused by Borrelia burgdorferi. The purpose of this study is to evaluate the relationship between sarcoidosis and Lyme borreliosis in a region of Japan where Lyme borreliosis is endemic. METHODS: We determined the seroprevalence of anti-Borrelia burgdorferi antibodies as well as antibodies three Japanese Borrelia strains by enzyme-linked immunosorbent assay and dotblot assay using purified Borrelia-specific proteins in 46 patients with confirmed sarcoidosis and 150 controls (50 disease controls and 100 healthy controls) in Hokkaido, the affected region. RESULTS: Fifteen patients with sarcoidosis (32.6%) tested positive for Borrelia spirochete in both assays, compared with two disease controls (4.0%) and two healthy controls (2.0%). The seroprevalence of anti-Borrelia antibodies in patients with sarcoidosis was much higher in the affected region than in the region in our previous study were Lyme borreliosis is non-endemic. CONCLUSION: In a region where Lyme borreliosis is endemic, Borrelia infection may be partially associated with sarcoidosis.

Excerpt:

In the far-western United States, the nymphal stage of the
western black-legged tick, Ixodes pacificus, has been implicated
as the primary vector to humans of Borrelia burgdorferi sensu
stricto (hereinafter referred to as B. burgdorferi), the
causative agent of Lyme borreliosis in North America. In the
present study, we sought to determine if infection prevalence
with B. burgdorferi in I.
pacificus nymphs and the density of infected nymphs differ
between dense-woodland types within Mendocino County, California,
and to develop and evaluate a spatially-explicit model for
density of infected nymphs in dense woodlands within this
high-incidence area for Lyme borreliosis. In total, 4.9%
(264) of 5431 I. pacificus nymphs tested for the presence of B.
burgdorferi were infected. Among the 78 sampling sites, infection
prevalence ranged from 0 to 22% and density of infected nymphs
from 0 to 2.04 per 100 m(2). Infection prevalence was highest in
woodlands dominated by hardwoods (6.2%) and lowest for redwood
(1.9%) and coastal pine (0%). Density of infected nymphs also was
higher in hardwood-dominated woodlands than in conifer-dominated
ones that included redwood or pine. Our spatial risk model, which
yielded an overall accuracy of 85%, indicated that warmer areas
with less variation between maximum and minimum monthly water
vapor in the air were more likely to include woodlands with
elevated acarological risk of exposure to infected nymphs. We
found that 37% of dense woodlands in the county were predicted to
pose an elevated risk of exposure to infected nymphs, and that
94% of the dense-woodland areas that were predicted to harbor
elevated densities of infected nymphs were located on
privately-owned land.

Excerpt:

BACKGROUND: Lyme borreliosis is a multisystemic disease which affects several organs such as skin, nervous system, joints and the heart. The presented study focused on patients with persisting symptoms of the disease, which could be in correlation with Lyme disease but antiborrelial antibodies were not confirmed by screening tests. MATERIAL AND METHODS: 32 patients with anamnestic data and suspected clinical signs of lyme borreliosis were tested for the presence of antiborrelia antibodies by using ELISA and westernblot analysis and the state of cellular and humoral immunity. RESULTS: All patients had specific antiborrelial antibodies confirmed by using the westernblot in spite of negative ELISA. Immunological investigations revealed a deficiency of cellular immunity in all patients and in a part of them (15.6%) a deficiency of humoral immunity was also found. The presence of different types of autoantibodies was detected in 17 (53.1%) patients. CONCLUSION: In patients with persisting difficulties that could be associated with Lyme disease, it is necessary to use the westernblot test which could prove the presence of specific antibodies. It is probably due to the very low production of specific antibodies caused also by the status of immune deficiency detected in all our patients (Tab. 1, Ref. 11).

Full article: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=20461540&retmode=ref&cmd=prlinks

Excerpt:

OBJECTIVE: By using the published incidence of Lyme borreliosis
in endemic regions of the World, and the sensitivity and
specificity data of the best Lyme serological tests, we computed
the positive predictive value of Borrelia burgdorferi antibody
testing. METHODS: The calculation of predictive value was based
on Bayes’ theorem. We also analyzed the frequency distribution of
the specific and non-specific symptoms and complaints of 27,194
patients sent to the Centre for Tick-borne Diseases in Budapest
from 1986 to 2008. RESULTS: This evaluation demonstrated that
practitioners often use Lyme serology in a “trial and error” way,
without any reasonable ground. According to our calculation the
positive predictive value of the best Lyme antibody tests if
applied in this way is <9.1%. CONCLUSION: Our study suggests that
the present practice of applying Lyme serological tests may
result in more harm than benefit.
 

Excerpt:

This case serves to underscore several clinical points. Firstly, Lyme borreliosis may present by mimicking a malignancy. Secondly, a previous episode of borrelial infection may not confer immunity. Reinfection is uncommon, but is more likely to occur in patients whose previous episode was promptly treated rather than in those with longstanding infection, who have a well‐developed antibody response before treatment.5 Thirdly, patients may not specifically recall a tick bite. Thus, it is important that a history of tick exposure risk, which may be residential, occupational or recreational, is sought from patients. Finally, Beevor’s sign has a useful localisation value