RESUMEN
The purpose of this study was evaluation of the prevalence of co-infection with Borrelia species, A. phagocytophilum and Babesia spp. in patients with tick-borne encephalitis (TBE). At total of 110 patients with TBE were included in the study. Serological tests for tick-borne encephalitis virus (TBEV), PCR for Borrelia species, Anaplasma phagocytophilum and Babesia spp., blood smears for A. phagocytophilum and Babesia spp. and BLAST analysis for Babesia spp. were performed. Results showed a significant majority of patients co-infected with Borrelia species (30/110; 27 %), much less with A. phagocytophilum (12/110; 10.9 %) and with Babesia spp. (1/110; 0.9 %). The BLAST analysis of the 18S rDNA sequence obtained with the Babesia spp. specific primers indicated that the patient was infected with Babesia microti. Triple co-infections (TBEV-Borrelia species- A. phagocytophilum) were observed in three (3/110; 2.7 %) patients. Conclusions were such that differential diagnosis in patients after the tick bite, presenting with acute symptoms, should include not only TBE and Lyme disease, but also other diseases transmitted by ticks. In patients with low parasitemia in suspicion of Babesia spp. infection PCR seems to be a more sensitive method than blood smear. Co-infection with various tick-borne pathogens must be always considered, especially in endemic regions.
Asunto(s)
Babesiosis/epidemiología , Coinfección/epidemiología , Ehrlichiosis/epidemiología , Encefalitis Transmitida por Garrapatas/complicaciones , Enfermedad de Lyme/epidemiología , Anaplasma phagocytophilum/aislamiento & purificación , Babesia microti/aislamiento & purificación , Borrelia/aislamiento & purificación , ADN Protozoario/química , ADN Protozoario/genética , ADN Ribosómico/química , ADN Ribosómico/genética , Femenino , Humanos , Masculino , Prevalencia , ARN Ribosómico 18S/genética , Análisis de Secuencia de ADNRESUMEN
PURPOSE: Apoptosis of activated T lymphocytes is essential to immunoregulation and its abnormalities have been observed in immune system disorders and persistent infections. To asses Borrelia burgdorferi influence on the susceptibility of T lymphocytes to apoptosis, we have measured expression of the Fas death receptor on these cells after incubation with live B. burgdorferi. MATERIAL AND METHODS: Peripheral blood mononuclear cells from 23 LD patients (18 with Lyme arthritis, 5 with neuroborreliosis) and 13 healthy controls (C) were incubated for 48 hours with and without live B. burgdorferi spirochetes: B. afzelii, B. garinii or B. burgdorferi sensu stricto. After incubation, Fas expression on CD3+ cells was measured cytometrically with FITC-labeled monoclonal antibody. RESULTS: Median fraction of Fas-expressing T lymphocytes increased under incubation with B. burgdorferi, with more cells expressing Fas after incubation with B. burgdorferi sensu stricto than with B. garinii. There was a tendency for a higher expression of Fas on T lymphocytes from LD patients then from controls, both in unstimulated and B. burgdorferi-stimulated cultures, but it did not reach a level of statistical significance. CONCLUSIONS: B. burgdorferi seems to increase Fas expression on CD3+ T lymphocytes, which may render these cells more susceptible to apoptosis. This effect is stronger for B. burgdorferi s.s. than for B. garinii genospecies.
Asunto(s)
Borrelia burgdorferi/patogenicidad , Neuroborreliosis de Lyme/inmunología , Neuroborreliosis de Lyme/metabolismo , Linfocitos T/inmunología , Receptor fas/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Apoptosis/fisiología , Complejo CD3/metabolismo , Células Cultivadas , Femenino , Humanos , Enfermedad de Lyme/inmunología , Enfermedad de Lyme/metabolismo , Neuroborreliosis de Lyme/microbiología , Masculino , Persona de Mediana Edad , Linfocitos T/metabolismoRESUMEN
PURPOSE: The aberrant inflammatory response is probably involved in the pathogenesis of chronic Lyme borreliosis, including chronic Lyme arthritis and neuroborreliosis. Transforming growth factor-beta 1 (TGF-beta1) is an important anti-inflammatory and immunomodulatory cytokine and its deficient synthesis is linked to exaggerated inflammation and immune response. MATERIAL AND METHODS: Peripheral blood mononuclear cells (PBMC) from 25 patients with Lyme borreliosis and 6 controls were incubated for 7 days with suspension of Borrelia afzeli, B. garinii and B. burgdorferi sensu stricto spirochetes. TGF-beta1 concentration in culture supernatants was measured with ELISA. Results were analyzed according to disease duration (group I--chronic borreliosis, n=20; group II--early borreliosis, n=5) and clinical form (LA--arthritis, NB--neuroborreliosis). RESULTS: TGF-beta1 concentration was increased in supernatants of PBMC cultures of patients with early neuroborreliosis, in comparison with chronic borreliosis and controls. In chronic, but not in early borreliosis, there was a tendency for decrease of TGF-beta1 synthesis under stimulation with B. burgdorferi spirochetes. CONCLUSIONS: Impaired synthesis of TGF-beta1 by mononuclear cells seems to be present in patients with chronic forms of Lyme borreliosis when compared to those with early stage of the disease. It may be a factor contributing to the persistence of inadequate inflammatory response in patients in whom chronic form of the disease develops.
Asunto(s)
Regulación de la Expresión Génica , Leucocitos Mononucleares/metabolismo , Enfermedad de Lyme/sangre , Factor de Crecimiento Transformador beta1/biosíntesis , Adulto , Borrelia/metabolismo , Borrelia burgdorferi/metabolismo , Enfermedad Crónica , Femenino , Humanos , Inflamación , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: In recent years, the role of pro- and antiinflammatory cytokines in the development of Lyme arthritis (LA) has been widely discussed. The purpose of the present study was to determine the concentration of interleukin-18 (IL-18), interleukin-1beta (IL-beta) and its soluble receptor sIL-1RII in serum of patients with LA as well as the usefulness of serum C-reactive protein (CRP) determination in LA diagnosis and monitoring of its treatment. PATIENTS AND METHODS: The study group consisted of 20 patients with LA. Before and after antibiotic treatment, the serum levels of IL-18, IL-1beta and sIL-1RII were measured immunoenzymatically using standard kits and the CRP level was measured by immunoturbidimetric method. RESULTS: Before treatment, the serum levels of IL-18, IL-1beta and sIL-1RII were significantly higher than in control group and after treatment the concentrations of IL-18, IL-1beta and sIL-1RII decreased significantly, but the level of IL-18 and sIL-1RII still remained higher than in control group. The elevated serum level of CRP was detected only in 6 of 20 patients and in 5 of them it returned to the baseline after treatment. CONCLUSION: The results of our study suggest that IL-18, IL-1beta and sIL-1RII might be involved in the development of LA. CRP may be useful in differential diagnosis in patients with suspicion of Lyme arthritis.
Asunto(s)
Artritis Infecciosa/sangre , Proteína C-Reactiva/metabolismo , Interleucina-18/sangre , Interleucina-1/sangre , Enfermedad de Lyme/sangre , Adulto , Anciano , Artritis Infecciosa/inmunología , Artritis Infecciosa/metabolismo , Femenino , Humanos , Enfermedad de Lyme/inmunología , Masculino , Persona de Mediana EdadRESUMEN
PURPOSE: Chemokines, including a chemoattractant for mononuclear cells CCL3 (MIP-1alpha), are responsible for attracting leukocytes into central nervous system (CNS) and cerebrospinal fluid (CSF) in meningitis and encephalomeningitis. We investigated the possibility of the involvement of CCL3 in tickborne encephalitis (TBE) pathogenesis. MATERIAL AND METHODS: We studied 26 patients with TBE; 13 with meningitis (group I) and 13 with encephalomeningits (group II). Control group included 11 patients without infectious disease of the CNS. CCL3 concentration was measured by ELISA in serum and CSF on admission (examination 1) and after 2 weeks (examination 2) in TBE patients and once in controls. RESULTS: In all control samples CCL3 concentration was below detection limit. In TBE, CCL3 serum concentration was: in group I--10.1 +/- 4.1 (mean +/- SD, ng/ml) in examination 1 and 12.4 +/- 4.8 in examination 2, and in group II--12.5 +/- 3.9 and 13.5 +/- 4.8, respectively. In CSF, CCL3 was detected: in group I in 5 patients in examination 1 (178 +/- 236 pg/ml) and 11 in examination 2 (457 +/- 215), in group II--in 8 (357 +/- 311) and 7 patients (326 +/- 330), respectively. There were no differences between group I and II. The comparison of CCL3 concentration gradient with albumin gradient between serum and CSF supported the possibility of intrathecal synthesis of CCL3. CONCLUSIONS: 1) Synthesis of CCL3, perhaps including intrathecal synthesis, is increased in TBE. 2) CCL3 concentration was much lower in CSF than in serum of the TBE patients, which argues against its significant role as chemoattractant in this condition.
Asunto(s)
Quimiocinas CC/sangre , Quimiocinas CC/líquido cefalorraquídeo , Encefalitis Transmitida por Garrapatas/patología , Adulto , Anciano , Animales , Quimiocina CCL3 , Encefalitis Transmitida por Garrapatas/sangre , Encefalitis Transmitida por Garrapatas/líquido cefalorraquídeo , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
PURPOSE: Chronic inflammation in Lyme borreliosis may be sustained by aberrant inflammatory response, characterized by Th1 lymphocyte predominance, which in turn may be determined by chemokines synthesized in inflammatory focus. The aim of the study was to evaluate synthesis of chemokines: interferon-induced T cell chemoattractant (I-TAC--chemoattractant for Th1 lymphocytes), and monocyte chemotactic protein (MCP-1) in Lyme borreliosis. MATERIAL AND METHODS: Study group consisted of 13 patients with erythema migrans, 10 with Lyme arthritis and 6 with neuroborreliosis. Serum, as well as cerebrospinal fluid (CSF) in neuroborreliosis, was obtained before (examination 1) and during (examination 2) antibiotic treatment. Control serum was obtained from 8 healthy volunteers and control csf from 8 patients in whom meningitis and neuroborreliosis was excluded after diagnostic lumbar puncture. The samples were assayed for MCP-1 and I-TAC by ELISA. RESULTS: Serum mean I-TAC concentration in examination 1 was 73.0 pg/ml in erythema migrans, 78.9 pg/ml in Lyme arthritis and 87.3 pg/ml in neuroborreliosis (29.9 pg/ml in controls, difference significant for neuroborreliosis) and did not change significantly in examination 2. MCP-1 serum concentration was significantly increased to 497.5 pg/ml in neuroborreliosis in examination 2. I-TAC concentration in csf remained low, while MCP-1 concentration in examination 1 was increased to 589.1 pg/ml, significantly higher than simultaneously in serum. CONCLUSIONS: I-TAC synthesis is increased in Lyme borreliosis and may be a factor favoring predominance of Th1 lymphocyte subset. MCP-1 creates chemotactic gradient towards central nervous system and may contribute to csf pleocytosis in neuroborreliosis.
Asunto(s)
Quimiocina CCL2/sangre , Quimiocina CCL2/líquido cefalorraquídeo , Quimiocinas CXC/sangre , Quimiocinas CXC/líquido cefalorraquídeo , Neuroborreliosis de Lyme , Adulto , Anciano , Borrelia/patogenicidad , Estudios de Casos y Controles , Quimiocina CXCL11 , Factores Quimiotácticos , Quimiotaxis , Femenino , Humanos , Neuroborreliosis de Lyme/sangre , Neuroborreliosis de Lyme/líquido cefalorraquídeo , Masculino , Persona de Mediana EdadRESUMEN
The purpose of this work was to evaluate the the level of exposition of humans on Toxocara eggs in North Eastern Poland on a base of serological tests and epidemiological and clinical data. 1025 inhabitants of North Eastern region of Poland were examine to detect antibodies against Toxocara antigens. 214 (20.7%) showed presence of antibodies against Toxocara. They were mostly males (71%) and country inhabitants (58.9%). No abnormalities in laboratory tests were found among these people. Some of them had complaints like joint pains (19.6%), temporary skin rash 2.3%).
Asunto(s)
Anticuerpos Antihelmínticos/análisis , Toxocara canis/aislamiento & purificación , Toxocariasis/diagnóstico , Toxocariasis/epidemiología , Adulto , Distribución por Edad , Anciano , Animales , Artralgia/epidemiología , Comorbilidad , Dermatitis/epidemiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Polonia/epidemiología , Pruebas Serológicas , Distribución por Sexo , Toxocara canis/inmunologíaRESUMEN
BACKGROUND: The aim of this study was to evaluate the concentrations of soluble CD4, CD8 and CD25 antigens in the serum of patients with early LocaLized, (group I, n = 22 patients) and early disseminated Lyme borreliosis (group II n = 23 patients), before and after antibiotic therapy compared with controls (group III n = 7 healthy persons). MATERIALS AND METHODS: The diagnosis of Lyme borreliosis based on clinical features was confirmed by ELISA and Western blot. The assays of sCD4, sCD8 and sCD25 concentrations were performed using Endogen (USA) kits. RESULTS: In group I the sCD4 level decreased in examination 2 (p < 0.001) compared to examination 1. The mean concentration of sCD8 in initial examination 1 in group II was higher than in controls (p < 0.0001); it decreased in examination 2 but was still higher (p < 0.01) than in controls (p < 0.006). Prior to treatment mean sCD25 concentration in group II was higher compared to controls (p < 0.0008) like in examination 2 after treatment (p < 0.02) and this persisted. The mean value of sCD8 in initial examination 1 before treatment in group II was higher than in group I (p < 0.00001). CONCLUSION: Increased initial concentrations of sCD8 and sCD25 indicate the activation of CD8 and CD25 lymphocytes and their role in immunopathogenesis of Lyme disease. Elevated levels of sCD8 in group II before and after treatment suggest a significant involvement of CD8 lymphocytes, indicating the role of long-lasting cellular response in this stage of Lyme disease.
Asunto(s)
Antígenos CD4/análisis , Enfermedad de Lyme/inmunología , Receptores de Antígenos de Linfocitos T/análisis , Receptores de Interleucina-2/análisis , Antibacterianos/uso terapéutico , Western Blotting , Antígenos CD4/inmunología , Linfocitos T CD8-positivos/inmunología , Progresión de la Enfermedad , Humanos , Enfermedad de Lyme/tratamiento farmacológico , Receptores de Antígenos de Linfocitos T/inmunología , Receptores de Interleucina-2/inmunología , Índice de Severidad de la EnfermedadRESUMEN
UNLABELLED: The aim of this study was to evaluate Lyme borreliosis morbidity among the inhabitants of Podlasie Province in the years of 1996-2000. MATERIAL AND METHODS: The new cases of Lyme borreliosis reported in the years of 1996-2000 in Podlasie Province were analyzed. The analysis included the data from Mz-56 and Mz-57 forms and the information from epidemiologic investigations sent to Regional Sanitary and Epidemiologic Station in Bialystok. In 1996-2000, screening examinations were carried out in the same group of 358 forestry workers including 44 (12.29%) females and 314 (87.71%) males aged from 21 to 64 (x = 41.2) years. Immunoenzymatic test of ELISA Borrelia recombinant IgM and IgG by Biomedica firm (Austria) were used to detect B. burgdorferi antibodies. RESULTS: In 1996-2000, 4933 of borreliosis cases were registered in Poland including 1377 (27.91%) in Podlasie Province. The morbidity rate in Podlasie province ranged from 15.05% in 1996 year to 21.29% in 2000 year of the whole country morbidity. At the same time, the incidence rate in Podlasie Province ranged from 9.09 in 1996 to 32.2 in 2000 year and was 6.72-fold higher than the incidence rate in the whole country. In Eastern and Central region of the province, 80.54% of cases were registered whereas, 14.09% by the Lakeside of Augustów and Suwalki only 5.37% in the western region of the province. It was proved that the morbidity increased in proportion to the age of patients (41.39% of patients were at the age of 30-49) and it decreased only above the age of 60. Thus, Lyme borreliosis affects mainly people at working age. The increase in B. burgdorferi antibody detectability was noticed in the population of forestry workers; it was detected in 38.55% in 1995 and in 2000 in 43.56% of the examined. Interestingly, 81 people infected with B.b in 1995-2000 included 74 men and only 7 women, supporting the statement that B.b infection affects mainly working professionals and the risk increases with the practice. CONCLUSIONS: Our studies indicate that Lyme borreliosis is a serious health problem among the inhabitants of Podlasie Province which is an endemic area for Ixodes ricinus ticks infected with B. burgdorferi spirochete.
Asunto(s)
Borrelia burgdorferi/aislamiento & purificación , Agricultura Forestal , Enfermedad de Lyme/epidemiología , Enfermedades Profesionales/epidemiología , Adulto , Anticuerpos Antibacterianos/sangre , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Mordeduras y Picaduras de Insectos/epidemiología , Enfermedad de Lyme/sangre , Enfermedad de Lyme/inmunología , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/sangre , Enfermedades Profesionales/inmunología , Polonia/epidemiologíaRESUMEN
Recognising of Lyme disease is based on epidemiology investigation, clinical manifestation of disease and results of diagnostic laboratory tests. Direct methods as isolation and culturing of Borrelia burgdorferi are very difficult and expensive. Depends on clinical stage PCR could be very useful but not often used. The other methods are based on detection of specific antispirochaetal antibodies produced in compartments or detection of antigens B. burgdorferi.
Asunto(s)
Enfermedad de Lyme/diagnóstico , Especificidad de Anticuerpos , Antígenos Bacterianos/inmunología , Western Blotting , Grupo Borrelia Burgdorferi/aislamiento & purificación , Diagnóstico Diferencial , Ensayo de Inmunoadsorción Enzimática , Técnica del Anticuerpo Fluorescente Indirecta , Humanos , Enfermedad de Lyme/inmunología , Enfermedad de Lyme/microbiologíaRESUMEN
We estimated serum concentrations of cytokines IL-1, IL-6, IL-8, TNF-alfa and IL-6R of patients with diagnosed Lyme disease treated with beta-lactam antibiotics. Detection of proinflammatory cytokines was performed in ELISA tests. The examination was performed before and after treatment. Comparison with control group stated statistically significant higher concentration of IL-1 and IL-6 before and after treatment. There were no differences in concentration of TNF-alfa, IL-8 and IL-6R. Comparing concentrations of cytokines before and after treatment there was no differences either. Lack of changes in concentration of proinflammatory cytokines during beta-lactam therapy could be explained by too short period of therapy or immunologic background of inflammatory process in Lyme disease which was only initiated by spirochete Borrelia burgdorferi.
Asunto(s)
Citocinas/metabolismo , Enfermedad de Lyme/metabolismo , Adulto , Femenino , Humanos , Interleucina-1/metabolismo , Interleucina-6/metabolismo , Interleucina-8/metabolismo , Masculino , Persona de Mediana Edad , Receptores de Interleucina-6/metabolismo , Factor de Necrosis Tumoral alfa/metabolismoRESUMEN
The purpose of the study was to assess the incidence of Borrelia burgdorferi antibodies and clinical forms of Lyme borreliosis among forestry workers in north-eastern Poland. The group studied consisted of 1,466 persons (297 women and 1,169 men), aged 20-70 years. In 439 (23.81%) persons the presence of B. burgdorferi antibodies was detected in serum, in 271 (18.49%) persons active Lyme borreliosis was diagnosed and 78 (5.32%) persons were carriers of B. burgdorferi antibodies. Arthritis (43.84%) and neuroborreliosis (32.95%) were found to be the most common forms of borreliosis.
Asunto(s)
Grupo Borrelia Burgdorferi/aislamiento & purificación , Agricultura Forestal , Enfermedad de Lyme/epidemiología , Enfermedades Profesionales/epidemiología , Adulto , Anciano , Anticuerpos Antibacterianos/análisis , Portador Sano/diagnóstico , Portador Sano/epidemiología , Femenino , Humanos , Enfermedad de Lyme/diagnóstico , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/microbiología , Polonia/epidemiologíaRESUMEN
This study aimed to estimate some PMN functions, involving phagocytic activity in patients with Lyme borreliosis. Decreased percentage PMN with FcR and CR receptors was observed. Increased immune complexes levels in the serum of patients before, and their normalization after treatment were found. These results indicate a depression of non-specific cellular response, which can influence the general immune system in patients with Lyme borreliosis.