Detection of Borrelia burgdorferi by polymerase chain reaction in synovial membrane, but not in synovial fluid from patients with persisting Lyme arthritis after antibiotic therapy

Priem, Susanne; Burmester, Gerd R.; Kamradt, Thomas; Wolbart, Karsten; Rittig, Michael; Krause, Andreas

doi:10.1136/ard.57.2.118

Cited by 131 publications

(78 citation statements)

References 13 publications

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“…These studies suggest that bacterial DNA is cleared from the tissue sites of animals after bacterial death but that the DNAs from different pathogens may have different kinetics at different sites. In human pathology, molecular methods based on DNA detection have been used to monitor the treatment of Whipple's disease (34), Lyme arthritis (33), and infections with Helicobacter pylori (42) and Chlamydia trachomatis (1). Our results show that even though bacterial DNA seems to be cleared over time in patients with IE, DNA detection should not be used for monitoring antibiotic efficacy in patients with ongoing IE.…”

Section: Discussionmentioning

confidence: 99%

PCR Detection of Bacteria on Cardiac Valves of Patients with Treated Bacterial Endocarditis

et al. 2005

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We used broad-range PCR amplification and sequencing to detect and identify bacterial DNA in 156 valves of patients treated for infective endocarditis (IE). Bacterial DNA was found more frequently in patients who underwent valve replacement while on antibiotic treatment for IE (60%) than in patients who had completed antibiotic treatment for IE (37%; P ‫؍‬ 0.02). We found specific bacterial DNA in valves removed from 11 of 30 patients who had completed antibiotic treatment for IE. Six had no histological evidence of IE. The presence of DNA was significantly correlated with the presence of histologic lesions (P ‫؍‬ 0.001) and with the presence of bacteria detected by Gram staining (P < 0.001). Bartonella and streptococci were detected for much longer after antibiotic treatment by PCR than other species (P ‫؍‬ 0.047 and 0.04, respectively), and coagulase-negative staphylococci were detected for much shorter periods (P ‫؍‬ 0.02). The finding that bacterial DNA was more likely to be detected in valves of patients with active IE than in patients who had completed antibiotic treatment for IE shows that bacterial DNA is cleared slowly. There was no significant correlation between the duration of antibiotic therapy and the presence of bacterial DNA in valves. Since the persistence of bacterial DNA in valves does not necessarily indicate the persistence of viable bacteria, the detection of bacterial DNA in valves from IE patients should be interpreted with caution, in particular in those patients with a past history of treated IE.

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Section: Discussionmentioning

confidence: 99%

PCR Detection of Bacteria on Cardiac Valves of Patients with Treated Bacterial Endocarditis

et al. 2005

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“…For instance, the persistence of bacterial infections, such as Borrelia burgdorferi 34 and chlamydia, 14,35 as well as CD40/CD40L overexpression in tissues [36][37][38][39] have been associated with chronic disease. Such persisting For personal use only.…”

Section: Discussionmentioning

confidence: 99%

Tuning the volume of the immune response: strength and persistence of stimulation determine migration and cytokine secretion of dendritic cells

Luft

Maraskovsky

Schnurr

et al. 2004

Blood

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Migration to lymph nodes and secretion of cytokines are critical functions of mature dendritic cells (DCs); however, these 2 functions are not necessarily linked. This is the first report showing that quantitative differences in identical signaling pathways determine DC migration and cytokine secretion. Using different polymerized forms of CD40 ligand, we demonstrate that the strength and persistence of CD40 signaling can induce either function. Induction of monocyte-derived DC (MoDC) migration required a weak and transient CD40 signal, whereas strong and persistent CD40 signaling blocked migration and biased toward cytokine secretion. In contrast to MoDCs, CD40 activation of CD1c ؉ peripheral blood DCs (PBDCs) induced a nonpersistent, intracellular signaling profile resulting in migratory-type DCs unable to secrete interleukin-12p70 (IL-12p70). Extracellular signal-regulated kinase 1/2 (ERK1/2) and p38K activation synergistically mediated cytokine secretion, whereas migration was enhanced by p38K activation but reduced by persistent ERK1/2 activity. This model of signal strength and persistence also applied when stimulating DCs with intact microbes. Thus, a novel concept emerges in which the type of immune response induced by DCs is tuned by the strength and persistence of DC activating signals.

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“…This possibility cannot be addressed in WT or Myd88 -/-mice because histopathologic evidence of arthritis resolves even though spirochetes persist in the joint for the life span of the infected mouse (10,14,37). In humans, treatment-resistant Lyme arthritis has been attributed to localized autoimmunity because B. burgdorferi DNA can no longer be detected in synovial fluid or synovectomy tissue (22,(38)(39)(40), and immune responses that crossreact with self antigens have been found (41)(42)(43)(44). Infection-induced autoimmunity, however, does not explain why this form of arthritis resolves over time, usually within 4 years (3,45).…”

Section: Figurementioning

confidence: 99%

Spirochete antigens persist near cartilage after murine Lyme borreliosis therapy

Bockenstedt

Gonzalez²,

Haberman³

et al. 2012

J. Clin. Invest.

188

174

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Detection of Borrelia burgdorferi by polymerase chain reaction in synovial membrane, but not in synovial fluid from patients with persisting Lyme arthritis after antibiotic therapy

Cited by 131 publications

References 13 publications

PCR Detection of Bacteria on Cardiac Valves of Patients with Treated Bacterial Endocarditis

PCR Detection of Bacteria on Cardiac Valves of Patients with Treated Bacterial Endocarditis

Tuning the volume of the immune response: strength and persistence of stimulation determine migration and cytokine secretion of dendritic cells

Spirochete antigens persist near cartilage after murine Lyme borreliosis therapy

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