Lyme borreliosis: basic science and clinical aspects

Hw, Pfister; Wilske, Bettina; Weber, Klaus

doi:10.1016/s0140-6736(94)90130-9

Cited by 91 publications

(47 citation statements)

References 25 publications

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“…Many excellent reviews have been published detailing progress in expanding the knowledge base on the microbiology of B. burgdorferi (20,29,50,283,307,351,353) and on the ecology and epidemiology (12,40,247,297,299), pathogenesis (127,225,321,335,357), clinical aspects (219,253,(313)(314)(315)(316)372), and laboratory diagnosis (18,39,291,360,362,365) of LB. It has been estimated that more than 2.7 million serum samples are tested each year for the presence of B. burgdorferi-specific antibodies in the United States alone (339).…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of Lyme Borreliosis

et al. 2005

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A large amount of knowledge has been acquired since the original descriptions of Lyme borreliosis (LB) and of its causative agent, Borrelia burgdorferi sensu stricto. The complexity of the organism and the variations in the clinical manifestations of LB caused by the different B. burgdorferi sensu lato species were not then anticipated. Considerable improvement has been achieved in detection of B. burgdorferi sensu lato by culture, particularly of blood specimens during early stages of disease. Culturing plasma and increasing the volume of material cultured have accomplished this. Further improvements might be obtained if molecular methods are used for detection of growth in culture and if culture methods are automated. Unfortunately, culture is insensitive in extracutaneous manifestations of LB. PCR and culture have high sensitivity on skin samples of patients with EM whose diagnosis is based mostly on clinical recognition of the lesion. PCR on material obtained from extracutaneous sites is in general of low sensitivity, with the exception of synovial fluid. PCR on synovial fluid has shown a sensitivity of up to >90% (when using four different primer sets) in patients with untreated or partially treated Lyme arthritis, making it a helpful confirmatory test in these patients. Currently, the best use of PCR is for confirmation of the clinical diagnosis of suspected Lyme arthritis in patients who are IgG immunoblot positive. PCR should not be used as the sole laboratory modality to support a clinical diagnosis of extracutaneous LB. PCR positivity in seronegative patients suspected of having late manifestations of LB most likely represents a false-positive result. Because of difficulties in direct methods of detection, laboratory tests currently in use are mainly those detecting antibodies to B. burgdorferi sensu lato. Tests used to detect antibodies to B. burgdorferi sensu lato have evolved from the initial formats as more knowledge on the immunodominant antigens has been collected. The recommendation for two-tier testing was an attempt to standardize testing and improve specificity in the United States. First-tier assays using whole-cell sonicates of B. burgdorferi sensu lato need to be standardized in terms of antigen composition and detection threshold of specific immunoglobulin classes. The search for improved serologic tests has stimulated the development of recombinant protein antigens and the synthesis of specific peptides from immunodominant antigens. The use of these materials alone or in combination as the source of antigen in a single-tier immunoassay may someday replace the currently recommended two-tier testing strategy. Evaluation of these assays is currently being done, and there is evidence that certain of these antigens may be broadly cross-reactive with the B. burgdorferi sensu lato species causing LB in Europe

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Section: Introductionmentioning

confidence: 99%

Diagnosis of Lyme Borreliosis

et al. 2005

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“…OspA in the brain activates TLR2 on microglia and astrocytes, which initiates immune activity and causes damage to brain tissue [14,50]. However, information regarding the interaction between ospA and neurons is lacking because the expression level of TLR2 in neurons is extremely low when compared with that of microglia or astrocytes.…”

Section: Ospa and Presynaptic Lossmentioning

confidence: 99%

“…B. burgdorferi causes Lyme disease, which is the most common tick-borne infection in Europe and in North America [14]. A recent study using rats infected with B. burgdorferi demonstrated that B. burgdorferi was observed across the blood-brain barrier (BBB) and that the expression level of ospA was augmented significantly in the brain [4].…”

Section: Introductionmentioning

confidence: 99%

Lipoproteins and Diseases of the Brain

Kim¹,

Palmore²

2017

Advances in Lipoprotein Research

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Apolipoprotein E4 (apoE4) and outer surface protein A (ospA) are pathogenic lipoproteins involved in the progression of Alzheimer's disease and Lyme neuroborreliosis, respectively. Results from previous studies indicate that apoE4 exhibits neurotoxicity by activating amyloid beta pathways, and ospA causes damage to the brain by stimulating immune activity of microglia and astrocytes. These results, however, lack information about the specific interactions that develop between neurons and these two lipoproteins. It is essential to investigate the effect of these lipoproteins on neuronal morphology and function to better understand the mechanism of damage and disease of the brain. This chapter summarizes previous studies on the role of apoE4 and ospA in diseases of the brain and discusses experimental results from our own work that suggests new roles for apoE4 and ospA in neuronal outgrowth and synaptic loss.

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“…Huge development was made during the past 20 years understanding Borrelia burgdorferi and its consequent illness. Its microbiology [4], epidemiology [5], diagnosis [6,7], and clinical practices [8][9][10] are studied in detail.…”

Section: Introductionmentioning

confidence: 99%

Lyme Disease and Oncothermia

Zais¹

2013

Conference Papers in Medicine

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Lyme disease is a tick-borne disease with multiple organ failures, and systemic disorders. Dramatic change becomes apparent in the chronic phase of the disease. Chronic fatigue syndrome, lapse of concentration, depression, joint pain, and muscle pain are a few, but major clinical symptoms characterizing the disease. The human immune system is defenseless.Borreliauses various mechanisms to escape from immunoattacks or antibiotic therapies. This “stealth phenomenon” needs new therapeutic principles to be interrupted. Our objective in this paper is to study the effect of oncothermia, which is a well-established oncological therapy, on Lyme disease. First, in our present work, we definitely concentrate on the quality of life of the patients.

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Lyme borreliosis: basic science and clinical aspects

Cited by 91 publications

References 25 publications

Diagnosis of Lyme Borreliosis

Diagnosis of Lyme Borreliosis

Lipoproteins and Diseases of the Brain

Lyme Disease and Oncothermia

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