anetoderma and borreliosis: is there a pathogenetic relationship?a 32-year-old man simultaneously developed anetoderma and acrodermatitis chronica atrophicans on his left arm and showed a positive serology for borreliosis with elisa and western blot tests. in addition, a 45 year-old man is presented with anetoderma without any associated systemic or cutaneous diseases, with b. afzelii confirmed as a singular causality through serology (elisa, western blot) and amplification of b. afzelii-specific dna from the skin by pcr. these two observations highly suggest ...200312948924
the urokinase receptor can be induced by borrelia burgdorferi through receptors of the innate immune system.monocytic cells exposed to borrelia burgdorferi, through unknown receptors, overexpress the urokinase receptor (upar), a key mediator of the plasminogen activation system. we show that combined blockade of cd14 and tlr2 causes a significant inhibition of b. burgdorferi-induced upar in mono mac 6 (mm6) cells. other pattern recognition receptors tested (cd11b/cd18, the mannose receptor, and the n-formyl-methionyl-leucyl-phenylalanine receptor) did not have demonstrated roles in b. burgdorferi-medi ...200314500474
an enzootic transmission cycle of lyme borreliosis spirochetes in the southeastern united states.lyme borreliosis, or lyme disease (ld), is a tick-borne zoonotic infection of biomedical significance, caused by borrelia burgdorferi sensu lato (s.l.) spirochetes and transmitted by ixodes species ticks. it usually circulates among wildlife vertebrate reservoirs and vector ticks but may infect humans, causing multisystem problems. in far western and northern north america, the host reservoirs, tick vectors, and genospecies of borrelia are well known but not so in the southern u.s., where there ...200314500917
detection of genetic diversity in linear plasmids 28-3 and 36 in borrelia burgdorferi sensu stricto isolates by subtractive hybridization.recent studies based on sequence divergence in the ospc gene have identified limited subpopulations of b. burgdorferi associated with invasive human disease. spirochetes with certain ospc types never cause human disease, while some others cause local infection at the primary skin site but do not hematogenously disseminate. only four ospc genotypes (a, b, i and k) are responsible for disseminated disease and are found in the blood and cerebrospinal fluid, and hence are termed invasive strains. su ...200314580390
genetic diversity among borrelia strains determined by single-strand conformation polymorphism analysis of the ospc gene and its association with invasiveness.lyme borreliosis (lb) is a tick-borne spirochetal infection caused by three borrelia species: borrelia afzelii, b. garinii, and b. burgdorferi sensu stricto. lb evolves in two stages: a skin lesion called erythema migrans and later, different disseminated forms (articular, neurological, cardiac.). previous research based on analysis of ospc sequences allowed the definition of 58 groups (divergence of <2% within a group and >8% between groups). only 10 of these groups include all of the strains i ...200314605139
complement resistance of borrelia burgdorferi correlates with the expression of bbcrasp-1, a novel linear plasmid-encoded surface protein that interacts with human factor h and fhl-1 and is unrelated to erp proteins.the etiologic agent of lyme disease, borrelia burgdorferi, is capable of circumventing the immune defense of a variety of potential vertebrate hosts. previous work has shown that interaction of host-derived complement regulators, factor h and factor h-like protein 1 (fhl-1), with up to five complement regulator-acquiring surface proteins (crasps) expressed by resistant b. burgdorferi sensu lato isolates conferred complement resistance. in addition expression of crasp-1 is directly correlated wit ...200414607842
phenotypes indicating cytolytic properties of borrelia-specific interferon-gamma secreting cells in chronic lyme neuroborreliosis.the immuno-pathogenetic mechanisms underlying chronic lyme neuroborreliosis are mainly unknown. human borrelia burgdorferi (bb) infection is associated with bb-specific secretion of interferon-gamma (ifn-gamma), which may be important for the elimination of bb, but this may also cause tissue injury. in order to increase the understanding of the pathogenic mechanisms in chronic neuroborreliosis, we investigated which cell types that secrete ifn-gamma. blood mononuclear cells from 13 patients with ...200314644037
detection of borrelia burgdorferi sensu lato dna in ixodes ricinus ticks in north-western order to estimate the risk of contracting lyme disease in the forest areas of north-western poland, pcr-based studies were carried out on 6,817 ixodes ricinus ticks for infection by the spirochaete b. burgdorferi sensu lato (s.l.). the studies were performed using the primers for the fla gene, conserved for all european genospecies of b. burgdorferi s.l. based on the incidence of b. burgdorferi s.l. dna in i. ricinus ticks at eight sampling sites during 1998-2001, it may be concluded that a r ...200314677908
selective induction of matrix metalloproteinases by borrelia burgdorferi via toll-like receptor 2 in monocytes.regulation of secretion of matrix metalloproteinase (mmp) underlies the basis of numerous physiological and pathological processes in multicellular organisms. the toll receptor family, which is conserved from drosophila species to humans, mediates pattern recognition of a diversity of ligands involved in morphogenesis and innate immunity. here, we show that secretion of mmp-9 is selectively induced through toll-like receptor (tlr) 2 in human and murine monocytic cells stimulated with borrelia bu ...200414702161
identification of novel virulence-associated genes via genome analysis of hypothetical genes.the sequencing of bacterial genomes has opened new perspectives for identification of targets for treatment of infectious diseases. we have identified a set of novel virulence-associated genes (vag genes) by comparing the genome sequences of six human pathogens that are known to cause persistent or chronic infections in humans: yersinia pestis, neisseria gonorrhoeae, helicobacter pylori, borrelia burgdorferi, streptococcus pneumoniae, and treponema pallidum. this comparison was limited to genes ...200414977936
populations of human t lymphocytes that traverse the vascular endothelium stimulated by borrelia burgdorferi are enriched with cells that secrete gamma interferon.some diseases are characterized by prevalence in the affected tissues of type 1 t lymphocytes, which secrete gamma interferon (ifn-gamma) and other proinflammatory cytokines. for example, type 1 t cells predominate in the lesions of patients with lyme disease, which is caused by the bacterium borrelia burgdorferi. we used an in vitro model of the blood vessel wall to test the premise that the vascular endothelium actively recruits circulating type 1 t cells to such lesions. when t lymphocytes is ...200414977959
borrelia burgdorferi-induced expression of matrix metalloproteinases from human chondrocytes requires mitogen-activated protein kinase and janus kinase/signal transducer and activator of transcription signaling pathways.elevations in matrix metalloproteinase 1 (mmp-1) and mmp-3 have been found in patients with lyme arthritis and in in vitro models of lyme arthritis using cartilage explants and chondrocytes. the pathways by which b. burgdorferi, the causative agent of lyme disease, induces the production of mmp-1 and mmp-3 have not been elucidated. we examined the role of the extracellular signal-regulated kinase 1/2 (erk1/2), c-jun n-terminal kinase (jnk), p38 mitogen-activated protein kinase (mapk) and the jan ...200415102798
anaplasma phagocytophilum ligation to toll-like receptor (tlr) 2, but not to tlr4, activates macrophages for nuclear factor-kappa b nuclear translocation.anaplasma phagocytophilum is an obligate intracellular bacterium that infects neutrophils and causes human anaplasmosis (formerly human granulocytic ehrlichiosis). interferon (ifn)- gamma causes immunopathology in a. phagocytophilum infection models. plasma ifn- gamma levels are elevated 4 h after infection in experimentally infected mice, which indicates innate immunity and possible toll-like receptors (tlrs). the ability of a. phagocytophilum to trigger proinflammatory responses via nuclear fa ...200415122530
lysine-dependent multipoint binding of the borrelia burgdorferi virulence factor outer surface protein e to the c terminus of factor h.serum resistance, an important virulence determinant of borrelia burgdorferi sensu lato strains belonging to the borrelia afzelii and b. burgdorferi sensu stricto genotypes, is related to binding of the complement inhibitor factor h to the spirochete surface protein outer surface protein e (ospe) and its homologues. in this study, we show that the c-terminal short consensus repeats 18-20 of both human and mouse factor h bind to ospe. analogously, factor h-related protein 1, a distinct plasma pro ...200415128807
4th meeting of the eu research network eurome: from the identification of genes and cellular networks in murine models of arthritis to novel therapeutic intervention strategies in rheumatoid arthritis, london, uk, 9 march 2004.rheumatoid arthritis (ra) is a common human disease with a prevalence of about 1% in most parts of the world. at the time of symptom onset it is difficult to predict the severity of subsequent disease course. after 2 years joint erosions are seen in most patients, and most patients become clinically disabled within 20 years. a recent meeting at the kennedy institute of rheumatology (imperial college, london) brought together representatives from several european centres of excellence, to discuss ...200415225359
facial nerve palsy after human herpesvirus 6 infection.facial nerve palsy has long been considered to have an infectious etiology, either viruses, mainly herpesviruses, or bacteria, such as borrelia burgdorferi. we report for the first time the association of human herpesvirus 6 and facial palsy in a previously healthy 1-year 9-month-old boy who developed left facial nerve palsy 7 days after exanthema subitum caused by human herpesvirus 6.200415247617
borrelia burgdorferi genes selectively expressed in ticks and mammals.lyme disease is a tick-borne infection caused by the spirochete borrelia burgdorferi. recent studies have focused on how the lyme disease bacterium overcomes the challenges faced by an organism that depends on a vector-borne life style. these studies indicate that the spirochete expresses different surface proteins at different stages of its life. here, aravinda de silva and erol fikrig review the evidence for differential gene expression and discuss the implications of these findings for the ly ...199715275064
detection and characterization of borrelia bissettii in rodents from the central california coast.this is the first report of borrelia burgdorferi sensu lato in rodents from san luis obispo county, with most isolates obtained from a previously unreported host, neotoma lepida thomas. b. burgdorferi sensu lato was identified in seven rodent species, including the california vole, microtus californicus peale; dusky-footed woodrat, neotoma fuscipes baird; desert woodrat, neotoma lepida thomas; brush mouse, peromyscus boylii baird; california mouse, peromyscus californicus gambel; deer mouse, per ...200415311469
[virological and immunological indices in patients with multiple sclerosis].the level of specific antibodies to viruses of measles, parotitis, type-6 herpes, epstein-barr, tick-borne encephalitis and borrelia burgdorferi as well as presence of genetic samples and antigens of the above infectious antigens were studied in patients with multiple sclerosis (ms). the cytokines th1 and th2 parameters were investigated in blood serum of patients at different ms stages. the titer of antibodies to measles virus was noted to be increasing in ms patients with age and disease aggra ...200415455682
the epidemiology of lyme borreliosis.the tick-transmitted bacterial infection known as lyme disease, or lyme borreliosis, has recently emerged as the leading arthropod-borne disease in europe and north america. several thousand new cases of human lyme disease are reported each year from europe and the usa. the causative agent, borrelia burgdorferi, has been isolated from several species of mammals, birds, ticks and insects and, in this article, thomas jaenson discusses the geographical differences in the epidemiology of the infecti ...199115463419
prevalence of borrelia burgdorferi sensu lato genospecies in host-seeking ixodes ricinus ticks in selected south bohemian locations (czech republic).in selected localities of ceské budÄ•jovice and ceský, krumlov districts, well known by stable high incidence of tick-borne encephalitis (tbe) human cases but with low incidence of lyme borreliosis, monitoring of borrelia burgdorferi sensu lato (s.l.) in ixodes ricinus ticks was performed. research was also aimed at the spread of i. ricinus to mountain areas of this region (national park sumava), as well as at investigating this tick for b. burgdorferi s.l. genospecies and tbe virus infection. al ...200415508414
relationships of a novel lyme disease spirochete, borrelia spielmani sp. nov., with its hosts in central determine whether the pathogenic variant of lyme disease spirochetes, isolate a14s, is perpetuated in a particular reservoir-vector relationship, we screened vector ticks in various central european sites for a related spirochete and determined its host association. a14s-like spirochetes infect numerous questing ticks in the petite camargue alsacienne (pc). they frequently infect dormice, but no mice or voles. garden dormice appear to be better reservoir hosts for a14s-like spirochetes than f ...200415528500
acute peripheral facial palsy in lyme disease -- a distal neuritis at the infection site.children with acute peripheral facial palsy have often suffered tick bites and/or erythema migrans in the head/neck region on the same side. with respect to the pathogenesis of neuroborreliosis this topographical association was investigated in an animal model.200415534758
serological diagnosis of human babesiosis by igg enzyme-linked immunosorbent enzyme-linked immunosorbent assay (elisa) for the detection of igg antibodies to babesia microti antigen was developed. b. microti antigens were harvested from experimentally infected hamster blood and used as a coating antigen. the sensitivity and specificity of the igg elisa relative to immunofluorescent antibody assay (ifa) testing was 95.5% and 94.1%, respectively. according to the receiver operating characteristic curve analysis, the area under the curve was 0.987. no cross-reactivity of ...200415696612
a novel fold for the factor h-binding protein bbcrasp-1 of borrelia burgdorferi.borrelia burgdorferi, a spirochete transmitted to human hosts during feeding of infected ixodes ticks, is the causative agent of lyme disease. serum-resistant b. burgdorferi strains cause a chronic, multisystemic form of the disease and bind complement factor h (fh) and fh-like protein 1 (fhl-1) on the spirochete surface. here we report the atomic structure for the key fhl-1- and fh-binding protein bbcrasp-1 and reveal a homodimer that presents a novel target for drug design.200515711564
invasion of human tissue ex vivo by borrelia burgdorferi.borrelia burgdorferi sensu stricto is an etiological agent of lyme disease. the lack of an adequate ex vivo system for human tissue infection is an obstacle to fully understanding the molecular mechanisms of invasion of tissue by b. burgdorferi and its adaptation within the human host. here, we report on the development of such a system. we inoculated blocks of human tonsillar tissue with b. burgdorferi spirochetes, cultured them in a low-shear rotating wall vessel (rwv) bioreactor, and analyzed ...200515838803
case study: periodic follow-up is necessary in morphea profunda to identify systemic evolution.the term "morphea" includes a wide spectrum of clinical entities, varying from localized plaques of only cosmetic importance to deep lesions resulting in considerable morbidity for the patient. in fact, although survival rates are no different from that of the general population, localized scleroderma may be associated with development of substantial disability, as occurs in deep morphea and in pediatric patients (disabling pansclerotic morphea of children). we report a case of morphea profunda ...200515891259
presence of borrelia burgdorferi (spirochaetales: spirochaetaceae) in southern kettle moraine state forest, wisconsin, and characterization of strain w97f51.lyme disease, caused by borrelia burgdorferi johnson, schmidt, hyde, steigerwalt & brenner; babesiosis, caused by babesia microti franca; and human granulocytic ehrlichiosis, caused by anaplasma phagocytophilum bakken & dumler have been reported in wisconsin, mainly in the endemic areas of the northwestern part of the state. people exposed to blacklegged ticks, ixodes scapularis say, from this region can potentially contract one or all of these diseases concurrently. within the past several year ...200515962800
[ixodes ticks of the town of cherkessk and its environs].the paper presents the results of the studies made in 2002-2004 to examine the species-specific composition of ixodes ticks. the ticks were gathered for a flag (155km routes being covered and 405 ticks being gathered); 48 dogs were examined, 320 ticks being gathered; 212 ticks were collected from human beings. the town dwellers' visit rates were grouped by ages and months. in the republic, borreliae, the causative agents of lyme borreliosis, were first isolated from ixodes ricinus by darkground ...200515984609
specific control of endogenous ccf10 pheromone by a conserved domain of the pcf10-encoded regulatory protein prgy in enterococcus faecalis.conjugative transfer of enterococcus faecalis plasmid pcf10 is induced by the heptapeptide pheromone ccf10. ccf10 produced by plasmid-free recipient cells is detected by pcf10-containing donor cells, which respond by induction of plasmid-encoded transfer functions. the pcf10-encoded membrane protein prgy is essential to prevent donor cells from responding to endogenously produced pheromone while maintaining the ability to respond to pheromone from an exogenous source; this function has not been ...200515995198
borrelia burgdorferi bmpa, bmpb, and bmpd proteins are expressed in human infection and contribute to p39 immunoblot reactivity in patients with lyme disease.the bmp proteins are a paralogous family of chromosomally encoded borrelia burgdorferi lipoproteins. they have similar predicted immunogenicities and similar electrophoretic mobilities by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. p39 reactivity against borrelia burgdorferi lysate in immunoblots of lyme disease patients has long been identified with reactivity to bmpa, but responses to other bmp proteins have not been examined. to determine if patients with lyme disease developed ...200516085911
[clinical reasoning and decision-making in practice. an older man with prostate carcinoma and a painless paraparesis of the legs].a 78-year-old man with metastasised prostate carcinoma presented with a painless paraparesis. his cerebrospinal fluid showed elevated protein and a mononuclear pleiocytosis, but cytology investigations of 5 separate samples revealed no malignant cells in the cerebrospinal fluid. extensive viral and bacterial tests (including elisa for borrelia burgdorferi) of serum and cerebrospinal fluid were negative. on the day radiation therapy for presumed leptomeningeal metastases was due to start the igg ...200516121663
lyme arthritis synovial gammadelta t cells instruct dendritic cells via fas ligand.gammadelta t cells participate in the innate immune response to a variety of infectious microorganisms. they also link to the adaptive immune response through their induction of maturation of dendritic cells (dc) during the early phase of an immune response when the frequency of ag-specific t cells is very low. we observe that in the presence of borrelia burgdorferi, synovial vdelta1 t cells from lyme arthritis synovial fluid potently induce maturation of dc, including production of il-12, and i ...200516237055
borrelia burgdorferi regulates expression of complement regulator-acquiring surface protein 1 during the mammal-tick infection cycle.during the natural mammal-tick infection cycle, the lyme disease spirochete borrelia burgdorferi comes into contact with components of the alternative complement pathway. b. burgdorferi, like many other human pathogens, has evolved the immune evasion strategy of binding two host-derived fluid-phase regulators of complement, factor h and factor h-like protein 1 (fhl-1). the borrelial complement regulator-acquiring surface protein 1 (crasp-1) is a surface-exposed lipoprotein that binds both factor ...200516239539
association between human leukocyte antigen class ii alleles and genotype of borrelia burgdorferi in patients with early lyme disease.on the basis of a polymerase chain reaction-restriction fragment-length polymorphism analysis of the 16s-23s ribosomal dna intergenic spacer, clinical isolates of borrelia burgdorferi can be classified into 3 genotypes designated as rst1, rst2, and rst3. rst1 strains are the most pathogenic, and rst3 strains are the least pathogenic.200516267776
demonstration of ospc type diversity in invasive human lyme disease isolates and identification of previously uncharacterized epitopes that define the specificity of the ospc murine antibody response.outer surface protein c (ospc) of the lyme disease spirochetes is an important virulence factor that has potential utility for vaccine development. of the 21 ospc types that have been identified, it has been postulated that types a, b, i, and k are specifically associated with invasive infections. through an analysis of isolates collected from patients in maryland we found that ospc types c, d, and n are also associated with invasive infections. this observation suggests that there is greater di ...200516299277
expression of icam-1, icam-2, ncam-1 and vcam-1 by human synovial cells exposed to borrelia burgdorferi in vitro.the interaction of resident tissue cells with migratory inflammatory cells is essential for the recruitment of immune effector cells to inflammatory sites. the sustained expression of adhesion molecules in the synovium of patients with chronic lyme arthritis seems to contribute to this chronic inflammation. whether cell adhesion molecules influence the early steps of borreliosis is unclear. therefore, we examined the expression of icam-1, icam-2, vcam-1 and ncam-1 in synovial cells exposed to tw ...200616307273
serological confirmation of borrelia burgdorferi infection in dogs in the czech republic.from the epidemiological point of view, dogs are very important since they are considered a suitable indicator of the spread of human borreliosis. serum samples obtained from healthy, asymptomatic military dogs from 12 different areas in the czech republic were examined for igg antibodies to borrelia burgdorferi sensu lato (s.l.). the total of 399 serum samples were tested by a whole-cell elisa. specific antibodies to borrelia burgdorferi s.l. were detected in 26 cases (6.5%). in different local ...200616437298
co-inoculation of borrelia afzelii with tick salivary gland extract influences distribution of immunocompetent cells in the skin and lymph nodes of mice.the impact of ixodes ricinus salivary gland extract (sge) on inflammatory changes in the skin and draining lymph nodes of mice, elicited by the infection with the important human pathogen, b. afzelii, was determined using flow cytometry. sge injected together with spirochetes reduced the numbers of leukocytes and gammadelta-t lymphocytes in infected epidermis at early time-points post infection. in draining lymph nodes, the anti-inflammatory effect of sge was manifested by the decrease of total ...200516475508
transfection "junk" dna - a link to the pathogenesis of alzheimer's disease?a transfection product incorporates in one molecule of human dna, an inserted segment of dna from another species. this communication addresses the hypothesis that a novel variation of the theme of transfection, namely "junk transfection" for which no protein product and no rna is transcribed, might offer insights into the pathogenesis of alzheimer's disease. it is hypothesized that spirochetal dna gains access to the intracellular compartment of nerve cells during the subclinical latency phase ...200616481123
serological evidence for tick-borne encephalitis, borreliosis, and human granulocytic anaplasmosis in mongolia.five hundred and forty-five serum samples from donors from various parts of mongolia were investigated for antibodies against the tick-borne encephalitis (tbe) virus, borrelia burgdorferi, and anaplasma phagocytophilum. seroprevalence against tbe was 5.1% in the province of selenge and 0.9% in bulgan province, seroprevalence against b. burgdorferi was 1.9% in selenge province and bulgan province, 13.9% in dornogov province, and 3.0% in tov province and ulaanbaatar. seroprevalence against a. phag ...200616524782
borrelia burgdorferi erp genes are expressed at different levels within tissues of chronically infected mammalian hosts.the spirochete borrelia burgdorferi is the causative agent of lyme disease and is transmitted to humans and other vertebrate hosts through the bites of ixodid ticks. b. burgdorferi erp (ospe-f related lipoprotein) family members are encoded on members of the 32 kb circular plasmid-like prophage family (cp32s). many erp proteins serve as receptors for the complement inhibitory factor h molecules of numerous vertebrate hosts, providing one mechanism by which the bacteria potentially evade the inna ...200616530008
molecular analysis of decorin-binding protein a (dbpa) reveals five major groups among european borrelia burgdorferi sensu lato strains with impact for the development of serological assays and indicates lateral gene transfer of the dbpa gene.the borrelia (b.) burgdorferi adhesin dbpa (decorin-binding protein a) is a valuable antigen for serodiagnosis of lyme borreliosis and a promising candidate for a vaccine. to investigate the heterogeneity of dbpa, we aligned dna sequences of 83 different dbpa genes (37 from the database, where the majority of sequences belong to b. burgdorferi sensu stricto and 46 were newly sequenced). analysis of 25 sequences from the species b. burgdorferi s.s., 16 from b. afzelii, 40 from b. garinii, and two ...200616530482
[concentrations of soluble factors participating in regulation of apoptosis of lymphocyte from patients with chronic lyme arthritis (preliminary report)].lyme borreliosis is a chronic infectious disease caused by borrelia burgdorferi spirochete. the excess and inadequate inflammatory response and even autoimmunity is considered to participate in its pathogenesis. apoptosis (programmed cell death) of activated lymphocytes contributes to regulation of immunological response and terminating the inflammation.200616617735
evidence that the bba68 protein (bbcrasp-1) of the lyme disease spirochetes does not contribute to factor h-mediated immune evasion in humans and other animals.bba68 (bbcrasp-1) of the lyme disease spirochetes binds human factor h (fh) and fh-like protein 1 (fhl-1). here we assess transcription of the bba68 gene and production of bba68 in infected mice and humans using real-time reverse transcriptase pcr and immunoblotting. the species specificity of fh binding to bba68 was also tested. the data suggest that bba68 does not play an important role in immune evasion in animals.200616622245
the ticking time bomb.a man with orbital myositis and optic neuritis tested positive serologically for multiple tick-borne diseases. erlichiosis, babesiosis, and lyme disease may occur together and affect the eye or orbit.200616644367
identification of a tlr-independent pathway for borrelia burgdorferi-induced expression of matrix metalloproteinases and inflammatory mediators through binding to integrin alpha 3 beta 1.borrelia burgdorferi stimulates a robust inflammatory response at sites of localization. binding of borrelial lipoproteins to tlr-2 is one pathway important in the host response to b. burgdorferi. however, while tlr-2 is clearly important in control of infection, inflammation is actually worsened in the absence of tlr-2 or the shared tlr adapter molecule, myd88, suggesting that there are alternative pathways regulating inflammation. integrins are cell surface receptors that play an important rol ...200616785564
is lyme disease always poly microbial?--the jigsaw hypothesis.lyme disease is considered to be caused by borrelia species of bacteria but slowly evidence is accumulating which suggests that lyme disease is a far more complex condition than borreliosis alone. this hypothesis suggests that it may be more appropriate to regard lyme disease as a tick borne disease complex. over recent years numerous different microbes have been found in ticks which are known to be zoonotic and can coinfect the human host. the hypothesis suggests that multiple coinfections are ...200616814477
autoantibodies from synovial lesions in chronic, antibiotic treatment-resistant lyme arthritis bind cytokeratin-10.although the causative agent of lyme disease is definitively known to be the tick-borne spirochete, borrelia burgdorferi, the etiology of chronic joint inflammation that ensues in a subset of patients remains less well understood. persistence of arthritis after apparent eradication of the spirochete suggests an autoimmune reaction downstream of the original bacterial infection. we have generated recombinant ab probes from synovial lesions within affected arthritic joints in an attempt to recapit ...200616888010
development of an ospc-based tetravalent, recombinant, chimeric vaccinogen that elicits bactericidal antibody against diverse lyme disease spirochete strains.lyme disease is the most common arthropod-borne disease in north america and europe. at present, there is no commercially available vaccine for use in humans. outer surface protein c (ospc) has antigenic and expression characteristics that make it an attractive vaccine candidate; however, sequence heterogeneity has impeded its use as a vaccinogen. sequence analyses have identified 21 well defined ospc phyletic groups or "types" (designated a-u). in this report we have mapped the linear epitopes ...200716996663
invasion of human neuronal and glial cells by an infectious strain of borrelia burgdorferi.human infection by borrelia burgdorferi, the etiological agent for lyme disease, can result in serious acute and late-term disorders including neuroborreliosis, a degenerative condition of the peripheral and central nervous systems. to examine the mechanisms involved in the cellular pathogenesis of neuroborreliosis, we investigated the ability of b. burgdorferi to attach to and/or invade a panel of human neuroglial and cortical neuronal cells. in all neural cells tested, we observed b. burgdorfe ...200617045505
binding of human complement regulators fhl-1 and factor h to crasp-1 orthologs of borrelia burgdorferi.the complement regulator-acquiring surface protein (crasp)-1 is a member of the paralogous gene family gbb54 and the dominant fhl-1 and factor h binding protein of borrelia burgdorferi sensu stricto (s.s.). it was shown recently that expression of bbcrasp-1 directly correlates with serum resistance of b. burgdorferi s.s. isolates. in the present study we have elucidated the putative potential of other members of the gbb54 paralogous family, including orthologs zsa66, zsa69, zsa70, zsa71, zsa72 a ...200617160605
lyme borreliosis and multiple sclerosis are associated with primary effusion lymphoma.multiple sclerosis (ms) is a chronic disease of the central nervous system characterized by chronic inflammation and demyelination. studies suggested that the viral, especially epstein-barr virus infection, and bacterial infections, especially borrelia burgdorferi infection, play a role in etiology of ms. ms prevalence parallels the distribution of the lyme disease pathogen b. burgdorferi. criteria used for diagnosis of ms can also be fulfilled in other conditions such as lyme disease, a multisy ...200717197115
wildlife, environment and (re)-emerging zoonoses, with special reference to sylvatic tick-borne zoonoses in north-western italy.over the last century, changes in land-use, modification of agriculture-livestock production systems, disruption of wildlife habitats, increase of human activities, higher frequency of international and intercontinental travels, wider circulation of animals and animal products have contributed to alter the distribution, presence and density of hosts and vectors. as a result, the number of emerging and reemerging diseases, including zoonoses, have greatly increased. some infectious pathogens, ori ...200617361062
detection and identification of anaplasma phagocytophilum, borrelia burgdorferi, and rickettsia helvetica in danish ixodes ricinus ticks.borreliosis is an endemic infection in denmark. recent serosurveys have indicated that human anaplasmosis may be equally common. the aim of this study was to look for anaplasma phagocytophilum and related pathogens in ixodes ricinus ticks and estimate their prevalence, compared to borrelia, using pcr. ticks were collected from three locations in denmark: jutland, funen, and bornholm. ticks from jutland and funen were analysed individually, ticks from bornholm were analysed in pools of 20. a. pha ...200717367468
emerging zoonoses and vector-borne infections affecting humans in europe.the purpose of this study was to assess and describe the current spectrum of emerging zoonoses between 2000 and 2006 in european countries. a computerized search of the medline database from january 1966 to august 2006 for all zoonotic agents in european countries was performed using specific criteria for emergence. fifteen pathogens were identified as emerging in europe from 2000 to august 2006: rickettsiae spp., anaplasma phagocytophilum, borrelia burgdorferi, bartonella spp., francisella tula ...200717445320
borrelia burgdorferi-induced monocyte chemoattractant protein-1 production in vivo and in vitro.matrix metalloproteinase 9 (mmp-9) is selectively upregulated in erythema migrans (em) lesions with acute lyme disease. this study explored whether upregulation of mmp-9 was associated with monocyte chemoattractant protein 1 (mcp-1) production, and borrelia burgdorferi (b. burgdorferi) could induce mcp-1 production in vivo and in vitro. the results indicated that expression of mcp-1 was significantly increased in u937 cells by b. burgdorferi. the activity of mmp-9 could be elevated by recombinan ...200717485071
binding of human factor h-related protein 1 to serum-resistant borrelia burgdorferi is mediated by borrelial complement regulator-acquiring surface proteins.isolates of borrelia burgdorferi, the causative agent of lyme disease, express up to 5 distinct complement regulator-acquiring surface proteins (crasp-1, -2, -3, -4, and -5).200717538892
biochemical analysis of a common human polymorphism associated with age-related macular degeneration.age-related macular degeneration (amd) is the leading cause of irreversible blindness in developed countries. a large number of human genetic studies have associated a common variant (y402h) of complement factor h (cfh) with a highly significant increase in amd risk. cfh is a modular protein with 20 homologous short consensus repeats (scrs). the y402h variant is located in scr7 of both cfh and factor h-like protein 1 (fhl-1), a splice variant of cfh (containing scr1-7) with unique biochemical pr ...200717580967
hidden in plain sight: borrelia burgdorferi and the extracellular matrix.borrelia burgdorferi, the tick-transmitted etiologic agent of lyme borreliosis, can colonize and persist in multiple tissue sites despite vigorous host immune responses. the extracellular matrix appears to provide a protective niche for the spirochete. recent studies in mice suggest that b. burgdorferi interacts in various ways with collagen and its associated molecules, exploiting molecular and structural features to establish microcolonial refugia. better knowledge of the genetic and structura ...200717600717
oedema of the metatarsal heads ii-iv and forefoot pain as an unusual manifestation of lyme disease: a case report.abstract: we report the case of a healthy 36 year old man who suffered from foot pain lasting for weeks, without having a specific medical history relating to it. the clinical evaluation was interpreted as a transfer metatarsalgia caused by a splayfoot. the radiographs revealed no pathology except the splayfoot deformity. due to persistent pain and swelling of the entire forefoot, after two weeks of conventional treatment, magnet resonance images (mri) and a blood sample were taken. the laborato ...200717620125
c-jun n-terminal kinase 1 is required for toll-like receptor 1 gene expression in macrophages.the regulation of innate immune responses to pathogens occurs through the interaction of toll-like receptors (tlrs) with pathogen-associated molecular patterns and the activation of several signaling pathways whose contribution to the overall innate immune response to pathogens is poorly understood. we demonstrate a mechanism of control of murine macrophage responses mediated by tlr1/2 heterodimers through c-jun n-terminal kinase 1 (jnk1) activity. jnk controls tumor necrosis factor alpha produc ...200717664270
resolution of chronic hepatitis c following inefficient cellular immune response likely leads to chronic hepatitis c virus (hcv) infection. resolution of chronic hcv infection in the absence of treatment is a rare occurrence. we report the case of a 39-year old white male with a 17-year history of chronic hcv infection, who eradicated hcv following a serious illness due to co-infection with babesia (babesiosis), borriela borgdorferi (lyme disease) and ehrlichia (human granulocytic ehrlichiosis). we hypothesize that the cellular immune ...200717696260
[lyme disease in children].lyme disease is a vector-borne infectious disease affecting especially skin, nervous system, heart and joints. in the early stage of borrelia infection, asymptomatic course is possible. the causative agent, the spirochete borrelia, is carried to the human body by tick. the bacteriological culture from blood, joint fluid or cerebrospinal fluid is very difficult. the laboratory diagnosis depends mainly on serological assays (elisa, western blot) and on the polymerase chain reaction (pcr). the trea ...200617784551
borrelia burgdorferi bbb07 interaction with integrin alpha3beta1 stimulates production of pro-inflammatory mediators in primary human chondrocytes.borrelia burgdorferi, the causative agent of lyme disease, activates multiple signalling pathways leading to induction of pro-inflammatory mediators at sites of inflammation. binding of b. burgdorferi to integrin alpha(3)beta(1) on human chondrocytes activates signalling leading to release of several pro-inflammatory mediators, but the b. burgdorferi protein that binds integrin alpha(3)beta(1) and elicits this response has remained unknown. a search of the b. burgdorferi genome for a canonical i ...200817822440
evaluation of the presence of selected viral and bacterial nucleic acids in pericardial samples from dogs with or without idiopathic pericardial effusion.many viruses have been identified in pericardial fluid and in tissue samples from humans with pericarditis by means of molecular diagnostics. in canine idiopathic pericardial effusion there is as yet no conclusive evidence to support the involvement of an infectious agent. this study was designed to investigate a possible relationship between idiopathic pericardial effusion in dogs and viruses most commonly encountered in humans affected with viral pericarditis. coxsackievirus b3 rna, influenza ...200917959400
[lyme carditis--a bitter lesson or a delayed diagnostic success--a case report].lyme carditis is a well known disorder; however, its diagnosis still remains a challenge because of varied clinical picture, low incidence rate and difficulties in detection of the aetiological agent (borrelia burgdorferi). we report a case of a 60-year-old man with a 2.5-year history of dilated cardiomyopathy, recurring episodes of acute heart failure and arrhythmias which finally were diagnosed as lyme carditis. the diagnosis was confirmed by endomyocardial biopsy that revealed spirochetes as ...200717979052
borrelia burgdorferi inhibits human neutrophil functions.outer surface proteins ospa and ospb are among the most prominent borrelia burgdorferi surface molecules. we constructed ospab and ospa complementation mutants of b. burgdorferi osp-less strain b313 and investigated the role of these surface proteins in the interactions of b. burgdorferi, human neutrophils and the complement system. we found that (1) ospb inhibits the phagocytosis and oxidative burst of human neutrophils at low serum concentrations, whereas ospa induces the oxidative burst in ne ...200818068388
tick infestation risk and borrelia burgdorferi s.l. infection-induced increase in host-finding efficacy of female ixodes ricinus under natural investigation of the risk of human tick infestation, together with the prevalence of borrelia burgdorferi s.l. infection, was conducted in a sylvatic habitat in western germany to provide data needed for future risk-benefit evaluations of acaricides used for clothing impregnation. additionally, data were collected on behavioural changes in borrelia burgdorferi s.l.-infected adult female i. ricinus ticks and the possible impact of such changes on host-finding efficacy. the risk of i. ricinus-i ...200818273686
the propensity of different borrelia burgdorferi sensu stricto genotypes to cause disseminated infections in humans.lineages of borrelia burgdorferi, the bacterium that causes lyme disease, can be characterized by distinct alleles at the outer surface protein c (ospc) locus. the lineages marked by ospc genotypes have been shown to be differentially invasive in different species of mammals, including humans; genotypes a, b, i, and k effectively disseminate to human blood and cerebrospinal fluid. in this report, we extend the sample of genotypes isolated from human blood to include genotypes n, h, c, m, and d, ...200818458317
neuroborreliosis with extrapyramidal symptoms: a case report.the disease of lyme is a tick-borne infection. it involves skin, the nervous system, joints and the heart. spirochaeta borrelia burgdorferi is the etiologic agent of the disease. in the majority of cases, clinical symptoms, like migrating erythema, occur from 3 to 30 days, sometimes to 3 months after a bite from a tick. the early disseminated infection involves multiple migrating erythema, neuroborreliosis, arthritis, myocarditis and other organ-related symptoms. the late stage of chronic infect ...200818619183
activation of gamma delta t cells by borrelia burgdorferi is indirect via a tlr- and caspase-dependent pathway.activation of the innate immune system typically precedes engagement of adaptive immunity. cells at the interface between these two arms of the immune response are thus critical to provide full engagement of host defense. among the innate t cells at this interface are gammadelta t cells. gammadelta t cells contribute to the defense from a variety of infectious organisms, yet little is understood regarding how they are activated. we have previously observed that human gammadelta t cells of the vd ...200818684928
identification and characterization of the factor h and fhl-1 binding complement regulator-acquiring surface protein 1 of the lyme disease spirochete borrelia spielmanii sp. nov.borrelia spielmanii, one of the etiological agents of lyme disease found in europe, evades host complement-mediated killing by recruitment of the immune regulators factor h and fhl-1 from human serum. serum-resistant and intermediate serum-resistant isolates express up to 3 distinct complement regulator-acquiring surface proteins (crasps) that bind factor h and/or fhl-1. the present study describes identification and functional characterization of bscrasp-1 as the dominant factor h and fhl-1 bin ...200918706858
spatial dynamics of lyme disease: a review.lyme disease (ld), the most frequently reported vector-borne disease in the united states, requires that humans, infected vector ticks, and infected hosts all occur in close spatial proximity. understanding the spatial dynamics of ld requires an understanding of the spatial determinants of each of these organisms. we review the literature on spatial patterns and environmental correlates of human cases of ld and the vector ticks, ixodes scapularis in the northeastern and midwestern united states ...200818787920
deciphering the ligand-binding sites in the borrelia burgdorferi complement regulator-acquiring surface protein 2 required for interactions with the human immune regulators factor h and factor h-like protein 1.borrelia burgdorferi, the etiologic agent of lyme disease, employs sophisticated means to evade killing by its mammalian hosts. one important immune escape mechanism is the inhibition of complement activation mediated by interactions of the host-derived immune regulators factor h (cfh) and factor h-like protein 1 (cfhl1) with borrelial complement regulator-acquiring surface proteins (bbcrasps). bbcrasp-2 is a distinctive cfh- and cfhl1-binding protein that is produced by serum-resistant b. burgd ...200818824548
borrelia burgdorferi napa-driven th17 cell inflammation in lyme arthritis.human lyme arthritis caused by borrelia burgdorferi is characterized by an inflammatory infiltrate that consists mainly of neutrophils and t cells. this study was undertaken to evaluate the role of the innate and acquired immune responses elicited by the neutrophil-activating protein a (napa) of b burgdorferi in patients with lyme arthritis.200818975343
borrelia burgdorferi infection-associated surface proteins erpp, erpa, and erpc bind human plasmin plays a critical role in mammalian infection by borrelia burgdorferi. the lyme disease spirochete expresses several plasminogen-binding proteins. bound plasminogen is converted to the serine protease plasmin and thereby may facilitate the bacterium's dissemination throughout the host by degrading extracellular matrix. in this work, we demonstrate plasminogen binding by three highly similar borrelial outer surface proteins, erpp, erpa, and erpc, all of which are expressed dur ...200919001079
granuloma annulare displaying pseudorosettes in borelia 2003, pseudorosettes were described as highly suspicious of infection by borrelia burgdorferi sensu lato in the appropriate clinical context. nevertheless, such a pattern has been described in the literature in other non-infectious conditions. on the other hand, granuloma annulare (ga) has been recently closely associated with infection by borrelia. we investigated how frequently pseudorosettes can be detected in common ga cases confirmed for borrelia by pcr.200819104742
live borrelia burgdorferi spirochetes elicit inflammatory mediators from human monocytes via the toll-like receptor signaling pathway.we investigated the mechanisms that lead to the production of proinflammatory mediators by human monocytes when these cells are exposed in vitro to live borrelia burgdorferi spirochetes. we first focused on myeloid differentiation primary response protein 88 (myd88), an adapter molecule that is essential in the toll-like receptor (tlr) pathway. real-time pcr, flow cytometry, and confocal microscopy experiments revealed that myd88 was maximally expressed in thp-1 cells after 24-h stimulation of t ...200919139200
molecular detection of borrelia bissettii dna in serum samples from patients in the czech republic with suspected borreliosis.until recently, three spirochete genospecies were considered to be the causative agents of lyme borreliosis (lb) in europe: borrelia burgdorferi sensu stricto, borrelia afzelii and borrelia garinii. however, the dna of borrelia valaisiana, borrelia lusitaniae, borrelia spielmanii and borrelia bissettii has already been detected in samples of human origin, or the spirochetes were isolated from the patients with symptoms of lb. molecular analysis of 12 selected serum samples collected in the regio ...200919187198
comparative cryo-electron tomography of pathogenic lyme disease spirochetes.spirochetes of the borrelia burgdorferi sensu lato group, the causative agents of lyme borreliosis, exhibit a complex biology evolved in its zoonotic cycle. cryo-electron tomography was used to investigate structural features of three species, b. burgdorferi, b. garinii and b. afzelii, known to cause different clinical manifestations in humans. all three organisms revealed an overall similar architecture and showed different numbers of periplasmic flagellar filaments, polar periplasmic void regi ...200919210619
[acute encephalitis. neuropsychiatric manifestations as expression of influenza virus infection].the aim is to review the encephalitis in infants and adolescents as well as its etiology, clinical manifestation, epidemiology, physiopathology, diagnostic methods and treatment, and the neuropsyquiatric signs appearing an influenza epidemy. encephalitis is an inflammation of the central nervous system (cns) which involves the brain. the clinical manifestations usually are: headache, fever and confusional stage. it could also be manifested as seizures, personality changes, or psiqyiatric symptom ...200919240010
local production of ifn-gamma by invariant nkt cells modulates acute lyme carditis.the lyme disease spirochete borrelia burgdorferi is the only known human pathogen that directly activates invariant nkt (inkt) cells. the number and activation kinetics of inkt cells vary greatly among different strains of mice. we now report the role of the inkt cell response in the pathogenesis of lyme disease using c57bl/6 mice, a strain with optimal inkt cell activation that is resistant to the development of spirochetal-induced inflammation. during experimental infection of b6 mice with b. ...200919265151
[familial predisposition and microbial etiology in dilated cardiomyopathy].cardiomyopathies are an important and diverse group of heart muscle diseases in which the heart muscle itself is structurally or functionally abnormal and in which coronary artery disease, hypertension, valvular and congenital heart disease are absent or do not sufficiently explain the observed myocardial abnormality. this often results in severe heart failure accompanied by arrhythmias and/or sudden death. clinical and morphological diversity of cardiomyopathies can reflect the broad spectrum o ...200919370326
a novel fibronectin binding motif in mscramms targets f3 modules.bbk32 is a surface expressed lipoprotein and fibronectin (fn)-binding microbial surface component recognizing adhesive matrix molecule (mscramm) of borrelia burgdorferi, the causative agent of lyme disease. previous studies from our group showed that bbk32 is a virulence factor in experimental lyme disease and located the fn-binding region to residues 21-205 of the lipoprotein.200919404402
the urokinase receptor (upar) facilitates clearance of borrelia burgdorferi.the causative agent of lyme borreliosis, the spirochete borrelia burgdorferi, has been shown to induce expression of the urokinase receptor (upar); however, the role of upar in the immune response against borrelia has never been investigated. upar not only acts as a proteinase receptor, but can also, dependently or independently of ligation to upa, directly affect leukocyte function. we here demonstrate that upar is upregulated on murine and human leukocytes upon exposure to b. burgdorferi both ...200919461880
human brain microvascular endothelial cell traversal by borrelia burgdorferi requires calcium signaling.neurological manifestations of lyme disease (or neuroborreliosis) occur variably and while it is clear that borrelia burgdorferi can invade the nervous system, how it does so is not well understood. pathogen penetration through the blood brain barrier (bbb) is often influenced by calcium signaling in the endothelial cells triggered by extracellular host-pathogen interactions. we examined the traversal of b. burgdorferi across the human bbb using in vitro model systems constructed of human brain ...200919489925
[climate changes and emerging diseases. what new infectious diseases and health problem can be expected?].increasing temperatures, but also other climatic factors, will have an impact on human health. apart from the direct consequences of extreme weather conditions (e.g., heat-related fatalities), indirect health consequences in the long-term are also of great importance. in addition to a likely increase in allergic diseases and additional complications in the course of cardiovascular and respiratory diseases, infectious diseases are of particular interest. in germany, endemic pathogens, such as han ...200919536444
tick-borne zoonotic bacteria in ticks collected from central spain.the prevalence of tick-borne and related bacteria infecting adult ticks in central spain was assessed by molecular methods. six areas were sampled monthly during a 2-year longitudinal study. a total of 1,038 questing and 442 feeding ticks, belonging to eight different species, were tested. the most abundant species were hyalomma lusitanicum (54% of captures), followed by dermacentor marginatus (23%) and rhipicephalus sanguineus (10%). four human pathogens, including seven rickettsia species, ana ...200919556569
first detection and molecular identification of borrelia garinii isolated from human skin in taiwan. 201019910482
inflammation and central nervous system lyme disease.lyme disease, caused by the bacterium borrelia burgdorferi, can cause multi-systemic signs and symptoms, including peripheral and central nervous system disease. this review examines the evidence for and mechanisms of inflammation in neurologic lyme disease, with a specific focus on the central nervous system, drawing upon human studies and controlled research with experimentally infected rhesus monkeys. directions for future human research are suggested that may help to clarify the role of infl ...201019944760
lipid binding orientation within cd1d affects recognition of borrelia burgorferi antigens by nkt cells.invariant natural killer t cells (inkt cells) respond to cd1d-presented glycolipids from borrelia burgdorferi, the causative agent of lyme disease. although mouse and human inkt cells respond to different antigens based on subtle differences in their fatty acids, the mechanism by which fatty acid structure determines antigenic potency is not well understood. here we show that the mouse and human cd1d present glycolipids having different fatty acids, based in part upon a difference at a single am ...201020080535
a bacterial elongation factor g homologue exclusively functions in ribosome recycling in the spirochaete borrelia burgdorferi.translation elongation factor g (ef-g) in bacteria plays two distinct roles in different phases of the translation system. ef-g catalyses the translocation of trnas on the ribosome in the elongation step, as well as the dissociation of the post-termination state ribosome into two subunits in the recycling step. in contrast to this conventional view, it has very recently been demonstrated that the dual functions of bacterial ef-g are distributed over two different ef-g paralogues in human mitocho ...201020132446
p66 porins are present in both lyme disease and relapsing fever spirochetes: a comparison of the biophysical properties of p66 porins from six borrelia species.the genus borrelia is the cause of the two human diseases: lyme disease (ld) and relapsing fever (rf). both ld and rf borrelia species are obligate parasites and are dependent on nutrients provided by their hosts. the first step of nutrient uptake across the outer membrane of these gram-negative bacteria is accomplished by water-filled channels, so-called porins. the knowledge of the porin composition in the outer membranes of the different pathogenic borrelia species is limited. only one porin ...201020188698
31-year-old man with fever, palpitations, and generalized rash. 201020360288
evaluation of real-time pcr targeting hbb gene for borrelia species identification.several molecular methods have been employed for borrelia species identification. newly developed technology, real-time polymerase chain reaction (rt-pcr), combines simultaneous amplification, detection and differentiation of strains in one pcr run. the aim of the study was to perform and evaluate rt-pcr for borreliaburgdorferi sensu lato species identification. borrelia species identification was accomplished on 374 borrelia strains using two approaches: 1.) mlui restriction of entire borrelial ...201020451566
evidence of multiple infectious agents in mycosis fungoides lesions.the etiology of mycosis fungoides (mf) remains to be determined. several studies have proposed a viral etiology with controversial results. in this case-control study we investigated the presence of epstein-barr virus (ebv) and the debated presence of human t-cell lymphotrophic virus i (htlv-i) sequences, by polymerase chain reaction on nucleic acid extracts from formalin-fixed paraffin-embedded skin biopsies. moreover, by a multivariate approach we analyzed in the same case-control study also t ...201020470773
evolution of northeastern and midwestern borrelia burgdorferi, united states.the per capita incidence of human lyme disease in the northeastern united states is more than twice that in the midwest. however, the prevalence of borrelia burgdorferi, the bacterium that causes lyme disease, in the tick vector is nearly identical in the 2 regions. the disparity in human lyme disease incidence may result from a disparity in the human invasiveness of the bacteria in the northeast and midwest caused by fundamentally different evolutionary histories. b. burgdorferi populations in ...201020507740
lyme disease and the detection of borrelia burgdorferi genospecies in ixodes ricinus ticks from central italy.the province of pesaro-urbino, situated in the marche region of central italy, can be considered to be an area at risk for lyme disease because of its ecological features. field data are not yet available although the disease is known to be present in neighbouring areas. during a field study lasting twelve months, ticks were collected from the vegetation, from wild cervids and also from humans who reported a tick bite at the local hospital. all ticks were identified and ixodes ricinus specimens ...201020560127
expression and sequence diversity of the complement regulating outer surface protein e in borrelia afzelii vs. borrelia garinii in patients with erythema migrans or neuroborreliosis.outer surface protein e (ospe) is a complement factor h-binding virulence factor of borrelial subspecies. it is usually absent from in vitro grown borrelia garinii, although in vivo b. garinii causes neuroborreliosis (nb). we analyzed the presence and sequence spectrum of the ospe genes in vivo in borrelia spirochetes. dna samples from the skin, serum and cerebrospinal fluid (csf) of patients with infections caused by borrelia afzelii or b. garinii were studied, and anti-ospe antibodies in the c ...201020603210
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