LymeNet Newsletter Volume 5 Issue 08

Volume: 5
Issue: 08
Date: 04-Aug-97

Table of Contents:

I. LYMENET: CID Publishes Special Lyme Supplement II. LYMENET: Fallon Seeks Patients for Pediatric Study III. LDRC: Nominations Sought for Distinguished Physician Award IV. J CLIN MICROBIOL: Molecular characterization of a 35-kilodalton protein of Borrelia burgdorferi, an antigen of diagnostic importance in early Lyme disease V. PEDIATR NEUROL: Lyme neuroborreliosis masquerading as a brainstem tumor in a 15-year-old VI. RHEUMATOL INT: Intracellular persistence of Borrelia burgdorferi in human synovial cells VII. About The LymeNet Newsletter

Newsletter:

*********************************************************************** * The National Lyme Disease Network * * http://www.lymenet.org/ * * LymeNet Newsletter * ***********************************************************************

IDX# Volume 5 / Number 08 / 04-AUG-97 IDX# INDEX IDX# IDX# I. LYMENET: CID Publishes Special Lyme Supplement IDX# II. LYMENET: Fallon Seeks Patients for Pediatric Study IDX# III. LDRC: Nominations Sought for Distinguished Physician Award IDX# IV. J CLIN MICROBIOL: Molecular characterization of a IDX# 35-kilodalton protein of Borrelia burgdorferi, an antigen IDX# of diagnostic importance in early Lyme disease IDX# V. PEDIATR NEUROL: Lyme neuroborreliosis masquerading as a IDX# brainstem tumor in a 15-year-old IDX# VI. RHEUMATOL INT: Intracellular persistence of Borrelia IDX# burgdorferi in human synovial cells IDX# VII. About The LymeNet Newsletter IDX#

I. LYMENET: CID Publishes Special Lyme Supplement ---------------------------------------------------- Sender: Marc Gabriel <[email protected]> Date: July 30, 1997

The journal Clinical Infectious Diseases has published a supplemental issue containing research presented at the Ninth Annual International Conference of Lyme Borreliosis and Other Tick-borne Diseases. The works contained in this supplement cover a wide range of topics, from microbiology to serology, treatment to chronic issues.

The LymeNet Newsletter recommends this publication for any physician who would like a primer on the vast array of issues surrounding LD. For a complete table of contents, please visit:

http://www.journals.uchicago.edu/CID/v25s1toc.html

Ordering information can be found at:

http://www.journals.uchicago.edu/CID/order1.html

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II. LYMENET: Fallon Seeks Patients for Pediatric Study -------------------------------------------------------- Sender: Marc Gabriel <[email protected]> Date: July 25, 1997

Dr. Brian A. Fallon, a physician noted for his investigation into the neuropsychiatric effects of LD, is currently recruiting children and adolescents to participate in a study of the cognitive effects of pediatric LD. Many children with LD experience difficulties at home and school. If properly diagnosed, many of these children could benefit from psychiatric assistance.

The children will receive a free neuropsychological evaluation as part of the study. To qualify, candidates must meet the following criteria:

* Between the ages of 9 and 16 * Be symptomatic for at least 6 months, but no more than 3 years * Have physician diagnosed EM rash or positive Western Blot result * Have symptoms that developed clearly after the onset of disease * Have difficulty remembering things or paying attention

For more information on the study, please contact Felice Tager at: (212) 543-5487.

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III. LDRC: Nominations Sought for Distinguished Physician Award ---------------------------------------------------------------- Sender: Phyllis Mervine <[email protected]>

The Lyme Disease Resource Center (LDRC) is accepting nominations for the 1997 Distinguished Physician Award, which recognizes a physician for clinical excellence, leadership, compassion, and dedication to the treatment of Lyme disease. The nomination deadline is September 1. The first Distinguished Physician Award recipient was Paul Emile Lavoie, MD, who died of pancreatic cancer at the age of 60 on January 23, 1994.

Dr. Lavoie was a specialist in rheumatology and internal medicine in private practice in San Francisco since 1973. He held several medical teaching appointments, including Clinical Professor of Medicine at UCSF. An active board participant of national, state, and local organizations, he was also a Founding Fellow of the American Rheumatology Association. In 1977, Dr. Lavoie diagnosed the first two cases of Lyme disease in the far-western United States. He subsequently played a major role in both the treatment and research of Lyme disease, often bridging the gap between the clinician and the biomedical community. He treated hundreds of patients with Lyme disease, and contributed 25 published papers on aspects ranging from laboratory diagnosis to clinical approaches. Lecturing widely, he participated in special Lyme disease conferences at both the National Institutes of Health and the Centers for Disease Control and Prevention.

Dr. Lavoie was presented with the Distinguished Physician Award at the LDRC Lyme disease conference in Ukiah, California, in October, 1993. In the last lecture of his life he reinterated a familiar theme: Lyme disease is a complex, multisystem illness which is often missed by the physician and may be recognized in only its later stages, with serious consequences for the patient. Dr. Lavoie was an unequivocal proponent of long-term oral antibiotic treatment.

The first Distinguished Physician Award was given to Dr. Lavoie by the Lyme Disease Resource Center and the Lyme Disease Foundation jointly, and has not been awarded since.

Please submit nominations (with rationale) to LDRC, PO Box 1891, Sonoma, CA 95476 by September 1, 1997. The presentation will be made at the LDRC Conference on Emerging Tick-Borne Diseases in the Western United States in Los Angeles on September 13.

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IV. J CLIN MICROBIOL: Molecular characterization of a 35-kilodalton protein of Borrelia burgdorferi, an antigen of diagnostic importance in early Lyme disease --------------------------------------------------------------------- AUTHORS: Gilmore RD Jr, Kappel KJ, Johnson BJ ORGANIZATION: National Center for Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado <[email protected]> REFERENCE: J Clin Microbiol 1997 Jan;35(1):86-91 ABSTRACT:

Antibodies against a 35-kDa antigen of Borrelia burgdorferi are detectable in the serum of about half of patients with early Lyme disease. The gene encoding this antigen was isolated from a genomic library of B. burgdorferi B31 (low passage), and full-length expression of the recombinant gene product was achieved in Escherichia coli. Antiserum raised against the recombinant protein was reactive with a B. burgdorferi protein of the same molecular size as the diagnostic 35-kDa antigen cited in an earlier study of criteria for the sero-diagnosis of early Lyme disease. Also, the recombinant protein was reactive with serum from patients with early Lyme disease who were seropositive for the 35-kDa antigen. DNA sequence analysis of the gene indicated an open reading frame of 909 bp encoding a protein with a calculated molecular mass of 34.3 kDa. This gene did not possess the usual initiation codon ATG but rather probably used a TTG codon. The deduced amino acid sequence of the N terminus exhibited a motif similar to that for signal peptides of lipoproteins.
Southern blotting revealed a chromosomal location for this gene; and it was specific for B. burgdorferi, B. afzellii, and B. garinii but not for B. hermsii, B. coriaciae, or B. turicatae.

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V. PEDIATR NEUROL: Lyme neuroborreliosis masquerading as a brainstem tumor in a 15-year-old ------------------------------------------------------------- AUTHORS: Curless RG, Schatz NJ, Bowen BC, Rodriguez Z, Ruiz A ORGANIZATION: Department of Neurology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Florida REFERENCE: Pediatr Neurol 1996 Oct;15(3):258-60 ABSTRACT:

A 15-year-old boy had onset of unilateral facial weakness. A few days later, he experienced mild vertigo, double vision, and headache. Examination confirmed a peripheral right seventh nerve weakness in addition to an internuclear ophthalmoplegia. The neurologic features suggested a pontine glioma. A T2-weighted MRI scan revealed demyelinating lesions in the pons and in several areas of the cerebrum, including the periventricular region. Subsequent history revealed that he had been diagnosed with Lyme arthritis 7 years earlier while living in Connecticut. The radiographic studies favored a diagnosis of multiple sclerosis. However, studies of blood and cerebrospinal fluid established a diagnosis of Lyme neuroborreliosis.

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VI. RHEUMATOL INT: Intracellular persistence of Borrelia burgdorferi in human synovial cells ---------------------------------------------------------------------- AUTHORS: Girschick HJ, Huppertz HI, Russmann H, Krenn V, Karch H ORGANIZATION: Children's Hospital, University of Wurzburg, Germany REFERENCE: Rheumatol Int 1996;16(3):125-32 ABSTRACT:

To investigate if Borrelia burgdorferi can persist in resident joint cells, an infection model using cell cultures of human synovial cells was established and compared to the interaction of Borrelia burgdorferi and human macrophages. Borrelia burgdorferi were found attached to the cell surface or folded into the cell membrane of synovial cells analysed by transmission electron and confocal laser scanning microscopy. In contrast to macrophages, morphologically intact Borrelia burgdorferi were found in the cytosol of synovial cells without engulfment by cell membrane folds or phagosomes. Borrelia burgdorferi were isolated from parallel cultures. Treatment with ceftriaxone eradicated extracellular Borrelia burgdorferi, but spirochetes were reisolated after lysis of the synovial cells. Borrelia burgdorferi persisted inside synovial cells for at least 8 weeks. These data suggested that Borrelia burgdorferi might be able to persist within resident joint cells in vivo.

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VII. ABOUT THE LYMENET NEWSLETTER ---------------------------------- For the most current information on LymeNet subscriptions, contributions, and other sources of information on Lyme disease, please refer to the LymeNet Home Page at: http://www.lymenet.org ----------------------------------------------------------------------- To unsubscribe from the LymeNet newsletter, send a message to: [email protected] On the first line of the message, write: unsub lymenet-l ----------------------------------------------------------------------- LymeNet - The Internet Lyme Disease Information Source ----------------------------------------------------------------------- Editor-in-Chief: Marc C. Gabriel <[email protected]> FAX (for contributions ONLY): 908-789-0028 Contributing Editors: Carl Brenner <[email protected]> John Setel O'Donnell <[email protected]> Frank Demarest <[email protected]> Advisors: Carol-Jane Stolow, Director <[email protected]>
William S. Stolow, President <[email protected]> The Lyme Disease Network of New Jersey ----------------------------------------------------------------------- WHEN COMMENTS ARE PRESENTED WITH AN ATTRIBUTION, THEY DO NOT NECESSARILY REPRESENT THE OPINIONS/ANALYSES OF THE EDITORS. ----------------------------------------------------------------------- THIS NEWSLETTER MAY BE REPRODUCED AND/OR POSTED ON BULLETIN BOARDS FREELY AS LONG AS IT IS NOT MODIFIED OR ABRIDGED IN ANY WAY. ----------------------------------------------------------------------- SEND ALL BUG REPORTS TO [email protected] -----------------------------------------------------------------------