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Volume: 3
Issue: 19
Date: 04-Dec-95


Table of Contents:

I.    LYMENET: The Multiple-Sclerosis Question
II.   J EGYPT SOC PARASITOL: ELISA screening for Lyme disease in
      children with chronic arthritis
III.  J CLIN MICROBIOL: Expression of outer surface proteins A
      and C of Borrelia burgdorferi in Ixodes ricinus
IV.   CLIN EXP IMMUNOL: The outer surface proteins of Lyme
      disease borrelia spirochetes stimulate T cells to secrete
      interferon-gamma (IFN-gamma): diagnostic and pathogenic
      implications
V.    J CLIN MICROBIOL: Variable serum immunoglobulin responses
      against different Borrelia burgdorferi sensu lato species
      in a population at risk for and patients with Lyme disease
VI.   About The LymeNet Newsletter


Newsletter:

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*                  The National Lyme Disease Network                  *
*                         LymeNet Newsletter                          *
***********************************************************************


IDX#                Volume 3 - Number 19 - 12/04/95
IDX#                            INDEX
IDX#
IDX#  I.    LYMENET: The Multiple-Sclerosis Question
IDX#  II.   J EGYPT SOC PARASITOL: ELISA screening for Lyme disease in
IDX#        children with chronic arthritis
IDX#  III.  J CLIN MICROBIOL: Expression of outer surface proteins A
IDX#        and C of Borrelia burgdorferi in Ixodes ricinus
IDX#  IV.   CLIN EXP IMMUNOL: The outer surface proteins of Lyme
IDX#        disease borrelia spirochetes stimulate T cells to secrete
IDX#        interferon-gamma (IFN-gamma): diagnostic and pathogenic
IDX#        implications
IDX#  V.    J CLIN MICROBIOL: Variable serum immunoglobulin responses
IDX#        against different Borrelia burgdorferi sensu lato species
IDX#        in a population at risk for and patients with Lyme disease
IDX#  VI.   About The LymeNet Newsletter
IDX#


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I.    LYMENET: The Multiple-Sclerosis Question
---------------------------------------------------
Sender: Grahame Shannon <76530.1025@compuserve.com>


EDITORIAL NOTE: For decades, hypotheses of a possible link between MS
and spirochetal illnesses have been discussed in the peer reviewed
literature.  While these theories have been dismissed my most
researchers, the topic continues to generate significant discussion.
One reader sent us a list of references to support the case of a link.
Here are the citations:


1. Buzzard E F Spirochetes in M.S. Lancet 11:98 1911

2. Bullock W E (now Gye) MS agent in Rabbits  Lancet 1185 1913

3. Kuhn P., Steiner G. Uber Die Ursache der M.S. Med Knli, 13:1001,
  1917


4. Steiner G. Guinea pig inoculation with MS tissues. Arch. f Psych.
  v  Nervenkrankh Berline LX, 1918


5. Steiner G. MS agent inoculation in monkeys. Zeitscr f. diges Neurol
  v Psychiat. Reger at Berlin XVLL: 491, 1919


6. Blacklock JW MS agent in Rabbits  J. Path and Bact. 28:1, 1925

7. Steiner G. Silver Staining of MS tissues. Nervenarzt 6:281, 1932

8. Rogers, Helen J. The question of silver cells as proof of the
  spirochetal theory of disseminated sclerosis. J. Neurol and
  Psychopathol. 13:50, 1932


9. Austregesilo A. Le schlerose en plaques de form subalque apropos
  d'un case. L'Encephale 28:633, 1933


10. Steiner G. Is MS an etiologically uniform infectious disease?
   Detroit Med. News Educational Issues 32:7, 1941


11. Adams D L Spirochetes in the ventricular fluid of monkeys
   inoculated from case of disseminated sclerosis. Surgo 14:11 1948


12. Steiner G. Acute plaques in M.S., their pathogenetic significance
   and the role of spirochetes as the etiological factor. J.
   Neuropath. and Exp. Neur. 11:no 4:343, 1954


13. Steiner G. Morphology of spirochaeta myelopthora in M.S.  J.
   Neuropath. and Exp. Neur. 13:221, 1954


14. Ichelson R R Cultivation of Spirochaetes from spinal fluids of MS
   cases and negative controls. Procl Soc. Exp. Biol. Med. 70:411,
   1957


15. Gay D  Dick G Is multiple sclerosis caused by an oral
   spirochaete?  Lancet (1986 Jul 12) 2(8498):75-7


16. Marshall V Multiple sclerosis is a chronic central nervous system
   infection by a spirochetal agent. Med Hypotheses (1988 Feb)
   25(2):89-92


17.Marshall V The relationship of peripheral nervous system (PNS)
  pathology to multiple sclerosis (MS)  J Neurol Sci (1988 Mar)
  84(1):117-9



=====*=====


II.   J EGYPT SOC PARASITOL: ELISA screening for Lyme disease in
     children with chronic arthritis
----------------------------------------------------------------
AUTHORS: Hammouda NA, Hegazy IH, el-Sawy EH
ORGANIZATION: Department of Parasitology, Faculty of Medicine,
             Alexandria University, Egypt
REFERENCE: J Egypt Soc Parasitol 1995 Aug;25(2):525-33
ABSTRACT:


One hundred patients, aged 6-15 years and presented to El-Shatby
University Children's Hospital with chronic/recurrent arthritis and
skin lesions suggestive of erythema chronicum migrans (ECM),
were investigated for presence of IgG antibodies against Borrelia
burgdorferi flagellum antigen ELISA test.  Four cases yielded positive
serum samples which were true positive cases as they showed negative
Venereal Disease Research Laboratory (VDRL) test.  Ticks collected
from domestic animals from the houses of serologically positive
patients were found belonging to hard tick: Rhipicephalus sanguineus.
Based on clinical ground, only one case was strongly suspected to
have Lyme disease due to the presence of the distinctive skin lesion
(ECM) while the other three cases were not diagnosed till the results
of serological test.  This study provides serological evidence
concerning the presence of Lyme disease in Egypt.  Further efforts of
identify its prevalence, various clinical presentations, vectors and
animal hosts are warranted.



=====*=====


III.  J CLIN MICROBIOL: Expression of outer surface proteins A
     and C of Borrelia burgdorferi in Ixodes ricinus
----------------------------------------------------------------
AUTHORS: Fingerle V, Hauser U, Liegl G, Petko B, Preac-Mursic V,
        Wilske B
ORGANIZATION: Max von Pettenkofer Institute fur Hygiene und
             Medizinische Mikrobiologie Universitt Munchen, Germany
REFERENCE: J Clin Microbiol 1995 Jul;33(7):1867-9
ABSTRACT:


A total of 472 field-collected Ixodes ricinus ticks from southern
Germany were investigated by immunofluorescence for the presence of
Borrelia burgdorferi with a polyvalent rabbit immune serum and with
monoclonal antibodies specific for outer surface proteins A and C
(OspA and OspC, respectively).  Borreliae were detected in 90 ticks
with the polyvalent immunofluorescence assay. Infection rates in
adults (females, 20.2%; males, 25.2%) were significantly higher than
in nymphs (12.1%).  OspA was detected in 77 ticks and OspC was
detected in only 1 tick with the respective monoclonal antibodies.
We therefore conclude that B. burgdorferi in unfed I. ricinus ticks
usually expresses OspA and very rarely OspC.



======*=====


IV.   CLIN EXP IMMUNOL: The outer surface proteins of Lyme
     disease borrelia spirochetes stimulate T cells to secrete
     interferon-gamma (IFN-gamma): diagnostic and pathogenic
     implications
-----------------------------------------------------------------
AUTHORS: Forsberg P, Ernerudh J, Ekerfelt C, Roberg M, Vrethem M,
        Bergstrom S
ORGANIZATION: Department of Infections Diseases, Faculty of Health
             Sciences, University Hospital, Linkoping, Sweden
REFERENCE: Clin Exp Immunol 1995 Sep;101(3):453-60
ABSTRACT:


Late stages of borrelia Lyme disease infections may be difficult to
diagnose because of unspecific symptoms and unreliable laboratory
tests, being too unspecific or insensitive.  The T cell immune
response was thus evaluated in these patients by using a sensitive
ELISPOT T cell assay that detects the secretion of IFN-gamma,
i.e. a T helper 1 (Th1) response on the single-cell level.  Three
subcellular fractions of the Lyme borreliosis strain Borrelia
afzelii were used for antigenic stimulation.  The outer surface
protein (Osp) fraction elicited the strongest response,
discriminating between borrelia infections (n = 15) compared with
other neurological diseases (n = 10) and normal controls (n = 12)
(P = 0.0001).  The more heterogeneous sonicated borrelia fraction also
elicited a strong response, however, also in some of the controls.
The flagellin fraction did not have a similar T cell-stimulating
effect.  When looking at subgroups of borrelia infections, central
nervous system (CNS) infections (n = 7) revealed a lower T cell

response in blood (P = 0.0128) compared with other borrelia
manifestations (n = 8).  Cerebrospinal fluid (CSF) lymphocytes were
available from three patients with CNS borreliosis, and all showed a
compartmentalization with higher responses to the Osp fraction in CSF
compared with blood, also in the two patients without any intrathecal-
specific antibody synthesis.  The ELISPOT method is feasible for
detecting a specific IFN-gamma T cell response in borrelia infections.
This Th1 response may well be of pathogenic relevance.



=====*=====


V.    J CLIN MICROBIOL: Variable serum immunoglobulin responses
     against different Borrelia burgdorferi sensu lato species in a
     population at risk for and patients with Lyme disease
--------------------------------------------------------------------
AUTHORS: Bunikis J, Olsen B, Westman G, Bergstroom S
ORGANIZATION: Department of Microbiology, Umea University, Sweden
REFERENCE: J Clin Microbiol 1995 Jun;33(6):1473-8
ABSTRACT:


Borrelia burgdorferi sensu lato species display considerable antigenic
polymorphism.  In order to evaluate the importance of this antigenic
heterogeneity in the serodiagnosis of Lyme disease, the serum
immunoglobulin G response in 148 healthy individuals from an area in
northern Sweden where Lyme disease is endemic and in 40 American
patients with Lyme disease was assessed.  In a seroprevalence study,
the control group included 173 individuals from a region of northern
Sweden where Lyme disease is not endemic.  The two enzyme immunoassays
used were based on outer membrane-associated proteins of either B.
burgdorferi sensu stricto or Borrelia garinii.  The Swedish
populations were also screened for antiflagellum seroreactivity.
The individuals from the area of endemicity were significantly more
seropositive for the subcellular protein fraction of the local B.
garinii isolate NBS16 than the control group (11.5 versus 2.9%;
P = 0.005) but were not significantly more positive for the other
antigens used.  In contrast, American patients with Lyme disease were

significantly more reactive against the North American B. burgdorferi
sensu stricto strain B31 than against B. garinii NBS16 (57.5 versus
15.0%; P = 0.0001).  Immunoblot analysis suggests that the borrelial
outer surface protein C is involved in triggering the production of
species-specific antibody during localized Lyme disease.  We conclude
that a species-specific immune response develops during infection with
Lyme disease Borrelia spp.  Thus, the reliability of a serological
investigation of Lyme disease increases when one measures antibody
titers against the outer membrane proteins of Lyme disease Borrelia
spp. occurring in a particular geographic region.



=====*=====


VI.   ABOUT THE LYMENET NEWSLETTER
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