LymeNet Newsletter Volume 6 Issue 01

Volume: 6
Issue: 01
Date: 15-Jan-98

Table of Contents:

I. LYMENET: U-Penn Using PCR To Unlock Lyme Mysteries II. ARCH NEUROL: Post-Lyme syndrome and chronic fatigue syndrome. Neuropsychiatric similarities and differences. III. PROC NATL ACAD SCI: Therapeutic passive vaccination against chronic Lyme disease in mice. IV. ZENTRALBL BAKTERIOL: The isolation of Borrelia burgdorferi spirochetes from clinical material in cell line cultures. V. ABOUT THE LYMENET NEWSLETTER

Newsletter:

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

Volume 6 / Number 01 / 15-JAN-98 INDEX

I. LYMENET: U-Penn Using PCR To Unlock Lyme Mysteries II. ARCH NEUROL: Post-Lyme syndrome and chronic fatigue syndrome. Neuropsychiatric similarities and differences. III. PROC NATL ACAD SCI: Therapeutic passive vaccination against chronic Lyme disease in mice. IV. ZENTRALBL BAKTERIOL: The isolation of Borrelia burgdorferi spirochetes from clinical material in cell line cultures. V. ABOUT THE LYMENET NEWSLETTER

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I. LYMENET: U-Penn Using PCR To Unlock Lyme Mysteries -------------------------------------------------------- BYLINE: By Marc C. Gabriel DATE: January 9, 1998

Researchers at the University of Pennsylvania are looking to discover why some Lyme patients continue to exhibit objective signs of infection despite supposedly adequate antibiotic therapy. To this end, they are seeking samples from patients for analysis.

Dr. H. Ralph Schumacher, Director of the Rheumatology-Immunology Center at the University of Pennsylvania School of Medicine, is leading the Lyme project. Dr. Schumacher is continuing the work previously performed by Drs. Manfred and Margaret Bayer at the Fox Chase Cancer Center in Philadelphia. Funding is being provided by the Lyme Disease Association of New Jersey.

At the most basic level, the project will use the polymerase chain reaction (PCR) method to attempt detection of Borrelia burgdorferi (Bb), the causitive agent of Lyme disease, in urine and synovial fluid samples. These results will be analyzed along with the patient's clinical, diagnostic and treatment data.

Subsequently, if funding permits, the researchers plan to investigate some basic aspects of how Borrelia invade and possibly persist in tissues. They will develop in situ hybridization to localize DNA or RNA of Bb. The cytokines produced by the cells surrounding Bb will be examined to see if certain people produce more cytokines that make it more difficult to eliminate infections. Measures other than antibiotics may be needed for such patients.

"Physician participation in this project is essential," says Patricia V. Smith, President of the Lyme Disease Association of New Jersey. "Patients and physicians alike have faced a myriad of problems associated with the diagnosis and treatment of Lyme disease - especially chronic Lyme disease. The studies conducted by Dr. Bayer and Dr. Schumacher, utilizing the latest molecular biology techniques, will help us to further elucidate the complexities of diagnosis, pathogenesis, and persistence of the organism."

All samples sent to Dr. Schumacher must be submitted by a physician. The Lyme Disease Network will make the required paper forms available for download and printing at their home page at:

http://www.lymenet.org/upenn/

The PCR technique for Bb detection has been in use for many years. Numerous commercial laboratories, including IgeneX Labs and BBI North American Labs, have been performing this test for several years.

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II. ARCH NEUROL: Post-Lyme syndrome and chronic fatigue syndrome. Neuropsychiatric similarities and differences. ------------------------------------------------------------------- AUTHORS: Gaudino EA, Coyle PK, Krupp LB ORGANIZATION: Department of Neurology, State University of New York at Stony Brook, USA. REFERENCE: Arch Neurol 1997 Nov;54(11):1372-6 ABSTRACT:

BACKGROUND: Patients with chronic fatigue syndrome (CFS) and post-Lyme syndrome (PLS) share many features, including symptoms of severe fatigue and cognitive difficulty. OBJECTIVE: To examine the neuropsychiatric differences in these disorders to enhance understanding of how mood, fatigue, and cognitive performance interrelate in chronic illness. METHODS: Twenty-five patients with CFS, 38 patients with PLS, and 56 healthy controls participated in the study. Patients with CFS met 1994 criteria for CFS and lacked histories suggestive of Lyme disease. Patients with PLS were seropositive for Lyme disease, had met the Centers for Disease Control and Prevention criteria, or had histories strongly suggestive of Lyme disease and were experiencing severe fatigue that continued 6 months or more following completion of antibiotic treatment for Lyme disease. All subjects completed self-report measures of somatic symptoms and mood disturbance and underwent neuropsychological testing. All patients also underwent a structured psychiatric interview.
RESULTS: Patients with CFS and PLS were similar in several somatic symptoms and in psychiatric profile. Patients with CFS reported more flulike symptoms than patients with PLS. Patients with PLS but not patients with CFS performed significantly worse than controls on tests of attention, verbal memory, verbal fluency, and motor speed. Patients with PLS without a premorbid history of psychiatric illness did relatively worse on cognitive tests than patients with PLS with premorbid psychiatric illness compared with healthy controls. CONCLUSIONS: Despite symptom overlap, patients with PLS show greater cognitive deficits than patients with CFS compared with healthy controls. This is particularly apparent among patients with PLS who lack premorbid psychiatric illness.

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III. PROC NATL ACAD SCI: Therapeutic passive vaccination against chronic Lyme disease in mice. ----------------------------------------------------------------- AUTHORS: Zhong W, Stehle T, Museteanu C, Siebers A, Gern L, Kramer M Wallich R, Simon MM ORGANIZATION: Max-Planck-Institut fur Immunbiologie, Stubeweg 51, D-79108 Freiburg, Germany. REFERENCE: Proc Natl Acad Sci U S A 1997 Nov 11;94(23):12533-8 ABSTRACT:

Passive and active immunization against outer surface protein A (OspA) has been successful in protecting laboratory animals against subsequent infection with Borrelia burgdorferi. Antibodies (Abs) to OspA convey full protection, but only when they are present at the time of infection. Abs inactivate spirochetes within the tick and block their transmission to mammals, but do not affect established infection because of the loss of OspA in the vertebrate host. Our initial finding that the presence of high serum titers of anti-OspC Abs (5 to 10 &mgr;g/ml) correlates with spontaneous resolution of disease and infection in experimentally challenged immunocompetent mice suggested that therapeutic vaccination with OspC may be feasible. We now show that polyclonal and monospecific mouse immune sera to recombinant OspC, but not to OspA, of B. burgdorferi resolve chronic arthritis and carditis and clear disseminated spirochetes in experimentally infected C.B.-17 severe combined immunodeficient mice in a dose-dependent manner. This was verified by macroscopical and
microscopical examination of affected tissues and recultivation of spirochetes from ear biopsies. Complete resolution of disease and infection was achieved, independent of whether OspC-specific immune sera (10 microg OspC-specific Abs) were repeatedly given (4x in 3- to 4-day intervals) before the onset (day 10 postinfection) or at the time of fully established arthritis and carditis (days 19 or 60 postinfection). The results indicate that in mice spirochetes constitutively express OspC and are readily susceptible to protective OspC-specific Abs throughout the infection. Thus, an OspC-based vaccine appears to be a candidate for therapy of Lyme disease.

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IV. ZENTRALBL BAKTERIOL: The isolation of Borrelia burgdorferi spirochetes from clinical material in cell line cultures. ---------------------------------------------------------------- AUTHORS: Tylewska-Wierzbanowska S, Chmielewski T ORGANIZATION: Department of Bacteriology, National Institute of Hygiene, Warsaw, Poland. REFERENCE: Zentralbl Bakteriol 1997 Oct;286(3):363-70 ABSTRACT:

It has been found that B. burgdorferi bacteria multiply in mouse fibroblasts. Mouse fibroblast of the L-929 cell line was inoculated with less than 10 up to 10(4) B. burgdorferi cells and incubated for 2-10 days at 35 degrees C in microaerophilic conditions. Within 2 days, visible growth was observed. The bacteria were present in growth medium and on/in mouse fibroblasts as revealed by the indirect immunofluorescence assay. At the same time, development of vacuolized fibroblastic giant cells was observed. Viable spirochetes were also detected in Eagle's medium from a L-929 fibroblast cell line culture, after approximately 2-5 days of incubation with blood, cerebro-spinal and synovial fluids of Lyme borreliosis patients. The bacteria were present in growth medium and on/in endothelial cells as revealed by the indirect immunofluorescence assay. The establishment of B. burgdorferi culture conditions in cell lines gives us a possibility to isolate the etiological agent of Lyme disease from patient blood, cerebrospinal and synovial fluids at different stages of infection.
The high sensitivity of this procedure would be helpful in a proper identification of the infection as well as in the control of treatment effectiveness.

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V. 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] -----------------------------------------------------------------------