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Volume: 4
Issue: 14
Date: 14-Oct-96


Table of Contents:

I.    LDF: New Jersey task Force Fund Raisers in October
II.   LYMENET: Steven Philips, MD., to Speak in CT
III.  LANCET: A new Borrelia species isolated from patients
      with relapsing fever in Spain
IV.   INFECT IMMUN: Outer surface protein C (OspC), but not P39,
      is a protective immunogen against a tick-transmitted
      Borrelia burgdorferi challenge: evidence for a
      conformational protective epitope in OspC
V.    N ENGL J MED: Prevention of Jarisch-Herxheimer reactions
      by treatment with antibodies against tumor necrosis factor
      alpha
VI.   About The LymeNet Newsletter


Newsletter:

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*                  The National Lyme Disease Network                  *
*                         LymeNet Newsletter                          *
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IDX#                Volume 4 - Number 14 - 10/14/96
IDX#                            INDEX
IDX#
IDX#  I.    LDF: New Jersey task Force Fund Raisers in October
IDX#  II.   LYMENET: Steven Philips, MD., to Speak in CT
IDX#  III.  LANCET: A new Borrelia species isolated from patients
IDX#        with relapsing fever in Spain
IDX#  IV.   INFECT IMMUN: Outer surface protein C (OspC), but not P39,
IDX#        is a protective immunogen against a tick-transmitted
IDX#        Borrelia burgdorferi challenge: evidence for a
IDX#        conformational protective epitope in OspC
IDX#  V.    N ENGL J MED: Prevention of Jarisch-Herxheimer reactions
IDX#        by treatment with antibodies against tumor necrosis factor
IDX#        alpha
IDX#  VI.   About The LymeNet Newsletter
IDX#



I.    LDF: New Jersey task Force Fund Raisers in October
--------------------------------------------------------
Sender: Tom Forschner <ldftf@aol.com>
Date: October 8, 1996


The Lyme Disease Foundation's New Jersey Task Force will be holding
its first Gold Tournament in the State of New Jersey on October 15,
1996 at Essex Fells Country Club.  We need your support now!


We need golfers and reception attendees.  We also need people to take
out ads in the Golf program, or to advertise by buying tee or cart
signs.


You don't have to be a golfer to help.

US Congressman Rodney Frelinghuysen will be joining us for the
reception and Bart Oates, formerly with the New York Giants, will be
golfing with us.  The Giants have donated an autographed football and
Rodney Hampton's autographed jersey.  The New Jersey Devils have
donated 4 "center ice" tickets (probably the best seats in the house)
for their games with Vancouver (Dec 5) and Boston (Jan 14).  
Whittenhaurer has donated a very fine men's watch and Lipton will be
providing beverages.


Other Lyme Disease Foundation events: Lipton Tea of Englewood Cliffs
will be holding a walk/run-a-thon on October 18th for its employees
to benefit the Lyme Disease Foundation.


Call me or Cheryl at the Foundation if you need more information at:
860-525-2000.  You may also contact some of the Task Force Volunteers
directly:


Roberta Bethencourt..............908-446-6296
Barbara Brennan..................908-879-5331
Martha Behrle....................201-403-8915
Ruth Vanderhoof..................201-334-7070



=====*=====


II.   LYMENET: Steven Philips, MD., to Speak in CT
--------------------------------------------------
Sender: Cindy Onorato, The Lyme Disease Network of CT


The Lyme Disease Network of Connecticut Proudly Presents:

            An Evening with Dr. Steven Phillips

Dr. Phillips has opened a practice in Ridgefield, CT.  He is a
graduate of the Yale University School of Medicine residency program
at Greenwich Hospital and has been performing research in Lyme
disease for the past 6 years.


Dr. Phillips will be talking about Lyme disease, its chronic
manifestations, testing and therapy.  The talk will focus on the
microbiology and immune system interactions inherent to Lyme disease,
and the therapeutic strategies designed specifically in light of
recent advances in the understanding of how Lyme disease works.


DATE:  Wednesday, October 16th at the Ridgefield Public Library in
Ridgefield, CT, at 8pm.  The Library is located on Main Street.



=====*=====


III.  LANCET: A new Borrelia species isolated from patients
     with relapsing fever in Spain
-----------------------------------------------------------
AUTHORS: Anda P, Sanchez-Yebra W, del Mar Vitutia M, Perez Pastrana E,
        Rodriguez I, Miller NS, Backenson PB, Benach JL
ORGANIZATION: Centro Nacional de Microbiologia, Virologia e
             Inmunologia Sanitarias, Instituto de Salud
             Carlos III, Madrid, Spain.
REFERENCE: Lancet 1996 Jul 20;348(9021):162-5
ABSTRACT:


BACKGROUND: Lyme disease and tick-borne relapsing fever are worldwide
systemic borrelioses caused by several Borrelia species transmitted
by hard ticks (family Ixodidae) and soft ticks (family Argasidae),
respectively.  A previous seroepidemiological study of Lyme
borreliosis showed several serologically reactive patients with
clinically atypical presentations, and this discovery led to the
hypothesis that some of the cases of Lyme borreliosis had been
caused by another borrelia organism.


METHODS: Blood from patients in southern Spain who had suspected Lyme
disease or relapsing-fever borreliosis was cultured before treatment
began.  Isolates of Borrelia spp were inoculated into several
strains of mice of different ages.  The 16S rRNA and flagellin in
genes of Borrelia spp were sequenced by PCR and assessed by
phylogenetic analyses.


FINDINGS: We isolated a species of Borrelia from three patients with
relapsing fever and from Ornithodorus spp ticks in southern Spain.
This organism (refractory to in-vitro cultivation) caused a relapsing
spirochaetaemia with multiple organ involvement in laboratory mice
that recreated the human disease.  Phylogenetic analysis showed that
this organism is a previously unrecognised species.


INTERPRETATION: We have discovered a new borrelia pathogen that is
closely related to the other tick-borne agents of relapsing fever
in Europe and Africa, and which causes a relapsing systemic disease
with serological similarities to Lyme borreliosis.



=====*=====


IV.   INFECT IMMUN: Outer surface protein C (OspC), but not P39, is
     a protective immunogen against a tick-transmitted Borrelia
     burgdorferi challenge: evidence for a conformational
     protective epitope in OspC
-------------------------------------------------------------------
AUTHORS: Gilmore RD Jr, Kappel KJ, Dolan MC, Burkot TR, Johnson BJ
ORGANIZATION: Division of Vector-Borne Infectious Diseases, National
             Center for Infectious Diseases, Centers for Disease
             Control and Prevention, Fort Collins, Colorado.
REFERENCE: Infect Immun 1996 Jun;64(6):2234-9
ABSTRACT:


Outbred mice were immunized with the soluble fraction of a crude
Escherichia coli lysate containing either recombinant outer surface
protein C (OspC or P39 of Borrelia burgdorferi B31 (low passage).
Following seroconversion, the mice were challenged with an
infectious dose of B. burgdorferi B31 via the natural transmission
mode of tick bite.  Three mice immunized with P39 were not
protected; however, all 12 of the recombinant OspC-immunized mice
were protected from infection as assayed by culture and serology.
Although OspC has been shown to be a protective immunogen against
challenge with in vitro-cultured borrelia administered by needle,
this study is the first to demonstrate OspC effectiveness against
tick-borne spirochetes.


Following feeding, all ticks still harbored B. burgdorferi, suggesting
that the mechanism of protection is not linked to destruction of the
infectious spirochete within the tick.  In a separate experiment,
groups of four mice were immunized with protein fractions from B.
burgdorferi B31 purified by preparative gel electrophoresis in an
attempt to identify potential protective antigens.  Many of these mice
developed high-titer-antibody responses against OspC, but curiously
the mice were susceptible to B. burgdorferi infection via tick bite.
These results suggest that the protective epitope(s) on OspC is heat
sensitive/conformational, a finding which has implications in
vaccine development.



=====*=====


V.    N ENGL J MED: Prevention of Jarisch-Herxheimer reactions by
     treatment with antibodies against tumor necrosis factor alpha
-------------------------------------------------------------------
AUTHORS: Fekade D, Knox K, Hussein K, Melka A, Lalloo DG, Coxon RE
        Warrell DA
ORGANIZATION: Department of Internal Medicine, Black Lion Hospital,
             Addis Ababa, Ethiopia.
REFERENCE: N Engl J Med 1996 Aug 1;335(5):311-5
ABSTRACT:


BACKGROUND: In patients with louse-borne relapsing fever (Borrelia
recurrentis infection), antimicrobial treatment is often followed by
sudden fever, rigors, and persistent hypotension (Jarisch-Herxheimer
reactions) that are associated with increases in plasma
concentrations of tumor necrosis factor alpha (TNF-alpha),
interleukin-6, and interleukin-8.  We attempted to determine whether
sheep polyclonal Fab antibody fragments against TNF-alpha
(anti-TNF-alpha Fab) could suppress the Jarisch-Herxheimer reaction.


METHODS: We conducted a randomized, double-blind, placebo-controlled
trial in 49 patients with proven louse-borne relapsing fever.
Immediately before the intramuscular injection of penicillin, the
patients received an intravenous infusion of either anti-TNF-alpha
Fab or a control solution.


RESULTS: Ten of the 20 patients given anti-TNF-alpha Fab had
Jarisch-Herxheimer reactions with rigors, as compared with 26 of the
29 control patients (P = 0.006).  The controls had significantly
greater mean maximal increases in temperature (1.5 vs. 0.8 degrees C,
P < 0.001), pulse rate (31 vs. 13 per minute, P < 0.001), and
systolic blood pressure (25 vs. 15 mm Hg, P < 0.003), as well as
higher mean peak plasma concentrations of interleukin-6 (50 vs. 17
micrograms per liter) and interleukin-8 (2000 vs 205 ng per liter)
(P < 0.001 for both comparisons).  Levels of TNF-alpha were
undetectable after treatment with anti-TNF-alpha Fab.


CONCLUSIONS: Pretreatment with sheep anti-TNF-alpha Fab suppresses
Jarisch-Herxheimer reactions that occur after penicillin treatment
for louse-borne relapsing fever, reduces the associated increases in
plasma concentrations of interleukin-6 and interleukin-8, and may be
useful in other forms of sepsis.



=====*=====


VI.   ABOUT THE LYMENET NEWSLETTER
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