LymeNet Newsletter Volume 3 Issue 17

Volume: 3
Issue: 17
Date: 06-Nov-95

Table of Contents:

I. ANTIMICROB AGENTS CHEMOTHER: Effects of penicillin, ceftriaxone, and doxycycline on morphology of Borrelia burgdorferi II. J NEUROL: Intrathecal immune response in patients with neuroborreliosis: specificity of antibodies for neuronal proteins III. J AM OSTERPATH ASSOC: Hypothyroidism with concurrent Lyme disease IV. INFECT IMMUN: Adherence of Borrelia burgdorferi to the proteoglycan decorin V. About The LymeNet Newsletter

Newsletter:

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IDX# Volume 3 - Number 17 - 11/06/95 IDX# INDEX IDX# IDX# I. ANTIMICROB AGENTS CHEMOTHER: Effects of penicillin, IDX# ceftriaxone, and doxycycline on morphology of Borrelia IDX# burgdorferi IDX# II. J NEUROL: Intrathecal immune response in patients with IDX# neuroborreliosis: specificity of antibodies for neuronal IDX# proteins IDX# III. J AM OSTERPATH ASSOC: Hypothyroidism with concurrent Lyme IDX# disease IDX# IV. INFECT IMMUN: Adherence of Borrelia burgdorferi to the IDX# proteoglycan decorin IDX# V. About The LymeNet Newsletter IDX#

QUOTE OF THE WEEK:

"Anyone who believes that the same thing can be suited to everyone is a great fool, since medicine is practiced not on mankind in general, but on every individual in particular."

-- Henri de Mondeville, Surgeon, 14th Century

I. ANTIMICROB AGENTS CHEMOTHER: Effects of penicillin, ceftriaxone, and doxycycline on morphology of Borrelia burgdorferi ---------------------------------------------------------------------- AUTHORS: Kersten A, Poitschek C, Rauch S, Aberer E ORGANIZATION: Department of Dermatology, University of Vienna, Austria REFERENCE: Antimicrob Agents Chemother 1995 May;39(5):1127-33 ABSTRACT:

Antibiotic therapy with penicillin, doxycycline, and ceftriaxone has proven to be effective for the treatment of Lyme borreliosis. In some patients, however, it was noticed that borreliae can survival in the tissues in spite of seemingly adequate therapy. For a better understanding of this phenomenon, we investigated the different modes of degeneration of Borrelia burgdorferi suspensions during a 96-h exposure to various antibiotics. By dark-field microscopy and ultrastructural investigations, increasing blebbing and the gradual formation of granular and cystic structures could be followed during the exposure time.

Although antibiotic concentrations at the MIC at which 90% of organisms are inhibited after 72 h were 80% or even greater, motile organisms were still present after incubation with penicillin and doxycycline but not after incubation with ceftriaxone. By transmission electron microscopy, intact spirochetal parts, mostly situated in cysts, were seen up to 96 h after exposure with all three antibiotics tested. According to experiences from studies with other spirochetes it is suggested that encysted borreliae, granules, and the remaining blebs might be responsible for the ongoing antigenic stimulus leading to complaints of chronic Lyme borreliosis.

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II. J NEUROL: Intrathecal immune response in patients with neuroborreliosis: specificity of antibodies for neuronal proteins -------------------------------------------------------------- AUTHORS: Kaiser R ORGANIZATION: Department of Neurology, University of Freiburg, Germany REFERENCE: J Neurol 1995 May;242(5):319-25 ABSTRACT:

Cerebrospinal fluid (CSF) and serum samples of 47 patients with serologically proven neuroborreliosis were examined by Western blotting for antibodies to a crude extract of human cortex (CNS) comprising a multitude (> 40) of protein bands. Intrathecal synthesis of total immunoglobulins was determined by the Reiber formula and of autoantibodies to CNS proteins by enzyme-linked immunoassay (ELISA) and by Western blotting. Employing ELISA, intrathecal synthesis of autoantibodies (IgG, IgM and/or IgA) was demonstrated in 40 of 47 patients with neuroborreliosis (85%), in 5 of 40 with multiple sclerosis (12%), and in 22 of 40 with viral meningoencephalitis (55%). Of 40, 35 and 15 patients with neuroborreliosis and an intrathecal synthesis of total IgG, IgM or IgA, 20 revealed an intrathecal production of IgG antibodies (50%), 24 of IgM antibodies (68%) and 6 of IgA autoantiodies (40%) in the CSF. The specificity of autoantibodies differed greatly between most patients.

Of 24 different CNS proteins which elicited an immune response in various patients, identities could be determined only for the myelin basic protein (5 of 40) and for the three neurofilament proteins (NF-68, NF-150, NF-200) (13 of 40 patients). In this limited number of patients no significant correlation between individual clinical symptoms and certain autoantiodies could be detected. The higher frequency of intrathecally produced autoantibodies in patients with neuroborreliosis is assumed to result from mitogenic rather than specific activation of autoreactive B-cell clones by Borrelia burgdorferi. The pathogenic relevance of these autoantibodies remains to be determined.

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III. J AM OSTERPATH ASSOC: Hypothyroidism with concurrent Lyme disease --------------------------------------------------------------- AUTHORS: Paparone PW ORGANIZATION: Lyme Disease Center for South Jersey, Absecon 08201, USA REFERENCE: J Am Osteopath Assoc 1995 Jul;95(7):435-7 ABSTRACT:

Lyme disease can be seen as localized, disseminated, acute, or chronic and can mimic other, more serious diseases. Even though it is a multisystemic illness, very few spirochetes are present; yet, once established in the host, it can persist for years. The antibody response is slow and variable, and the spirochete is difficult to isolate from clinical specimens, even those obtained from the pathognomonic skin lesion. These variables, together with nonspecific symptoms, make the diagnosis of Lyme disease difficult. The author describes an unusual case of Lyme disease superimposed on severe primary hypothyroidism in which the thyroid disorder was so advanced and pronounced that the diagnosis of Borrelia infection could easily have been missed.

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IV. INFECT IMMUN: Adherence of Borrelia burgdorferi to the proteoglycan decorin ------------------------------------------------------------ AUTHORS: Guo BP, Norris SJ, Rosenberg LC, Hook M ORGANIZATION: Department of Biochemistry and Biophysics, Albert B. Alkek Institute of Biosciences and Technology, Texas A&M University, Houston 77030, USA REFERENCE: Infect Immun 1995 Sep;63(9):3467-72 ABSTRACT:

Lyme disease is a tick-borne infection that can develop into a chronic, multisystemic disorder. The causative agent, Borrelia burgdorferi, is initially deposited by the tick into the host dermis, where it associates with collagen fibers, replicates, and eventually disseminates to other tissues. We have examined the adherence of the spirochete to different components of the collagen fiber and demonstrated that decorin, a proteoglycan which decorates collagen fibers, can support the attachment of B. burgdorferi. No significant direct attachment to isolated type I or III collagens could be detected. Attachment of the spirochetes to decorin was highly specific, and the process could be inhibited by soluble decorin but not by various unlabeled, unrelated components. B. burgdorferi also bound soluble 125I-labeled decorin in a time- and concentration- dependent manner. Spirochete binding of soluble 125I-labeled decorin required intact proteoglycan and could not be inhibited by either isolated core protein or glycosaminoglycan chain. B. burgdorferi
expresses two decorin-binding proteins with apparent molecular masses of 19 and 20 kDa as revealed in a Western blot (immunoblot)-type assay. Our results indicate that decorin may mediate the adherence of B. burgdorferi to collagen fibers in skin and other tissues.

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