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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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*                  The National Lyme Disease Network                  *
*                         LymeNet 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.



=====*=====


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.



=====*=====


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.



=====*=====


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.



=====*=====


V.    ABOUT THE LYMENET NEWSLETTER
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