LymeNet Newsletter Volume 3 Issue 19

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:

*********************************************************************** * 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 <[email protected]>

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

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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.

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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.

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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.

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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.

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