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Infectious Disease Clinics of North... Sep 2022Arthritis is the most common late manifestation of Borrelia burgdorferi infection in the United States, usually beginning months after the tick bite. In most patients... (Review)
Review
Arthritis is the most common late manifestation of Borrelia burgdorferi infection in the United States, usually beginning months after the tick bite. In most patients with Lyme arthritis (LA) today, arthritis is the presenting manifestation of the disease. Patients have swelling and pain in one or a few large joints, especially the knee. Serologic testing is the mainstay of diagnosis. Responses to antibiotic treatment are generally excellent, although a small percentage of patients have persistent, postinfectious synovitis after 2 to 3 months of oral and IV antibiotics, which respond to anti-inflammatory therapies. Herein we review the clinical presentation, diagnosis, and management of LA.
Topics: Humans; Anti-Bacterial Agents; Anti-Inflammatory Agents; Arthritis; Lyme Disease
PubMed: 36116835
DOI: 10.1016/j.idc.2022.03.006 -
Current Issues in Molecular Biology 2021Lyme disease are obligately parasitic, tick- transmitted, invasive, persistent bacterial pathogens that cause disease in humans and non-reservoir vertebrates primarily... (Review)
Review
Lyme disease are obligately parasitic, tick- transmitted, invasive, persistent bacterial pathogens that cause disease in humans and non-reservoir vertebrates primarily through the induction of inflammation. During transmission from the infected tick, the bacteria undergo significant changes in gene expression, resulting in adaptation to the mammalian environment. The organisms multiply and spread locally and induce inflammatory responses that, in humans, result in clinical signs and symptoms. virulence involves a multiplicity of mechanisms for dissemination and colonization of multiple tissues and evasion of host immune responses. Most of the tissue damage, which is seen in non-reservoir hosts, appears to result from host inflammatory reactions, despite the low numbers of bacteria in affected sites. This host response to the Lyme disease can cause neurologic, cardiovascular, arthritic, and dermatologic manifestations during the disseminated and persistent stages of infection. The mechanisms by which a paucity of organisms (in comparison to many other infectious diseases) can cause varied and in some cases profound inflammation and symptoms remains mysterious but are the subjects of diverse ongoing investigations. In this review, we provide an overview of virulence mechanisms and determinants for which roles have been demonstrated , primarily in mouse models of infection.
Topics: Animals; Arthropod Vectors; Borrelia; Disease Models, Animal; Disease Susceptibility; Gene Expression Regulation, Bacterial; Host-Pathogen Interactions; Humans; Lyme Disease; Ticks; Virulence; Virulence Factors
PubMed: 33353871
DOI: 10.21775/cimb.042.473 -
Nature Reviews. Rheumatology Aug 2021Infectious agents can trigger autoimmune responses in a number of chronic inflammatory diseases. Lyme arthritis, which is caused by the tick-transmitted spirochaete... (Review)
Review
Infectious agents can trigger autoimmune responses in a number of chronic inflammatory diseases. Lyme arthritis, which is caused by the tick-transmitted spirochaete Borrelia burgdorferi, is effectively treated in most patients with antibiotic therapy; however, in a subset of patients, arthritis can persist and worsen after the spirochaete has been killed (known as post-infectious Lyme arthritis). This Review details the current understanding of the pathogenetic events in Lyme arthritis, from initial infection in the skin, through infection of the joints, to post-infectious chronic inflammatory arthritis. The central feature of post-infectious Lyme arthritis is an excessive, dysregulated pro-inflammatory immune response during the infection phase that persists into the post-infectious period. This response is characterized by high amounts of IFNγ and inadequate amounts of the anti-inflammatory cytokine IL-10. The consequences of this dysregulated pro-inflammatory response in the synovium include impaired tissue repair, vascular damage, autoimmune and cytotoxic processes, and fibroblast proliferation and fibrosis. These synovial characteristics are similar to those in other chronic inflammatory arthritides, including rheumatoid arthritis. Thus, post-infectious Lyme arthritis provides a model for other chronic autoimmune or autoinflammatory arthritides in which complex immune responses can be triggered and shaped by an infectious agent in concert with host genetic factors.
Topics: Autoimmune Diseases; Autoimmunity; Borrelia burgdorferi; Humans; Inflammation; Lyme Disease
PubMed: 34226730
DOI: 10.1038/s41584-021-00648-5 -
Emerging Infectious Diseases Aug 2021Lyme disease, or Lyme borreliosis, is the most common tickborne disease in the United States and Europe. In both locations, Ixodes species ticks transmit the Borrelia... (Review)
Review
Lyme disease, or Lyme borreliosis, is the most common tickborne disease in the United States and Europe. In both locations, Ixodes species ticks transmit the Borrelia burgdorferi sensu lato bacteria species responsible for causing the infection. The diversity of Borrelia species that cause human infection is greater in Europe; the 2 B. burgdorferi s.l. species collectively responsible for most infections in Europe, B. afzelii and B. garinii, are not found in the United States, where most infections are caused by B. burgdorferi sensu stricto. Strain differences seem to explain some of the variation in the clinical manifestations of Lyme disease, which are both minor and substantive, between the United States and Europe. Future studies should attempt to delineate the specific virulence factors of the different species of B. burgdorferi s.l. responsible for these variations in clinical features.
Topics: Animals; Borrelia; Borrelia burgdorferi Group; Europe; Humans; Ixodes; Lyme Disease; United States
PubMed: 34286689
DOI: 10.3201/eid2708.204763 -
Current Issues in Molecular Biology 2021Lyme disease (Lyme borreliosis) is a tick-borne, zoonosis of adults and children caused by genospecies of the sensu lato complex. The ailment, widespread throughout the...
Lyme disease (Lyme borreliosis) is a tick-borne, zoonosis of adults and children caused by genospecies of the sensu lato complex. The ailment, widespread throughout the Northern Hemisphere, continues to increase globally due to multiple environmental factors, coupled with increased incursion of humans into habitats that harbor the spirochete. sensu lato is transmitted by ticks from the complex. In North America, causes nearly all infections; in Europe, and are most associated with human disease. The spirochete's unusual fragmented genome encodes a plethora of differentially expressed outer surface lipoproteins that play a seminal role in the bacterium's ability to sustain itself within its enzootic cycle and cause disease when transmitted to its incidental human host. Tissue damage and symptomatology (i.e., clinical manifestations) result from the inflammatory response elicited by the bacterium and its constituents. The deposition of spirochetes into human dermal tissue generates a local inflammatory response that manifests as erythema migrans (EM), the hallmark skin lesion. If treated appropriately and early, the prognosis is excellent. However, in untreated patients, the disease may present with a wide range of clinical manifestations, most commonly involving the central nervous system, joints, or heart. A small percentage (~10%) of patients may go on to develop a poorly defined fibromyalgia-like illness, post-treatment Lyme disease (PTLD) unresponsive to prolonged antimicrobial therapy. Below we integrate current knowledge regarding the ecologic, epidemiologic, microbiologic, and immunologic facets of Lyme disease into a conceptual framework that sheds light on the disorder that healthcare providers encounter.
Topics: Animals; Arthropod Vectors; Borrelia burgdorferi; Disease Management; Disease Susceptibility; Host-Pathogen Interactions; Humans; Life Cycle Stages; Lyme Disease; Organ Specificity; Ticks
PubMed: 33303701
DOI: 10.21775/cimb.042.333 -
German Medical Science : GMS E-journal 2020Lyme borreliosis is the most common tick-borne infectious disease in Europe. A neurological manifestation occurs in 3-15% of infections and can manifest as...
Lyme borreliosis is the most common tick-borne infectious disease in Europe. A neurological manifestation occurs in 3-15% of infections and can manifest as polyradiculitis, meningitis and (rarely) encephalomyelitis. This S3 guideline is directed at physicians in private practices and clinics who treat Lyme neuroborreliosis in children and adults. Twenty AWMF member societies, the Robert Koch Institute, the German Borreliosis Society and three patient organisations participated in its development. A systematic review and assessment of the literature was conducted by the German Cochrane Centre, Freiburg (Cochrane Germany). The main objectives of this guideline are to define the disease and to give recommendations for the confirmation of a clinically suspected diagnosis by laboratory testing, antibiotic therapy, differential diagnostic testing and prevention.
Topics: Adult; Animals; Borrelia burgdorferi; Child; Clinical Laboratory Techniques; Diagnosis, Differential; Disease Vectors; Erythema Chronicum Migrans; Germany; Humans; Lyme Neuroborreliosis; Patient Care Management; Post-Lyme Disease Syndrome; Preventive Health Services
PubMed: 32341686
DOI: 10.3205/000279 -
Clinical Infectious Diseases : An... Apr 2020Lyme disease, caused by some Borrelia burgdorferi sensu lato, is the most common tick-borne illness in the Northern Hemisphere and the number of cases, and geographic... (Clinical Trial)
Clinical Trial
Lyme disease, caused by some Borrelia burgdorferi sensu lato, is the most common tick-borne illness in the Northern Hemisphere and the number of cases, and geographic spread, continue to grow. Previously identified B. burgdorferi proteins, lipid immunogens, and live mutants lead the design of canonical vaccines aimed at disrupting infection in the host. Discovery of the mechanism of action of the first vaccine catalyzed the development of new strategies to control Lyme disease that bypassed direct vaccination of the human host. Thus, novel prevention concepts center on proteins produced by B. burgdorferi during tick transit and on tick proteins that mediate feeding and pathogen transmission. A burgeoning area of research is tick immunity as it can unlock mechanistic pathways that could be targeted for disruption. Studies that shed light on the mammalian immune pathways engaged during tick-transmitted B. burgdorferi infection would further development of vaccination strategies against Lyme disease.
Topics: Animals; Borrelia burgdorferi; Humans; Ixodes; Lyme Disease; Ticks; Vaccination; Vaccines
PubMed: 31620776
DOI: 10.1093/cid/ciz872 -
Cell Oct 2021Lyme disease is on the rise. Caused by a spirochete Borreliella burgdorferi, it affects an estimated 500,000 people in the United States alone. The antibiotics currently...
Lyme disease is on the rise. Caused by a spirochete Borreliella burgdorferi, it affects an estimated 500,000 people in the United States alone. The antibiotics currently used to treat Lyme disease are broad spectrum, damage the microbiome, and select for resistance in non-target bacteria. We therefore sought to identify a compound acting selectively against B. burgdorferi. A screen of soil micro-organisms revealed a compound highly selective against spirochetes, including B. burgdorferi. Unexpectedly, this compound was determined to be hygromycin A, a known antimicrobial produced by Streptomyces hygroscopicus. Hygromycin A targets the ribosomes and is taken up by B. burgdorferi, explaining its selectivity. Hygromycin A cleared the B. burgdorferi infection in mice, including animals that ingested the compound in a bait, and was less disruptive to the fecal microbiome than clinically relevant antibiotics. This selective antibiotic holds the promise of providing a better therapeutic for Lyme disease and eradicating it in the environment.
Topics: Animals; Anti-Bacterial Agents; Borrelia burgdorferi; Calibration; Cinnamates; Drug Evaluation, Preclinical; Feces; Female; HEK293 Cells; Hep G2 Cells; Humans; Hygromycin B; Lyme Disease; Mice; Microbial Sensitivity Tests; Microbiota
PubMed: 34619078
DOI: 10.1016/j.cell.2021.09.011 -
BMC Microbiology Aug 2023With almost 700 000 estimated cases each year in the United States and Europe, Lyme borreliosis (LB), also called Lyme disease, is the most common tick-borne illness in... (Review)
Review
With almost 700 000 estimated cases each year in the United States and Europe, Lyme borreliosis (LB), also called Lyme disease, is the most common tick-borne illness in the world. Transmitted by ticks of the genus Ixodes and caused by bacteria Borrelia burgdorferi sensu lato, LB occurs with various symptoms, such as erythema migrans, which is characteristic, whereas others involve blurred clinical features such as fatigue, headaches, arthralgia, and myalgia. The diagnosis of Lyme borreliosis, based on a standard two-tiered serology, is the subject of many debates and controversies, since it relies on an indirect approach which suffers from a low sensitivity depending on the stage of the disease. Above all, early detection of the disease raises some issues. Inappropriate diagnosis of Lyme borreliosis leads to therapeutic wandering, inducing potential chronic infection with a strong antibody response that fails to clear the infection. Early and proper detection of Lyme disease is essential to propose an adequate treatment to patients and avoid the persistence of the pathogen. This review presents the available tests, with an emphasis on the improvements of the current diagnosis, the innovative methods and ideas which, ultimately, will allow more precise detection of LB.
Topics: Animals; Humans; Lyme Disease; Borrelia burgdorferi; Ixodes; Europe
PubMed: 37528399
DOI: 10.1186/s12866-023-02935-5 -
Current Issues in Molecular Biology 2021Relapsing fever (RF) is caused by several species of ; all, except two species, are transmitted to humans by soft (argasid) ticks. The species is transmitted from one... (Review)
Review
Relapsing fever (RF) is caused by several species of ; all, except two species, are transmitted to humans by soft (argasid) ticks. The species is transmitted from one human to another by the body louse, while is vectored by hard-bodied ixodid tick species. RF have several pathogenic features that facilitate invasion and dissemination in the infected host. In this article we discuss the dynamics of vector acquisition and subsequent transmission of RF to their vertebrate hosts. We also review taxonomic challenges for RF as new species have been isolated throughout the globe. Moreover, aspects of pathogenesis including symptomology, neurotropism, erythrocyte and platelet adhesion are discussed. We expound on RF evasion strategies for innate and adaptive immunity, focusing on the most fundamental pathogenetic attributes, multiphasic antigenic variation. Lastly, we review new and emerging species of RF and discuss future directions for this global disease.
Topics: Animals; Arthropod Vectors; Borrelia; Disease Management; Disease Susceptibility; Global Health; Host-Pathogen Interactions; Humans; Relapsing Fever; Ticks
PubMed: 33372163
DOI: 10.21775/cimb.042.519