< Back to Research Top Published Date 13/12/2013 Three sudden cardiac deaths associated with Lyme carditis - United States, November 2012-July 2013 Journal Morbidity and Mortality Weekly Report ? Centre for Disease Control & Prevention Citation MMWR Morb Mortal Wkly Rep. 2013 Dec 13;62(49):993-6 DOI ​ Authors Ray G, Schulz T, Daniels W, Daly ER, Andrew TA, Brown CM, Cummings P, Nelson R, Cartter ML, Backenson PB, White JL, Kurpiel PM, Rockwell R, Rotans AS, Squires LS, Linden JV, Prial M , House J , Pontones P, Batten B, Blau D, DeLeon-Carnes M, Muehlenbachs A, Ritter J , Sanders J, Zaki SR , Mead P , Hinckley A, Nelson C, Perea A, Schriefer M, Molins C, Forrester D, Hertzog C Abstract Lyme disease is a multisystem illness caused by Borrelia burgdorferi, a spirochete transmitted by certain species of Ixodes ticks. Approximately 30,000 confirmed and probable cases of Lyme disease were reported in the United States in 2012, primarily from high-incidence states in the Northeast (Connecticut, Delaware, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont) and upper Midwest (Minnesota and Wisconsin). Common manifestations include cutaneous, neurologic, and rheumatologic signs and symptoms. Symptomatic infection of the heart is rare in recognized Lyme disease cases and usually resolves promptly with appropriate antibiotic therapy. Nonetheless, cardiac involvement occasionally can cause life-threatening cardiac conduction abnormalities. During November 2012-July 2013, one woman and two men (ranging in age from 26 to 38 years) from high-incidence Lyme disease states experienced sudden cardiac death and, on postmortem examination, were found to have evidence of Lyme carditis. The three deaths were investigated by the Connecticut Department of Public Health, Massachusetts Department of Public Health, New Hampshire Department of Public Health, New York State Department of Health, and CDC. Donated corneas from two decedents had been transplanted to three recipients before the diagnosis of Lyme disease was established, but no evidence of disease transmission was found. Although death from Lyme carditis is rare, it should be considered in cases of sudden cardiac death in patients from high-incidence Lyme disease regions. Reducing exposure to ticks is the best method for preventing Lyme disease and other tickborne infections. URL Previous https://www.ncbi.nlm.nih.gov/pubmed/24336130 No Review Needed? Next

< Back to Research Top Published Date 01/04/2013 Type 1 and type 2 strains of Mycoplasma pneumoniae form different biofilms Journal Microbiology (Reading, England) Citation Microbiology. 2013 Apr;159(Pt 4):737-47 DOI 10.1099/mic.0.064782-0 Authors Simmons WL, Daubenspeck JM, Osborne JD, Balish MF, Waites KB, Dybvig K Abstract Several mycoplasma species have been shown to form biofilms that confer resistance to antimicrobials and which may affect the host immune system, thus making treatment and eradication of the pathogens difficult. The present study shows that the biofilms formed by two strains of the human pathogen Mycoplasma pneumoniae differ quantitatively and qualitatively. Compared with strain UAB PO1, strain M129 grows well but forms biofilms that are less robust, with towers that are less smooth at the margins. A polysaccharide containing N-acetylglucosamine is secreted by M129 into the culture medium but found in tight association with the cells of UAB PO1. The polysaccharide may have a role in biofilm formation, contributing to differences in virulence, chronicity and treatment outcome between strains of M. pneumoniae. The UAB PO1 genome was found to be that of a type 2 strain of M. pneumoniae, whereas M129 is type 1. Examination of other M. pneumoniae isolates suggests that the robustness of the biofilm correlates with the strain type. URL Previous https://mic.microbiologyresearch.org/content/journal/micro/10.1099/mic.0.064782-0#tab2 No Review Needed? Next

< Back to Research Top Published Date 25/03/2016 The diagnostic accuracy of serological tests for Lyme borreliosis in Europe: a systematic review and meta-analysis Journal BMC Infectious Diseases Citation BMC Infect Dis. 2016 Mar 25;16:140 DOI 10.1186/s12879-016-1468-4 Authors Leeflang MM, Ang CW, Berkhout J, Bijlmer HA, Van Bortel W, Brandenburg AH, Van Burgel ND, Van Dam AP, Dessau RB, Fingerle V, Hovius JW, Jaulhac B, Meijer B, Van Pelt W, Schellekens JF, Spijker R, Stelma FF, Stanek G, Verduyn-Lunel F, Zeller H, Sprong H Abstract BACKGROUND: Interpretation of serological assays in Lyme borreliosis requires an understanding of the clinical indications and the limitations of the currently available tests. We therefore systematically reviewed the accuracy of serological tests for the diagnosis of Lyme borreliosis in Europe. METHODS: We searched EMBASE en MEDLINE and contacted experts. Studies evaluating the diagnostic accuracy of serological assays for Lyme borreliosis in Europe were eligible. Study selection and data-extraction were done by two authors independently. We assessed study quality using the QUADAS-2 checklist. We used a hierarchical summary ROC meta-regression method for the meta-analyses. Potential sources of heterogeneity were test-type, commercial or in-house, Ig-type, antigen type and study quality. These were added as covariates to the model, to assess their effect on test accuracy. RESULTS: Seventy-eight studies evaluating an Enzyme-Linked ImmunoSorbent assay (ELISA) or an immunoblot assay against a reference standard of clinical criteria were included. None of the studies had low risk of bias for all QUADAS-2 domains. Sensitivity was highly heterogeneous, with summary estimates: erythema migrans 50% (95% CI 40% to 61%); neuroborreliosis 77% (95% CI 67% to 85%); acrodermatitis chronica atrophicans 97% (95% CI 94% to 99%); unspecified Lyme borreliosis 73% (95% CI 53% to 87%). Specificity was around 95% in studies with healthy controls, but around 80% in cross-sectional studies. Two-tiered algorithms or antibody indices did not outperform single test approaches. CONCLUSIONS: The observed heterogeneity and risk of bias complicate the extrapolation of our results to clinical practice. The usefulness of the erological tests for Lyme disease depends on the pre-test probability and subsequent predictive values in the setting where the tests are being used. Future diagnostic accuracy studies should be prospectively planned cross-sectional studies, done in settings where the test will be used in practice. URL Previous https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-016-1468-4 No Review Needed? Next

< Back to Research Top Published Date 28/02/2018 Otolaryngological symptoms in patients treated for tick-borne diseases Journal Polish Journal of Otolaryngology Citation Otolaryngol Pol. 2018 Feb 28;72(1):30-34 DOI 10.5604/01.3001.0011.5948 Authors Sowula K , Szaleniec J, Gawlik J, Skladzien J Abstract In recent years tick-borne diseases have become a very serious problem. The most common of these infections are borreliosis (Lyme disease) and tick-borne encephalitis (TBE). Lately there is growing incidence of Bartonella, Babesia, Anaplasma and Brucella co-infections. The similarity between the symptoms of tick-borne diseases and other pathologies causes serious diagnostic issues. MATERIAL AND METHODS: 216 patients aged 18-55, who presented to the outpatient clinic for tick-borne diseases in the years 2014-2016, were enrolled in the study. The patients had been diagnosed with Lyme disease and co-infections. The principal diagnostic tests to confirm the infections included ELISA, Western-Blot and circulating immune complexes (CIC). RESULTS: In the group of 216 patients, 162 presented with otolaryngological symptoms. The most common complaint was tinnitus (76,5%) accompanied by vertigo and dizziness (53,7%), headache (39%), unilateral sensorineural hearing loss (16,7%). The patients also had tick-borne coinfections, among them the most common was Bartonella henselae (33,4%) and Bartonella quintana (13%). CONCLUSIONS: Otolaryngological symptoms are a common manifestation of tick-borne diseases. They are most frequently observed in Lyme disease and Bartonella spp. infections. The symptoms in the head and neck region are usually occur in chronic Lyme disease with predominant IgG antibodies nad VlsE antigen. URL Previous https://otolaryngologypl.com/resources/html/article/details?id=167291&language=en No Review Needed? Next

< Back to Research Top Published Date 16/06/2017 Suicide and Lyme and associated diseases Journal Neuropsychiatric Disease and Treatment Citation Neuropsychiatr Dis Treat. 2017 Jun 16;13:1575-1587 DOI 10.2147/NDT.S136137 Authors Bransfield RC Abstract PURPOSE: The aim of this paper is to investigate the association between suicide and Lyme and associated diseases (LAD). No journal article has previously performed a comprehensive assessment of this subject. INTRODUCTION: Multiple case reports and other references demonstrate a causal association between suicidal risk and LAD. Suicide risk is greater in outdoor workers and veterans, both with greater LAD exposure. Multiple studies demonstrate many infections and the associated proinflammatory cytokines, inflammatory-mediated metabolic changes, and quinolinic acid and glutamate changes alter neural circuits which increase suicidality. A similar pathophysiology occurs in LAD. METHOD: A retrospective chart review and epidemiological calculations were performed. RESULTS: LAD contributed to suicidality, and sometimes homicidality, in individuals who were not suicidal before infection. A higher level of risk to self and others is associated with multiple symptoms developing after acquiring LAD, in particular, explosive anger, intrusive images, sudden mood swings, paranoia, dissociative episodes, hallucinations, disinhibition, panic disorder, rapid cycling bipolar, depersonalization, social anxiety disorder, substance abuse, hypervigilance, generalized anxiety disorder, genital-urinary symptoms, chronic pain, anhedonia, depression, low frustration tolerance, and posttraumatic stress disorder. Negative attitudes about LAD from family, friends, doctors, and the health care system may also contribute to suicide risk. By indirect calculations, it is estimated there are possibly over 1,200 LAD suicides in the US per year. CONCLUSION: Suicidality seen in LAD contributes to causing a significant number of previously unexplained suicides and is associated with immune-mediated and metabolic changes resulting in psychiatric and other symptoms which are possibly intensified by negative attitudes about LAD from others. Some LAD suicides are associated with being overwhelmed by multiple debilitating symptoms, and others are impulsive, bizarre, and unpredictable. Greater understanding and a direct method of acquiring LAD suicide statistics is needed. It is suggested that medical examiners, the Centers for Disease Control and Prevention, and other epidemiological organizations proactively evaluate the association between LAD and suicide. URL Previous https://www.dovepress.com/suicide-and-lyme-and-associated-diseases-peer-reviewed-article-NDT No Review Needed? Next

< Back to Research Top Published Date 11/10/2019 The Long-Term Persistence of Borrelia burgdorferi Antigens and DNA in the Tissues of a Patient with Lyme Disease Journal Antibiotics (Basel) Citation Antibiotics 2019, 8(4), 183 DOI 10.3390/antibiotics8040183 Authors Sapi E, Kasliwala RS , Torres JP, Oldakowski M, Markland S, Gaur G, Melillo A, Eisendle K, Liegner KB, Libien J, Goldman JE, Ismail H Abstract Whether Borrelia burgdorferi, the causative agent of Lyme disease, can persist for long periods in the human body has been a controversial question. The objective of this study was to see if we could find B. burgdorferi in a Lyme disease patient after a long clinical course and after long-term antibiotic treatment. Therefore, we investigated the potential presence of B. burgdorferi antigens and DNA in human autopsy tissues from a well-documented serum-, PCR-, and culture-positive Lyme disease patient, a 53-year-old female from northern Westchester County in the lower Hudson Valley Region of New York State, who had received extensive antibiotic treatments during extensive antibiotic treatments over the course of her 16-year-long illness. We also asked what form the organism might take, with special interest in the recently found antibiotic-resistant aggregate form, biofilm. We also examined the host tissues for the presence of inflammatory markers such as CD3+ T lymphocytes. Autopsy tissue sections of the brain, heart, kidney, and liver were analyzed by histological and immunohistochemical methods (IHC), confocal microscopy, fluorescent in situ hybridization (FISH), polymerase chain reaction (PCR), and whole-genome sequencing (WGS)/metagenomics. We found significant pathological changes, including borrelial spirochetal clusters, in all of the organs using IHC combined with confocal microscopy. The aggregates contained a well-established biofilm marker, alginate, on their surfaces, suggesting they are true biofilm. We found B. burgdorferi DNA by FISH, polymerase chain reaction (PCR), and an independent verification by WGS/metagenomics, which resulted in the detection of B. burgdorferi sensu stricto specific DNA sequences. IHC analyses showed significant numbers of infiltrating CD3+ T lymphocytes present next to B. burgdorferi biofilms. In summary, we provide several lines of evidence that suggest that B. burgdorferi can persist in the human body, not only in the spirochetal but also in the antibiotic-resistant biofilm form, even after long-term antibiotic treatment. The presence of infiltrating lymphocytes in the vicinity of B. burgdorferi biofilms suggests that the organism in biofilm form might trigger chronic inflammation. URL Previous https://www.mdpi.com/2079-6382/8/4/183/htm No Review Needed? Next

< Back to Research Top Published Date 04/08/2020 Complement evasion strategies of Borrelia burgdorferi sensu lato Journal FEBS Letters Citation 594(16):2645-2656 DOI 10.1002/1873-3468.13894 Authors Dulipati V, Meri S, Panelius J Abstract Borreliosis (Lyme disease) is a spirochetal disease caused by the species complex of Borrelia burgdorferi transmitted by Ixodes spp. ticks. Recorded to be the most common tick-borne disease in the world, the last two decades have seen an increase in disease incidence and distribution, exceeding 360 000 cases in Europe alone. If untreated, infection may cause skin symptoms, arthritis, and neurological or cardiac complications. Borrelia spirochetes have developed strategies to evade the mammalian host immune system. These include the complement system, which is an important first-line defense mechanism against invading microbes. To evade the complement, spirochetes bind soluble complement regulators factor H (FH), factor H-like protein, and C4bp to their outer surfaces. B. burgdorferi spirochetes can inhibit the classical pathway of complement by the outer surface protein (Osp) BBK32, which blocks the activation of the C1 complex, composed of C1q, C1r, and C1s. The FH-binding proteins of borreliae include Osps OspE, CspA, and CspZ. Following repeated infections, antibodies against these proteins develop and may provide functional immunity against borreliosis. This review discusses critical immune evasion strategies, focusing on complement evasion by borreliae. URL Previous https://febs.onlinelibrary.wiley.com/doi/full/10.1002/1873-3468.13894 No Review Needed? Next