1/21. Identification of candidate T-cell epitopes and molecular mimics in chronic Lyme disease.Elucidating the cellular immune response to infectious agents is a prerequisite for understanding disease pathogenesis and designing effective vaccines. In the identification of microbial T-cell epitopes, the availability of purified or recombinant bacterial proteins has been a chief limiting factor. In chronic infectious diseases such as lyme disease, immune-mediated damage may add to the effects of direct infection by means of molecular mimicry to tissue autoantigens. Here, we describe a new method to effectively identify both microbial epitopes and candidate autoantigens. The approach combines data acquisition by positional scanning peptide combinatorial libraries and biometric data analysis by generation of scoring matrices. In a patient with chronic neuroborreliosis, we show that this strategy leads to the identification of potentially relevant T-cell targets derived from both borrelia burgdorferi and the host. We also found that the antigen specificity of a single T-cell clone can be degenerate and yet the clone can preferentially recognize different peptides derived from the same organism, thus demonstrating that flexibility in T-cell recognition does not preclude specificity. This approach has potential applications in the identification of ligands in infectious diseases, tumors and autoimmune diseases.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/21. Eradication of borrelia burgdorferi infection in primary marginal zone B-cell lymphoma of the skin.Primary cutaneous B-cell lymphomas have been associated with borrelia burgdorferi, the spirochete responsible for lyme disease. Recently, cutaneous marginal zone B-cell lymphoma has been proposed as a distinct clinical-pathological entity. We report a case of primary cutaneous marginal zone lymphoma, associated with B burgdorferi infection. polymerase chain reaction (PCR) amplification of the third complementarity determining region (CDR3) of the immunoglobulin heavy chain gene showed the presence of a monoclonal lymphoproliferation, therefore strengthening the histological diagnosis of a malignant process. B burgdorfer-specific hbb gene sequences were detected by PCR in the lymphoma tissue at diagnosis but not after antibiotic treatment. A nearly complete clinical and histological regression was observed after B burgdorferi eradication, with immunohistochemistry studies showing disappearance of plasma cell differentiation and a marked decline in the number of CD3 T cells and Ki-67 cells. Our case confirms the link between B burgdorferi and some cutaneous lymphomas. The disappearance of the microorganism accompanied by the unequivocal decrease of most indicators of active T- and B-cell immune response strongly supported a pathogenetic role for B burgdorferi in sustaining an antigen-driven development and growth of this cutaneous marginal zone lymphoma. Antibiotic therapy (analogous to helicobacter pylori infection in gastric MALT lymphoma) might be helpful with the aim of averting or at least deferring the indication for more aggressive treatment.- - - - - - - - - - ranking = 0.33333333333333keywords = antigen (Clic here for more details about this article) |
3/21. Antibody response to IR6, a conserved immunodominant region of the VlsE lipoprotein, wanes rapidly after antibiotic treatment of borrelia burgdorferi infection in experimental animals and in humans.Invariable region (IR)(6), an immunodominant conserved region of VlsE, the antigenic variation protein of borrelia burgdorferi, is currently used for the serologic diagnosis of lyme disease in humans and canines. A longitudinal assessment of anti-IR(6) antibody levels in B. burgdorferi-infected rhesus monkeys revealed that this level diminished sharply after antibiotic treatment (within 25 weeks). In contrast, antibody levels to P39 and to whole-cell antigen extracts of B. burgdorferi either remained unchanged or diminished less. A longitudinal analysis in dogs yielded similar results. In humans, the anti-IR(6) antibody titer diminished by a factor of > or =4 in successfully treated patients and by a factor of <4 in treatment-resistant patients. This result suggests that the quantification of anti-IR(6) antibody titer as a function of time should be investigated further as a test to assess response to lyme disease therapy or to determine whether a B. burgdorferi infection has been eliminated.- - - - - - - - - - ranking = 0.66666666666667keywords = antigen (Clic here for more details about this article) |
4/21. Seronegative Lyme arthritis caused by Borrelia garinii.A case of a female patient suffering from Lyme arthritis (LA) without elevated antibody levels to borrelia burgdorferi sensu lato is reported. Seronegative Lyme arthritis was diagnosed based on the classic clinical manifestations and dna-detected Borrelia garinii in blood and synovial fluid of the patient, after all other possible causes of the disease had been ruled out. The disease was resistant to the first treatment with antibacterial agents. Six months after the therapy, arthritis still persisted and dna of Borrelia garinii was repeatedly detected in the synovial fluid and the tissue of the patient. At the same time, antigens or parts of spirochaetes were detected by electron microscopy in the synovial fluid, the tissue and the blood of the patient. The patient was then repeatedly treated by antibiotics and synovectomy has been performed.- - - - - - - - - - ranking = 0.33333333333333keywords = antigen (Clic here for more details about this article) |
5/21. Human granulocytic ehrlichiosis in italy: first report on two confirmed cases.We report here the two first cases of human ehrlichiosis described in italy. One patient presented symptoms indicative of ehrlichiosis, such as fever, conjunctivitis, and increase of hepatic enzymes; HGE was confirmed by fourfold seroconversion for HGE antigen. The second patient, a forest worker, was affected by lyme disease, and in this case HGE was suspected because of fever, leukopenia, and seroconversion.- - - - - - - - - - ranking = 0.33333333333333keywords = antigen (Clic here for more details about this article) |
6/21. Coexistence of antibodies to tick-borne agents of babesiosis and Lyme borreliosis in patients from Cotia county, State of Sao Paulo, brazil.This paper reports a case of coinfection caused by pathogens of lyme disease and babesiosis in brothers. This was the first case of borreliosis in brazil, acquired in Cotia County, State of S o Paulo, brazil. Both children had tick bite history, presented erythema migrans, fever, arthralgia, mialgia, and developed positive serology (ELISA and Western-blotting) directed to borrelia burgdorferi G 39/40 and babesia bovis antigens, mainly of IgM class antibodies, suggestive of acute disease. Also, high frequencies of antibodies to B. bovis was observed in a group of 59 Brazilian patients with Lyme borreliosis (25.4%), when compared with that obtained in a normal control group (10.2%) (chi-square = 5.6; p < 0.05). Interestingly, both children presented the highest titers for IgM antibodies directed to both infective diseases, among all patients with Lyme borreliosis.- - - - - - - - - - ranking = 0.33333333333333keywords = antigen (Clic here for more details about this article) |
7/21. Inflammatory signs, antibody response and antigen detection in cerebrospinal fluid over the course of neuroborreliosis.CSF and serum specimens were consecutively obtained from three patients with neuroborreliosis (stage I, II and III), CSF protein content, cell counts and differential, IgG index, oligoclonal bands and anti-B. burgdorferi antibodies were measured. cerebrospinal fluid (CSF) was tested for Borrelia-dna being present prior to and after antibiotic treatment. While dna could be identified before ceftriaxone was administered, there were no more amplification products afterwards. The goal of this study was to compare the usefulness of serodiagnostic methods and the detection of borrelia burgdorferi-dna in patients with clinically confirmed neuroborreliosis to test the efficiency of antibiotic therapy.- - - - - - - - - - ranking = 1.3333333333333keywords = antigen (Clic here for more details about this article) |
8/21. relapsing fever and its serological discrimination from Lyme borreliosis.patients with Borrelia-caused relapsing fever produce cross-reacting antibodies to borrelia burgdorferi, the anti-genetically related causative agent of Lyme borreliosis. The antibody response of the serum of a patient (acute and convalescent) with relapsing fever was analysed by the immunoblot technique using Borrelia hermsii and B. burgdorferi as antigens. The diagnosis was established by microscopic detection of spirochetes in the patient's blood. The patient's serum showed significantly elevated titers of IgG and IgM in a B. burgdorferi indirect immunofluorescence assay. Immunoblot analysis indicated the presence of cross-reacting antibodies directed to B. burgdorferi antigens with apparent molecular weights of 60, 41, 40, 36, 30 and 20 kDa.- - - - - - - - - - ranking = 0.66666666666667keywords = antigen (Clic here for more details about this article) |
9/21. Isolation of borrelia burgdorferi from a Lyme seronegative patient in northern italy: expression of OspB immunodominant proteins on the isolated strain.This paper describes the antigenic characteristics of a strain of borrelia burgdorferi isolated from a patient seronegative for Lyme borreliosis, in the early stage of the illness. The strain was not recognized by a late serum sample from the patient; the isolate reacted in immunoblotting with some of the monoclonal antibodies directed against the immunodominant antigens of borrelia burgdorferi. In addition to the OspA antigen this strain carries also the epitopes of OspB proteins, unlike the majority of European borrelia burgdorferi strains.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
10/21. lyme disease associated with fibromyalgia.OBJECTIVE: To describe the clinical and laboratory findings as well as results of treatment in patients with lyme disease associated with fibromyalgia. DESIGN: Observational cohort study. The mean duration of observation was 2.5 years (range, 1 to 4 years). SETTING: Diagnostic lyme disease clinic in a university hospital. patients: Of 287 patients seen with lyme disease during a 3.5-year period, 22 (8%) had fibromyalgia associated with this illness, and 15 (5%) participated in the observational study. MEASUREMENTS: Symptoms and signs of fibromyalgia, immunodiagnostic tests for lyme disease, and tests of neurologic function. RESULTS: Of the 15 patients, 9 developed widespread musculoskeletal pain, tender points, dysesthesias, memory difficulties, and debilitating fatigue a mean duration of 1.7 months after early lyme disease; the remaining six patients developed those symptoms during the course of Lyme arthritis. At the time of our evaluation, late in the course of their illness, 11 patients had positive immunoglobulin (Ig) G antibody responses to borrelia burgdorferi by enzyme-linked immunosorbent assay (ELISA), one had a positive Western blot, and the three seronegative patients had positive cellular immune responses to borrelial antigens. Four patients had abnormal cerebrospinal fluid analyses that showed an elevated protein level, a slight pleocytosis, or intrathecal antibody production to the spirochete. The signs of lyme disease resolved with antibiotic therapy, usually intravenous ceftriaxone, 2 g/d for 2 to 4 weeks, except in one patient with persistent knee swelling. However, 14 of the 15 patients continued to have symptoms of fibromyalgia. Currently, only one patient is completely asymptomatic. CONCLUSIONS: lyme disease may trigger fibromyalgia, but antibiotics do not seem to be effective in the treatment of the fibromyalgia.- - - - - - - - - - ranking = 0.33333333333333keywords = antigen (Clic here for more details about this article) |
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