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Kašpárková N, Bártová E, Žákovská A, Budíková M, Sedlák K. Antibodies against Borrelia burgdorferi Sensu Lato in Clinically Healthy and Sick Horses: First Report from the Czech Republic. Microorganisms 2023; 11:1706. [PMID: 37512879 PMCID: PMC10386530 DOI: 10.3390/microorganisms11071706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/05/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
Lyme disease, caused by some strains of bacterial spirochetes Borrelia burgdorferi sensu lato (Bbsl), affects humans but also domestic animals including horses. The primary pathogens in horses in Europe are B. afzelii, B. garinii and B. burgdorferi sensu stricto. To our knowledge, there are no data available on the seropositivity of B. burgdorferi s.l. in horses from the Czech Republic. In this country, horses are mainly used for sport, breeding, and recreational riding in areas where vectors of B. burgdorferi s.l. are present, which is why they are frequently at risk of infection. The aim of the study was to detect anti-borrelia IgM and IgG antibodies in clinically healthy and sick horses from the Czech Republic and to evaluate the risk factors of infection. In total, sera of 262 horses (247 clinically healthy horses and 15 horses hospitalized due to symptoms of encephalitis/meningoencephalitis) were examined by an indirect sandwich enzyme-linked immunosorbent assay. Positivity of B. burgdorferi was 27% (66/247) in clinically healthy horses (21% IgM, 7% IgG and 3% IgM + IgG antibodies) and 20% (3/15) in horses with clinical signs (20% IgM, 7% IgG and 7% IgM + IgG). In the clinically healthy horses, positivity statistically differed (p ≤ 0.05) only in Pony and Warmblood breeds, being the most affected at 32% and 30%, respectively, while other characteristics (sex, age, usage and localities) had no effect on positivity. This is the first survey of antibodies to B. burgdorferi s.l. in Czech horses showing that horses are exposed to ticks infected with B. burgdorferi s.l. This should be taken into account when making differential diagnoses in patients with non-specific symptoms to start with adequate therapy.
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Affiliation(s)
- Nikola Kašpárková
- Department of Biology and Wildlife Diseases, Faculty of Veterinary Hygiene and Ecology, University of Veterinary Sciences Brno, Palackého tř. 1946/1, 612 42 Brno, Czech Republic
| | - Eva Bártová
- Department of Biology and Wildlife Diseases, Faculty of Veterinary Hygiene and Ecology, University of Veterinary Sciences Brno, Palackého tř. 1946/1, 612 42 Brno, Czech Republic
| | - Alena Žákovská
- Department of Experimental Biology, Faculty of Science, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
- Department of Biology, Faculty of Education, Masaryk University, Poříčí 7/9, 625 00 Brno, Czech Republic
| | - Marie Budíková
- Department of Mathematics and Statistics, Faculty of Science, Masaryk University, Kotlářská 267/2, 611 37 Brno, Czech Republic
| | - Kamil Sedlák
- State Veterinary Institute Prague, Sídlištní 136/24, 165 03 Prague, Czech Republic
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Divers TJ, Mongodin EF, Miller CB, Belgrave RL, Gardner RB, Fraser CM, Schutzer SE. Genomic hybrid capture assay to detect Borrelia burgdorferi: an application to diagnose neuroborreliosis in horses. J Vet Diagn Invest 2022; 34:909-912. [PMID: 35864735 DOI: 10.1177/10406387221112617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Antemortem diagnosis of neuroborreliosis in horses has been hindered by both the low sensitivity of PCR testing for Borrelia burgdorferi in CSF and the low specificity of serum:CSF ELISA ratios used to determine intrathecal antibody production against the bacterium. PCR testing of the CSF of an adult horse with acute neurologic disease for the B. burgdorferi flagellin gene was negative. However, we enriched B. burgdorferi DNA through nucleic acid hybrid capture, followed by next-generation sequencing, and identified B. burgdorferi in the CSF of the horse, confirming a diagnosis of neuroborreliosis.
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Affiliation(s)
- Thomas J Divers
- College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Emmanuel F Mongodin
- Institute of Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | | | | | - Claire M Fraser
- Institute of Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Steven E Schutzer
- Institute of Genome Sciences, Rutgers New Jersey Medical School, Newark, NJ, USA
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3
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Pathologic Conditions of the Nervous System in Horses. Vet Clin North Am Equine Pract 2022; 38:427-443. [PMID: 35810149 DOI: 10.1016/j.cveq.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The variety of neurologic diseases which affect horses makes pathologic examination of the nervous system a complex and lengthy process. An understanding of the common causes of neurologic disease, antemortem neurolocalization, and supplementation of the necropsy examination with ancillary testing will help to diagnose a large number of causes of neurologic disease. A general understanding of neuropathology and collaborative relationship with your local pathologists will aid in the definitive diagnosis of neurologic diseases.
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Panteleienko OV, Makovska IF, Tsarenko TM. Influence of ecological and climatic conditions on the spread of Borrelia burgdorferi in domestic dogs in Ukraine. REGULATORY MECHANISMS IN BIOSYSTEMS 2022. [DOI: 10.15421/022257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Abstract
Lyme-borreliosis is a zoonotic, infectious disease that has a complex chain of transmission of the pathogen Borrelia burgdorferi sensu lato and includes the relationship between ixodid ticks, vertebrate hosts, humans and companion animals in the environment. The article shows general trends in the prevalence of canine Lyme-borreliosis in Ukraine depending on environmental, climatic and physiographic factors. The results of a comparative cartographic analysis of the prevalence of Lyme borreliosis among domestic dogs in Ukraine are presented by systematizing, mathematical and statistical processing of the data obtained by surveying veterinarians engaged in clinical veterinary practice. The paper includes generalized data on the clinical manifestations, methods of diagnosis and treatment of Lyme borreliosis in dogs. We determined the dependence of the prevalence of Lyme borreliosis in dogs on the types of physical and geographical territories – natural zones of Ukraine. Each of the natural zones differs in types of relief, climatic conditions, soil types, composition of fauna and flora, which affect the epizootic chain of Lyme disease. There is a clear correlation between the incidence of Lyme borreliosis in dogs and the types of natural areas. The highest incidence of Lyme borreliosis in dogs was observed in the forest-steppe zone and the zone of broad-leaved forests. A sharp decrease in the incidence of dogs was recorded in areas of mixed forests, the Ukrainian Carpathians and in the South of Ukraine in the steppe zone. The study also confirmed that the prevalence of Lyme disease among domestic dogs was influenced by the climatic factors, in particular: gross moisture of territories, average annual air temperature and soil temperature. In Ukraine, veterinarians in the vast majority of cases use serological diagnostic methods: immunochromatographic analysis, immunoenzymatic assay, and western blot, which are insufficient, since the presence of antibodies to the Lyme borreliosis pathogen is only a confirmation of the animal's contact with the antigen and may not indicate the presence of the disease in the clinical form. The generalized data on the use of antimicrobial drugs in the treatment of Lyme borreliosis in dogs indicate the predominant use of tetracycline antibiotics and cephalosporins. The majority of veterinarians reported symptoms of Lyme arthritis, somewhat fewer reported Lyme nephritis, neuroborreliosis, Lyme carditis and in rare cases, veterinarians observed erythema at the site of tick bite. About half of the veterinarians in Ukraine observed an increase in the incidence of Lyme disease in dogs, indicating a probable deterioration of the epizootic and epidemiological situation regarding Lyme borreliosis, especially in areas with favourable conditions for the circulation of Lyme borreliosis pathogens in natural and urban ecotopes. The results substantiate the need for the further study of the circulation of Borrelia burgdorferi sensu lato and their ability to cause disease in humans and animals, as well as the need to implement the principles of the One Health concept for the control and management of Lyme borreliosis.
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Guarino C, Pinn-Woodcock T, Levine DG, Miller J, Johnson AL. Case Report: Nuchal Bursitis Associated With Borrelia burgdorferi Infection in a Horse. Front Vet Sci 2021; 8:743067. [PMID: 34631864 PMCID: PMC8495068 DOI: 10.3389/fvets.2021.743067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 08/18/2021] [Indexed: 11/17/2022] Open
Abstract
Cases of cranial nuchal bursitis associated with Borrelia burgdorferi infection have not been thoroughly described. Here, we describe the case of a 17-year-old mare that was presented for low head carriage, dull demeanor, and resistance to haltering. Imaging supported a diagnosis of nuchal bursitis, and bursoscopy with surgical debridement of the nuchal bursa was performed. B. burgdorferi was identified by molecular diagnostics in serial samples of the bursal fluid, with no other organisms identified. Serology revealed significant elevation in antibodies directed against OspA of B. burgdorferi, but not the typical infection markers, OspC and OspF. Intravenous ceftiofur was administered for 80 days, and the nuchal bursa was directly injected with ceftiofur. The mare recovered and was able to return to work with no recrudescence of clinical signs over the following year to date. Infection with B. burgdorferi should be considered as a differential in cases of septic nuchal bursitis.
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Affiliation(s)
- Cassandra Guarino
- Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY, United States
| | - Toby Pinn-Woodcock
- Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY, United States
| | - David G Levine
- New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA, United States
| | - Julia Miller
- General Medicine, Alliance Equine Health Care, Glenmoore, PA, United States
| | - Amy L Johnson
- New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA, United States
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Springer A, Glass A, Topp AK, Strube C. Zoonotic Tick-Borne Pathogens in Temperate and Cold Regions of Europe-A Review on the Prevalence in Domestic Animals. Front Vet Sci 2020; 7:604910. [PMID: 33363242 PMCID: PMC7758354 DOI: 10.3389/fvets.2020.604910] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/18/2020] [Indexed: 12/16/2022] Open
Abstract
Ticks transmit a variety of pathogens affecting both human and animal health. In temperate and cold regions of Europe (Western, Central, Eastern, and Northern Europe), the most relevant zoonotic tick-borne pathogens are tick-borne encephalitis virus (TBEV), Borrelia spp. and Anaplasma phagocytophilum. More rarely, Rickettsia spp., Neoehrlichia mikurensis, and zoonotic Babesia spp. are identified as a cause of human disease. Domestic animals may also be clinically affected by these pathogens, and, furthermore, can be regarded as sentinel hosts for their occurrence in a certain area, or even play a role as reservoirs or amplifying hosts. For example, viraemic ruminants may transmit TBEV to humans via raw milk products. This review summarizes the role of domestic animals, including ruminants, horses, dogs, and cats, in the ecology of TBEV, Borrelia spp., A. phagocytophilum, Rickettsia spp., N. mikurensis, and zoonotic Babesia species. It gives an overview on the (sero-)prevalence of these infectious agents in domestic animals in temperate/cold regions of Europe, based on 148 individual prevalence studies. Meta-analyses of seroprevalence in asymptomatic animals estimated an overall seroprevalence of 2.7% for TBEV, 12.9% for Borrelia burgdorferi sensu lato (s.l.), 16.2% for A. phagocytophilum and 7.4% for Babesia divergens, with a high level of heterogeneity. Subgroup analyses with regard to animal species, diagnostic test, geographical region and decade of sampling were mostly non-significant, with the exception of significantly lower B. burgdorferi s.l. seroprevalences in dogs than in horses and cattle. More surveillance studies employing highly sensitive and specific test methods and including hitherto non-investigated regions are needed to determine if and how global changes in terms of climate, land use, agricultural practices and human behavior impact the frequency of zoonotic tick-borne pathogens in domestic animals.
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Affiliation(s)
| | | | | | - Christina Strube
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, Hanover, Germany
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Scherrer NM, Knickelbein KE, Engiles JB, Johnstone LK, Tewari D, Johnson AL. Ocular disease in horses with confirmed ocular or central nervous system Borrelia infection: Case series and review of literature. Vet Ophthalmol 2020; 23:1014-1024. [PMID: 32862516 DOI: 10.1111/vop.12817] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 08/04/2020] [Accepted: 08/04/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe the clinical presentation, treatment, and clinical outcome of horses with ocular disease and evidence of systemic or ocular Lyme disease. ANIMALS STUDIED Five horses met the inclusion criteria of ocular disease with evidence of B burgdorferi present in ocular or CNS tissues. PROCEDURE The goal of this study was to describe the clinical presentation and progression of ocular disease when associated with ocular or CNS B burgdorferi infection in horses. A retrospective review of medical records was performed on horses admitted for ocular disease with evidence of B burgdorferi infection between 1998 and 2015. The diagnosis of B burgdorferi-associated uveitis was based on histopathologic lesions of lymphohistiocytic and suppurative uveitis/endophthalmitis and intralesional argyrophilic spirochetes in either ocular or CNS tissue consistent with Borrelia. Leptospiral uveitis was ruled out by PCR. RESULTS All five horses in the current study had intraocular inflammation at the time of presentation. Medical management with anti-inflammatories was successful in controlling uveitis in the two horses in which treatment of uveitis was attempted. Systemic treatment with oral tetracyclines was unsuccessful in a single case in which treatment of Borrelia was attempted. Four horses were euthanized due to progression of neurologic disease. The surviving horse had an enucleation performed and did not show systemic signs. CONCLUSIONS Infection with Borrelia burgdorferi should be considered in endemic areas as a differential for horses with ocular disease, in particular, uveitis. The prognosis for uveitis and neurologic disease associated with Lyme disease was poor in the current study.
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Affiliation(s)
- Nicole M Scherrer
- New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA, USA
| | - Kelly E Knickelbein
- William R. Pritchard Veterinary Medical Teaching Hospital, UC Davis, Davis, CA, USA
| | - Julie B Engiles
- New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA, USA
| | - Laura K Johnstone
- New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA, USA
| | - Deepanker Tewari
- Pennsylvania Veterinary Laboratory Pennsylvania Department of Agriculture, Harrisburg, PA, USA
| | - Amy L Johnson
- New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA, USA
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Seroprevalence of Antibodies Against Anaplasma Phagocytophilum and Borrelia Burgdorferi in Horses (Equus Caballus) from Northern Algeria. J Vet Res 2020; 64:413-419. [PMID: 32984632 PMCID: PMC7497754 DOI: 10.2478/jvetres-2020-0045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 06/25/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction Horses (Equus caballus) are susceptible to tick-borne diseases. Two of them, Lyme borreliosis due to Borrelia burgdorferi and granulocytic anaplasmosis due to Anaplasma phagocytophilum were investigated in Algerian horses. The diseases have been less extensively studied in horses and results pertinent to Algeria have not been published. Material and Methods Blood samples were obtained from 128 horses. IgG antibodies directed against Anaplasma phagocytophilum and Borrelia burgdorferi were detected by an indirect immunofluorescence antibody test (IFAT) and ELISA. The potential effects of age, gender, breed, and health status on seropositivity were also evaluated. Results Using IFAT, 28 (21.8%) and 25 (19.5%) animals were positive for B. burgdorferi and A. phagocytophilum, respectively. Using ELISA, 19 (14.8%) and 33 (25.9%) animals were positive for these bacteria. Conclusion The study shows that horses in Algeria are exposed or co-exposed to tick-transmitted zoonotic bacterial species.
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Sommerauer S, Blohm K, Spergser J, Buchner HHF. Arthritis, panuveitis and hyperaesthesia associated with
Borrelia afzelii
infection in a warmblood gelding. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2019-000911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Sophia Sommerauer
- Department for Companion Animals and HorsesEquine ClinicUniversity of Veterinary Medicine ViennaViennaAustria
| | - Klaas‐Ole Blohm
- Department for Companion Animals and HorsesOphthalmology UnitUniversity of Veterinary Medicine ViennaViennaAustria
| | - Joachim Spergser
- Institute of Bacteriology, Mycology and HygieneUniversity of Veterinary Medicine ViennaViennaAustria
| | - Heinz Hans Florian Buchner
- Department for Companion Animals and HorsesEquine ClinicUniversity of Veterinary Medicine ViennaViennaAustria
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Rudenko N, Golovchenko M, Kybicova K, Vancova M. Metamorphoses of Lyme disease spirochetes: phenomenon of Borrelia persisters. Parasit Vectors 2019; 12:237. [PMID: 31097026 PMCID: PMC6521364 DOI: 10.1186/s13071-019-3495-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 05/09/2019] [Indexed: 12/22/2022] Open
Abstract
The survival of spirochetes from the Borrelia burgdorferi (sensu lato) complex in a hostile environment is achieved by the regulation of differential gene expression in response to changes in temperature, salts, nutrient content, acidity fluctuation, multiple host or vector dependent factors, and leads to the formation of dormant subpopulations of cells. From the other side, alterations in the level of gene expression in response to antibiotic pressure leads to the establishment of a persisters subpopulation. Both subpopulations represent the cells in different physiological states. "Dormancy" and "persistence" do share some similarities, e.g. both represent cells with low metabolic activity that can exist for extended periods without replication, both constitute populations with different gene expression profiles and both differ significantly from replicating forms of spirochetes. Persisters are elusive, present in low numbers, morphologically heterogeneous, multi-drug-tolerant cells that can change with the environment. The definition of "persisters" substituted the originally-used term "survivors", referring to the small bacterial population of Staphylococcus that survived killing by penicillin. The phenomenon of persisters is present in almost all bacterial species; however, the reasons why Borrelia persisters form are poorly understood. Persisters can adopt varying sizes and shapes, changing from well-known forms to altered morphologies. They are capable of forming round bodies, L-form bacteria, microcolonies or biofilms-like aggregates, which remarkably change the response of Borrelia to hostile environments. Persisters remain viable despite aggressive antibiotic challenge and are able to reversibly convert into motile forms in a favorable growth environment. Persisters are present in significant numbers in biofilms, which has led to the explanation of biofilm tolerance to antibiotics. Considering that biofilms are associated with numerous chronic diseases through their resilient presence in the human body, it is not surprising that interest in persisting cells has consequently accelerated. Certain diseases caused by pathogenic bacteria (e.g. tuberculosis, syphilis or leprosy) are commonly chronic in nature and often recur despite antibiotic treatment. Three decades of basic and clinical research have not yet provided a definite answer to the question: is there a connection between persisting spirochetes and recurrence of Lyme disease in patients?
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Affiliation(s)
- Natalie Rudenko
- Biology Centre CAS, Institute of Parasitology, Branisovska 31, 37005 Ceske Budejovice, Czech Republic
| | - Maryna Golovchenko
- Biology Centre CAS, Institute of Parasitology, Branisovska 31, 37005 Ceske Budejovice, Czech Republic
| | - Katerina Kybicova
- National Institute of Public Health, Srobarova 48, 100 42 Prague 10, Czech Republic
| | - Marie Vancova
- Biology Centre CAS, Institute of Parasitology, Branisovska 31, 37005 Ceske Budejovice, Czech Republic
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11
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Pecoraro HL, Felippe MJB, Miller AD, Divers TJ, Simpson KW, Guyer KM, Duhamel GE. Neuroborreliosis in a horse with common variable immunodeficiency. J Vet Diagn Invest 2019; 31:241-245. [PMID: 30661472 DOI: 10.1177/1040638718824146] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Common variable immunodeficiency (CVID) is a rare condition in adult horses characterized by hypogammaglobulinemia and increased susceptibility to parasitic and bacterial infections, including recurrent respiratory diseases, septicemia, and meningitis. Lyme disease is often included as a differential diagnosis in CVID horses with signs of meningitis; however, the Borrelia burgdorferi organism has not been demonstrated previously within central nervous system tissues of CVID horses with neurologic disease, to our knowledge. We report herein a case of neuroborreliosis in a CVID horse, confirmed by combined immunologic testing, histopathology, real-time PCR assay, fluorescent in situ hybridization, and immunohistochemical staining. Implications of these findings include heightened monitoring of CVID horses for Lyme disease in endemic areas and appropriate therapy in the case of neurologic disease.
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Affiliation(s)
- Heidi L Pecoraro
- Departments of Biomedical Sciences, Section of Anatomic Pathology (Pecoraro, Miller, Duhamel), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Clinical Sciences (Felippe, Divers, Simpson), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Town and Country Veterinary Service, Boonton, NJ (Guyer)
| | - M Julia B Felippe
- Departments of Biomedical Sciences, Section of Anatomic Pathology (Pecoraro, Miller, Duhamel), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Clinical Sciences (Felippe, Divers, Simpson), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Town and Country Veterinary Service, Boonton, NJ (Guyer)
| | - Andrew D Miller
- Departments of Biomedical Sciences, Section of Anatomic Pathology (Pecoraro, Miller, Duhamel), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Clinical Sciences (Felippe, Divers, Simpson), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Town and Country Veterinary Service, Boonton, NJ (Guyer)
| | - Thomas J Divers
- Departments of Biomedical Sciences, Section of Anatomic Pathology (Pecoraro, Miller, Duhamel), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Clinical Sciences (Felippe, Divers, Simpson), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Town and Country Veterinary Service, Boonton, NJ (Guyer)
| | - Kenneth W Simpson
- Departments of Biomedical Sciences, Section of Anatomic Pathology (Pecoraro, Miller, Duhamel), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Clinical Sciences (Felippe, Divers, Simpson), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Town and Country Veterinary Service, Boonton, NJ (Guyer)
| | - Kimberly M Guyer
- Departments of Biomedical Sciences, Section of Anatomic Pathology (Pecoraro, Miller, Duhamel), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Clinical Sciences (Felippe, Divers, Simpson), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Town and Country Veterinary Service, Boonton, NJ (Guyer)
| | - Gerald E Duhamel
- Departments of Biomedical Sciences, Section of Anatomic Pathology (Pecoraro, Miller, Duhamel), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Clinical Sciences (Felippe, Divers, Simpson), College of Veterinary Medicine, Cornell University, Ithaca, NY.,Town and Country Veterinary Service, Boonton, NJ (Guyer)
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Abstract
Given the variable clinical signs attributed to Borrelia burgdorferi, including infectious arthritis, neurologic disease, and behavioral changes, B burgdorferi is an important differential for decreased performance in sport horses. The primary vectors (Ixodes tick species) are expanding their range and thus Borrelia species are located in a wider area, making exposure more likely. Due to regionally high seroprevalence and vague clinical signs, diagnosis of Lyme disease in the horse is believed overestimated. Antibiotics are first-line treatment of confirmed Lyme disease. A single positive serologic test, by itself, is not conformation of Lyme disease but is evidence of current or past infection.
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13
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Mittelman NS, Stefanovski D, Johnson AL. Utility of C-reactive protein and serum amyloid A in the diagnosis of equine protozoal myeloencephalitis. J Vet Intern Med 2018; 32:1726-1730. [PMID: 30216559 PMCID: PMC6189384 DOI: 10.1111/jvim.15254] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 04/11/2018] [Accepted: 06/04/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Accurate antemortem EPM diagnosis requires evidence of intrathecal antibody production. Some advocate the use of acute phase proteins in addition to serology, which alone results in substantial false positives. HYPOTHESIS/OBJECTIVES The purpose of this study was to determine if serum C-reactive protein (CRP) or serum amyloid A (SAA) concentrations were elevated in cases of equine protozoal myeloencephalitis (EPM) compared to other neurological diseases. ANIMALS 25 clinical cases of equine neurological disease: EPM (10), cervical vertebral stenotic myelopathy (CVSM) (10), neuroborreliosis (2), equine motor neuron disease (1), degenerative myelopathy (1), and leukoencephalomalacia (1). METHODS Serum and CSF CRP and SAA were measured. Selection criteria included neurologic disease, antemortem diagnosis of EPM or CVSM, or postmortem diagnosis of EPM, CVSM, or other neurologic disease, and availability of serological results and archived samples for testing. RESULTS Serum SAA and serum CRP levels were generally undetectable or low in horses with EPM (median CRP ≤0.1 mg/L, ≤0.1-14.4 mg/L; median SAA ≤0.1 mg/L, ≤0.1-6.11 mg/L) and CVSM (median CRP ≤0.1, ≤0.1-2.41 mg/L; median SAA ≤0.1mg/L, ≤0.1-13.88 mg/L). CSF CRP and SAA for horses with EPM (median CRP 3.35 mg/l, 0.19-13.43 mg/l; median SAA ≤0.1 mg/L, ≤0.1-2.4 mg/L) and CVSM (median CRP 4.015 mg/L, 0.16-9.62 mg/L; median SAA 0.62 mg/L, ≤0.1-2.91 mg/L) were also undetectable or low. Kruskal-Wallis test showed no statistically significant differences between serum CRP (P = .14), serum SAA (P = .79), spinal fluid CRP (P = .65), or spinal fluid SAA between horses with EPM and CVSM (P = .52). CONCLUSION Neither SAA nor CRP in serum or CSF aid diagnosis of EPM.
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Affiliation(s)
- Neil S Mittelman
- From the Department of Clinical Studies-New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA (Mittelman, Stefanovski, Johnson)
| | - Darko Stefanovski
- From the Department of Clinical Studies-New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA (Mittelman, Stefanovski, Johnson)
| | - Amy L Johnson
- From the Department of Clinical Studies-New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA (Mittelman, Stefanovski, Johnson)
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Middelveen MJ, Sapi E, Burke J, Filush KR, Franco A, Fesler MC, Stricker RB. Persistent Borrelia Infection in Patients with Ongoing Symptoms of Lyme Disease. Healthcare (Basel) 2018; 6:E33. [PMID: 29662016 PMCID: PMC6023324 DOI: 10.3390/healthcare6020033] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 03/27/2018] [Accepted: 04/11/2018] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Lyme disease is a tickborne illness that generates controversy among medical providers and researchers. One of the key topics of debate is the existence of persistent infection with the Lyme spirochete, Borreliaburgdorferi, in patients who have been treated with recommended doses of antibiotics yet remain symptomatic. Persistent spirochetal infection despite antibiotic therapy has recently been demonstrated in non-human primates. We present evidence of persistent Borrelia infection despite antibiotic therapy in patients with ongoing Lyme disease symptoms. METHODS In this pilot study, culture of body fluids and tissues was performed in a randomly selected group of 12 patients with persistent Lyme disease symptoms who had been treated or who were being treated with antibiotics. Cultures were also performed on a group of ten control subjects without Lyme disease. The cultures were subjected to corroborative microscopic, histopathological and molecular testing for Borrelia organisms in four independent laboratories in a blinded manner. RESULTS Motile spirochetes identified histopathologically as Borrelia were detected in culture specimens, and these spirochetes were genetically identified as Borreliaburgdorferi by three distinct polymerase chain reaction (PCR)-based approaches. Spirochetes identified as Borrelia burgdorferi were cultured from the blood of seven subjects, from the genital secretions of ten subjects, and from a skin lesion of one subject. Cultures from control subjects without Lyme disease were negative for Borrelia using these methods. CONCLUSIONS Using multiple corroborative detection methods, we showed that patients with persistent Lyme disease symptoms may have ongoing spirochetal infection despite antibiotic treatment, similar to findings in non-human primates. The optimal treatment for persistent Borrelia infection remains to be determined.
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Affiliation(s)
| | - Eva Sapi
- Department of Biology and Environmental Science, University of New Haven, West Haven, CT 06516, USA.
| | - Jennie Burke
- Australian Biologics, Sydney, NSW 2000, Australia.
| | - Katherine R Filush
- Department of Biology and Environmental Science, University of New Haven, West Haven, CT 06516, USA.
| | - Agustin Franco
- School of Health Sciences, Universidad Catolica Santiago de Guayaquil, Guayaquil 090615, Ecuador.
| | - Melissa C Fesler
- Union Square Medical Associates, 450 Sutter Street, Suite 1504, San Francisco, CA 94108, USA.
| | - Raphael B Stricker
- Union Square Medical Associates, 450 Sutter Street, Suite 1504, San Francisco, CA 94108, USA.
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15
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Sprong H, Azagi T, Hoornstra D, Nijhof AM, Knorr S, Baarsma ME, Hovius JW. Control of Lyme borreliosis and other Ixodes ricinus-borne diseases. Parasit Vectors 2018; 11:145. [PMID: 29510749 PMCID: PMC5840726 DOI: 10.1186/s13071-018-2744-5] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 02/23/2018] [Indexed: 12/25/2022] Open
Abstract
Lyme borreliosis (LB) and other Ixodes ricinus-borne diseases (TBDs) are diseases that emerge from interactions of humans and domestic animals with infected ticks in nature. Nature, environmental and health policies at (inter)national and local levels affect the risk, disease burden and costs of TBDs. Knowledge on ticks, their pathogens and the diseases they cause have been increasing, and resulted in the discovery of a diversity of control options, which often are not highly effective on their own. Control strategies involving concerted actions from human and animal health sectors as well as from nature managers have not been formulated, let alone implemented. Control of TBDs asks for a “health in all policies” approach, both at the (inter)national level, but also at local levels. For example, wildlife protection and creating urban green spaces are important for animal and human well-being, but may increase the risk of TBDs. In contrast, culling or fencing out deer decreases the risk for TBDs under specific conditions, but may have adverse effects on biodiversity or may be societally unacceptable. Therefore, in the end, nature and health workers together must carry out tailor-made control options for the control of TBDs for humans and animals, with minimal effects on the environment. In that regard, multidisciplinary approaches in environmental, but also medical settings are needed. To facilitate this, communication and collaboration between experts from different fields, which may include patient representatives, should be promoted.
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Affiliation(s)
- Hein Sprong
- Centre for Zoonoses & Environmental Microbiology, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands. .,Laboratory of Entomology, Wageningen University and Research Centre, Wageningen, the Netherlands.
| | - Tal Azagi
- Centre for Zoonoses & Environmental Microbiology, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Dieuwertje Hoornstra
- Center for Experimental and Molecular Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Ard M Nijhof
- Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Sarah Knorr
- Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - M Ewoud Baarsma
- Center for Experimental and Molecular Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Joppe W Hovius
- Center for Experimental and Molecular Medicine, Academic Medical Center, Amsterdam, the Netherlands
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16
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Johnson AL, Johnstone LK, Stefanovski D. Cerebrospinal fluid Lyme multiplex assay results are not diagnostic in horses with neuroborreliosis. J Vet Intern Med 2018; 32:832-838. [PMID: 29460492 PMCID: PMC5866998 DOI: 10.1111/jvim.15067] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 12/19/2017] [Accepted: 01/18/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The accuracy of the Lyme multiplex assay for the diagnosis of neuroborreliosis in horses is unknown. HYPOTHESIS/OBJECTIVES To describe Lyme multiplex results in horses with a postmortem diagnosis of neuroborreliosis. The hypothesis was that paired serum and cerebrospinal fluid (CSF) results and a CSF : serum ratio would allow differentiation of horses with neuroborreliosis from those with other neurologic diseases. ANIMALS Ninety horses that had neurologic examinations, serum and CSF Lyme multiplex analyses, and postmortem examination of the nervous system performed. METHODS Retrospective study. Data collected included signalment, ante- and postmortem diagnoses, and serum and CSF Lyme multiplex results. The CSF : serum ratio was calculated by dividing CSF median fluorescent intensity (MFI) by serum MFI for each result. RESULTS Ten horses had a final diagnosis of neuroborreliosis, 70 were diagnosed with other neurologic diseases, and 10 had no neurologic disease. Not all horses with neuroborreliosis had positive results: 4/10 had at least 1 positive serum result, 5/10 had at least 1 positive CSF result, and 3/10 had at least 1 CSF result 4-fold higher than the corresponding serum result. Results were similar for the 70 horses with other neurologic diseases: 53% had at least 1 positive serum result, 50% had at least 1 positive CSF result, and 16% had at least 1 CSF result 4-fold higher than the corresponding serum result. CONCLUSIONS AND CLINICAL IMPORTANCE Positive Lyme multiplex results were common in horses with neurologic diseases and did not adequately differentiate horses with neuroborreliosis from horses with other disorders.
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Affiliation(s)
- Amy L. Johnson
- Department of Clinical Studies, New Bolton CenterUniversity of Pennsylvania School of Veterinary MedicineKennett SquarePennsylvania
| | | | - Darko Stefanovski
- Department of Clinical Studies, New Bolton CenterUniversity of Pennsylvania School of Veterinary MedicineKennett SquarePennsylvania
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17
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Divers TJ, Gardner RB, Madigan JE, Witonsky SG, Bertone JJ, Swinebroad EL, Schutzer SE, Johnson AL. Borrelia burgdorferi Infection and Lyme Disease in North American Horses: A Consensus Statement. J Vet Intern Med 2018; 32:617-632. [PMID: 29469222 PMCID: PMC5866975 DOI: 10.1111/jvim.15042] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 12/14/2017] [Accepted: 12/14/2017] [Indexed: 11/27/2022] Open
Abstract
Borrelia burgdorferi infection is common in horses living in Lyme endemic areas and the geographic range for exposure is increasing. Morbidity after B. burgdorferi infection in horses is unknown. Documented, naturally occurring syndromes attributed to B. burgdorferi infection in horses include neuroborreliosis, uveitis, and cutaneous pseudolymphoma. Although other clinical signs such as lameness and stiffness are reported in horses, these are often not well documented. Diagnosis of Lyme disease is based on exposure to B. burgdorferi, cytology or histopathology of infected fluid or tissue and antigen detection. Treatment of Lyme disease in horses is similar to treatment of humans or small animals but treatment success might not be the same because of species differences in antimicrobial bioavailability and duration of infection before initiation of treatment. There are no approved equine label Lyme vaccines but there is strong evidence that proper vaccination could prevent infection in horses.
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Affiliation(s)
- T J Divers
- Department of Clinical Sciences, Cornell University, Ithaca, NY
| | | | - J E Madigan
- Department of Medicine and Epidemiology, University of California - Davis, CA
| | - S G Witonsky
- Department of Large Animal Clinical Sciences, Virginia-Maryland Region CVM, Blacksburg, VA
| | - J J Bertone
- CVMm Western University of Health Sciences, Pomona, CA
| | | | - S E Schutzer
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ
| | - A L Johnson
- Department of Clinical Studies, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA
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18
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Caol S, Divers T, Crisman M, Chang YF. In vitro susceptibility of Borrelia burgdorferi isolates to three antibiotics commonly used for treating equine Lyme disease. BMC Vet Res 2017; 13:293. [PMID: 28962614 PMCID: PMC5622483 DOI: 10.1186/s12917-017-1212-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 09/22/2017] [Indexed: 02/02/2023] Open
Abstract
Background Lyme disease in humans is predominantly treated with tetracycline, macrolides or beta lactam antibiotics that have low minimum inhibitory concentrations (MIC) against Borrelia burgdorferi. Horses with Lyme disease may require long-term treatment making frequent intravenous or intramuscular treatment difficult and when administered orally those drugs may have either a high incidence of side effects or have poor bioavailability. The aim of the present study was to determine the in vitro susceptibility of three B. burgdorferi isolates to three antibiotics of different classes that are commonly used in practice for treating Borrelia infections in horses. Results Broth microdilution assays were used to determine minimum inhibitory concentration of three antibiotics (ceftiofur sodium, minocycline and metronidazole), for three Borrelia burgdorferi isolates. Barbour-Stoner-Kelly (BSK K + R) medium with a final inoculum of 106Borrelia cells/mL and incubation periods of 72 h were used in the determination of MICs. Observed MICs indicated that all isolates had similar susceptibility to each drug but susceptibility to the tested antimicrobial agents varied; ceftiofur sodium (MIC = 0.08 μg/ml), minocycline hydrochloride (MIC = 0.8 μg/ml) and metronidazole (MIC = 50 μg/ml). Conclusions The MIC against B. burgorferi varied among the three antibiotics with ceftiofur having the lowest MIC and metronidazole the highest MIC. The MIC values observed for ceftiofur in the study fall within the range of reported serum and tissue concentrations for the drug metabolite following ceftiofur sodium administration as crystalline-free acid. Minocycline and metronidazole treatments, as currently used in equine practice, could fall short of attaining MIC concentrations for B. burgdorferi.
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Affiliation(s)
- Sanjie Caol
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA.,Currently Research Center of Swine Disease, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, 611130, China
| | - Thomas Divers
- Department of Clinical Sciences College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA.
| | - Mark Crisman
- Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA, 24061, USA
| | - Yung-Fu Chang
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
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19
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Guarino C, Asbie S, Rohde J, Glaser A, Wagner B. Vaccination of horses with Lyme vaccines for dogs induces short-lasting antibody responses. Vaccine 2017; 35:4140-4147. [PMID: 28668566 DOI: 10.1016/j.vaccine.2017.06.052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 05/15/2017] [Accepted: 06/15/2017] [Indexed: 01/25/2023]
Abstract
Borrelia burgdorferi can induce Lyme disease. Approved Lyme vaccines for horses are currently not available. In an effort to protect horses, veterinarians are using Lyme vaccines licensed for dogs. However, data to assess the response of horses to, or determine the efficacy of this off-label vaccine use are missing. Here, antibodies against outer surface protein A (OspA), OspC, and OspF were quantified in diagnostic serum submissions from horses with a history of vaccination with canine Lyme vaccines. The results suggested that many horses respond with low and often short-lasting antibody responses. Subsequently, four experimental vaccination trials were performed. First, we investigated antibody responses to three canine vaccines in B. burgdorferi-naïve horses. One killed bacterin vaccine induced antibodies against OspC. OspA antibodies were low for all three vaccines and lasted less than 16weeks. The second trial tested the impact of the vaccine dose using the OspA/OspC inducing bacterin vaccine in horses. A 2mL dose produced higher OspA and OspC antibody values than a 1mL dose. However, the antibody response again quickly declined, independent of dose. Third, the horses were vaccinated with 2 doses of a recombinant OspA vaccine. Previous vaccination and/or environmental exposure enhanced the magnitude and longevity of the OspA antibody response to about 20weeks. Last, the influence of intramuscular versus subcutaneous vaccine administration was investigated for the recombinant OspA vaccine. OspA antibody responses were not influenced by injection route. The current work highlights that commercial Lyme vaccines for dogs induce only transient antibody responses in horses which can also be of low magnitude. Protection from infection with B. burgdorferi should not be automatically assumed after vaccinating horses with Lyme vaccines for dogs.
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Affiliation(s)
- Cassandra Guarino
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Sanda Asbie
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Jennifer Rohde
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Amy Glaser
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Bettina Wagner
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
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20
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Diseases of the Nervous System. Vet Med (Auckl) 2017. [PMCID: PMC7322266 DOI: 10.1016/b978-0-7020-5246-0.00014-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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21
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Slaughter KM, Halland SK, Schur LA, Wagner B, DeMel DM, Bertone JJ. Humoral response of Borrelia burgdorferi
outer surface protein A (OspA) vaccination in equids. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12690] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- K. M. Slaughter
- College of Veterinary Medicine; Western University of Health Sciences; Pomona California USA
| | - S. K. Halland
- College of Veterinary Medicine; Western University of Health Sciences; Pomona California USA
| | - L. A. Schur
- Desert Pines Equine Medical and Surgical Center; Las Vegas Nevada USA
| | - B. Wagner
- College of Veterinary Medicine; Cornell University; Ithaca New York USA
| | - D. M. DeMel
- College of Veterinary Medicine; Western University of Health Sciences; Pomona California USA
| | - J. J. Bertone
- College of Veterinary Medicine; Western University of Health Sciences; Pomona California USA
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22
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Basile RC, Yoshinari NH, Mantovani E, Bonoldi VN, Macoris DDG, Queiroz-Neto AD. Brazilian borreliosis with special emphasis on humans and horses. Braz J Microbiol 2016; 48:167-172. [PMID: 27769883 PMCID: PMC5220628 DOI: 10.1016/j.bjm.2016.09.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 05/20/2016] [Indexed: 01/05/2023] Open
Abstract
Borreliosis caused by Borrelia burgdorferi sensu lato is a cosmopolitan zoonosis studied worldwide; it is called Lyme disease in many countries of the Northern Hemisphere and Lyme-like or Baggio-Yoshinari Syndrome in Brazil. However, despite the increasing number of suspect cases, this disease is still neglected in Brazil by the medical and veterinary communities. Brazilian Lyme-like borreliosis likely involves capybaras as reservoirs and Amblyomma and Rhipicephalus ticks as vectors. Thus, domestic animals can serve as key carriers in pathogen dissemination. This zoonosis has been little studied in horses in Brazil. The first survey was performed in the state of Rio de Janeiro, and this Brazilian Borreliosis exhibits many differences from the disease widely described in the Northern Hemisphere. The etiological agent shows different morphological and genetic characteristics, the disease has a higher recurrence rate after treatment with antibiotics, and the pathogen stimulates intense symptoms such as a broader immune response in humans. Additionally, the Brazilian zoonosis is not transmitted by the Ixodes ricinus complex. With respect to clinical manifestations, Baggio-Yoshinari Syndrome has been reported to cause neurological, cardiac, ophthalmic, muscle, and joint alterations in humans. These symptoms can possibly occur in horses. Here, we present a current panel of studies involving the disease in humans and equines, particularly in Brazil.
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Affiliation(s)
- Roberta Carvalho Basile
- Universidade Estadual Paulista, Faculdade de Ciências Agrárias e Veterinárias, Jaboticabal, São Paulo, SP, Brazil.
| | | | - Elenice Mantovani
- Universidade de São Paulo, Departamento de reumatologia, São Paulo, SP, Brazil
| | | | - Delphim da Graça Macoris
- Universidade Estadual Paulista, Faculdade de Ciências Agrárias e Veterinárias, Jaboticabal, São Paulo, SP, Brazil
| | - Antonio de Queiroz-Neto
- Universidade Estadual Paulista, Faculdade de Ciências Agrárias e Veterinárias, Jaboticabal, São Paulo, SP, Brazil
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Johnstone LK, Engiles JB, Aceto H, Buechner-Maxwell V, Divers T, Gardner R, Levine R, Scherrer N, Tewari D, Tomlinson J, Johnson AL. Retrospective Evaluation of Horses Diagnosed with Neuroborreliosis on Postmortem Examination: 16 Cases (2004-2015). J Vet Intern Med 2016; 30:1305-12. [PMID: 27327172 PMCID: PMC5094551 DOI: 10.1111/jvim.14369] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 03/30/2016] [Accepted: 05/26/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Equine neuroborreliosis (NB), Lyme disease, is difficult to diagnose and has limited description in the literature. OBJECTIVE Provide a detailed description of clinical signs, diagnostic, and pathologic findings of horses with NB. ANIMALS Sixteen horses with histologically confirmed NB. METHODS Retrospective review of medical records at the University of Pennsylvania and via an ACVIM listserv query with inclusion criteria requiring possible exposure to Borrelia burgdorferi and histologic findings consistent with previous reports of NB without evidence of other disease. RESULTS Sixteen horses were identified, 12 of which had additional evidence of NB. Clinical signs were variable including muscle atrophy or weight loss (12), cranial nerve deficits (11), ataxia (10), changes in behavior (9), dysphagia (7), fasciculations (6), neck stiffness (6), episodic respiratory distress (5), uveitis (5), fever (2), joint effusion (2), and cardiac arrhythmias (1). Serologic analysis was positive for B. burgdorferi infection in 6/13 cases tested. CSF abnormalities were present in 8/13 cases tested, including xanthochromia (4/13), increased total protein (5/13; median: 91 mg/dL, range: 25-219 mg/dL), and a neutrophilic (6/13) or lymphocytic (2/13) pleocytosis (median: 25 nucleated cells/μL, range: 0-922 nucleated cells/μL). PCR on CSF for B. burgdorferi was negative in the 7 cases that were tested. CONCLUSION AND CLINICAL IMPORTANCE Diagnosis of equine NB is challenging due to variable clinical presentation and lack of sensitive and specific diagnostic tests. Negative serology and normal CSF analysis do not exclude the diagnosis of NB.
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Affiliation(s)
- L K Johnstone
- University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Kennett Square, PA
| | - J B Engiles
- University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Kennett Square, PA
| | - H Aceto
- University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Kennett Square, PA
| | - V Buechner-Maxwell
- Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA
| | - T Divers
- Cornell University College of Veterinary Medicine, Ithaca, NY
| | - R Gardner
- B.W. Furlong & Associates, Oldwick, NJ
| | - R Levine
- Henderson Veterinary Associates, Elizabethtown, PA
| | - N Scherrer
- University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Kennett Square, PA
| | - D Tewari
- Pennsylvania Veterinary Laboratory, Pennsylvania Department of Agriculture, Harrisburg, PA
| | - J Tomlinson
- Cornell University College of Veterinary Medicine, Ithaca, NY
| | - A L Johnson
- University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Kennett Square, PA
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Affiliation(s)
- A. C. E. Draper
- Department of Veterinary Population Medicine; University of Minnesota; St Paul USA
| | - C. J. Finno
- Department of Veterinary Population Medicine; University of Minnesota; St Paul USA
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25
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Kern A, Schnell G, Bernard Q, Bœuf A, Jaulhac B, Collin E, Barthel C, Ehret-Sabatier L, Boulanger N. Heterogeneity of Borrelia burgdorferi Sensu Stricto Population and Its Involvement in Borrelia Pathogenicity: Study on Murine Model with Specific Emphasis on the Skin Interface. PLoS One 2015. [PMID: 26197047 PMCID: PMC4510351 DOI: 10.1371/journal.pone.0133195] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Lyme disease is a multisystemic disorder caused by B. burgdorferi sl. The molecular basis for specific organ involvement is poorly understood. The skin plays a central role in the development of Lyme disease as the entry site of B. burgdorferi in which specific clones are selected before dissemination. We compared the skin inflammatory response (antimicrobial peptides, cytokines and chemokines) elicited by spirochete populations recovered from patients presenting different clinical manifestations. Remarkably, these spirochete populations induced different inflammatory profiles in the skin of C3H/HeN mice. As spirochete population transmitted into the host skin is heterogeneous, we isolated one bacterial clone from a population recovered from a patient with neuroborreliosis and compared its virulence to the parental population. This clone elicited a strong cutaneous inflammatory response characterized by MCP-1, IL-6 and antimicrobial peptides induction. Mass spectrometry of this clone revealed 110 overexpressed proteins when compared with the parental population. We further focused on the expression of nine bacterial surface proteins. bb0347 coding for a protein that interacts with host fibronectin, allowing bacterial adhesion to vascular endothelium and extracellular matrix, was found to be induced in host skin with another gene bb0213 coding for a hypothetical protein. These findings demonstrate the heterogeneity of the B. burgdorferi ss population and the complexity of the interaction involved early in the skin.
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Affiliation(s)
- Aurélie Kern
- EA7290: Virulence bactérienne précoce: groupe Borréliose de Lyme, Facultés de médecine et de pharmacie, Université de Strasbourg, Strasbourg, France
- Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts, United States of America
| | - Gilles Schnell
- Laboratoire de Spectrométrie de Masse BioOrganique, Institut Pluridisciplinaire Hubert Curien, Université de Strasbourg, CNRS, UMR7178, Strasbourg, France
| | - Quentin Bernard
- EA7290: Virulence bactérienne précoce: groupe Borréliose de Lyme, Facultés de médecine et de pharmacie, Université de Strasbourg, Strasbourg, France
| | - Amandine Bœuf
- Laboratoire de Spectrométrie de Masse BioOrganique, Institut Pluridisciplinaire Hubert Curien, Université de Strasbourg, CNRS, UMR7178, Strasbourg, France
| | - Benoît Jaulhac
- EA7290: Virulence bactérienne précoce: groupe Borréliose de Lyme, Facultés de médecine et de pharmacie, Université de Strasbourg, Strasbourg, France
| | - Elody Collin
- EA7290: Virulence bactérienne précoce: groupe Borréliose de Lyme, Facultés de médecine et de pharmacie, Université de Strasbourg, Strasbourg, France
| | - Cathy Barthel
- EA7290: Virulence bactérienne précoce: groupe Borréliose de Lyme, Facultés de médecine et de pharmacie, Université de Strasbourg, Strasbourg, France
| | - Laurence Ehret-Sabatier
- Laboratoire de Spectrométrie de Masse BioOrganique, Institut Pluridisciplinaire Hubert Curien, Université de Strasbourg, CNRS, UMR7178, Strasbourg, France
| | - Nathalie Boulanger
- EA7290: Virulence bactérienne précoce: groupe Borréliose de Lyme, Facultés de médecine et de pharmacie, Université de Strasbourg, Strasbourg, France
- * E-mail:
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26
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Rocha PRD, Bertuglia A, Biasibetti E, Bullone M, Rosamilia A, Masoero L, Capucchio MT. Subependymal Reaction Secondary to Choroid Plexus Papilloma in a Horse. J Equine Vet Sci 2014. [DOI: 10.1016/j.jevs.2013.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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27
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Affiliation(s)
- J. Bartol
- New England Equine Medical and Surgical Center; New Hampshire USA
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28
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Dynamics of connective-tissue localization during chronic Borrelia burgdorferi infection. J Transl Med 2013; 93:900-10. [PMID: 23797360 PMCID: PMC4139070 DOI: 10.1038/labinvest.2013.81] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 05/28/2013] [Accepted: 05/29/2013] [Indexed: 12/21/2022] Open
Abstract
The etiologic agent of Lyme disease, Borrelia burgdorferi, localizes preferentially in the extracellular matrix during persistence. In chronically infected laboratory mice, there is a direct association between B. burgdorferi and the proteoglycan decorin, which suggests that decorin has a role in defining protective niches for persistent spirochetes. In this study, the tissue colocalization of B. burgdorferi with decorin and the dynamics of borrelial decorin tropism were evaluated during chronic infection. Spirochetes were found to colocalize absolutely with decorin, but not collagen I in chronically infected immunocompetent C3H mice. Passive immunization of infected C3H-scid mice with B. burgdorferi-specific immune serum resulted in the localization of spirochetes in decorin-rich microenvironments, with clearance of spirochetes from decorin-poor microenvironments. In passively immunized C3H-scid mice, tissue spirochete burdens were initially reduced, but increased over time as the B. burgdorferi-specific antibody levels waned. Concurrent repopulation of the previously cleared decorin-poor microenvironments was observed with the rising tissue spirochete burden and declining antibody titer. These findings indicate that the specificity of B. burgdorferi tissue localization during chronic infection is determined by decorin, driven by the borrelia-specific antibody response, and fluctuates with the antibody response.
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Wagner B, Goodman LB, Rollins A, Freer HS. Antibodies to OspC, OspF and C6 antigens as indicators for infection with Borrelia burgdorferi in horses. Equine Vet J 2013; 45:533-7. [PMID: 23432019 DOI: 10.1111/evj.12033] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Accepted: 12/07/2012] [Indexed: 11/29/2022]
Abstract
REASONS FOR PERFORMING STUDY Lyme disease is caused by Borrelia burgdorferi, which is transmitted by infected ticks (Ixodes spp.). Reports on Lyme disease in horses have increased in recent years. Nevertheless, the diagnosis of Lyme disease in horses is still challenging owing to its vague clinical presentation and the limitations of diagnostic tests. OBJECTIVES This study used a new serological Lyme multiplex assay to examine antibody responses to 3 antigens of B. burgdorferi, outer surface protein (Osp) C, OspF and C6, and to verify their use as markers for early and late infection stages in horses. METHODS Multiplex analysis of antibodies to OspC, OspF and C6 in equine patient sera (n = 191) was performed. A subset of the sera (n = 90) was also tested using a commercial C6-based Lyme test. RESULTS Antibodies to OspF and C6 highly correlate as reliable markers of infection with B. burgdorferi in horses. Antibodies to OspC, which have been confirmed as early infection markers in man and dogs, were only detected in some patient sera, suggesting that OspC antibodies are indicators of early infection in horses. Commercial C6 testing identified most infected horses but also resulted in false positive and false negative interpretations. CONCLUSIONS Serological multiplex testing is a rapid and quantitative diagnostic method to confirm infection with B. burgdorferi and to identify the stage of infection. In horses with risk of exposure and clinical signs, multiplex testing supports the diagnosis of Lyme disease. POTENTIAL RELEVANCE Antimicrobial treatment of B. burgdorferi is time sensitive. Treatment success decreases with time of persistent infection, while the risk of developing chronic disease increases. The ability to identify early infection with B. burgdorferi provides practitioners and clinicians with a tool to improve the diagnosis of equine Lyme disease and make treatment decisions.
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Affiliation(s)
- B Wagner
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, New York, USA.
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Divers T, Grice A, Mohammed H, Glaser A, Wagner B. Changes in Borrelia burgdorferi ELISA antibody over time in both antibiotic treated and untreated horses. Acta Vet Hung 2012; 60:421-9. [PMID: 23160024 DOI: 10.1556/avet.2012.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Changes in ELISA serology are frequently used to determine antibiotic treatment success for Lyme disease in horses. This concept was based upon a previous report showing a marked decline in ELISA values in experimentally infected and antibiotic-treated ponies. Changes in Lyme serology following antibiotic treatment in naturally infected horses have not been reported. The objective of this study was to compare Borrelia ELISA antibody concentrations in naturally exposed horses both before and following antibiotic treatment for Lyme disease. A retrospective study was performed comparing oxytetracycline- or doxycyclinetreated (n = 68) and untreated (n = 183) horses from a single equine practice and their change in Borrelia ELISA values over a similar time period. Antibiotictreated horses had a decline in ELISA values in comparison to control horses (P ≤ 0.05) and untreated horses were twice as likely to have their ELISA values increase (OR = 0.5; 95% C.I. = 0.3-0.9) compared to treated horses. The magnitude of the decline in ELISA units following treatments was small compared to that previously reported in experimentally infected and treated ponies. Field-exposed horses with high Borrelia burgdorferi ELISA values who are treated with either oxytetracycline or doxycycline can be expected to have only a small decline in ELISA values following treatment. Persistently high ELISA titres following appropriate treatments for Lyme disease may not, without appropriate clinical signs, be a reason for more prolonged treatment.
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Affiliation(s)
- Thomas Divers
- 1 Cornell University Department of Clinical Sciences Ithaca NY 14853 USA
| | - Amy Grice
- 3 Rhinebeck Equine 26 Losee Lane Rhinebeck NY USA
| | - Hussni Mohammed
- 2 Cornell University Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine Ithaca NY 14853 USA
| | - Amy Glaser
- 2 Cornell University Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine Ithaca NY 14853 USA
| | - Bettina Wagner
- 2 Cornell University Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine Ithaca NY 14853 USA
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Kean IR, Irvine KL. Lyme disease: aetiopathogenesis, factors for disease development and control. Inflammopharmacology 2012; 21:101-11. [DOI: 10.1007/s10787-012-0156-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 10/18/2012] [Indexed: 11/25/2022]
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Wagner B, Erb HN. Dogs and horses with antibodies to outer-surface protein C as on-time sentinels for ticks infected with Borrelia burgdorferi in New York State in 2011. Prev Vet Med 2012; 107:275-9. [PMID: 22841496 DOI: 10.1016/j.prevetmed.2012.07.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2012] [Revised: 07/06/2012] [Accepted: 07/07/2012] [Indexed: 11/25/2022]
Abstract
Reported cases of Lyme disease (a chronic disease caused by infection with Borrelia burgdorferi) in humans increased more than two-fold between 1992 and 2006 in the United States. Recently, the annual number of reported human Lyme disease cases stabilized (according to the Center for Disease Control and Prevention) but the geographic distribution seemed to increase. In New York (NY) State, USA, a spread from the original Lyme disease focus in southeastern parts of the state has occurred. We determined incidence risks of new companion animal infection in 2011 with B. burgdorferi by county in 451 dog and 2100 horse sera; the samples were non-randomly collected by referring veterinarians in NY State between June 15, 2011 and January 31, 2012 because of suspicion of infection with B. burgdorferi or during annual health checks. All samples were submitted to the New York State Animal Health Center; the samples were submitted from 50 out of 62 counties in the state. Incident infections were determined by measuring antibodies to outer surface protein C (OspC; a marker of early infection that is detectable in serum from 3 weeks to 5 months after infection). Incident infections with B. burgdorferi were detected in 23% (95% confidence interval (CI): 19, 27) of canine samples and in 8% (95%CI: 7, 10) of equine samples. In 21 counties, samples were submitted from only one species (i.e. only dogs or only horses) that indicated incident infection. Recognition of incidence infections in dogs and horses might serve as a sentinel for infected ticks in different NY State counties; detection of the OspC antigen can provide a sensitive, new tool to allow recognition of risk for possible human and animal infection with B. burgdorferi by geographic region. We recommend that both dogs and horses be part of such a passive surveillance system.
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Affiliation(s)
- B Wagner
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
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Priest HL, Irby NL, Schlafer DH, Divers TJ, Wagner B, Glaser AL, Chang YF, Smith MC. Diagnosis of Borrelia-associated uveitis in two horses. Vet Ophthalmol 2012; 15:398-405. [DOI: 10.1111/j.1463-5224.2012.01000.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Update on infectious diseases affecting the equine nervous system. Vet Clin North Am Equine Pract 2011; 27:573-87. [PMID: 22100045 DOI: 10.1016/j.cveq.2011.08.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Wagner B, Freer H, Rollins A, Erb HN, Lu Z, Gröhn Y. Development of a multiplex assay for the detection of antibodies to Borrelia burgdorferi in horses and its validation using Bayesian and conventional statistical methods. Vet Immunol Immunopathol 2011; 144:374-81. [PMID: 21890217 DOI: 10.1016/j.vetimm.2011.08.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Revised: 08/02/2011] [Accepted: 08/08/2011] [Indexed: 10/17/2022]
Abstract
Lyme disease is a zoonotic, vector-borne disease and occurs in mammals including horses. The disease is induced by infection with spirochetes of the Borrelia burgdorferi sensu lato group. Infection of mammalian hosts requires transmission of spirochetes by infected ticks during tick bites. Lyme disease diagnosis is based on clinical signs, possible exposure to infected ticks, and antibody testing which is traditionally performed by ELISA and Western blotting (WB). This report describes the development and validation of a new fluorescent bead-based multiplex assay for the detection of antibodies to B. burgdorferi outer surface protein A (OspA), OspC and OspF antigens in horse serum. Testing of 562 equine sera was performed blindly and in parallel by using WB and the new multiplex assay. Because a true gold standard is missing for Lyme antibody testing, we performed and compared different statistical approaches to validate the new Lyme multiplex assay. One approach was to use WB results as a 'relative gold standard' in ROC-curve and likelihood-ratio analyses of the new test. Cut-off values and interpretation ranges of the multiplex assay were established by the analysis. The second statistical approach used a Bayesian model for the calculation of diagnostic sensitivities and specificities of the multiplex assay. The Bayesian analysis takes into consideration that no true gold standard exists for detecting antibodies to B. burgdorferi and estimated sensitivities and specificities of both tests that were compared. Therefore, the Bayesian analysis also resulted in an evaluation of diagnostic sensitivity and specificity of WB. Overall, the new assay was characterized by low background values and a wide dynamic quantification range for the detection of antibodies to OspA, OspC and OspF antigens of B. burgdorferi. The diagnostic sensitivity and specificity for the OspA bead-based assay were calculated as 49% and 85%, respectively, and by a standard ROC curve analysis only because the Bayesian model could not be run on this parameter. The Bayesian-derived diagnostic sensitivities of the OspC and OspF assays were 80% and 86%, respectively. For comparison, the Bayesian-derived estimates for WB resulted in sensitivities of 72% for OspC and 80% for OspF. The Bayesian diagnostic specificities of the multiplex assay were 79% and 69% for OspC and OspF, respectively. WB analysis had specificities of 92% for OspC and 77% for OspF. Although the analysis of a new assay in the absence of a true gold standard remains challenging, the approach used here can help to address this problem when new technologies and traditionally used test standards differ significantly in their analytical sensitivities, which consequently causes problems in the calculation of diagnostic sensitivity and sensitivity values for the new assay. In summary, the new multiplex assay for the detection of antibodies to B. burgdorferi OspA, OspC and OspF antigens in horse serum has improved analytical and diagnostic sensitivities compared to WB analysis. Multiplex analysis is a valuable quantitative tool that simultaneously detects antibodies indicative for natural infection with and/or vaccination against the Lyme pathogen.
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Affiliation(s)
- Bettina Wagner
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY, USA.
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Antibody profiling of Borrelia burgdorferi infection in horses. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2011; 18:1562-7. [PMID: 21775514 DOI: 10.1128/cvi.05123-11] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Infection with Borrelia burgdorferi is common in horses and ponies from the New England and mid-Atlantic regions of the United States. Here, we evaluated luciferase immunoprecipitation systems (LIPS) for profiling antibody responses against three different antigenic targets for the diagnosis of equine B. burgdorferi infection. LIPS testing of horse serum samples suspected of Lyme infection revealed that approximately 75% of the horse samples (114/159) were seropositive against the synthetic VOVO antigen, comprising repeated immunodominant C6 epitopes as well as OspC immunodominant epitopes. A comparison of VOVO and immunofluorescence assays (IFA) showed that 51% of the samples were positive in both assays (VOVO(+)/IFA(+)), 13% were VOVO(-)/IFA(+), 21% were VOVO(+)/IFA(-), and 15% were negative in both. To further understand humoral responses to B. burgdorferi and reconcile the diagnostic differences between IFA and VOVO, two additional B. burgdorferi LIPS tests were performed with DbpA and DbpB. Robust seropositive antibody responses against DbpA and/or DbpB were detected in 98% (79/81) of the VOVO(+)/IFA(+) and 93% (50/54) of the discrepant samples. Additionally, some of the samples negative by both VOVO and IFA showed immunoreactivity against DbpA and/or DbpB. Overall, 94% of the suspected horse samples were seropositive by LIPS, and heat map analysis revealed that seropositive samples often were immunoreactive with at least two of the three antigens. These results suggest that LIPS tests employing multiple recombinant antigens offer a promising approach for the evaluation of antibody responses in Lyme disease.
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