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Yogeeta F, Devi M, Abdul Rauf S, Rajper SB. Uncommon Bilateral Idiopathic Facial Nerve Palsy (Bell's Palsy) in an Infant: An Atypical Age and Clinical Challenges Explored: A Case Report. EAR, NOSE & THROAT JOURNAL 2024:1455613241258650. [PMID: 38804657 DOI: 10.1177/01455613241258650] [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: 05/29/2024] Open
Abstract
Our case study explores Bell's palsy, a rare lower motor neuron facial nerve paralysis, particularly rare in newborns. While often idiopathic, it can stem from congenital or developmental factors. Unilateral facial paralysis is more prevalent, with Bell's palsy accounting for more than 50%, while bilateral facial paralysis is exceptionally rare. We present a distinctive case of idiopathic Bell palsy in a 3.5-month-old infant, initially affecting the right side and spontaneously resolved within 30 days, followed by involvement on the left side a month later. Despite comprehensive evaluations and treatment, persistent facial weakness was observed on the left side. The patient initially responded well but faced ongoing challenges during the second attack. Our findings underscore the need for further research to improve the understanding and management of these cases.
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Affiliation(s)
- Fnu Yogeeta
- Liaquat National Medical College, Karachi, Pakistan
| | - Muskan Devi
- Liaquat National Medical College, Karachi, Pakistan
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2
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Bhatia MK, Abdelbaky M, Lahoti L. Diagnostic Challenges of Lyme Co-infections: Lessons From a Lyme and Herpes Simplex Virus-1 (HSV-1) Cocktail. Cureus 2024; 16:e60213. [PMID: 38868243 PMCID: PMC11167585 DOI: 10.7759/cureus.60213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 06/14/2024] Open
Abstract
Lyme borreliosis (LB) is a complex tick-borne illness with diverse presentations. We report a case of LB meningitis with herpes simplex virus-1 (HSV-1) co-infection in a 55-year-old woman initially presenting with isolated facial nerve palsy. This case illustrates the multifaceted diagnostic challenges associated with Lyme co-infections. It emphasizes the need for thorough testing to identify all potential pathogens and the importance of differentiating between true co-infection and incidental HSV-1 reactivation. Understanding these complexities is crucial for guiding appropriate treatment decisions.
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Affiliation(s)
- Mannat K Bhatia
- Department of Internal Medicine, Rutgers Robert Wood Johnson Medical School, Saint Peter's University Hospital, New Brunswick, USA
| | - Mohamed Abdelbaky
- Department of Internal Medicine, Rutgers Robert Wood Johnson Medical School, Saint Peter's University Hospital, New Brunswick, USA
| | - Lokesh Lahoti
- Department of Internal Medicine, Rutgers Robert Wood Johnson Medical School, Saint Peter's University Hospital, New Brunswick, USA
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3
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Perthame E, Chartier L, George JC, Varloud M, Ferquel E, Choumet V. Case presentation and management of Lyme disease patients: a 9-year retrospective analysis in France. Front Med (Lausanne) 2024; 10:1296486. [PMID: 38298513 PMCID: PMC10829333 DOI: 10.3389/fmed.2023.1296486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/06/2023] [Indexed: 02/02/2024] Open
Abstract
Introduction Lyme borreliosis (LB) is the most common vector disease in temperate countries of the northern hemisphere. It is caused by Borrelia burgdorferi sensu lato complex. Methods To study the case presentation of LB in France, we contacted about 700 physicians every year between 2003 and 2011. An anonymous questionnaire was established allowing the collection of 3,509 cases. The information collected was imported or directly entered into databases and allowed identifying variables that were validated in a multiple correspondence analysis (MCA). Results Sixty percent of the cases were confirmed, 10% were probable, 13.5% doubtful, 10.2% asymptomatic seropositive and 6.3% were negative. The clinical manifestations reported were cutaneous (63%), neurological (26%), articular (7%), ocular (1.9%) and cardiac (1.3%). Almost all patients were treated. When focusing more particularly on confirmed cases, our studies confirm that children have a distinct clinical presentation from adults. There is a gender effect on clinical presentation, with females presenting more often with erythema migrans or acrodermatitis chronica atrophicans than males, while males present more often with neurological signs or arthritis than females. Discussion This is the first time that a comprehensive study of suspected Lyme borreliosis cases has been conducted over several years in France. Although we were not able to follow the clinical course of patients after treatment, these results suggest the interest of refining the questionnaire and of following up a cohort of patients over a sufficiently long period to obtain more information on their fate according to different parameters.
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Affiliation(s)
- Emeline Perthame
- Bioinformatics and Biostatistics Hub, Institut Pasteur, Université Paris Cité, Paris, France
| | - Loïc Chartier
- LYSARC, Centre Hospitalier Lyon-Sud, Pierre-Bénite Cedex, France
| | | | | | - Elisabeth Ferquel
- Unité Environnement et Risques Infectieux, Institut Pasteur, Université Paris Cité, Paris, France
| | - Valérie Choumet
- Unité Environnement et Risques Infectieux, Institut Pasteur, Université Paris Cité, Paris, France
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4
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Willems R, Verhaeghe N, Perronne C, Borgermans L, Annemans L. Cost of illness in patients with post-treatment Lyme disease syndrome in Belgium. Eur J Public Health 2023; 33:668-674. [PMID: 36972275 PMCID: PMC10393486 DOI: 10.1093/eurpub/ckad045] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND A proportion of patients with Lyme borreliosis (LB) report long-term persisting signs and symptoms, even after recommended antibiotic treatment, which is termed post-treatment Lyme disease syndrome (PTLDS). Consensus on guidance regarding diagnosis and treatment is currently lacking. Consequently, patients suffer and are left searching for answers, negatively impacting their quality of life and healthcare expenditure. Yet, health economic data on PTLDS remain scarce. The aim of this article is therefore to assess the cost-of-illness related to PTLDS, including the patient perspective. METHODS PTLDS patients (N = 187) with confirmed diagnosis of LB were recruited by a patient organization. Patients completed a self-reported questionnaire on LB-related healthcare utilization, absence from work and unemployment. Unit costs (reference year 2018) were obtained from national databases and published literature. Mean costs and uncertainty intervals were calculated via bootstrapping. Data were extrapolated to the Belgian population. Generalized linear models were used to determine associated covariates with total direct costs and out-of-pocket expenditures. RESULTS Mean annual direct costs amounted to €4618 (95% CI €4070-5152), of which 49.5% were out-of-pocket expenditures. Mean annual indirect costs amounted to €36 081 (€31 312-40 923). Direct and indirect costs at the population level were estimated at €19.4 and 151.5 million, respectively. A sickness or disability benefit as source of income was associated with higher direct and out-of-pocket costs. CONCLUSIONS The economic burden associated with PTLDS on patients and society is substantial, with patients consuming large amounts of non-reimbursed healthcare resources. Guidance on adequate diagnosis and treatment of PTLDS is needed.
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Affiliation(s)
- Ruben Willems
- Department of Public Health and Primary Care, Interuniversity Centre for Health Economics Research (I-CHER), Ghent University, Gent, Belgium
| | - Nick Verhaeghe
- Department of Public Health and Primary Care, Interuniversity Centre for Health Economics Research (I-CHER), Ghent University, Gent, Belgium
| | - Christian Perronne
- Infectious Diseases Department, University Hospital Raymond Poincaré, APHP, Université de Versailles Saint-Quentin-Paris Saclay, Garches, France
| | - Liesbeth Borgermans
- Department of Public Health and Primary Care, Interuniversity Centre for Health Economics Research (I-CHER), Ghent University, Gent, Belgium
| | - Lieven Annemans
- Department of Public Health and Primary Care, Interuniversity Centre for Health Economics Research (I-CHER), Ghent University, Gent, Belgium
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5
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Dagenais A, Villalba-Guerrero C, Olivier M. Trained immunity: A “new” weapon in the fight against infectious diseases. Front Immunol 2023; 14:1147476. [PMID: 36993966 PMCID: PMC10040606 DOI: 10.3389/fimmu.2023.1147476] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 02/23/2023] [Indexed: 03/18/2023] Open
Abstract
Innate immune cells can potentiate the response to reinfection through an innate form of immunological memory known as trained immunity. The potential of this fast-acting, nonspecific memory compared to traditional adaptive immunological memory in prophylaxis and therapy has been a topic of great interest in many fields, including infectious diseases. Amidst the rise of antimicrobial resistance and climate change—two major threats to global health—, harnessing the advantages of trained immunity compared to traditional forms of prophylaxis and therapy could be game-changing. Here, we present recent works bridging trained immunity and infectious disease that raise important discoveries, questions, concerns, and novel avenues for the modulation of trained immunity in practice. By exploring the progress in bacterial, viral, fungal, and parasitic diseases, we equally highlight future directions with a focus on particularly problematic and/or understudied pathogens.
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Affiliation(s)
- Amy Dagenais
- Department of Microbiology and Immunology, Faculty of Medicine, Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, Canada
| | - Carlos Villalba-Guerrero
- Department of Microbiology and Immunology, Faculty of Medicine, Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, Canada
| | - Martin Olivier
- Department of Microbiology and Immunology, Faculty of Medicine, Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, Canada
- Department of Medicine, Faculty of Medicine, Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, Canada
- *Correspondence: Martin Olivier,
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6
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Hauser N, Conlon KC, Desai A, Kobziar LN. Climate Change and Infections on the Move in North America. Infect Drug Resist 2022; 14:5711-5723. [PMID: 35002262 PMCID: PMC8722568 DOI: 10.2147/idr.s305077] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 11/12/2021] [Indexed: 12/18/2022] Open
Abstract
Climate change is increasingly recognized for its impacts on human health, including how biotic and abiotic factors are driving shifts in infectious disease. Changes in ecological conditions and processes due to temperature and precipitation fluctuations and intensified disturbance regimes are affecting infectious pathogen transmission, habitat, hosts, and the characteristics of pathogens themselves. Understanding the relationships between climate change and infectious diseases can help clinicians broaden the scope of differential diagnoses when interviewing, diagnosing, and treating patients presenting with infections lacking obvious agents or transmission pathways. Here, we highlight key examples of how the mechanisms of climate change affect infectious diseases associated with water, fire, land, insects, and human transmission pathways in the hope of expanding the analytical framework for infectious disease diagnoses. Increased awareness of these relationships can help prepare both clinical physicians and epidemiologists for continued impacts of climate change on infectious disease in the future.
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Affiliation(s)
- Naomi Hauser
- Department of Medicine, Division of Infectious Disease, University of California Davis Health, Sacramento, CA, USA.,Climate Adaptation Research Center, University of California, Davis, CA, USA
| | - Kathryn C Conlon
- Climate Adaptation Research Center, University of California, Davis, CA, USA.,Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, USA.,Department of Veterinary Medicine & Epidemiology, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Angel Desai
- Department of Medicine, Division of Infectious Disease, University of California Davis Health, Sacramento, CA, USA
| | - Leda N Kobziar
- Department of Natural Resources and Society, University of Idaho, Coeur d'Alene, ID, USA
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7
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Arango CA, Chang MK, Waters LM. Selected Infectious Diseases. Fam Med 2022. [DOI: 10.1007/978-3-030-54441-6_46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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8
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Chakravarthi ST, Joshi SG. An Association of Pathogens and Biofilms with Alzheimer's Disease. Microorganisms 2021; 10:microorganisms10010056. [PMID: 35056505 PMCID: PMC8778325 DOI: 10.3390/microorganisms10010056] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 11/16/2022] Open
Abstract
As one of the leading causes of dementia, Alzheimer's disease (AD) is a condition in which individuals experience progressive cognitive decline. Although it is known that beta-amyloid (Aβ) deposits and neurofibrillary tangles (NFT) of tau fibrils are hallmark characteristics of AD, the exact causes of these pathologies are still mostly unknown. Evidence that infectious diseases may cause AD pathology has been accumulating for decades. The association between microbial pathogens and AD is widely studied, and there are noticeable correlations between some bacterial species and AD pathologies, especially spirochetes and some of the oral microbes. Borrelia burgdorferi has been seen to correlate with Aβ plaques and NFTs in infected cells. Because of the evidence of spirochetes in AD patients, Treponema pallidum and other oral treponemes are speculated to be a potential cause of AD. T. pallidum has been seen to form aggregates in the brain when the disease disseminates to the brain that closely resemble the Aβ plaques of AD patients. This review examines the evidence as to whether pathogens could be the cause of AD and its pathology. It offers novel speculations that treponemes may be able to induce or correlate with Alzheimer's disease.
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Affiliation(s)
- Sandhya T. Chakravarthi
- Center for Surgical Infection and Biofilm, College of Medicine, Drexel University, Philadelphia, PA 19104, USA;
| | - Suresh G. Joshi
- Center for Surgical Infection and Biofilm, College of Medicine, Drexel University, Philadelphia, PA 19104, USA;
- Drexel School of Biomedical Engineering, Science & Health Systems, Drexel University, Philadelphia, PA 19104, USA
- Correspondence: or ; Tel.: +1-215-895-1988
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9
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Tkáčová Z, Bhide K, Mochnáčová E, Petroušková P, Hruškovicová J, Kulkarni A, Bhide M. Comprehensive Mapping of the Cell Response to Borrelia bavariensis in the Brain Microvascular Endothelial Cells in vitro Using RNA-Seq. Front Microbiol 2021; 12:760627. [PMID: 34819924 PMCID: PMC8606740 DOI: 10.3389/fmicb.2021.760627] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 10/11/2021] [Indexed: 12/01/2022] Open
Abstract
Borrelia bavariensis can invade the central nervous system (CNS) by crossing the blood-brain barrier (BBB). It is predicted that B. bavariensis evokes numerous signaling cascades in the human brain microvascular endothelial cells (hBMECs) and exploits them to traverse across the BBB. The complete picture of signaling events in hBMECs induced by B. bavariensis remains uncovered. Using RNA sequencing, we mapped 11,398 genes and identified 295 differentially expressed genes (DEGs, 251 upregulated genes and 44 downregulated genes) in B. bavariensis challenged hBMECs. The results obtained from RNA-seq were validated with qPCR. Gene ontology analysis revealed the participation of DEGs in a number of biological processes like cell communication, organization of the extracellular matrix, vesicle-mediated transport, cell response triggered by pattern recognition receptors, antigen processing via MHC class I, cellular stress, metabolism, signal transduction, etc. The expression of several non-protein coding genes was also evoked. In this manuscript, we discuss in detail the correlation between several signaling cascades elicited and the translocation of BBB by B. bavariensis. The data revealed here may contribute to a better understanding of the mechanisms employed by B. bavariensis to cross the BBB.
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Affiliation(s)
- Zuzana Tkáčová
- Laboratory of Biomedical Microbiology and Immunology, The University of Veterinary Medicine and Pharmacy, Kosice, Slovakia
| | - Katarína Bhide
- Laboratory of Biomedical Microbiology and Immunology, The University of Veterinary Medicine and Pharmacy, Kosice, Slovakia
| | - Evelina Mochnáčová
- Laboratory of Biomedical Microbiology and Immunology, The University of Veterinary Medicine and Pharmacy, Kosice, Slovakia
| | - Patrícia Petroušková
- Laboratory of Biomedical Microbiology and Immunology, The University of Veterinary Medicine and Pharmacy, Kosice, Slovakia
| | - Jana Hruškovicová
- Laboratory of Biomedical Microbiology and Immunology, The University of Veterinary Medicine and Pharmacy, Kosice, Slovakia
| | - Amod Kulkarni
- Laboratory of Biomedical Microbiology and Immunology, The University of Veterinary Medicine and Pharmacy, Kosice, Slovakia.,Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Mangesh Bhide
- Laboratory of Biomedical Microbiology and Immunology, The University of Veterinary Medicine and Pharmacy, Kosice, Slovakia.,Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
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10
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Lobo-Prat D, Corominas H, Pomar V. Suitability of serology tests for the diagnosis of Lyme disease. Single center urban cohort. Med Clin (Barc) 2021; 157:395-396. [PMID: 33279209 DOI: 10.1016/j.medcli.2020.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 10/22/2022]
Affiliation(s)
- David Lobo-Prat
- Servei de Reumatologia, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - Hèctor Corominas
- Servei de Reumatologia, Hospital de la Santa Creu i Sant Pau, Barcelona, España; Universitat Autònoma de Barcelona (UAB), Barcelona, España.
| | - Virginia Pomar
- Unitat de Malalties Infeccioses, Servei de Medicina interna, Hospital de Sant Pau,, Barcelona, España
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11
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Weise C, Schulz MC, Frank K, Cetindis M, Koos B, Weise H. Acute arthritis of the right temporomandibular joint due to Lyme disease: a case report and literature review. BMC Oral Health 2021; 21:400. [PMID: 34399746 PMCID: PMC8365916 DOI: 10.1186/s12903-021-01744-4] [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: 03/07/2021] [Accepted: 07/12/2021] [Indexed: 12/02/2022] Open
Abstract
Background Lyme disease is the most frequent tick-borne infectious disease in Europe. It often presents with a wide variety of symptoms. For this reason, affection of the temporomandibular joint (TMJ) caused by Lyme disease (LD) can be misdiagnosed as a common temporomandibular disorder (TMD). Case presentation The purpose of this case report of a 25-year-old woman presenting to the Departments of Orthodontics and Oral and Maxillofacial Surgery with extensive symptoms of temporomandibular disorder is to illustrate the delayed diagnosis of Lyme disease which was only made after extensive therapy of the temporomandibular joint. The specialist literature only reports a few cases of patients suffering from Lyme disease with TMJ manifestations. Conclusion This case report and the relevant literature review aim to emphasize the importance of accurate request of medical history and differential diagnosis of acute TMJ arthritis and arthralgia. Early interdisciplinary diagnosis of Lyme disease and early antibiotic therapy are essential to avoid misdiagnosis and unnecessary, sometimes invasive, therapies.
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Affiliation(s)
- Christina Weise
- Department of Orthodontics, Center of Dentistry, Oral Medicine and Maxillofacial Surgery With Dental School, University Hospital Tübingen, Eberhard Karls Universität, Osianderstr. 2-8, 72076, Tübingen, Germany
| | - Matthias C Schulz
- Department of Oral and Maxillofacial Surgery, Center of Dentistry, Oral Medicine and Maxillofacial Surgery With Dental School , University Hospital Tübingen, Eberhard Karls Universität, Osianderstr. 2-8, 72076, Tübingen, Germany.
| | - Karin Frank
- Department of Orthodontics, Center of Dentistry, Oral Medicine and Maxillofacial Surgery With Dental School, University Hospital Tübingen, Eberhard Karls Universität, Osianderstr. 2-8, 72076, Tübingen, Germany
| | - Marcel Cetindis
- Department of Oral and Maxillofacial Surgery, Center of Dentistry, Oral Medicine and Maxillofacial Surgery With Dental School , University Hospital Tübingen, Eberhard Karls Universität, Osianderstr. 2-8, 72076, Tübingen, Germany
| | - Bernd Koos
- Department of Orthodontics, Center of Dentistry, Oral Medicine and Maxillofacial Surgery With Dental School, University Hospital Tübingen, Eberhard Karls Universität, Osianderstr. 2-8, 72076, Tübingen, Germany
| | - Hannes Weise
- Department of Orthodontics, Center of Dentistry, Oral Medicine and Maxillofacial Surgery With Dental School, University Hospital Tübingen, Eberhard Karls Universität, Osianderstr. 2-8, 72076, Tübingen, Germany.,Department of Oral and Maxillofacial Surgery, Center of Dentistry, Oral Medicine and Maxillofacial Surgery With Dental School , University Hospital Tübingen, Eberhard Karls Universität, Osianderstr. 2-8, 72076, Tübingen, Germany
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12
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Detecting and phasing minor single-nucleotide variants from long-read sequencing data. Nat Commun 2021; 12:3032. [PMID: 34031367 PMCID: PMC8144375 DOI: 10.1038/s41467-021-23289-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 04/15/2021] [Indexed: 02/04/2023] Open
Abstract
Cellular genetic heterogeneity is common in many biological conditions including cancer, microbiome, and co-infection of multiple pathogens. Detecting and phasing minor variants play an instrumental role in deciphering cellular genetic heterogeneity, but they are still difficult tasks because of technological limitations. Recently, long-read sequencing technologies, including those by Pacific Biosciences and Oxford Nanopore, provide an opportunity to tackle these challenges. However, high error rates make it difficult to take full advantage of these technologies. To fill this gap, we introduce iGDA, an open-source tool that can accurately detect and phase minor single-nucleotide variants (SNVs), whose frequencies are as low as 0.2%, from raw long-read sequencing data. We also demonstrate that iGDA can accurately reconstruct haplotypes in closely related strains of the same species (divergence ≥0.011%) from long-read metagenomic data.
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13
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Kumar M, Acharya S, Vineetha R, Pai KM. Bilateral Bell's palsy in a young female: a rare case report. Med Pharm Rep 2021; 94:118-120. [PMID: 33629059 PMCID: PMC7880067 DOI: 10.15386/mpr-1389] [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: 06/07/2019] [Revised: 09/03/2019] [Accepted: 09/30/2019] [Indexed: 11/24/2022] Open
Abstract
Bell’s palsy is described as a type of facial paralysis, which is unilateral in 70% of the cases. Bell’s palsy accounts for about 23% of bilateral facial paralysis. Here, we present a rare case of bilateral Bell’s palsy in a 15-year-old female who developed sudden facial weakness with no associated symptoms. The patient was subjected to thorough clinical, laboratory, and necessary radiological investigations. As there was no conclusive evidence from any of the investigations, this could be a case of idiopathic bilateral Bell’s palsy. This is the first ever case of bilateral Bell’s palsy in a young female which has been reported in the Indian population.
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Affiliation(s)
- Mathangi Kumar
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shruthi Acharya
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ravindranath Vineetha
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Keerthilatha M Pai
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Thompson D, Watt JA, Brissette CA. Host transcriptome response to Borrelia burgdorferi sensu lato. Ticks Tick Borne Dis 2020; 12:101638. [PMID: 33360384 DOI: 10.1016/j.ttbdis.2020.101638] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/30/2020] [Accepted: 12/02/2020] [Indexed: 10/22/2022]
Abstract
The host immune response to infection is a well-coordinated system of innate and adaptive immune cells working in concert to prevent the colonization and dissemination of a pathogen. While this typically leads to a beneficial outcome and the suppression of disease pathogenesis, the Lyme borreliosis bacterium, Borrelia burgdorferi sensu lato, can elicit an immune profile that leads to a deleterious state. As B. burgdorferi s.l. produces no known toxins, it is suggested that the immune and inflammatory response of the host are responsible for the manifestation of symptoms, including flu-like symptoms, musculoskeletal pain, and cognitive disorders. The past several years has seen a substantial increase in the use of microarray and sequencing technologies to investigate the transcriptome response induced by B. burgdorferi s.l., thus enabling researchers to identify key factors and pathways underlying the pathophysiology of Lyme borreliosis. In this review we present the major host transcriptional outcomes induced by the bacterium across several studies and discuss the overarching theme of the host inflammatory and immune response, and how it influences the pathology of Lyme borreliosis.
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Affiliation(s)
- Derick Thompson
- Department of Biomedical Sciences, University of North Dakota, Grand Forks, ND, United States.
| | - John A Watt
- Department of Biomedical Sciences, University of North Dakota, Grand Forks, ND, United States.
| | - Catherine A Brissette
- Department of Biomedical Sciences, University of North Dakota, Grand Forks, ND, United States.
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15
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The diverse roles of RIP kinases in host-pathogen interactions. Semin Cell Dev Biol 2020; 109:125-143. [PMID: 32859501 PMCID: PMC7448748 DOI: 10.1016/j.semcdb.2020.08.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/09/2020] [Accepted: 08/09/2020] [Indexed: 12/16/2022]
Abstract
Receptor Interacting Protein Kinases (RIPKs) are cellular signaling molecules that are critical for homeostatic signaling in both communicable and non-communicable disease processes. In particular, RIPK1, RIPK2, RIPK3 and RIPK7 have emerged as key mediators of intracellular signal transduction including inflammation, autophagy and programmed cell death, and are thus essential for the early control of many diverse pathogenic organisms. In this review, we discuss the role of each RIPK in host responses to bacterial and viral pathogens, with a focus on studies that have used pathogen infection models rather than artificial stimulation with purified pathogen associated molecular patterns. We also discuss the intricate mechanisms of host evasion by pathogens that specifically target RIPKs for inactivation, and finally, we will touch on the controversial issue of drug development for kinase inhibitors to treat chronic inflammatory and neurological disorders, and the implications this may have on the outcome of pathogen infections.
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16
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Veinović G, Ćakić S, Mihaljica D, Sukara R, Tomanović S. Comparison of growth and morphology of Borrelia burgdorferi sensu lato in BSK-H and BSK-II media stored for prolonged periods. APMIS 2020; 128:552-557. [PMID: 32794590 DOI: 10.1111/apm.13069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 06/29/2020] [Indexed: 11/26/2022]
Abstract
Barbour-Stoenner-Kelly II (BSK-II) and BSK-H media were used for cultivation and isolation of fastidious Borrelia species - the causative agents of Lyme borreliosis. Culture media have a limited shelf life and require adequate storage. Our goal was to assess how the growth of Borrelia would be affected by prolonged storage of media and inadequate storage conditions (BSK-H stored at +4 °C for 2.5 years and BSK-II stored at -20 °C for 11 years). Growth of different Borrelia afzelii, Borrelia garinii, Borrelia lusitaniae and Borrelia valaisiana strains was assessed during 2 weeks of incubation at 33 °C. Monitored parameters included cell count per mL, morphology and motility. The results of this study have shown weaker growth of borrelia strains in BSK-H at +4 °C (median final cell number of 1.5 × 106 /mL) than in BSK-II at -20 °C (median final cell number of 7.75 × 106 /mL) and in fresh BSK-H media (median final cell number of 8.95 × 106 /mL). Duration of storage of media had no impact on Borrelia morphology and motility. Our results indicate that temperature of -20 °C is optimal for long-term storage of medium, BSK-II stored for 11 years provided effective support to growth of Borrelia and may be employed for cultivation.
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Affiliation(s)
- Gorana Veinović
- Group for Medical Entomology, Centre of Excellence for Food and Vector Borne Zoonoses, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Sanja Ćakić
- Group for Medical Entomology, Centre of Excellence for Food and Vector Borne Zoonoses, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Darko Mihaljica
- Group for Medical Entomology, Centre of Excellence for Food and Vector Borne Zoonoses, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Ratko Sukara
- Group for Medical Entomology, Centre of Excellence for Food and Vector Borne Zoonoses, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Snežana Tomanović
- Group for Medical Entomology, Centre of Excellence for Food and Vector Borne Zoonoses, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
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Udziela S, Biesiada G, Osiewicz M, Michalak M, Stażyk K, Garlicki A, Czepiel J. Musculoskeletal manifestations of Lyme borreliosis - a review. Arch Med Sci 2020; 18:726-731. [PMID: 35591816 PMCID: PMC9102650 DOI: 10.5114/aoms.2020.96458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/23/2020] [Indexed: 12/03/2022] Open
Abstract
Lyme borreliosis (LB) is a zoonotic disease caused by Gram-negative bacteria Borrelia burgdorferi sensu lato. The majority of reported cases of LB originate in the northern hemisphere, mostly in the US and Europe. One of the typical manifestations of LB are musculoskeletal symptoms; they may appear in any of the three LB stages. The diagnosis is based on clinical manifestations and confirmed by serological tests. One course of antibiotic therapy is sufficient for LB to dissipate in most cases, although for some patients, the symptoms subside gradually even after completion of therapy. Patients who have been demonstrated to have specific antibodies but are symptomless should not be treated. In instances where the advised treatment proved to be unsuccessful, patients should be referred to rheumatologist for additional diagnostics. The goal of this review is to update physicians on current scientific knowledge on musculoskeletal manifestations of LB.
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Affiliation(s)
| | - Grażyna Biesiada
- Department of Infectious and Tropical Diseases, Jagiellonian University Medical College, Krakow, Poland
| | - Magdalena Osiewicz
- Department of Integrated Dentistry, Dental Institute, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Mateusz Michalak
- Students’ Scientific Society Jagiellonian University Medical College, Krakow, Poland
| | - Katarzyna Stażyk
- Department of Infectious and Tropical Diseases, Jagiellonian University Medical College, Krakow, Poland
| | - Aleksander Garlicki
- Department of Infectious and Tropical Diseases, Jagiellonian University Medical College, Krakow, Poland
| | - Jacek Czepiel
- Department of Infectious and Tropical Diseases, Jagiellonian University Medical College, Krakow, Poland
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Chemokine Ligand 13 (CXCL13) in Neuroborreliosis and Neurosyphilis as Selected Spirochetal Neurological Diseases: A Review of Its Diagnostic Significance. Int J Mol Sci 2020; 21:ijms21082927. [PMID: 32331231 PMCID: PMC7216086 DOI: 10.3390/ijms21082927] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/16/2020] [Accepted: 04/20/2020] [Indexed: 02/07/2023] Open
Abstract
Neuroborreliosis (NB) and neurosyphilis (NS) are abnormal conditions caused by spirochetal bacteria which affect the nervous system. Diagnosis of neuroborreliosis and neurosyphilis is determined by clinical examination of visible symptoms, serum and cerebrospinal fluid (CSF) analysis, and serological detection of antibodies against Borrelia burgdorferi sensu lato and Treponema pallidum, respectively. Establishing a diagnosis may sometimes pose a number of diagnostic difficulties. A potential role of chemokine ligand 13 (CXCL13) as an accurate diagnostic biomarker of intrathecal inflammation has been suggested. In this review, we focused on changes in serum and cerebrospinal fluid concentration of chemokine ligand 13 in selected spirochetal neurological diseases neuroborreliosis and neurosyphilis reported in the available literature. We performed an extensive search of the literature relevant to our investigation via the MEDLINE/PubMed database. It has been proven that CXCL13 determination can provide rapid information regarding central nervous system inflammation in patients with selected spirochetosis. We described that neuroborreliosis and neurosyphilis are associated with an elevated CXCL13 concentration, mainly in the cerebrospinal fluid. Moreover, literature data suggest that CXCL13 determination is the most interesting additional marker for diagnosis and monitoring of neuroborreliosis and neurosyphilis thanks to its high sensitivity. Based on these published findings, we suggest that CXCL13 has high diagnostic utility and may be applied in laboratory diagnostics as a potential diagnostic marker in human spirochetal neurologic diseases.
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Wolf MJ, Watkins HR, Schwan WR. Ixodes scapularis: Vector to an Increasing Diversity of Human Pathogens in the Upper Midwest. WMJ : OFFICIAL PUBLICATION OF THE STATE MEDICAL SOCIETY OF WISCONSIN 2020; 119:16-21. [PMID: 32348066 PMCID: PMC7209771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION The black-legged tick, Ixodes scapularis (I scapularis), is now recognized as the deadliest tick vector in the United States. The Upper Midwest, particularly Wisconsin and Minnesota, are endemic to a diversity of tick-transmitted infectious diseases. Although Borrelia burgdorferi, the agent of Lyme disease, still accounts for the majority of diagnosed infections, I scapularis is known to transmit other bacterial, viral, and parasitic agents. OBJECTIVE To provide an overview of the array of pathogenic microorganisms carried by I scapularis ticks in the Upper Midwest. METHODS A literature review was conducted to collect and analyze current information about I scapularis lifestyle, transmission, microorganisms carried by the arthropod vector, and the diseases that occur as a result of infections with these microorganisms in the Upper Midwest. RESULTS Diagnosis of co-infection from tick-borne zoonosis in humans has increased over the last 2 decades. Since I scapularis can transmit multiple pathogens, it is clinically important because different diagnostic testing and treatment strategies may need to be implemented for a patient with I scapularis-borne infection(s). CONCLUSIONS This review has concentrated on I scapularis-transmitted diseases affecting the Upper Midwest and has explored the ecology of the I scapularis vector and its role in pathogen transmission.
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Affiliation(s)
- Matthew J Wolf
- Department of Microbiology, University of Wisconsin-La Crosse, La Crosse, Wisconsin
| | - Hannah R Watkins
- Department of Microbiology, University of Wisconsin-La Crosse, La Crosse, Wisconsin
| | - William R Schwan
- Department of Microbiology, University of Wisconsin-La Crosse, La Crosse, Wisconsin,
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Arango CA, Chang MK, Waters LM. Selected Infectious Diseases. Fam Med 2020. [DOI: 10.1007/978-1-4939-0779-3_46-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Cytokine Expression Patterns and Single Nucleotide Polymorphisms (SNPs) in Patients with Chronic Borreliosis. Antibiotics (Basel) 2019; 8:antibiotics8030107. [PMID: 31366164 PMCID: PMC6784230 DOI: 10.3390/antibiotics8030107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/21/2019] [Accepted: 07/25/2019] [Indexed: 12/19/2022] Open
Abstract
(1) Background: Genetically based hyperinflammation may play a role in pathogen defense. We here questioned whether alterations in circulating monocytes/macrophages, inflammatory biomarkers and a functional SNP (single nucleotide polymorphisms) of the Interleukin-6 (IL-6) promotor might play a role in patients with persistent, and treatment resistant borreliosis. (2) Methods: Leukocyte subpopulations were studied by flow cytometry; plasma cytokines were determined by a chemiluminescence based ELISA (Immulite®), and genotypes of the IL-6 promotor SNP rs1800795 were determined by pyrosequencing. (3) Results: In a cohort of n = 107 Lyme borreliosis patients, who concomitantly manifested either malignant diseases (group 1), autoimmune disorders (group 2), neurological diseases (group 3), or morbidities caused by multiple other infectious complications (group 4), we found decreased numbers of anti-inflammatory CD163-positive macrophages, elevated concentrations of inflammatory cytokines, and an imbalance of IL-6 promotor SNP rs1800795 genotypes. The most prominently upregulated cytokines were IL-1β, and IL-8. (4) Conclusions: Increased pro-inflammatory phenotypes identified by monocyte/macrophage subtypes and concomitantly increased cytokines appear to be valid to monitor disease activity in patients with persistent Lyme borreliosis. Patterns may vary by additional co-morbidities. In patients with autoimmune diseases, increased frequencies of a heterozygous IL-6 promotor SNP rs1800795 were identified. This functional SNP may guide chronic inflammation, impacting other cytokines to trigger trigger chronicity and therapeutic resistance in Lyme borreliosis.
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Osiewicz M, Manfredini D, Biesiada G, Czepiel J, Garlicki A, Aarab G, Pytko-Polończyk J, Lobbezoo F. Prevalence of Function-Dependent Temporomandibular Joint and Masticatory Muscle Pain, and Predictors of Temporomandibular Disorders among Patients with Lyme Disease. J Clin Med 2019; 8:jcm8070929. [PMID: 31261623 PMCID: PMC6679175 DOI: 10.3390/jcm8070929] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 06/25/2019] [Accepted: 06/27/2019] [Indexed: 01/10/2023] Open
Abstract
The aim was to determine the occurrence of temporomandibular disorders (TMDs) in patients with Lyme disease (LD), and to estimate the contribution of factors that may identify TMD among LD patients. In seventy-six (N = 76) adult patients with LD (mean age 57.6 ± 14.6 years) and 54 healthy non-Lyme volunteers with a mean age of 56.4 ± 13.5 years, possible function (i.e., non-pain) diagnoses were established using the Research Diagnostic Criteria of Temporomandibular Disorders (RDC/TMD). Pain diagnoses were established by means of the function-dependent dynamic and static tests. The two groups did not significantly differ in the frequency of disc displacements diagnoses and function-dependent pain diagnoses. LD showed a significantly higher frequency (p < 0.001) of osteoarthrosis than the control group. For the prediction of pain diagnoses in LD patients, the single regression analyses pointed out an association with age, sleep bruxism (SB), and awake bruxism (AB). Two predictors (i.e., SB (p = 0.002) and AB (p = 0.017)) were statistically significant in the final multiple variable model. The frequency of TMD in patients with LD based on function-dependent tests was not significantly different from that in the control group. This investigation suggests that the contribution of bruxism to the differentiation between patients with Lyme and TMD is high.
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Affiliation(s)
- Magdalena Osiewicz
- Department of Integrated Dentistry, Dental Institute, Faculty of Medicine, Jagiellonian University Medical College, 31-155 Krakow, Poland.
| | | | - Grażyna Biesiada
- Department of Infectious and Tropical Diseases, Faculty of Medicine, Jagiellonian University Medical College, 31-155 Krakow, Poland
| | - Jacek Czepiel
- Department of Infectious and Tropical Diseases, Faculty of Medicine, Jagiellonian University Medical College, 31-155 Krakow, Poland
| | - Aleksander Garlicki
- Department of Infectious and Tropical Diseases, Faculty of Medicine, Jagiellonian University Medical College, 31-155 Krakow, Poland
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre forDentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands
| | - Jolanta Pytko-Polończyk
- Department of Integrated Dentistry, Dental Institute, Faculty of Medicine, Jagiellonian University Medical College, 31-155 Krakow, Poland
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre forDentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands
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AKAR N, ÇALIŞKAN E, ÖZTÜRK CE, ANKARALI H, KILINÇEL Ö, ÖKSÜZ Ş, ŞAHİN İ. Seroprevalence of hantavirus and Borrelia burgdorferi in Düzce (Turkey) forest villages
and the relationship with sociodemographic features. Turk J Med Sci 2019; 49:483-489. [PMID: 30862151 PMCID: PMC7018355 DOI: 10.3906/sag-1807-160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background/aim Hantavirus and Borrelia burgdorferi are two zoonotic agents that pose a great risk especially for people living in forest
areas. This study aimed to investigate the seroprevalence of hantavirus and B. burgdorferi in forest villages of Düzce and its relationship
with sociodemographic features. Materials and methods The presence of immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies against hantavirus and
B. burgdorferi in serum samples was investigated via enzyme-linked immunosorbent assay (ELISA). Hantavirus IgG and B. burgdorferi
IgM and IgG positivity was then validated by western blot (WB) method. Results During the analyses, 193 serum samples were tested. Eleven (6%) cases of hantavirus IgM was found positive by ELISA. Six
(3%) cases of hantavirus IgG, 3 (2%) cases of B. burgdorferi IgM, and 12 (6%) cases of B. burgdorferi IgG were found positive by WB.
Borrelia burgdorferi IgG positivity was found to be higher in the 46–70 age group and it was seen that the positivity was the highest
among those who lived in mud-brick houses. Conclusion This study was the first to determine the frequency of hantavirus in the study region and it includes current data for B.
burgdorferi. Consequently, it is recommended that similar studies be carried out on rodents in all the regions at risk.
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Affiliation(s)
- Nida AKAR
- Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, AnkaraTurkey
- * To whom correspondence should be addressed. E-mail:
| | - Emel ÇALIŞKAN
- Department of Medical Microbiology, Faculty of Medicine, Düzce University, DüzceTurkey
| | - Cihadiye Elif ÖZTÜRK
- Department of Medical Microbiology, Faculty of Medicine, Düzce University, DüzceTurkey
| | - Handan ANKARALI
- Department of Biostatistics and Medical Science, Faculty of Medicine, İstanbul Medeniyet University, İstanbulTurkey
| | - Özge KILINÇEL
- Medical Microbiology Laboratory, Düzce Atatürk State Hospital, DüzceTurkey
| | - Şükrü ÖKSÜZ
- Department of Medical Microbiology, Faculty of Medicine, Düzce University, DüzceTurkey
| | - İdris ŞAHİN
- Department of Medical Microbiology, Faculty of Medicine, Düzce University, DüzceTurkey
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Osiewicz M, Manfredini D, Biesiada G, Czepiel J, Garlicki A, Pytko-Polończyk J, Lobbezoo F. Differences between palpation and static/dynamic tests to diagnose painful temporomandibular disorders in patients with Lyme disease. Clin Oral Investig 2019; 23:4411-4416. [PMID: 30982182 DOI: 10.1007/s00784-019-02890-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 04/02/2019] [Indexed: 01/14/2023]
Abstract
OBJECTIVES The aim was to determine the frequency of Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD)-based pain diagnoses and dynamic/static tests-based pain diagnoses, and to assess the agreement of palpation tests with static/dynamic tests. MATERIALS AND METHODS Eighty-six (N = 86) adult patients with Lyme disease (mean age 57.0 ± 14.3 years; male/female ratio was 42/44) were examined according to techniques described in the RDC/TMD. Additionally, dynamic/static tests were performed. For RDC/TMD-based pain diagnoses and dynamic/static tests-based pain diagnoses, descriptive frequencies were calculated. Differences between the frequency of palpation-based diagnoses and of dynamic/static-based diagnoses as well as the agreement between pain diagnoses established with the two diagnostic approaches were assessed. RESULTS RDC/TMD-based pain diagnoses were made in 61 patients for myofascial pain and in 11 patients for arthralgia and/or osteoarthritis. Based on dynamic/static tests, mainly myogenous pain was diagnosed in 6 patients, and a mainly arthrogenous pain in 5. The agreement of palpation tests with static/dynamic tests in Lyme disease population was poor. CONCLUSION A high prevalence of TMD symptoms was found in patients with Lyme disease. The results suggest that using palpation tests alone could overestimate primary TMDs when comorbid conditions are present. CLINICAL RELEVANCE Dynamic/static tests should be used as part of the routine TMD assessment. In case of Lyme disease as the actual cause of the facial pain, while the dentist might be suspecting TMD when dynamic/static TMD tests are negative, referral to an appropriate specialist for the diagnosis and treatment of Lyme disease needs to be made.
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Affiliation(s)
- Magdalena Osiewicz
- Department of Integrated Dentistry, Dental Institute, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.
| | | | - Grażyna Biesiada
- Department of Infectious and Tropical Diseases, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Jacek Czepiel
- Department of Infectious and Tropical Diseases, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Aleksander Garlicki
- Department of Infectious and Tropical Diseases, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Jolanta Pytko-Polończyk
- Department of Integrated Dentistry, Dental Institute, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Chavda V, Patel S. Lyme Neuroborreliosis - The Mystifying Pitfall: "Neuropathology and Current Therapeutics". ACTA ACUST UNITED AC 2019; 14:49-68. [PMID: 30919784 DOI: 10.2174/1574891x14666190327114641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 02/28/2019] [Accepted: 03/18/2019] [Indexed: 11/22/2022]
Abstract
Lyme's Disease (LD) is a severe, rapidly growing, broad spectrum chronic infection caused by the bacterium 'Borrelia (B.) burgdorferi', which can be easily transmitted through the bite of certain species of ticks. The prevalence of LD is swiftly mounting in the present scenario in many countries from species to species. Although Lyme's infection is now detectable via serologic examination of early and late Lyme neuroborreliosis (LNB), the management of persistent symptoms is still fraught with quora of doubt and debate. LD is a multisystem spirochete which results after the dissemination of B. burgdorferi from a dermal inoculation site after a tick bite. Lyme's infection can easily get transmitted to the central nervous system and develop various neurological symptoms due to inflammation and an autoimmune response from body may lead to life-threatening "Lyme Borreliosis". The neurological symptoms are well mixed in presentation, late and confusing to get differentiated easily from other diseases. The use of antibiotics in post Lyme infection with neurological complications is still a topic of debate. Babesiosisstates, and human ehrlichiosis' the two other diseases, are associated with the same ticks that spread the LD. However, the prevalence of diagnosed human cases is usually much lower than that of actual cases of LD due to misdiagnosis, late diagnosis or undiagnosis at y such lateral neuroinfection stage after the tick bite. The current review focuses on the molecular neuropathology and current advancements in LD. There are very few patents or discoveries made on borrelia infection, drawing attention towards more focused and targeted research for the cure.
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Affiliation(s)
- Vishal Chavda
- Department of Pharmacology, Institute of Pharmacy, Nirma University, Ahmadabad 382481, Gujarat, India
| | - Snehal Patel
- Department of Pharmacology, Institute of Pharmacy, Nirma University, Ahmadabad 382481, Gujarat, India
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Cikman A, Aydin M, Gulhan B, Karakecili F, Demirtas L, Kesik OA. Geographical Features and Seroprevalence of Borrelia burgdorferi in Erzincan, Turkey. J Arthropod Borne Dis 2018; 12:378-386. [PMID: 30918907 PMCID: PMC6423460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 10/08/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND We aimed to determine the geographical features and seroprevalence of Borrelia burgdorferi in Erzincan, Turkey, which has a high tick population due to its geographical position and climatic conditions. METHODS From January to December 2014, 368 people living in Erzincan, northeastern Turkey were enrolled. B. burgdorferi IgG antibodies were investigated in the collected serum samples using the ELISA method in 2015. Positive and borderline results were confirmed using the Western Blot (WB) method. RESULTS Borrelia burgdorferi IgG positivity was found to be 4.1% by ELISA and 2.17% by WB. Of the seropositive people according to WB, 25% resided in areas within 2000m of rivers, 50% in areas with a slope of 0-5°, and 62.5% in areas with an altitude of lower than 1500 meters. CONCLUSION The seroprevalence of Lyme borreliosis was high in Erzincan, particularly among people engaged in animal husbandry in rural areas. In addition, the seroprevalence of Borrelia varied according to geographical features, increasing in areas with a lower slope and altitude.
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Affiliation(s)
- Aytekin Cikman
- Department of Medical Microbiology, School of Medicine, Erzincan University, Erzincan, Turkey,Corresponding author: Dr Aytekin Cikman, E-mail:
| | - Merve Aydin
- Department of Medical Microbiology, School of Medicine, Erzincan University, Erzincan, Turkey,Department of Medical Microbiology, School of Medicine, KTO Karatay University, Konya, Turkey
| | - Baris Gulhan
- Department of Medical Microbiology, School of Medicine, Erzincan University, Erzincan, Turkey
| | - Faruk Karakecili
- Department of Infectious Diseases, School of Medicine, Erzincan University, Erzincan, Turkey
| | - Levent Demirtas
- Department of Internal Medicine, School of Medicine, Erzincan University, Erzincan, Turkey
| | - Ozan Arif Kesik
- Department of Geography, Faculty of Arts and Sciences, Erzincan University, Erzincan, Turkey
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Long B, Koyfman A, Gottlieb M. Evaluation and Management of Septic Arthritis and its Mimics in the Emergency Department. West J Emerg Med 2018; 20:331-341. [PMID: 30881554 PMCID: PMC6404712 DOI: 10.5811/westjem.2018.10.40974] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 10/21/2018] [Accepted: 10/28/2018] [Indexed: 02/06/2023] Open
Abstract
Septic arthritis is a dangerous medical condition associated with significant morbidity and mortality. However, the differential diagnosis can be broad with conditions that mimic this disease and require different evaluation and treatment. This narrative review presents the emergency medicine evaluation and management, as well as important medical conditions that may mimic this disease. Septic arthritis commonly presents with monoarticular joint pain with erythema, warmth, swelling, and pain on palpation and movement. Fever is present in many patients, though most are low grade. Blood testing and imaging may assist with the diagnosis, but the gold standard is joint aspiration. Management includes intravenous antibiotics and orthopedic surgery consult for operative management vs. serial aspirations. Clinicians should consider mimics, such as abscess, avascular necrosis, cellulitis, crystal-induced arthropathies, Lyme disease, malignancy, osteomyelitis, reactive arthritis, rheumatoid arthritis, and transient synovitis. While monoarticular arthritis can be due to septic arthritis, other medical and surgical conditions present similarly and require different management. It is essential for the emergency clinician to be aware how to diagnose and treat these mimics.
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Affiliation(s)
- Brit Long
- Brooke Army Medical Center, Department of Emergency Medicine, Houston, Texas
| | - Alex Koyfman
- The University of Texas Southwestern Medical Center, Department of Emergency Medicine, Dallas, Texas
| | - Michael Gottlieb
- Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois
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Danger-Associated Molecular Patterns (DAMPs): the Derivatives and Triggers of Inflammation. Curr Allergy Asthma Rep 2018; 18:63. [PMID: 30267163 DOI: 10.1007/s11882-018-0817-3] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW Allergen is an umbrella term for irritants of diverse origin. Along with other offenders such as pathogens, mutagens, xenobiotics, and pollutants, allergens can be grouped as inflammatory agents. Danger-associated molecular patterns (DAMPs) are altered metabolism products of necrotic or stressed cells, which are deemed as alarm signals by the innate immune system. Like inflammation, DAMPs play a role in correcting the altered physiological state, but in excess, they can be lethal due to their signal transduction roles. In a vicious loop, inflammatory agents are DAMP generators and DAMPs create a pro-inflammatory state. Only a handful of DAMPs such as uric acid, mtDNA, extracellular ATP, HSPs, amyloid β, S100, HMGB1, and ECM proteins have been studied till now. A large number of DAMPs are still obscure, in need to be unveiled. The identification and functional characterization of those DAMPs in inflammation pathways can be insightful. RECENT FINDINGS As inflammation and immune activation have been implicated in almost all pathologies, studies on them have been intensified in recent times. Consequently, the pathologic mechanisms of various DAMPs have emerged. Following PRR ligation, the activation of inflammasome, MAPK, and NF-kB is some of the common pathways. The limited number of recognized DAMPs are only a fraction of the vast array of other DAMPs. In fact, any misplaced or abnormal level of metabolite can be a DAMP. Sophisticated analysis studies can reveal the full profile of the DAMPs. Lowering the level of DAMPs is useful therapeutic intervention but certainly not as effective as avoiding the DAMP generators, i.e., the inflammatory agents. So, rather than mitigating DAMPs, efforts should be focused on the elimination of inflammatory agents.
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Shroff G, Hopf-Seidel P. A Novel Scoring System Approach to Assess Patients with Lyme Disease (Nutech Functional Score). J Glob Infect Dis 2018; 10:3-6. [PMID: 29563715 PMCID: PMC5850763 DOI: 10.4103/jgid.jgid_11_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: A bacterial infection by Borrelia burgdorferi referred to as Lyme disease (LD) or borreliosis is transmitted mostly by a bite of the tick Ixodes scapularis in the USA and Ixodes ricinus in Europe. Various tests are used for the diagnosis of LD, but their results are often unreliable. We compiled a list of clinically visible and patient-reported symptoms that are associated with LD. Based on this list, we developed a novel scoring system. Methodology: Nutech functional Score (NFS), which is a 43 point positional (every symptom is subgraded and each alternative gets some points according to its position) and directional (moves in direction bad to good) scoring system that assesses the patient's condition. Results: The grades of the scoring system have been converted into numeric values for conducting probability based studies. Each symptom is graded from 1 to 5 that runs in direction BAD → GOOD. Conclusion: NFS is a unique tool that can be used universally to assess the condition of patients with LD.
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Affiliation(s)
| | - Petra Hopf-Seidel
- Neurologist and Psychiatrist, Expert for Lyme Disease, Ansbach, Germany
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Davidsson M. The Financial Implications of a Well-Hidden and Ignored Chronic Lyme Disease Pandemic. Healthcare (Basel) 2018; 6:E16. [PMID: 29438352 PMCID: PMC5872223 DOI: 10.3390/healthcare6010016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 12/11/2017] [Accepted: 12/22/2017] [Indexed: 12/27/2022] Open
Abstract
1 million people are predicted to get infected with Lyme disease in the USA in 2018. Given the same incidence rate of Lyme disease in Europe as in the USA, then 2.4 million people will get infected with Lyme disease in Europe in 2018. In the USA by 2050, 55.7 million people (12% of the population) will have been infected with Lyme disease. In Europe by 2050, 134.9 million people (17% of the population) will have been infected with Lyme disease. Most of these infections will, unfortunately, become chronic. The estimated treatment cost for acute and chronic Lyme disease for 2018 for the USA is somewhere between 4.8 billion USD and 9.6 billion USD and for Europe somewhere between 10.1 billion EUR and 20.1 billion EUR. If governments do not finance IV treatment with antibiotics for chronic Lyme disease, then the estimated government cost for chronic Lyme disease for 2018 for the USA is 10.1 billion USD and in Europe 20.1 billion EUR. If governments in the USA and Europe want to minimize future costs and maximize future revenues, then they should pay for IV antibiotic treatment up to a year even if the estimated cure rate is as low as 25%. The cost for governments of having chronic Lyme patients sick in perpetuity is very large.
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Affiliation(s)
- Marcus Davidsson
- Economist and Independent Researcher, https://papers.ssrn.com/sol3/cf_dev/AbsByAuth.cfm?per_id=895329.
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Díaz P, Arnal JL, Remesar S, Pérez-Creo A, Venzal JM, Vázquez-López ME, Prieto A, Fernández G, López CM, Panadero R, Benito A, Díez-Baños P, Morrondo P. Molecular identification of Borrelia spirochetes in questing Ixodes ricinus from northwestern Spain. Parasit Vectors 2017; 10:615. [PMID: 29262835 PMCID: PMC5738910 DOI: 10.1186/s13071-017-2574-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 12/06/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Ixodes ricinus, the predominant tick species in Europe, can transmit the causative agents of important human diseases such as Lyme borreliosis (LB), caused by Borrelia spirochetes. In northern Spain, LB is considered endemic; recently, a significant increase of the annual incidence of LB was reported in the northwestern (NW) region. METHODS In order to provide information on the prevalence of Borrelia spp., pooled and individually free-living I. ricinus from NW Spain were molecularly analyzed. Positive samples were characterized at the fla and Glpq genes and the rrfA-rrlB intergenic spacer region to identify Borrelia species/genospecies. RESULTS Borrelia burgdorferi (sensu lato) (s.l.) individual prevalence and MIR were significantly higher in adult females (32.3 and 16%) than in nymphs (18.8 and 6.2%) and adult males (15.6 and 8.4%). Five Borrelia genospecies belonging to the B. burgdorferi (s.l.) group were identified: B. garinii was predominant, followed by B. valaisiana, B. lusitaniae, B. afzelii and B. burgdorferi (sensu stricto) (s.s.). One species belonging to the tick-borne relapsing fever group (B. miyamotoi) was also found, showing low individual prevalence (1%), positive pool (0.7%) and MIR (0.1%) values. To our knowledge, this is the first citation of B. miyamotoi in free-living ticks from Spain. CONCLUSIONS The significant prevalences of B. burgdorferi (s.l.) genospecies detected in questing ticks from NW Spain are similar to those detected in northern and central European countries and higher to those previously found in Spain. These results together with the high incidence of LB in humans and the high seroprevalence of B. burgdorferi (s.l.) in roe deer shown in other studies reveal that the northwest area is one of the most risky regions for acquiring LB in Spain.
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Affiliation(s)
- Pablo Díaz
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | | | - Susana Remesar
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | - Ana Pérez-Creo
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | - José Manuel Venzal
- Laboratorio de Vectores y enfermedades transmitidas, Facultad de Veterinaria, CENUR Litoral Norte, Universidad de la República, Salto, Uruguay
| | | | - Alberto Prieto
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | - Gonzalo Fernández
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | - Ceferino Manuel López
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | - Rosario Panadero
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | | | - Pablo Díez-Baños
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | - Patrocinio Morrondo
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
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Moon KL, Chown SL, Loh SM, Oskam CL, Fraser CI. Australian penguin ticks screened for novel Borrelia species. Ticks Tick Borne Dis 2017; 9:410-414. [PMID: 29275874 DOI: 10.1016/j.ttbdis.2017.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 12/07/2017] [Accepted: 12/08/2017] [Indexed: 10/18/2022]
Abstract
Lyme borreliosis (or Lyme Disease) is an emerging threat to human health in the Northern Hemisphere caused by tick-borne bacteria from the Borrelia burgdorferi sensu lato (Bbsl) complex. Seabirds are important reservoir hosts of some members of the Bbsl complex in the Northern Hemisphere, and some evidence suggests this may be true of penguins in the Southern Hemisphere. While the Bbsl complex has not been detected in Australia, a novel Borrelia species ('Candidatus Borrelia tachyglossi') was recently sequenced from native ticks (Ixodes holocyclus and Bothriocroton concolor) parasitising echidnas (Tachyglossus aculeatus), suggesting unidentified borreliae may be circulating amongst native wildlife and their ticks. In the present study, we investigated whether ticks parasitising little penguins (Eudyptula novaehollandiae) harbour native or introduced Borrelia bacteria. We chose this penguin species because it is heavily exploited by ticks during the breeding season, lives in close proximity to other potential reservoir hosts (including native wildlife and migratory seabirds), and is known to be infected with other tick-borne pathogens (Babesia). We screened over 230 penguin ticks (Ixodes spp.) from colonies in south-eastern Australia, and found no evidence of Borrelia DNA. The apparent absence or rarity of the bacterium in south-eastern Australia has important implications for identifying potential tick-borne pathogens in an understudied region.
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Affiliation(s)
- Katherine L Moon
- Fenner School of Environment and Society, Australian National University, Acton, ACT 2601, Australia; School of Biological Sciences, Monash University, Clayton, VIC 3800, Australia.
| | - Steven L Chown
- School of Biological Sciences, Monash University, Clayton, VIC 3800, Australia
| | - Siew-May Loh
- Vector & Waterborne Pathogens Research Group, School of Veterinary and Life Sciences, Murdoch University, Murdoch, WA 6150, Australia
| | - Charlotte L Oskam
- Vector & Waterborne Pathogens Research Group, School of Veterinary and Life Sciences, Murdoch University, Murdoch, WA 6150, Australia
| | - Ceridwen I Fraser
- Fenner School of Environment and Society, Australian National University, Acton, ACT 2601, Australia
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Yu P, Liu Z, Niu Q, Yang J, Abdallah MO, Chen Z, Liu G, Luo J, Yin H. Molecular evidence of tick-borne pathogens in Hyalomma anatolicum ticks infesting cattle in Xinjiang Uygur Autonomous Region, Northwestern China. EXPERIMENTAL & APPLIED ACAROLOGY 2017; 73:269-281. [PMID: 28875270 DOI: 10.1007/s10493-017-0162-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 07/17/2017] [Indexed: 06/07/2023]
Abstract
Although tick-borne pathogens have been widely reported in ticks in China, there is little information available on the prevalence of information in Hyalomma ticks from cattle. This study aims to determine the occurrence of pathogens in Hyalomma anatolicum collected from cattle in Xinjiang Uygur Autonomous Region, China, by PCR, sequencing and phylogenetic analysis. Borrelia burgdorferi s.s., Rickettsia massiliae and Anaplasma bovis were identified, whereas DNA of Ehrlichia species and an Anaplasma platys-like pathogen were also detected. Our findings highlight the risk of infection of animals and humans with these pathogens in north-western China.
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Affiliation(s)
- Peifa Yu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, 730046, Gansu, People's Republic of China
| | - Zhijie Liu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, 730046, Gansu, People's Republic of China
| | - Qingli Niu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, 730046, Gansu, People's Republic of China
| | - Jifei Yang
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, 730046, Gansu, People's Republic of China
| | - Mirza Omar Abdallah
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, 730046, Gansu, People's Republic of China
| | - Ze Chen
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, 730046, Gansu, People's Republic of China
| | - Guangyuan Liu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, 730046, Gansu, People's Republic of China
| | - Jianxun Luo
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, 730046, Gansu, People's Republic of China.
| | - Hong Yin
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, 730046, Gansu, People's Republic of China.
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, 225009, People's Republic of China.
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Patel S. Every member of the kingdom Animalia is a potential vector of human pathogens. Microb Pathog 2017; 109:1-3. [PMID: 28487229 DOI: 10.1016/j.micpath.2017.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 05/02/2017] [Accepted: 05/04/2017] [Indexed: 10/19/2022]
Abstract
Zoonotic diseases are a subset of infectious diseases, which account for enormous morbidity and mortality. Pathologies like malaria, rabies, Lyme disease, leptospirosis, avian flu etc. are microbe- and parasite-caused ailments, where the etiological agents are introduced into or on the human body via ticks, mosquitoes, birds, rodents, bats, and deer, among other members of kingdom Animalia. While some of the zoonotic diseases are well-investigated and caution taken against, a lot many are yet to be recognized. This ignorance costs health, and lives, especially in developing countries. To promote awareness regarding the risks of immunogenicity and pathogen dissemination by hitherto unknown non-plant organisms, the members of kingdom Animalia, this letter has been compiled. The vector exploitation mechanisms of the pathogens, and in silico evidences of conserved protein domains across the potential pathogen reservoirs have been mentioned to underline the importance of this topic.
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Affiliation(s)
- Seema Patel
- Bioinformatics and Medical Informatics Research Center, San Diego State University, San Diego, 92182, USA.
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35
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Vázquez-López ME, Fernández G, Díaz P, Díez-Morrondo C, Pego-Reigosa R, Coira-Nieto A. [Usefulness of serological studies for the early diagnosis of Lyme disease in Primary Health Care Centres]. Aten Primaria 2017; 50:16-22. [PMID: 28476293 PMCID: PMC6836939 DOI: 10.1016/j.aprim.2017.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 12/12/2016] [Accepted: 01/02/2017] [Indexed: 11/07/2022] Open
Abstract
Objetivo Determinar la utilidad del diagnóstico precoz de la enfermedad de Lyme (EL) en los Centros de Atención Primaria (CAP) empleando el ELISA como técnica de cribado serológico. Métodos Se realiza un estudio retrospectivo (2006-2013) consistente en la determinación mediante ELISA de la seropositividad a Borrelia de 2.842 personas consideradas en riesgo de padecer EL. Se estudia la relación entre el hábitat y la zona de residencia de las personas con seropositividad a Borrelia, según la procedencia de las muestras (CAP/Hospital). Resultados El 15,2% de los sueros resultaron positivos frente a Borrelia spp. La seropositividad fue significativamente superior en las muestras remitidas desde los CAP que desde el Hospital y en los habitantes del rural y la montaña frente al área urbana y la meseta. El porcentaje de seropositividad se incrementó con el transcurso de los años. Los médicos de Atención Primaria detectaron mayor porcentaje de enfermos de Lyme en Fase I y tras la instauración del tratamiento no se observaron secuelas. Conclusiones El papel del médico de atención primaria es primordial en el diagnóstico precoz de la EL, constatándose un mayor porcentaje de seropositivos entre las muestras remitidas desde los CAP con predominio del diagnóstico en Fase I de enfermedad y la resolución sin secuelas. La detección de anticuerpos específicos frente a Borrelia, mediante ELISA, es una prueba útil para el cribado de pacientes en riesgo de EL.
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Affiliation(s)
| | - Gonzalo Fernández
- Unidad de Epidemiología, Zoonosis y Salud Pública, Facultad de Veterinaria, Universidad de Santiago de Compostela, Lugo, España
| | - Pablo Díaz
- Unidad de Epidemiología, Zoonosis y Salud Pública, Facultad de Veterinaria, Universidad de Santiago de Compostela, Lugo, España
| | | | | | - Amparo Coira-Nieto
- Servicio de Microbiología, Hospital Universitario Lucus Agusti, Lugo, España
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Kang JG, Ko S, Smith WB, Kim HC, Lee IY, Chae JS. Prevalence of Anaplasma, Bartonella and Borrelia Species in Haemaphysalis longicornis collected from goats in North Korea. J Vet Sci 2017; 17:207-16. [PMID: 26645342 PMCID: PMC4921669 DOI: 10.4142/jvs.2016.17.2.207] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 09/10/2015] [Accepted: 10/07/2015] [Indexed: 11/20/2022] Open
Abstract
North Korea is located on the northern part of the Korean Peninsula in East Asia. While tick-borne pathogens of medical and veterinary importance have been reported from China and South Korea, they have not been reported from North Korea. To screen for zoonotic tick-borne pathogens in North Korea, ticks were collected from domestic goats. A total of 292 (27 nymph, 26 male, 239 female) Haemaphysalis (H.) longicornis were collected and assayed individually for selected tick-borne pathogens. A total of 77 (26.4%) were positive for Anaplasma bovis, followed by Bartonella (B.) grahamii (15, 5.1%), Anaplasma phagocytophilum (12, 4.1%), Bartonella henselae (10, 3.4%), and Borrelia spp. (3, 1.0%) based on 16S ribosomal RNA and ITS species-specific nested polymerase chain reaction. Using the groEL-based nested PCR, a total of 6 and 1 H. longicornis were positive for B. grahamii and B. henselae, respectively. All products were sequenced and demonstrated 100% identity and homology with previously reported sequences from other countries in GenBank. This is the first report of the detection of tick-borne pathogens in the North Korea and suggests that farm animals may act as reservoirs for zoonotic tick-borne pathogens.
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Affiliation(s)
- Jun-Gu Kang
- Laboratory of Veterinary Internal Medicine, BK21 PLUS Program for Creative Veterinary Science Research, and Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Sungjin Ko
- Laboratory of Veterinary Internal Medicine, BK21 PLUS Program for Creative Veterinary Science Research, and Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - W Barney Smith
- College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA
| | - Heung-Chul Kim
- Laboratory of Veterinary Internal Medicine, BK21 PLUS Program for Creative Veterinary Science Research, and Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - In-Yong Lee
- Department of Environmental Medical Biology, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Joon-Seok Chae
- Laboratory of Veterinary Internal Medicine, BK21 PLUS Program for Creative Veterinary Science Research, and Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
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Rozwadowska B, Albertyńska M, Okła H, Jasik KP, Swinarew AS, Mazurek U, Dudek S, Urbańska-Jasik D, Poprawa I. Induction of Apoptosis in Normal Human Dermal Fibroblasts Infected withBorrelia burgdorferiSensu Lato. Vector Borne Zoonotic Dis 2017; 17:237-242. [DOI: 10.1089/vbz.2016.2057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Beata Rozwadowska
- Department of Skin Structural Studies, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia in Katowice, Poland
| | - Marta Albertyńska
- Department of Skin Structural Studies, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia in Katowice, Poland
| | - Hubert Okła
- Department of Skin Structural Studies, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia in Katowice, Poland
- Institute of Materials Science, Faculty of Computer Science and Materials Science, University of Silesia in Katowice, Poland
| | - Krzysztof P. Jasik
- Department of Skin Structural Studies, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia in Katowice, Poland
| | - Andrzej S. Swinarew
- Institute of Materials Science, Faculty of Computer Science and Materials Science, University of Silesia in Katowice, Poland
| | - Urszula Mazurek
- Department of Molecular Biology, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia in Katowice, Poland
| | - Sławomir Dudek
- Department of Pharmacognosy and Phytochemistry, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia in Katowice, Poland
| | - Danuta Urbańska-Jasik
- Department of Animal Histology and Embryology, Faculty of Biology and Environmental Protection, University of Silesia in Katowice, Poland
| | - Izabela Poprawa
- Department of Animal Histology and Embryology, Faculty of Biology and Environmental Protection, University of Silesia in Katowice, Poland
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38
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Arango CA, Shah N, Nalamalapu SR. Selected Infectious Diseases. Fam Med 2017. [DOI: 10.1007/978-3-319-04414-9_46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Kostić T, Momčilović S, Perišić ZD, Apostolović SR, Cvetković J, Jovanović A, Barać A, Šalinger-Martinović S, Tasić-Otašević S. Manifestations of Lyme carditis. Int J Cardiol 2016; 232:24-32. [PMID: 28082088 DOI: 10.1016/j.ijcard.2016.12.169] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 12/18/2016] [Accepted: 12/25/2016] [Indexed: 02/02/2023]
Abstract
The first data of Lyme carditis, a relatively rare manifestation of Lyme disease, were published in eighties of the last century. Clinical manifestations include syncope, light-headedness, fainting, shortness of breath, palpitations, and/or chest pain. Atrioventricular (AV) electrical block of varying severity presents the most common conduction disorder in Lyme carditis. Although is usually mild, AV block can fluctuates rapidly and progress from a prolonged P-R interval to a His-Purkinje block within minutes to hours and days. Rarely, Lyme disease may be the cause of endocarditis, while some studies and reports, based on serological and/or molecular investigations, have suggested possible influence of Borrelia burgdorferi on degenerative cardiac valvular disease. Myocarditis, pericarditis, pancarditis, dilated cardiomyopathy, and heart failure have also been described as possible manifestations of Lyme carditis. The clinical course of Lyme carditis is generally mild, short term, and in most cases, completely reversible after adequate antibiotic treatment.
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Affiliation(s)
- Tomislav Kostić
- Clinic for Cardiovascular Diseases, Clinical Center Niš, Blvd Zorana Djindjica 48, 18000 Niš, Serbia; Department of Cardiology, Faculty of Medicine, University of Niš, Serbia, Blvd Zorana Djindjica 81, 18000 Niš, Serbia
| | - Stefan Momčilović
- Clinic for Cardiovascular Diseases, Clinical Center Niš, Blvd Zorana Djindjica 48, 18000 Niš, Serbia.
| | - Zoran D Perišić
- Clinic for Cardiovascular Diseases, Clinical Center Niš, Blvd Zorana Djindjica 48, 18000 Niš, Serbia; Department of Cardiology, Faculty of Medicine, University of Niš, Serbia, Blvd Zorana Djindjica 81, 18000 Niš, Serbia
| | - Svetlana R Apostolović
- Clinic for Cardiovascular Diseases, Clinical Center Niš, Blvd Zorana Djindjica 48, 18000 Niš, Serbia; Department of Cardiology, Faculty of Medicine, University of Niš, Serbia, Blvd Zorana Djindjica 81, 18000 Niš, Serbia
| | - Jovana Cvetković
- Institute for Treatment and Rehabilitation "Niška Banja", Srpskih junaka 2, 18205 Niška Banja, Niš, Serbia
| | - Andriana Jovanović
- Faculty of Medicine, University of Niš Serbia, Blvd Zorana Djindjica 81, 18000 Niš, Serbia
| | - Aleksandra Barać
- Clinic for Infectious and Tropical Diseases, Clinical Center Serbia, Blvd Oslobodjenja 16, 11000, Belgrade
| | - Sonja Šalinger-Martinović
- Clinic for Cardiovascular Diseases, Clinical Center Niš, Blvd Zorana Djindjica 48, 18000 Niš, Serbia; Department of Cardiology, Faculty of Medicine, University of Niš, Serbia, Blvd Zorana Djindjica 81, 18000 Niš, Serbia
| | - Suzana Tasić-Otašević
- Center of Microbiology and Parasitology, Public Health Institute Niš, Serbia, Blvd Zorana Djindjica 81, 18000 Niš, Serbia; Department of Microbiology and Immunology, Faculty of Medicine, University of Niš, Serbia, Blvd Zorana Djindjica 81, 18000 Niš, Serbia
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Ma Z, Zhang W. A case of fulminant type 1 diabetes after erythema multiforme. Diabetes Res Clin Pract 2016; 120:182-3. [PMID: 27580389 DOI: 10.1016/j.diabres.2016.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Accepted: 08/10/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Zhao Ma
- Dept of Pharmacy, Hangzhou Third Hospital, Hangzhou 310009, China.
| | - Wei Zhang
- Hangzhou Institute for Food and Drug Control, Hangzhou 310022, China
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Dudek S, Ziółko E, Kimsa-Dudek M, Solarz K, Mazurek U, Wierzgoń A, Kokot T, Muc-Wierzgoń M. Expression Profiles of Toll-Like Receptors in the Differentiation of an Infection with Borrelia burgdorferi Sensu Lato Spirochetes. Arch Immunol Ther Exp (Warsz) 2016; 65:175-182. [PMID: 27604757 DOI: 10.1007/s00005-016-0416-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 06/01/2016] [Indexed: 11/25/2022]
Abstract
The similarity of Lyme borreliosis to other diseases and its complex pathogenesis present diagnostic and therapeutic difficulties. The changes that occur at the cellular and molecular levels after a Borrelia sp. infection still remain poorly understood. Therefore, the present study focused on the expression of TLR and TLR-signaling genes in human dermal fibroblasts in the differentiation of an infection with Borrelia burgdorferi sensu lato spirochetes. Normal human dermal fibroblasts were cultured with the spirochetes of Borrelia burgdorferi sensu stricto, Borrelia afzelii and Borrelia garinii. Total RNA was extracted from the cells using TRIzol reagent. The analysis of the expression profiles of TLRs and TLR-related genes was performed using commercially available oligonucleotide microarrays of HG-U133A. The GeneSpring 12.0 platform and significance analysis of microarrays were used for the statistical analysis of microarray data. The analyses using the oligonucleotide microarray and QRT-PCR techniques permitted to identify the genes encoding TLR4 and TLR6 as specific for infection with B. afzelii and B. burgdorferi sensu stricto. In turn, TLR3 was only characteristic for an infection with B. burgdorferi sensu stricto. There were no changes in the TLR gene expression after infection with B. garinii. Our findings confirm that Borrelia has a major effect on fibroblast gene expression. Further characterization of changes in gene expression may lead to valuable insights into the role of the toll-like receptor in the pathogenesis of Lyme disease and may provide guidelines for the development of diagnostic markers for an infection with a particular Borrelia genospecies. Moreover, this will help to identify better treatment strategies for Lyme disease.
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Affiliation(s)
- Slawomir Dudek
- Department of Pharmacognosy and Phytochemistry, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Sosnowiec, Poland
| | - Ewa Ziółko
- Department of Internal Medicine, School of Public Health, Silesian Medical University in Katowice, Bytom, Poland
| | - Magdalena Kimsa-Dudek
- Department of Food and Nutrition, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Sosnowiec, Poland
| | - Krzysztof Solarz
- Department of Parasitology, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Sosnowiec, Poland
| | - Urszula Mazurek
- Department of Molecular Biology, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Sosnowiec, Poland
| | - Aleksander Wierzgoń
- Faculty of Energy and Environmental Engineering, Silesian University of Technology, Gliwice, Poland
| | - Teresa Kokot
- Department of Internal Medicine, School of Public Health, Silesian Medical University in Katowice, Bytom, Poland
| | - Małgorzata Muc-Wierzgoń
- Department of Internal Medicine, School of Public Health, Silesian Medical University in Katowice, Bytom, Poland.
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Zákutná Ľ, Dorko E, Rimárová K, Kizeková M. Pilot Cross-Sectional Study of Three Zoonoses (Lyme Disease, Tularaemia, Leptospirosis) among Healthy Blood Donors in Eastern Slovakia. Cent Eur J Public Health 2016; 23:100-6. [PMID: 26851418 DOI: 10.21101/cejph.a4052] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 03/25/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of the study was to determine the seroprevalence of three zoonotic infections among healthy blood donors/volunteers in Eastern Slovakia. METHODS Sera from 124 blood donors were investigated for the presence of antibodies against Borrelia burgdorferi, Francisella tularensis and Leptospira pomona. The participants also completed the questionnaire about demographic, exposure and epidemiological characteristics. Two serological methods were used for the diagnosis: the enzyme linked protein A/G assay (ELPAGA) and the Western blot (WB). First, sera were screened by ELPAGA (except for leptospirosis). RESULTS The observed seroprevalence was 15% for Lyme borreliosis (LB) and 4% for tularaemia (TUL). The results were confirmed by WB. Positive IgG antibodies (WB method) were detected only in 1.6% of examined for LB and 0.8% for TUL. Our results did not identify any antibodies against Leptospira pomona agent in the examined healthy blood donors group. CONCLUSIONS ELPAGA seroprevalence for TUL was significantly higher in blood donors working in the agricultural area in the direct contact with hay, straw, manure, and agricultural land. Our outputs determine tick bite as a significant risk factor for LB. The study confirms the explosion of tick-borne diseases in the healthy population of people. The exposure risk for leptospirosis seems to be minimal.
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Affiliation(s)
- Ľubica Zákutná
- Department of Public Health and Hygiene, Faculty of Medicine, P. J. Šafárik University, Košice, Slovak Republic
| | - Erik Dorko
- Department of Public Health and Hygiene, Faculty of Medicine, P. J. Šafárik University, Košice, Slovak Republic
| | - Kvetoslava Rimárová
- Department of Public Health and Hygiene, Faculty of Medicine, P. J. Šafárik University, Košice, Slovak Republic
| | - Marianna Kizeková
- Department of Occupational Medicine and Clinical Toxicology, Faculty of Medicine, P. J. Šafárik University and L. Pasteur University Hospital, Košice, Slovak Republic
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Gupta RS. Impact of genomics on the understanding of microbial evolution and classification: the importance of Darwin's views on classification. FEMS Microbiol Rev 2016; 40:520-53. [PMID: 27279642 DOI: 10.1093/femsre/fuw011] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2016] [Indexed: 12/24/2022] Open
Abstract
Analyses of genome sequences, by some approaches, suggest that the widespread occurrence of horizontal gene transfers (HGTs) in prokaryotes disguises their evolutionary relationships and have led to questioning of the Darwinian model of evolution for prokaryotes. These inferences are critically examined in the light of comparative genome analysis, characteristic synapomorphies, phylogenetic trees and Darwin's views on examining evolutionary relationships. Genome sequences are enabling discovery of numerous molecular markers (synapomorphies) such as conserved signature indels (CSIs) and conserved signature proteins (CSPs), which are distinctive characteristics of different prokaryotic taxa. Based on these molecular markers, exhibiting high degree of specificity and predictive ability, numerous prokaryotic taxa of different ranks, currently identified based on the 16S rRNA gene trees, can now be reliably demarcated in molecular terms. Within all studied groups, multiple CSIs and CSPs have been identified for successive nested clades providing reliable information regarding their hierarchical relationships and these inferences are not affected by HGTs. These results strongly support Darwin's views on evolution and classification and supplement the current phylogenetic framework based on 16S rRNA in important respects. The identified molecular markers provide important means for developing novel diagnostics, therapeutics and for functional studies providing important insights regarding prokaryotic taxa.
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Affiliation(s)
- Radhey S Gupta
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
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Petrosino MI, Attanasi M, Marcovecchio ML, Scaparrotta A, Di Pillo S, Rossi N, Chiarelli F. Erythema multiforme syndrome associated with acute acquired cytomegalovirus infection. Arch Med Sci 2016; 12:684-6. [PMID: 27279865 PMCID: PMC4889704 DOI: 10.5114/aoms.2016.59943] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 09/09/2014] [Indexed: 11/17/2022] Open
Affiliation(s)
| | - Marina Attanasi
- Department of Pediatrics, University of Chieti, Chieti, Italy
| | | | | | | | - Nadia Rossi
- Department of Pediatrics, University of Chieti, Chieti, Italy
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Abstract
Musculoskeletal complaints, which are frequently associated with Lyme disease, often prompt patients to see a physician. In particular, transient episodes of spontaneous knee effusion are common early in the progression of Lyme disease, and, if left untreated, 60% of patients diagnosed with the disease develop Lyme arthritis. This disease is easily treated with antibiotics; therefore, inclusion of Lyme disease in the differential diagnosis as a potential cause of a spontaneous knee effusion can prevent the development of more severe symptoms associated with the disease. However, the time required to receive test results and the inconsistencies between serum and synovial tests can complicate diagnosis of the disease.
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Xing J, Radkay L, Monaco SE, Roth CG, Pantanowitz L. Cerebrospinal Fluid Cytology of Lyme Neuroborreliosis: A Report of 3 Cases with Literature Review. Acta Cytol 2015; 59:339-44. [PMID: 26343489 DOI: 10.1159/000439160] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 08/03/2015] [Indexed: 11/19/2022]
Abstract
Lyme disease can affect the central nervous system causing a B-cell-predominant lymphocytic pleocytosis. Since most reactions to infection in the cerebrospinal fluid (CSF) are typically T-cell predominant, a B-cell-predominant lymphocytosis raises concern for lymphoma. We present 3 Lyme neuroborreliosis cases in order to illustrate the challenging cytomorphological and immunophenotypic features of their CSF specimens. Three male patients who presented with central nervous system manifestations were diagnosed with Lyme disease. The clinical presentation, laboratory tests, CSF cytological examination and flow-cytometric studies were described for each case. CSF cytology showed lymphocytic pleocytosis with increased plasmacytoid cells and/or plasma cells. Flow cytometry showed the presence of polytypic B lymphocytes with evidence of plasmacytic differentiation in 2 cases. In all cases, Lyme disease was confirmed by the Lyme screening test and Western blotting. In such cases of Lyme neuroborreliosis, flow cytometry of CSF samples employing plasmacytic markers and cytoplasmic light-chain analysis is diagnostically helpful to exclude lymphoma.
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Affiliation(s)
- Juan Xing
- University of Pittsburgh Medical Center, Pittsburgh, Pa., USA
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Puri BK, Hakkarainen-Smith JS, Derham A, Monro JA. Co-administration of α-lipoic acid and glutathione is associated with no significant changes in serum bilirubin, alkaline phosphatase or γ-glutamyltranspeptidase levels during the treatment of neuroborreliosis with intravenous ceftriaxone. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2015; 12:227-230. [PMID: 25968441 DOI: 10.1515/jcim-2014-0058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 04/23/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND While pharmacotherapy with intravenous ceftriaxone, a third-generation cephalosporin, is a potential treatment of Lyme neuroborreliosis, there is concern that it can cause the formation of biliary sludge, leading to hepatobiliary complications such as biliary colic, jaundice and cholelithiasis, which are reflected in changes in serum levels of bilirubin and markers of cholestatic liver injury (alkaline phosphatase and γ-glutamyltranspeptidase). It has been suggested that the naturally occurring substances α-lipoic acid and glutathione may be helpful in preventing hepatic disease. α-Lipoic acid exhibits antioxidant, anti-inflammatory and anti-apoptotic activities in the liver, while glutathione serves as a sulfhydryl buffer. The aim of this study was to determine whether co-administration of α-lipoic acid and glutathione is associated with significant changes in serum levels of bilirubin, alkaline phosphatase and γ-glutamyltranspeptidase during the treatment of Lyme neuroborreliosis with long-term intravenous ceftriaxone. METHODS Serum levels of bilirubin, alkaline phosphatase and γ-glutamyltranspeptidase were measured in 42 serologically positive Lyme neuroborreliosis patients before and after long-term treatment with intravenous ceftriaxone (2-4 g daily) with co-administration of oral/intravenous α-lipoic acid (600 mg daily) and glutathione (100 mg orally or 0.6-2.4 g intravenously daily). RESULTS None of the patients developed biliary colic and there were no significant changes in serum bilirubin, alkaline phosphatase or γ-glutamyltranspeptidase levels over the course of the intravenous ceftriaxone treatment (mean length 75.0 days). CONCLUSIONS Co-administration of α-lipoic acid and glutathione is associated with no significant changes in serum bilirubin, alkaline phosphatase or γ-glutamyltranspeptidase levels during the treatment of neuroborreliosis with intravenous ceftriaxone.
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Liew PX, Kubes P. Intravital imaging - dynamic insights into natural killer T cell biology. Front Immunol 2015; 6:240. [PMID: 26042123 PMCID: PMC4438604 DOI: 10.3389/fimmu.2015.00240] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 05/05/2015] [Indexed: 12/22/2022] Open
Abstract
Natural killer T (NKT) cells were first recognized more than two decades ago as a separate and distinct lymphocyte lineage that modulates an expansive range of immune responses. As innate immune cells, NKT cells are activated early during inflammation and infection, and can subsequently stimulate or suppress the ensuing immune response. As a result, researchers hope to harness the immunomodulatory properties of NKT cells to treat a variety of diseases. However, many questions still remain unanswered regarding the biology of NKT cells, including how these cells traffic from the thymus to peripheral organs and how they play such contrasting roles in different immune responses and diseases. In this new era of intravital fluorescence microscopy, we are now able to employ this powerful tool to provide quantitative and dynamic insights into NKT cell biology including cellular dynamics, patrolling, and immunoregulatory functions with exquisite resolution. This review will highlight and discuss recent studies that use intravital imaging to understand the spectrum of NKT cell behavior in a variety of animal models.
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Affiliation(s)
- Pei Xiong Liew
- Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary , Calgary, AB , Canada
| | - Paul Kubes
- Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary , Calgary, AB , Canada
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Lyme disease: a case report of a 17-year-old male with fatal Lyme carditis. Cardiovasc Pathol 2015; 24:317-21. [PMID: 25864163 DOI: 10.1016/j.carpath.2015.03.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Revised: 03/15/2015] [Accepted: 03/16/2015] [Indexed: 12/25/2022] Open
Abstract
Lyme disease is a systemic infection commonly found in the northeastern, mid-Atlantic, and north-central regions of the United States. Of the many systemic manifestations of Lyme disease, cardiac involvement is uncommon and rarely causes mortality. We describe a case of a 17-year-old adolescent who died unexpectedly after a 3-week viral-like syndrome. Postmortem examination was remarkable for diffuse pancarditis characterized by extensive infiltrates of lymphocytes and focal interstitial fibrosis. In the cardiac tissue, Borrelia burgdorferi was identified via special stains, immunohistochemistry, and polymerase chain reaction. The findings support B. burgdorferi as the causative agent for his fulminant carditis and that the patient suffered fatal Lyme carditis. Usually, Lyme carditis is associated with conduction disturbances and is a treatable condition. Nevertheless, few cases of mortality have been reported in the literature. Here, we report a rare example of fatal Lyme carditis in an unsuspected patient.
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[Epidemiology of Lyme disease in a healthcare area in north-west Spain]. GACETA SANITARIA 2015; 29:213-6. [PMID: 25726250 DOI: 10.1016/j.gaceta.2015.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 01/21/2015] [Accepted: 01/23/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To evaluate the influence of some risk factors on the incidence rate of Lyme disease and the main clinical manifestations. METHODS A retrospective study of Lyme disease (2006-2013) was performed in north-west Spain; we included only patients who fulfilled the epidemiological surveillance criteria defined by the Centers for Disease Control and Prevention. RESULTS The incidence rate varied between 2.64 and 11.61/100,000 inhabitants/year. Significant differences were found in relation to habitat, age and area of residence. Patients showed neurological (67.59%), dermatological (47.22%), rheumatological (15.74%) and cardiac (13.88%) manifestations, alone or combined. CONCLUSIONS Due to the increase of the disease in north-west Spain and the differences observed between the different areas, epidemiological studies are needed that increase the index of diagnostic suspicion and lead to the implementation of effective prevention measures.
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