Analysis of selected serological parameters in patients with diagnosed Lyme borreliosis and in seropositive patients with no clinical symptoms

OBJECTIVES

The aim of the study was to analyze some metalloproteinases, cytokines, and chemokines in LB patients and healthy seropositive subjects. The presence of IgM/IgG antibodies against specific Borreliella antigens was analyzed in the presence or absence of clinical manifestations of LB.

MATERIAL AND METHODS

The study involved 38 patients diagnosed with LB and arthralgia and/or arthritis symptoms, and 57 foresters presenting no clinical symptoms of LB. The ELISA test was applied for general screening of anti-Borreliella IgM/IgG. Western blot was used for confirmatory diagnosis of LB for the positive and borderline results. Serum IL-2, IL-4, IL-6, IL-10, IL-17A, IFN-γ, TNF, IL-8, CCL5, CXCL9/MIG, CCL2/MCP-1, CXCL10/IP-10 concentrations were measured with the use of the Human Cytometric CBA test. The concentration of MMP-2 and MMP-9 in the serum was determined with the use of ELISA tests.

RESULTS

Analysis of the cytokines and chemokines revealed that only the concentration of IL-2 was significantly higher (2.4 pg/m; p=0.00641) in patients with LB symptoms than in the seropositive individuals (0.4 pg/ml). The MMP2 concentration was significantly higher (233.3 ng/ml; p=0.00294) in patients with clinical manifestations of LB than in those occupationally exposed to tick bites, but did not have anti-Borreliella antibodies (192.0 ng/ml).

CONCLUSIONS

The presence of IgG antibodies against a number of Borreliella antigens and the differences in the IL-2 and MMP2 levels in seropositive or seronegative individuals and symptomatic LB patients, may indicate differences in the intensity of the immune response to the infection and, consequently, may induce development of clinical manifestations of the disease in seropositive and seronegative individuals.

Pilot study of Ixodes ricinus ticks preference for human ABO blood groups using a simple in vitro method

INTRODUCTION AND OBJECTIVES

The existence of a blood group preference for ticks is a problem widely discussed among the lay public but often neglected by the scientific community. The Ixodes ricinus tick transmits serious zoonotic diseases such as Lyme borreliosis, tick encephalitis, or anaplasmosis. The preventive strategies include vaccination (if available) and individual measures including the use of repellents and avoidance of risk areas.

MATERIAL AND METHODS

Since this topic is relatively neglected in the scientific literature, a simple in vitro method was used. Ticks used in this study were collected in the suburban region of Ruda in Brno, Czech Republic. One hundred active nymphs of the collected ticks were tested for preferences for blood groups, using Petri dishes and blood samples from volunteers. To demonstrate the threat of ticks and the diseases they transmit, the positivity of one of the most abundant zoonosis, Lyme borreliosis, was tested using dark-field microscopy.

RESULTS

The results obtained showed that the examined ticks were attracted most by blood group A, whereas the least preferred was group B, which was proved statistically (p <0.05). The mean positivity of collected ticks for the presence of spirochaetes was 9.35%.

CONCLUSIONS

The results indicate that the host selection of ticks may be influenced by the physiological or biochemical profile of an individual, such as their blood group. This means that a blood group of an individual can be one of the factors that increase the risk of tick bite and the transmission of dangerous diseases and thus must not be underestimated.

Predictors of Crimean-Congo hemorrhagic fever in the Emergency Department

OBJECTIVE

Crimean-Congo hemorrhagic fever (CCHF) is an acute illness affecting multiple organ systems characterized by thrombocytopenia, and/or leukopenia, elevated levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and creatine kinase (CK) and it has a case-fatality of 8% to 80%. In this article, we aimed to determine the clinical and laboratory findings that predicts the disease on admission.

PATIENTS AND METHODS

We retrospectively analyzed the medical data of the patients admitted to our emergency department (ED) due to tick bite. These patients were divided into two groups according to their transcriptase-polymerase chain reaction (RT-PCR) test results. Findings of PCR (+) (Group 1) and PCR (-) (Group 2) patients were compared.

RESULTS

Epistaxis was found to be statistically significant clinical finding in Group 1. Also, while aspartate transaminase (AST) levels and potassium (K) level were significantly higher, platelet count and white blood count (WBC) were significantly lower in Group 1 when compared to Group 2.

CONCLUSIONS

Predictors of CCHF in the ED are epistaxis, leukopenia, thrombocytopenia and elevated K and AST levels. In our study, the fatality rate of CCHF was found to be 21.6%.

First report on the seroprevalence of the Crimean-Congo haemorrhagic fever virus, a tick-borne virus, in Malaysia's Orang Asli population

OBJECTIVE

The Crimean-Congo haemorrhagic fever virus (CCHFV), which is transmitted by the ticks of Hyalomma spp. in general and H. marginatumin particular, can cause severe disease in humans, with mortality rates of 3-30%. Other than from the bites of infected ticks, CCHFV can also be transmitted through contact with patients with the acute phase of infection or contact with blood or tissues from viraemic livestock.  Outbreaks of human cases of haemorrhagic manifestations have been documented since 1945 and described in parts of Africa, Asia, Eastern Europe and the Middle East and most recently India in 2011. In addition, serological evidence of the disease has been reported in some countries where no human cases were reported. As regional neighbours China and India have been affected by this virus, this study was conducted to determine the seroprevalence of CCHFV among Orang Asli population of Malaysia as the most at risk people who residing in the deep forests.

PATIENTS AND METHODS

A total of 682 serum samples were collected from the Orang Asli population residing in eight states in peninsular Malaysia and analysed for the presence of anti-CCHFV immunoglobulin G (IgG) using a commercial enzyme-linked immunosorbent assay kit.

RESULTS

The study subjects comprised 277 (40.6%) men and 405 (59.4%) women. However, anti-CCHFV IgG was detected in only one female serum sample (0.1%). The presence of anti-CCHFV IgG could not be correlated to age or sex from these findings.

CONCLUSIONS

The results of this screening survey showed that the seroprevalence of the anti-CCHFV IgG among Malaysia's Orang Asli population is too low for detection or totally negative compared with that in neighbouring countries, such as India and China.