Hermanowska-Szpakowicz T

Concentrations of Macrophage Inflammatory Proteins MIP-1α and MIP-1β and Interleukin 8 (Il-8) in Lyme Borreliosis

Background:Components of the spirochete Borrelia burgdorferi sensu lato (B. burgdorferi s.l.) do not have chemotactic activity. However, B. burgdorferi s.l. causes a chemotactic response, probably by stimulating synthesis of cytokines of the chemokine family by host cells. Our aim was to confirm that the synthesis of chemokines is increased in Lyme borreliosis and that they may account for leukocyte migration, thus being involved in inflammatory response.Materials and Methods:We measured concentrations of chemokines: interleukin 8 (Il-8) and macrophage inflammatory protein 1α and 1β (MIP-1α, -1β) in serum of 20 patients with erythema migrans (early localized infection, group I), of 19 patients with Lyme arthritis (chronic infection, group II), and in serum and cerebrospinal fluid (CSF) of 20 patients with neuroborreliosis (early disseminated infection, group III), before and after 2 weeks of antibiotic therapy (examinations 1 and 2), as well as in the sera of 12 healthy blood donors and CSF of ten patients in whom Lyme borreliosis and meningitis were excluded (control group). Interleukin 1β (Il-1β) level in serum and CSF and pleocytosis of CSF were assessed simultaneously.Results:The mean concentrations of all studied chemokines in serum were significantly elevated in all study groups in examination 1 and decreased in examination 2. The concentration of Il-8 in serum was higher in group I and the concentration of MIP-1α in group III was higher in comparison with group II. Serum concentrations of all chemokines in group I and III correlated with the concentration of Il-1β, while in group II this correlation appeared only for Il-8 in examination 2. Concentrations of all chemokines in CSF were significantly increased, but as for MIP-1α and 1β they remained lower than in serum. The concentration of Il-8 in CSF was variable and reached values several fold higher than in the serum in some patients. There was no correlation between chemokine concentrations and CSF pleocytosis.Conclusion:The synthesis of chemokines (Il-8, MIP-1α and 1β) is increased in Lyme borreliosis and, at least in the early stages of the disease, is related to the synthesis of Il-1β. Chemokine concentrations depend on the clinical form of Lyme borreliosis, with a tendency for higher values in early infection (erythema migrans and neuroborreliosis). Of the chemokines studied, Il-8 created a chemotactic gradient towards the inflammation site, and thus might be responsible for leukocyte migration.

Serum Levels of Interleukin-18 (IL-18), Interleukin-1β (IL-1β), its Soluble Receptor sIL-1RII and C-reactive Protein (CRP) in Patients with Lyme Arthritis

Background:In recent years, the role of pro- and antiinflammatory cytokines in the development of Lyme arthritis (LA) has been widely discussed. The purpose of the present study was to determine the concentration of interleukin-18 (IL-18), interleukin-1β (IL-β) and its soluble receptor sIL-1RII in serum of patients with LA as well as the usefulness of serum C-reactive protein (CRP) determination in LA diagnosis and monitoring of its treatment.Patients and Methods:The study group consisted of 20 patients with LA. Before and after antibiotic treatment, the serum levels of IL-18, IL-1β and sIL-1RII were measured immunoenzymatically using standard kits and the CRP level was measured by immunoturbidimetric method.Results:Before treatment, the serum levels of IL-18, IL-1β and sIL-1RII were significantly higher than in control group and after treatment the concentrations of IL-18, IL-1β and sIL-1RII decreased significantly, but the level of IL-18 and sIL-1RII still remained higher than in control group. The elevated serum level of CRP was detected only in 6 of 20 patients and in 5 of them it returned to the baseline after treatment.Conclusion:The results of our study suggest that IL-18, IL-1β and sIL-1RII might be involved in the development of LA. CRP may be useful in differential diagnosis in patients with suspicion of Lyme arthritis.

Tick-borne encephalitis in north-eastern Poland in 1997-2001: a retrospective study.

The aim of this study was to characterize the epidemiology and clinical features of tick-borne encephalitis in north-eastern Poland. Clinical and epidemiological data were analysed of patients hospitalized with the diagnosis in the Department of the Infectious Diseases and Neuroinfections of the Medical University in Bialystok in 1997-2001. Tick-borne encephalitis was diagnosed in 152 patients: 51 (34%) presented with meningitis, 89 (59%) with meningoencephalitis and 12 (8%) with meningoencephalomyelitis. Headache (84%) and fever (81%) were the most common symptoms. Meningeal signs were present in 137 patients (90%). Most common neurological abnormalities were: Oppenheim and Babinski signs (74 patients, 49%), ataxia (37, 24%), impaired consciousness (37, 24%) and pareses (16, 10%). Of patients examined, 146 (96%) had raised pleiocytosis, frequently accompanied by high cerebrospinal fluid protein concentration (90%), raised erythrocyte sedimentation rate (65%), peripheral blood leucocytosis (26%) and increased aminotransferase activity (16%). There was only 1 forest worker among the patients. Tick-borne encephalitis remains common in north-eastern Poland but, possibly because of effective vaccination, it has virtually disappeared among forest employees. The diagnosis appears difficult in some cases, as meningeal signs may not be present and laboratory findings may not be suggestive of a viral infection.

Concentration of Soluble CD4, CD8 and CD25 Receptors in Early Localized and Early Disseminated Lyme Borreliosis

AbstractBackground: The aim of this study was to evaluate the concentrations of soluble CD4, CD8 and CD25 antigens in the serum of patients with early localized, (group I, n = 22 patients) and early disseminated Lyme borreliosis (group II n = 23 patients), before and after antibiotic therapy compared with controls (group III n = 7 healthy persons). Materials and Methods: The diagnosis of Lyme borreliosis based on clinical featres was confirmed by ELISA and Western blot. The asseys of sCD4, sCD8 and sCD25 concentrations were performed using Endogen (USA) kits. Results: In group I the sCD4 level decreased in examination 2 (p < 0.001) compared to examination 1. The mean concentration of sCD8 in initial examination 1 in group II was higher than in controls (p < 0.0001); it decreased in examination 2 but was still higher (p < 0.01) than in controls (p < 0.006). Prior to treatment mean sCD25 concentration in group II was higher compared to controls (p < 0.0008) like in examination 2 after treatment (p < 0.02) and this persisted. The mean value of sCD8 in initial examination 1 before treatment in group II was higher than in group I (p < 0.00001). Conclusion: Increased initial concentrations of sCD8 and sCD25 indicate the activation of DD8 and CD25 lymphocytes and their role in immunopathogenesis of Lyme disease. Elevated levels of sCD8 in group II before and after treatment suggest a significant involvement of CD8 lymphocytes, indicating the role of long-lasting cellular response in this stage of Lyme disease.