Detection of Borrelia burgdorferi in skin biopsies from patients with morphea by polymerase chain reaction

Aim: We looked for the evidence of Borrelia infection in patients with morphea by serologic means and by polymerase chain reaction (PCR) analysis of skin biopsy samples. Background: The possible relationship between Lyme borreliosis and morphea has been suggested by certain clinical, immunological and microbiological findings, but many authors were hot be able to demonstrate Borrelia burgdorferi infection in patients with morphea and cast doubts on an etiological role for B. bungdorferi in this skin lesion. Patients and methods: Ten patients with morphea, 9 females (range: 8-65 years) and one 44-year-old man were examined. Serological tests for Lyme borreliosis were performed by immunofluorescence assay and flagellin enzyme-linked immunosorbent assay. Skin biopsy specimens were taken from the periphery of morphea lesions for histological examination and PCR. Results: Antibodies to B. burgdorferi were detected in 3 patients and B. burgdorferi DNA was demonstrated in 5 patients. Conclusions: The amplification of DNA with PCR analysis seems to open new prospects for the detection of Borrelia genome in tissues. In the present study we were able to demonstrate the presence of B. burgdorferi DNA in patients with morphea, even in seronegative patients. These data confirm that PCR is an interesting tool in skin lesion diagnosis and support the hypothesis of an etiological association between B. burgdorferi infection and some cases of morphea

Vegetation feedbacks during drought exacerbate ozone air pollution extremes in Europe

Reducing surface ozone to meet the European Union\u2019s target for human health has proven challenging despite stringent controls on ozone precursor emissions over recent decades. The most extreme ozone pollution episodes are linked to heatwaves and droughts, which are increasing in frequency and intensity over Europe, with severe impacts on natural and human systems. Here, we use observations and Earth system model simulations for the period 1960\u20132018 to show that ecosystem\u2013atmosphere interactions, especially reduced ozone removal by water-stressed vegetation, exacerbate ozone air pollution over Europe. These vegetation feedbacks worsen peak ozone episodes during European mega-droughts, such as the 2003 event, offsetting much of the air quality improvements gained from regional emissions controls. As the frequency of hot and dry summers is expected to increase over the coming decades, this climate penalty could be severe and therefore needs to be considered when designing clean air policy in the European Union