Lajm neuroborelioza

Lyme borreliosis (LB) is a multisystemic zoonotic disease which in humans can involve the skin, joints, heart and/or nervous system. In this study a total of 11 patients with clinical manifestations have been assessed at the Institute for Occupational Health. Evaluation of the patients was done in order to determine their working capability and further professional orientation. Patients were of different gender, age, education and profession. They fulfilled at least two of the three criteria: tick infestation data (epidemiological criteria), central and/or peripheral neurological symptoms (clinical criteria) and a positive serological finding. Diagnosis was done upon classical clinical criteria: electromyeloneurography (EMNG) analysis, neurological impairments, electroencephalography (EEG), computer tomography (CT) and/or magnetic resonance imaging (MRI). IgM and IgG antibodies against B. burgdorferi were determined by commercial ELISA kits. IgM antibodies were recorded in the serum of 4 (44.4%) and IgG in 6 (66.7%) patients. Electro-myeloneurography findings of the upper and lower limbs were positive in 5 (83.3%), electroencephalography in 4 (66.6%) of the 6 observed patients and CT was positive in 4 (36.4%) of the 5 observed patients. The study has established that in patients with neuroborreliosis (NB) the capability to carry out intellectual tasks, as well as responsible duties is impaired due to poor memory. Patients suffering from peripheral neuropathies are not fit to withstand longterm walks, weight lifting and carrying or any other form of physical stress.Lajm borelioza je multisistemsko oboljenje, iz grupe zoonoza koje kod ljudi može zahvatiti kožu, zglobove, srce i/ili nervni sistem. Istraživanjem je obuhvaćeno 11 bolesnika sa kliničkim manifestacijama neuroborelioze koji su ispitivani u Institutu za medicinu rada Srbije u cilju ocene radne sposobnosti i dalje profesionalne orijentacije. Ispitani su bolesnici različite starosti, pola, nivoa obrazovanja i različitih zanimanja koji su ispunili minimalno dva od tri kriterijuma i to: podatak o ubodu krpelja (epidemiološki kriterijum), ispoljavanje centralnih i/ili, perifernih neuroloških simptoma (klinički kriterijum) i pozitivan serološki nalaz. Dijagnoza neuroborelioze je postavljena na osnovu klasičnih kliničkih kriterijuma: neurološ kih ispada, analize elektro-mioneurografije (EMNG), elektroencefalografije (EEG), kompjuterske tomografije (CT) i/ili magnetne rezonance (MRI). Ispitivanje prisustva antitela IgM i IgG klase u krvnom serumu prema B. burgdorferi vršeno je komercijalnim ELISA testom. Antitela IgM klase registrovana su u serumu četiri (44,4%), dok su IgG antitela registrovana kod 6 (66,7%) ispitanih pacijenata. Nalaz elektro-mioneurografije gornjih i donjih ekstremiteta je bio pozitivan kod pet (83,3%), nalaz elektroencefalografije kod četiri (66,6%) od šest ispitanih pacijenata, dok je nalaz CT bio pozitivan kod 4 (36,4%) od pet ispitanih pacijenata. Sprovedenim ispitivanjem je utvrđeno da je kod bolesnika sa razvijenom neuroboreliozom smanjena sposobnost za bilo koju vrstu intelektualnog rada, kao i za poslove koji su povezani sa moralnom i materijalnom odgovornošću zbog problema sa pamćenjem. Kod bolesnika sa perifernim neuropatijama postoji nesposobnost za poslove koji uključuju dugotrajno stajanje i hodanje, dizanje i nošenje tereta, kao i bilo koju vrstu fizičkog rada

Pesquisa de anticorpos anti-Borrelia burgdorferi em cães da região de Cotia, São Paulo, Brasil

Dogs sera samples collected from Cotia County, São Paulo were tested using indirect immunoenzymatic test (ELISA) in order to study Lyme disease serology in dogs. ELISA method was standardized and G39/40 North American strain of Borrelia burgdorferi was used as antigen. Positive results were confirmed employing the Western blotting technique. Because of the possibility of cross-reactions, sera were also tested for different serological strains of Leptospira interrogans and L. biflexa using microscopic sera agglutination test. Twenty-three of 237 (9.7%) serum samples were positive in the ELISA; 20 of them (86.9%) were confirmed by the Western blotting, what suggests that Cotia may be a risk area for Lyme disease. Although 4 samples (1.7%) were positive for Lyme disease and leptospirosis, no correlation was found between the results (X² = 0.725; p = 0.394) what suggests absence of serological cross reactivity.Com a finalidade de estudar a ocorrência da doença de Lyme em cães no Brasil, o teste imunoenzimático (ELISA) indireto, utilizado para o diagnóstico da doença no homem, foi padronizado para a espécie canina. Utilizou-se como antígeno a cepa americana de Borrelia burgdorferi G 39/40. Os soros de cães procedentes da região de Cotia, área de risco para ocorrência da doença de Lyme, foram testados e os resultados positivos foram confirmados através da técnica de "Western blotting". Para investigação de possíveis reações cruzadas, os soros foram também testados para diferentes variantes sorológicas de Leptospira interrogans e L. biflexa pela técnica de soroaglutinação microscópica. Dos 237 soros testados pela técnica de ELISA, 23 (9,7%) foram positivos, sendo que 20 (86,9%) destes soros foram também positivos pela técnica de "Western blotting", sugerindo que a região de Cotia seja área de risco para doença de Lyme. Embora 4 (1,7%) dos soros testados apresentassem positividade para doença de Lyme e para leptospirose concomitantemente, não foi observada associação entre estes resultados (X² = 0,725 e p = 0,394), sugerindo ausência de reatividade sorológica cruzada entre as duas enfermidades

SEROPREVALENCE OF IgG ANTIBODIES AGAINST BORRELIA BURGDORFERI IN DOGS IN BELGRADE AREA, SERBIA

In this study the seroprevalence of anti-Borrelia burgdorferi IgG antibodies in populations of naturally exposed dogs in the Belgrade area was determined. Serum samples of 215 dogs were tested with in-house made indirect immunofluorescent-antibody assay (IFA), enzyme-linked immunosorbent assay (ELISA), and Western blot assay (WB). Sera were from 34 pet dogs suspected of having Lyme borreliosis, 41 hunting dogs, 125 shelter dogs, and 15 clinically healthy pet dogs. Results of WB were used as a standard against which the performances of ELISA and IFA were evaluated. ELISA was significantly more sensitive than IFA (84.8 vs 67.9%), whereas the specificities of these tests were just slightly different (94.4% vs 92.6 %). Borrelia burgdorferi seroprevalence of 24.7% among tested dogs was recorded by WB test. The highest seroprevalence of 31.2% was found in the group of shelter dogs, while hunting and pet dogs showed lower seroprevalence of 19.5% and 17.6%, but the difference was statistically insignificant. These results are the first report on the seroprevalence of IgG antibodies to B. burgdorferi in dogs in the Belgrade area and could be of importance in the assessment of the risk of infection with B. burgdorferi in human population

Approach to prediction and receiver operating characteristic analysis of a regression model for assessing the severity of the course Lyme borreliosis in children

Abstract Introduction: Lyme borreliosis (LB) is a multisystemic zoonotic disease transmitted by the bite of in- fected tick vectors. The aim of the study is to develop a mathematical model for predicting the risk of severity of Lyme disease by the risk factor of the disseminated form of LB in children who have had a tick attack. To test the effectiveness of the formula for predicting the development of the disseminated stage of LB, we built a receiver operating characteristic (ROC) curve and determined the specificity and sensitivity of our model. The results of the examination of 122 patients with the confirmed local and disseminated stages of LB were taken as a basis. Material and methods: To build a prognostic model for prediction of the risk of the developing of the stage in LB predicting the risk of severity of course in Lyme borreliosis (PRSCLB), 122 children (aged 13 ±3 years) with LB were examined using multivariate regression analysis, including 52 boys and 70 girls. Groups of patients: 79 children with erythema migrans, 16 with Lyme arthritis, and 27 with nervous system involvement by LB. The quality of the prognostic model was checked by the Nagelkerke R Square (Nagelkerke R2) and the acceptability of this model was assessed using ROC analysis. Results: The method of multivariate regression analysis for predicting severe course and organ and system damage in LB in children, taking into account the factors and variants of the disease itself, makes it possible to develop a mathematical model for predicting the relative response factors (RRF) of severe forms of Lyme disease and will improve the effectiveness of treatment. This will create all the prerequisites for high-quality preventive measures and reduce the relative response factors rate. The initial data for predicting the severity of LB were 28 factors. According to the results of regres- sion analysis, 24 factors were included in the model for predicting the severity of LB. Conclusions: The results of the study showed that the multifactorial model predicts the severity and organ and system damage in LB in children with an accuracy of 95%. The ROC curve, which was built on the basis of the results, has an area under the curve of 0.94, which indicates the high efficiency of the model. Key words: Lyme borreliosis, Lyme disease, children, regression model, receiver operating charac- teristic analysis

Prevalencia de Borrelia burgdorferi sensu lato en roedores sinantrópicos de dos comunidades rurales de Yucatán, México

Introduction: Lyme disease is a multisystemic zoonotic disease caused by Borrelia burgdorferi sensu lato. This spirochete circulates in an enzootic cycle between the primary vertebrate reservoir and its tick vectors. Different species of rodents are known to be efficient natural reservoirs for B. burgdorferi s.l. Objective: To estimate the prevalence of B. burgdorferi s.l. in synanthropic rodents from two rural communities of Yucatán, México. Materials and methods: A total of 123 rodents (94 Mus musculus and 29 Rattus rattus) were trapped, and ear and bladder samples were collected. Flagelin B (flaB) genes and outer membrane lipoproteins ospC y p66 were amplified in order to detect B. burgdorferi s.l. presence in the samples. The obtained amplicons were sequenced. Results: The overall infection rates in rodents were 36.5% for flaB (45/123), 10.5% (13/123) for p66, and 3.2% (4/123) for ospC. Rattus rattus had 17.2% of infection and M. musculus, 42.5%. From all examined tissue, 11.3% (14/123) of bladders, and 17.0% (21/123) of ears were infected with the spirochete Borrelia burgdorferi s.l. No statistical differences (p>0.05) were found between the two tissue samples used for diagnosis. The ospC gen was 98% homologous to Borrelia garinii, one species of the B. burgdorferi s.l. complex. Conclusions: We concluded that rodents have a high prevalence of B. burgdorferi s.l. infection, and both species of rodents, M. musculus and R. rattus, might be playing an important role in the maintenance of this bacterium in rural communities of Yucatán, México.Introducción. La enfermedad de Lyme es una zoonosis multisistémica causada por Borrelia burgdorferi sensu lato. Esta espiroqueta circula en un ciclo enzoótico entre un reservorio vertebrado primario y las garrapatas. Se ha encontrado que varias especies de roedores son eficientes reservorios naturales de B. burgdorferi s.l.Objetivo. Estimar la prevalencia de B. burgdorferi s.l. en roedores sinantrópicos en dos comunidades rurales de Yucatán, México.Materiales y métodos. Se capturaron 123 roedores (94 Mus musculus y 29 Rattus rattus) para obtener muestras de tejidos de oreja y vejiga. Para la detección de B. burgdorferi s.l. en las muestras, se amplificaron los genes de la flagelina B (fla B) y las lipoproteínas de membrana externa, ospC y p66, mediante reacción en cadena de la polimerasa, y se secuenciaron los amplicones obtenidos.Resultados. La frecuencia de infección por B. burgdorferi s.l. en roedores fue de 36,5 % para flaB (45/123), de 10,5 % (13/123) para p66 y de 3,2 % (4/123) para ospC. En R. rattus la frecuencia de infección fue de 17,2 % y en M. musculus fue de 42,5 %. La frecuencia de infección de B. burgdorferi s.l. en los tejidos estudiados fue de 11,3 % (14/123) en muestras de tejido de vejiga y de 17,0 % (21/123) en las de oreja. No se encontraron diferencias estadísticas (p>0,05) en la frecuencia de infección entre los dos tipos de muestras de tejido utilizadas para el diagnóstico. El gen ospC presentó 98 % de homología con la especie Borrelia garinii, una de las especies heterogéneas del complejo B. burgdorferi s.l.Conclusiones. Los roedores presentaron una alta prevalencia de infección con B. burgdorferi s.l.; las especies M. musculus y R. rattus podrían jugar un papel importante en la continuidad de la presencia de esta bacteria en comunidades rurales de Yucatán, México

Clinical, pathological, immunohistochemical and virological findings of eastern equine encephalitis in two horses

Natural eastern equine encephalitis alphavirus (EEEV) infection was diagnosed in two adult horses with anorexia and colic, changes in sensorium, hyperexcitability, and terminal severe depression. Myocardium, tunica muscularis of stomach, intestine, urinary bladder, and spleen capsule had coagulative necrosis and perivascular lymphocytic infiltrate. Central nervous system (CNS) lesions were diffuse polioencephalomyelitis with leptomeningitis characterized by perivascular T lymphocyte cuffing, marked gliosis, neuronophagia, and multifocal microabscesses. Lesions were more prominent within cerebral cortex, thalamus, hypothalamus, and mesencephalon. EEEV was identified in the cytoplasm of cardiac myocytes and smooth muscle cells of spleen, stomach, intestine, urinary bladder, blood vessels, and dendritic cells. In the CNS, EEEV-positive cells included neurons, astrocytes, oligodendrocytes, microglia, and neutrophils. EEEV was isolated from the CNS of both horses. The detailed description of the encephalic and spinal EEEV localization and the findings of EEEV in extraneural tissues contribute to the understanding of this important multisystemic zoonotic disease

Pro-inflammatory cytokines predominate in the brains of dogs with visceral leishmaniasis: A natural model of neuroinflammation during systemic parasitic infection

Visceral leishmaniasis is a multisystemic zoonotic disease that can manifest with several symptoms, including neurological disorders. To investigate the pathogenesis of brain alterations occurring during visceral leishmaniasis infection, the expression of the cytokines IL-1β, IL-6, IL-10, IL-12p40, IFN-γ, TGF-β and TNF-α and their correlations with peripheral parasite load were evaluated in the brains of dogs naturally infected with Leishmania infantum. IL-1β, IFN-γ and TNF-α were noticeably up-regulated, and IL-10, TGF-β and IL-12p40 were down-regulated in the brains of infected dogs. Expression levels did not correlate with parasite load suggestive that the brain alterations are due to the host's immune response regardless of the phase of the disease. These data indicate the presence of a pro-inflammatory status in the nervous milieu of dogs with visceral leishmaniasis especially because IL-1β and TNF-α are considered key factors for the initiation, maintenance and persistence of inflammation. © 2012 Elsevier B.V

Effect of Artesunate on Leishmania Amazonesis Induced Neuroinflammation and Nociceptive Behavior in Male Balb/C Mice

Background: Leishmaniasis is a multisystemic zoonotic disease with several symptoms, including neurological disorders. Leishmaniasis is accompanied by an increase in nociceptive behaviors, linked to the presence of a chronic inflammatory state, in both peripheral tissue and the central nervous system. Artesunate is a more stable derivative of its precursor artemisin and has been shown to be a pluripotent agent with different pharmacological actions. Methods: In this study, we investigated the effects of artesunate in Leishmania amazonensi- infected BALB/c mice, evaluating its effectiveness in reducing inflammation, neuroinflammation, and nociceptive and sickness behaviors. Results: Our results demonstrate a significant increase in pain sensitivity and sickness behaviors after L. amazonensis infection. Moreover, the infection induced a significant increase in inflammatory response at both the paw and spinal cord level. Treatment with artesunate was able to induce a significant decrease in tissue inflammation and neuroinflammation and thus induce a significant decrease in pain sensitivity and sickness behaviors. Conclusions: The results from this study indicate that artesunate is a good candidate for treatment and/or as an adjuvant in leishmanicidal therapy, and to prevent and alleviate leishmaniasis-induced pain and neuroinflammation and thereby improve the quality of life of leishmaniasis patients