Singh S K, Girschick H J
Paediatric Rheumatology, Children's Hospital, University of Würzburg, Würzburg, Germany.
Clin Microbiol Infect. 2004 Jul;10(7):598-614. doi: 10.1111/j.1469-0691.2004.00895.x.
Lyme borreliosis in humans is an inflammatory disease affecting multiple organ systems, including the nervous system, cardiovascular system, joints and muscles. The causative agent, the spirochaete Borrelia burgdorferi, is transmitted to the host by a tick bite. The pathogenesis of the disease in its early stages is associated largely with the presence of viable bacteria at the site of inflammation, whereas in the later stages of disease, autoimmune features seem to contribute significantly. In addition, it has been suggested that chronic persistence of B. burgdorferi in affected tissues is of pathogenic relevance. Long-term exposure of the host immune system to spirochaetes and/or borrelial compounds may induce chronic autoimmune disease. The study of bacterium-host interactions has revealed a variety of proinflammatory and also immunomodulatory-immunosuppressive features caused by the pathogen. Therapeutic strategies using antibiotics are generally successful, but chronic disease may require immunosuppressive treatment. Effective and safe vaccines using recombinant outer surface protein A have been developed, but have not been propagated because of fears that autoimmunity might be induced. Nevertheless, new insights into the modes of transmission of B. burgdorferi to the warm-blooded host have been generated by studying the action of these vaccines.
人类莱姆病是一种影响多个器官系统的炎症性疾病，包括神经系统、心血管系统、关节和肌肉。病原体是螺旋体伯氏疏螺旋体，通过蜱虫叮咬传播给宿主。该疾病早期的发病机制很大程度上与炎症部位存在活细菌有关，而在疾病后期，自身免疫特征似乎起了重要作用。此外，有研究表明伯氏疏螺旋体在受影响组织中的长期持续存在具有致病相关性。宿主免疫系统长期暴露于螺旋体和/或疏螺旋体化合物可能会诱发慢性自身免疫性疾病。对细菌与宿主相互作用的研究揭示了病原体引起的多种促炎以及免疫调节-免疫抑制特征。使用抗生素的治疗策略通常是成功的，但慢性病可能需要免疫抑制治疗。已经开发出使用重组外膜蛋白A的有效且安全的疫苗，但由于担心可能诱发自身免疫而未推广。然而，通过研究这些疫苗的作用，人们对伯氏疏螺旋体向温血宿主的传播方式有了新的认识。
