与巨噬细胞活化相关的趋化因子和细胞因子的mRNA水平，在美国莱姆病红斑移行性皮肤病变患者中高于奥地利莱姆病患者。

Higher mRNA levels of chemokines and cytokines associated with macrophage activation in erythema migrans skin lesions in patients from the United States than in patients from Austria with Lyme borreliosis.

作者信息

Jones Kathryn L, Muellegger Robert R, Means Terry K, Lee Marshall, Glickstein Lisa J, Damle Nitin, Sikand Vijay K, Luster Andrew D, Steere Allen C

机构信息

Division of Rheumatology, Allergy, and Immunology, Center for Immunology and Inflammatory Diseases, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.

出版信息

Clin Infect Dis. 2008 Jan 1;46(1):85-92. doi: 10.1086/524022.

DOI:10.1086/524022

PMID:18171218

Abstract

BACKGROUND

Erythema migrans (EM) is caused primarily by Borrelia afzelii in Europe and solely by Borrelia burgdorferi in the United States. B. burgdorferi infection in the United States has previously been associated with faster expansion of EM lesions and with more associated symptoms, compared with B. afzelii infection in Europe. However, reasons for these differences are not yet known.

METHODS

We determined the Borrelia species infecting 67 US or Austrian patients with EM. The clinical pictures and chemokine and cytokine mRNA levels in lesional skin were then compared in the 19 B. burgdorferi-infected US patients and the 37 B. afzelii-infected Austrian patients, the 2 largest groups.

RESULTS

The 19 B. burgdorferi-infected US patients had faster-expanding EM lesions and a median of 4 associated signs and symptoms, whereas the 37 B. afzelii-infected Austrian patients had slower-expanding lesions and usually did not experience associated symptoms. Compared with the EM lesions of B. afzelii-infected Austrian patients, those of B. burgdorferi-infected US patients had significantly higher mRNA levels of chemokines associated with activation of macrophages, including chemoattractants for neutrophils (CXCL1), macrophages (CCL3 and CCL4), and T helper 1 cells (CXCL9, CXCL10, and CXCL11). In addition, compared with the EM lesions of Austrian patients, the EM lesions of US patients tended to have higher mRNA levels of the macrophage-associated proinflammatory cytokines interleukin 1beta and tumor necrosis factor alpha, and they had significantly higher mRNA expression of the antiinflammatory cytokines interleukin 10 and transforming growth factor beta.

CONCLUSIONS

The EM lesions of B. burgdorferi-infected US patients expanded faster, were associated with more symptoms, and had higher mRNA levels of macrophage-associated chemokines and cytokines than did the EM lesions of B. afzelii-infected Austrian patients.

摘要

背景

欧洲的游走性红斑（EM）主要由阿氏疏螺旋体引起，而在美国则仅由伯氏疏螺旋体引起。与欧洲的阿氏疏螺旋体感染相比，美国的伯氏疏螺旋体感染以前被认为与EM皮损的更快扩展以及更多相关症状有关。然而，这些差异的原因尚不清楚。

方法

我们确定了感染67例美国或奥地利EM患者的疏螺旋体种类。然后比较了19例感染伯氏疏螺旋体的美国患者和37例感染阿氏疏螺旋体的奥地利患者（两个最大的组）的临床表现以及皮损中趋化因子和细胞因子的mRNA水平。

结果

19例感染伯氏疏螺旋体的美国患者的EM皮损扩展更快，且平均有4种相关体征和症状，而37例感染阿氏疏螺旋体的奥地利患者的皮损扩展较慢，且通常没有相关症状。与感染阿氏疏螺旋体的奥地利患者的EM皮损相比，感染伯氏疏螺旋体的美国患者的皮损中与巨噬细胞活化相关的趋化因子的mRNA水平显著更高，包括中性粒细胞趋化因子（CXCL1）、巨噬细胞趋化因子（CCL3和CCL4）以及辅助性T1细胞趋化因子（CXCL9、CXCL10和CXCL11）。此外，与奥地利患者的EM皮损相比，美国患者的EM皮损中巨噬细胞相关的促炎细胞因子白细胞介素1β和肿瘤坏死因子α的mRNA水平往往更高，且抗炎细胞因子白细胞介素10和转化生长因子β的mRNA表达显著更高。