Grygorczuk Sambor, Péter Olivier, Kondrusik Maciej, Moniuszko Anna, Zajkowska Joanna, Dunaj Justyna, Żukiewicz-Sobczak Wioletta, Pancewicz Sławomir
Department of Infectious Diseases and Neuroinfections, Medical University in Białystok, Poland.
Ann Agric Environ Med. 2013;20(1):21-9.
Several Borrelia burgdorferi sensu lato species cause Lyme borreliosis throughout Europe and their geographic distribution may influence clinical manifestations of the disease. In Poland, Lyme borreliosis presents mainly with neurologic and cutaneous symptoms, while clinically overt arthritis is rare. The presented study investigates the prevalence of B. burgdorferi s.l. genospecies in a group of patients with different clinical forms and stages of Lyme borreliosis in north-east of Poland. This has not previously been studied.
Preferential reactivity towards different B.burgdorferi s.l. species was investigated with a previously validated immunoblot assay in sera of 33 patients with disseminated Lyme borreliosis: 10 with neuroborreliosis, 6 with acrodermatitis chronica atrophicans and 17 with osteoarticular symptoms. Also typed were B.burgdorferi s.l. DNA isolated from the skin and synovial fluid of 7 patients with erythema migrans, acrodermatitis chronic atrophicans and arthritis.
Preferential reactivity was detected in 30 out of 33 serum samples. Of these, 25 reacted preferentially with B.afzelii, 3 with B. garinii and 2 with B. burgdorferi ss. B.burgdorferi DNA was isolated from all studied samples and typed as B.afzelii in 5. In a patient with acrodermatitis chronica atrophicans studied with both methods simultaneously, B.afzelii was identified by both genotyping and serotyping.
Both methods gave consistent results, indicating B.afzelii as the main agent of all the clinical forms of the Lyme borreliosis in the study area.
多种狭义伯氏疏螺旋体物种在欧洲引发莱姆病,其地理分布可能影响该病的临床表现。在波兰,莱姆病主要表现为神经和皮肤症状,而临床明显的关节炎较为罕见。本研究调查了波兰东北部不同临床形式和阶段的莱姆病患者群体中狭义伯氏疏螺旋体基因种的流行情况。此前尚未有过此类研究。
采用先前验证的免疫印迹法,对33例播散性莱姆病患者的血清进行检测,以研究对不同狭义伯氏疏螺旋体物种的优先反应性:10例为神经型莱姆病患者,6例为慢性萎缩性肢端皮炎患者,17例有关节炎症状。还对从7例游走性红斑、慢性萎缩性肢端皮炎和关节炎患者的皮肤及滑液中分离出的狭义伯氏疏螺旋体DNA进行了分型。
33份血清样本中有30份检测到优先反应性。其中,25份优先与阿氏疏螺旋体反应,3份与伽氏疏螺旋体反应,2份与狭义伯氏疏螺旋体反应。所有研究样本均分离出狭义伯氏疏螺旋体DNA,其中5份分型为阿氏疏螺旋体。在一名同时用两种方法研究的慢性萎缩性肢端皮炎患者中,通过基因分型和血清分型均鉴定出阿氏疏螺旋体。
两种方法结果一致,表明阿氏疏螺旋体是研究区域内所有临床形式莱姆病的主要病原体。