Clinical Chemistry and Transfusion Medicine, Kalmar County Hospital, 385 91 Kalmar, Sweden; Department of Clinical and Experimental Medicine, Linköping University, 581 83 Linköping, Sweden.
Department of Clinical and Experimental Medicine, Linköping University, 581 83 Linköping, Sweden.
Ticks Tick Borne Dis. 2018 Mar;9(3):742-748. doi: 10.1016/j.ttbdis.2018.02.011. Epub 2018 Feb 16.
Determinants of a subclinical course of Lyme borreliosis (LB) remain largely unknown. The aim of this study was to assess the extent, sex and age profiles of subclinical Borrelia seroconversion in a LB endemic area in Sweden and to map blood cellular Borrelia-specific immune marker patterns in individuals with a previous subclinical LB course compared with patients previously diagnosed with Lyme neuroborreliosis (LNB).
A large group of 1113 healthy blood donors was screened for multiple IgG anti-Borrelia antibodies and asked to complete a health inquiry regarding previous LB. A group of subjects with anti-Borrelia-specific IgG antibodies but no previous history of LB (subclinical LB, n = 60) was identified together with 22 cases of previous LNB. Whole Borrelia spirochetes, strains B. afzelii ACA1 and B. garinii Ip90, were used for ex vivo whole blood stimulations, whereas outer surface protein enriched fractions of the same strains were used for stimulation of peripheral blood mononuclear cells (PBMCs). An extensive panel of immune markers was analysed in the supernatants after stimulation using multiplex bead arrays, and Borrelia-specific secretion was determined by subtracting the spontaneous secretion.
A total of 125/1113 blood donors reported previous clinical LB. In contrast, 66 donors denied previous LB but showed multiple IgG anti-Borrelia antibodies; these were defined as subclinical subjects, of whom 60 were available for further studies. The subclinical subjects consisted of significantly more men and had a younger age compared with the LNB patients (p ≤ 0.01). Discriminant analysis revealed a distinct pattern of sex, age and PBMC B. garinii-specific levels of IL-10, IL-17A and CCL20 discriminating subclinical subjects from LNB patients.
This study confirms that subclinical Borrelia seroconversion is common in south-eastern Sweden. The findings further suggest that male sex, younger age together with B. gariniii induced levels of IL-10, IL-17A and CCL20 may be associated with a subclinical course.
莱姆病（LB）亚临床病程的决定因素在很大程度上尚不清楚。本研究的目的是评估瑞典莱姆病流行地区亚临床伯氏疏螺旋体血清转化的程度、性别和年龄分布，并绘制与以前诊断为莱姆神经Borreliosis（LNB）的患者相比，具有先前亚临床 LB 病程的个体的血液细胞伯氏疏螺旋体特异性免疫标志物图谱。
对 1113 名健康献血者进行了多种 IgG 抗伯氏疏螺旋体抗体筛查，并要求他们完成有关以前 LB 的健康调查。确定了一组具有抗伯氏疏螺旋体特异性 IgG 抗体但无以前 LB 病史的个体（亚临床 LB，n=60），以及 22 例以前的 LNB。使用全 Borrelia 螺旋体、B. afzelii ACA1 和 B. garinii Ip90 菌株进行体外全血刺激，而使用相同菌株的外表面蛋白富集部分刺激外周血单核细胞（PBMC）。使用多重珠阵列分析刺激后上清液中的广泛免疫标志物面板，并通过减去自发分泌来确定 Borrelia 特异性分泌。
共有 1113 名献血者中的 125 名报告了以前的临床 LB。相比之下，有 66 名献血者否认有以前的 LB，但显示出多种 IgG 抗伯氏疏螺旋体抗体；这些被定义为亚临床受试者，其中 60 名可用于进一步研究。与 LNB 患者相比，亚临床受试者中男性明显更多，年龄更小（p≤0.01）。判别分析显示，性别、年龄和 PBMC 中 Borrelia garinii 特异性的 IL-10、IL-17A 和 CCL20 水平的独特模式可将亚临床受试者与 LNB 患者区分开来。
本研究证实，莱姆病亚临床血清转化在瑞典东南部很常见。研究结果还表明，男性、年轻年龄以及 Borrelia garinii 诱导的 IL-10、IL-17A 和 CCL20 水平可能与亚临床病程有关。
