Department of Biological and Environmental Sciences, NanoScience Center, University of Jyväskylä, Jyväskylä, Finland.
Te?ted Ltd, Mattilaniemi 6-8, Jyväskylä, Finland.
Sci Rep. 2018 Oct 29;8(1):15932. doi: 10.1038/s41598-018-34393-9.
There is insufficient evidence to support screening of various tick-borne diseases (TBD) related microbes alongside Borrelia in patients suffering from TBD. To evaluate the involvement of multiple microbial immune responses in patients experiencing TBD we utilized enzyme-linked immunosorbent assay. Four hundred and thirty-two human serum samples organized into seven categories followed Centers for Disease Control and Prevention two-tier Lyme disease (LD) diagnosis guidelines and Infectious Disease Society of America guidelines for post-treatment Lyme disease syndrome. All patient categories were tested for their immunoglobulin M (IgM) and G (IgG) responses against 20 microbes associated with TBD. Our findings recognize that microbial infections in patients suffering from TBDs do not follow the one microbe, one disease Germ Theory as 65% of the TBD patients produce immune responses to various microbes. We have established a causal association between TBD patients and TBD associated co-infections and essential opportunistic microbes following Bradford Hill's criteria. This study indicated an 85% probability that a randomly selected TBD patient will respond to Borrelia and other related TBD microbes rather than to Borrelia alone. A paradigm shift is required in current healthcare policies to diagnose TBD so that patients can get tested and treated even for opportunistic infections.
目前尚无足够的证据支持在患有 TBD 的患者中同时筛查与伯氏疏螺旋体相关的各种蜱传疾病(TBD)相关微生物。为了评估多种微生物免疫反应在 TBD 患者中的参与情况,我们利用酶联免疫吸附试验(ELISA)进行了研究。我们将 432 个人类血清样本分为七类,这些样本遵循了疾病控制与预防中心(CDC)的两阶段莱姆病(LD)诊断指南和美国传染病学会(IDSA)的治疗后莱姆病综合征指南。所有患者类别均接受了针对与 TBD 相关的 20 种微生物的免疫球蛋白 M(IgM)和 G(IgG)反应检测。我们的研究结果表明,TBD 患者中的微生物感染不符合一种微生物、一种疾病的“ Germ Theory”理论,因为 65%的 TBD 患者对各种微生物产生免疫反应。我们已经根据布拉德福德·希尔(Bradford Hill)的标准,在 TBD 患者与 TBD 相关的合并感染和必要的机会性微生物之间建立了因果关联。本研究表明,随机选择的 TBD 患者对伯氏疏螺旋体和其他相关 TBD 微生物产生反应的概率为 85%,而不是仅对伯氏疏螺旋体产生反应。目前需要对医疗保健政策进行范式转变,以便对 TBD 进行诊断,从而使患者能够接受检测和治疗,甚至是针对机会性感染的治疗。