Di Domenico Enea Gino, Cavallo Ilaria, Bordignon Valentina, D'Agosto Giovanna, Pontone Martina, Trento Elisabetta, Gallo Maria Teresa, Prignano Grazia, Pimpinelli Fulvia, Toma Luigi, Ensoli Fabrizio
Clinical Pathology and Microbiology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy.
Department of Research, Advanced Diagnostics, and Technological Innovation, Translational Research Area, Regina Elena National Cancer Institute IRCCS, Rome, Italy.
Front Neurol. 2018 Dec 3;9:1048. doi: 10.3389/fneur.2018.01048. eCollection 2018.
Lyme borreliosis (LB) is the most common tick-borne disease caused by the spirochete in North America and or in Europe and Asia, respectively. The infection affects multiple organ systems, including the skin, joints, and the nervous system. Lyme neuroborreliosis (LNB) is the most dangerous manifestation of Lyme disease, occurring in 10-15% of infected individuals. During the course of the infection, bacteria migrate through the host tissues altering the coagulation and fibrinolysis pathways and the immune response, reaching the central nervous system (CNS) within 2 weeks after the bite of an infected tick. The early treatment with oral antimicrobials is effective in the majority of patients with LNB. Nevertheless, persistent forms of LNB are relatively common, despite targeted antibiotic therapy. It has been observed that the antibiotic resistance and the reoccurrence of Lyme disease are associated with biofilm-like aggregates in , and , both and , allowing spp. to resist to adverse environmental conditions. Indeed, the increased tolerance to antibiotics described in the persisting forms of spp., is strongly reminiscent of biofilm growing bacteria, suggesting a possible role of biofilm aggregates in the development of the different manifestations of Lyme disease including LNB.
莱姆病（LB）是北美由螺旋体引起的最常见的蜱传疾病，在欧洲和亚洲分别也是如此。该感染会影响多个器官系统，包括皮肤、关节和神经系统。莱姆神经疏螺旋体病（LNB）是莱姆病最危险的表现形式，发生在10% - 15%的受感染个体中。在感染过程中，细菌在宿主组织中迁移，改变凝血和纤维蛋白溶解途径以及免疫反应，在被感染蜱叮咬后2周内到达中枢神经系统（CNS）。早期口服抗菌药物治疗对大多数LNB患者有效。然而，尽管进行了针对性的抗生素治疗，LNB的持续形式相对常见。据观察，莱姆病的抗生素耐药性和复发与 、 和 中的生物膜样聚集体有关，这使得 spp.能够抵抗不利的环境条件。事实上，在 spp.持续形式中所描述的对抗生素耐受性的增加，强烈让人联想到生物膜生长细菌，这表明生物膜聚集体在包括LNB在内的莱姆病不同表现形式的发展中可能起作用。
