Garg Kunal, Thoma Abbie, Avramovic Gordana, Gilbert Leona, Shawky Marc, Ray Minha Rajput, Lambert John Shearer
Te?ted Oy, 40100 Jyväskylä, Finland.
Department of Infectious Diseases, Catherine Mc Auley Education & Research Centre, Mater Misericordiae University Hospital, 21 Nelson Street, Dublin 7, D07 A8NN Dublin, Ireland.
Antibiotics (Basel). 2024 Jul 25;13(8):693. doi: 10.3390/antibiotics13080693.
Tick-borne illnesses (TBIs), especially those caused by Borrelia, are increasingly prevalent worldwide. These diseases progress through stages of initial localization, early spread, and late dissemination. The final stage often leads to post-treatment Lyme disease syndrome (PTLDS) or chronic Lyme disease (CLD), characterized by persistent and non-specific multisystem symptoms affecting multiple systems, lasting over six months after antibiotic therapy. PTLDS significantly reduces functional ability, with 82-96% of patients experiencing pain, including arthritis, arthralgia, and myalgia. Inflammatory markers like CRP and TNF-alpha indicate ongoing inflammation, but the link between chronic pain and other biomarkers is underexplored. This study examined the relationship between pain and biomarkers in TBI patients from an Irish hospital and their response to antibiotic treatment. Pain ratings significantly decreased after antibiotic treatment, with median pain scores dropping from 7 to 5 ( = 27215.50, < 0.001). This suggests a persistent infection responsive to antibiotics. Age and gender did not influence pain ratings before and after treatment. The study found correlations between pain ratings and biomarkers such as transferrin, CD4%, platelets, and neutrophils. However, variations in these biomarkers did not significantly predict pain changes when considering biomarkers outside the study. These findings imply that included biomarkers do not directly predict pain changes, possibly indicating allostatic load in symptom variability among long-term TBI patients. The study emphasizes the need for appropriate antibiotic treatment for TBIs, highlighting human rights issues related to withholding pain relief.
蜱传疾病（TBIs），尤其是由疏螺旋体引起的疾病，在全球范围内日益普遍。这些疾病会经历初始定位、早期传播和晚期扩散阶段。最后阶段通常会导致治疗后莱姆病综合征（PTLDS）或慢性莱姆病（CLD），其特征是影响多个系统的持续且非特异性的多系统症状，在抗生素治疗后持续超过六个月。PTLDS会显著降低功能能力，82%至96%的患者会经历疼痛，包括关节炎、关节痛和肌痛。像CRP和TNF-α这样的炎症标志物表明存在持续炎症，但慢性疼痛与其他生物标志物之间的联系尚未得到充分研究。本研究调查了一家爱尔兰医院的TBI患者疼痛与生物标志物之间的关系以及他们对抗生素治疗的反应。抗生素治疗后疼痛评分显著下降，中位疼痛评分从7降至5（=27215.50，<0.001）。这表明存在对抗生素有反应的持续性感染。年龄和性别在治疗前后均未影响疼痛评分。研究发现疼痛评分与转铁蛋白、CD4%、血小板和中性粒细胞等生物标志物之间存在相关性。然而，在考虑研究之外的生物标志物时，这些生物标志物的变化并不能显著预测疼痛变化。这些发现意味着所纳入的生物标志物不能直接预测疼痛变化，这可能表明长期TBI患者症状变异性中的应激负荷。该研究强调了对TBIs进行适当抗生素治疗的必要性，突出了与 withholding pain relief相关的人权问题。 （注：“withholding pain relief”此处翻译可能不太准确，需结合更专业背景准确理解其含义后完善，暂直译为“ withholding pain relief”）
