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[慢性游走性红斑疾病的螺旋体病因]

[Spirochete etiology of erythema chronicum migrans disease].

作者信息

Ackermann R, Kabatzki J, Boisten H P, Steere A C, Grodzicki R L, Hartung S, Runne U

出版信息

Dtsch Med Wochenschr. 1984 Jan 20;109(3):92-7. doi: 10.1055/s-2008-1069145.

Abstract

From ticks of the type Ixodes ricinus, 19 strains of a spirochete were isolated at three places of infection of erythema chronicum migrans disease. The spirochete was immunologically related to Borrelia duttoni, Treponema pallidum and Ixodes dammini spirochete, the causative organism of North American erythema chronicum migrans disease (Lyme disease). The isolated spirochete differed from the North American one in its reaction with monoclonal antibodies and possibly in its electronmicroscopic structure. A corresponding spirochete was isolated from the blood of a woman with erythema chronicum migrans. Of 39 patients with erythema chronicum migrans mostly treated with antibiotics 50% had increased IgG antibody titre (1:64 to 1:1024) against the isolated spirochete, while among 51 untreated patients with tick-transmitted meningopolyneuritis 90% had increased IgG antibody titres. Fourfold antibody titres increases or falls were found on 50 occasions. IgG antibody titres up to 1:64 were demonstrated also in CSF, in 22 instances with significant changes. Increased serum IgM antibody titres of 1:32 to 1:256 were observed in 20% and 68%, respectively, of patients. These findings suggest that the isolated spirochete is the causative agent of erythema chronicum migrans disease in Europe. Its antigen structure and arrangement is similar to that of the causative agent of Lyme disease.

摘要

从蓖麻硬蜱中,在慢性游走性红斑病的三个感染地点分离出19株螺旋体。该螺旋体在免疫上与达顿疏螺旋体、梅毒螺旋体以及北美慢性游走性红斑病(莱姆病)的病原体达米尼硬蜱螺旋体相关。分离出的螺旋体在与单克隆抗体的反应以及可能的电子显微镜结构方面与北美螺旋体不同。从一名患有慢性游走性红斑的女性血液中分离出了相应的螺旋体。在39名主要接受抗生素治疗的慢性游走性红斑患者中,50%的患者针对分离出的螺旋体的IgG抗体滴度升高(从1:64至1:1024),而在51名未经治疗的蜱传脑膜多神经炎患者中,90%的患者IgG抗体滴度升高。在50个病例中发现抗体滴度有四倍的升高或降低。在脑脊液中也发现了高达1:64的IgG抗体滴度,22例有显著变化。分别在20%和68%的患者中观察到血清IgM抗体滴度升高至1:32至1:256。这些发现表明,分离出的螺旋体是欧洲慢性游走性红斑病的病原体。其抗原结构和排列与莱姆病病原体相似。

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