Dillon W I, Saed G M, Fivenson D P
Department of Dermatology, Henry Ford Health Sciences Center, Detroit, MI, USA.
J Am Acad Dermatol. 1995 Oct;33(4):617-20. doi: 10.1016/0190-9622(95)91281-9.
Borrelia burgdorferi has been linked to the pathogenesis of morphea and lichen sclerosus et atrophicus (LSA). However, considerable controversy still exists as to the actual role, if any, that this spirochete plays in the development of these diseases. Antibody titer determinations have been inconclusive and polymerase chain reaction (PCR) studies have yielded conflicting results.
We sought to show whether PCR analysis detected B. burgdorferi in archival tissue specimens from the involved skin of 20 North American patients with morphea, 10 patients with LSA, and four patients with scleroderma.
We used two different sets of PCR primers for the B. burgdorferi flagellin gene, one specific for European strains of B. burgdorferi, and another common to both European and American strains. A subset of these samples were further amplified with nested PCR primers.
None of the samples showed PCR products with either primer sets, whereas purified B. burgdorferi DNA and lesional erythema chronicum migrans tissues, which were used as positive controls, yielded easily detectable products with all primer sets.
These data suggest that B. burgdorferi infection plays no role in the development of morphea, LSA, or scleroderma in North American patients; these findings further support the recent observations that B. burgdorferi strain variability is associated with differential spectra of disease in North America compared with that found in various parts of Europe.
伯氏疏螺旋体与硬斑病和萎缩性硬化性苔藓（LSA）的发病机制有关。然而，关于这种螺旋体在这些疾病发展中实际所起的作用（如果有作用的话）仍存在相当大的争议。抗体滴度测定结果尚无定论，聚合酶链反应（PCR）研究也得出了相互矛盾的结果。
我们试图表明PCR分析能否在20例北美硬斑病患者、10例LSA患者和4例硬皮病患者受累皮肤的存档组织标本中检测到伯氏疏螺旋体。
我们使用了两组不同的针对伯氏疏螺旋体鞭毛蛋白基因的PCR引物，一组对欧洲伯氏疏螺旋体菌株具有特异性，另一组对欧洲和美国菌株均通用。这些样本的一个子集用巢式PCR引物进一步扩增。
所有样本用任何一组引物均未显示出PCR产物，而用作阳性对照的纯化伯氏疏螺旋体DNA和病灶性慢性游走性红斑组织，用所有引物组均产生了易于检测到的产物。
这些数据表明，伯氏疏螺旋体感染在北美患者硬斑病、LSA或硬皮病的发展中不起作用；这些发现进一步支持了最近的观察结果，即与欧洲各地发现的情况相比，北美伯氏疏螺旋体菌株的变异性与不同的疾病谱相关。
