Info about European chronic (=late) borreliosis

General or non-medical topics with information and discussion related to Lyme disease and other tick-borne diseases.
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Re: Info about European chronic (=late) Lyme

Post by X-member » Wed 21 Dec 2011 0:53

http://www.ncbi.nlm.nih.gov/pubmed/15958074
Clin Exp Immunol. 2005 Jul;141(1):89-98.

Innate immune responses in Lyme borreliosis: enhanced tumour necrosis factor-alpha and interleukin-12 in asymptomatic individuals in response to live spirochetes.

Sjöwall J, Carlsson A, Vaarala O, Bergström S, Ernerudh J, Forsberg P, Ekerfelt C.
SourceDivisions of Infectious Diseases, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, University Hospital, Linköping, Sweden.

Abstract
Innate immunity is important for early defence against borrelia spirochetes and should play a role in the clinical outcome of the infection. In order to study early cytokine responses, in vitro differentiated dendritic cells (DCs) and whole blood cells from 21 patients with different clinical outcomes of Lyme neuroborreliosis were stimulated with live borrelia spirochetes. The borrelia-induced secretion of interleukin (IL)-4, IL-10, IL-12p70, interferon (IFN)-gamma and tumour necrosis factor (TNF)-alpha in DCs and IL-1beta, IL-6, IL-8, IL-10, IL-12p70, TNF-alpha, regulated upon activation normal T cell expressed and secreted (RANTES), monocyte chemoattractant protein (MCP)-1, macrophage inflammatory protein (MIP)-1alpha, MIP-1beta and eotaxin in whole blood cells was measured by enzyme-linked immunospot (ELISPOT) and multiplex arrays, respectively. We found increased numbers of TNF-alpha-secreting DCs (P = 0.018) in asymptomatic seropositive individuals compared to patients with subacute neuroborreliosis and seronegative controls. Asymptomatic individuals were also found to have elevated levels of IL-12p70 (P = 0.031) in whole blood cell supernatants compared to seronegative controls. These results are in line with previous experiments using cells of the adaptive immune response, indicating that strong T helper type 1 (Th1) proinflammatory responses might be associated with a successful resolution of Lyme disease.

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Re: Info about European chronic (=late) Lyme

Post by X-member » Wed 21 Dec 2011 1:05

http://www.ncbi.nlm.nih.gov/pubmed/20718718
APMIS. 2010 Sep 1;118(9):665-73.

Persistence of borrelial DNA in the joints of Borrelia burgdorferi-infected mice after ceftriaxone treatment.
Yrjänäinen H, Hytönen J, Hartiala P, Oksi J, Viljanen MK.
SourceDepartment of Medical Microbiology and Immunology, University of Turku, Finland.

Abstract
We have earlier shown that Borrelia burgdorferi-infected and ceftriaxone-treated mice have viable spirochetes in their body, since immunosuppressive treatment allows B. burgdorferi to be detected by culture. However, the niche of the persisting spirochetes remained unknown. In the present study, we analyzed the tissues of B. burgdorferi-infected and ceftriaxone-treated mice by culture and PCR to reveal the foci of persisting spirochetes. C3H/HeN mice were infected via intradermal needle injection with B. burgdorferi s.s. N40. The mice were treated as follows: (i) short (5 days) and (ii) long (18 days) course of ceftriaxone at 2 weeks of infection and killed after either 10 or 30 weeks, or (iii) the mice received ceftriaxone for 5 days at 18 weeks of infection and were killed 21 weeks after the treatment. All samples of ceftriaxone-treated mice were culture negative, whereas all untreated controls were culture positive. Importantly, B. burgdorferi DNA was detected in the joints of 30-100% of the treated mice. In conclusion, these results combined with earlier results suggest that the joint or a tissue adjacent to the joint is the niche of persisting B. burgdorferi in ceftriaxone-treated mice.

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Re: Info about European chronic (=late) Lyme

Post by X-member » Wed 21 Dec 2011 19:57

From Hungary:

http://www.ncbi.nlm.nih.gov/pubmed/20840915
Orv Hetil. 2010 Sep 26;151(39):1585-90.
[Acute atrioventricular block in chronic Lyme disease].
[Article in Hungarian]
Wagner V, Zima E, Gellér L, Merkely B.
SourceSemmelweis Egyetem, Altalános Orvostudományi Kar Kardiológiai Tanszék Budapest Városmajor u. 68. 1122.

Abstract
The tick bite transmitted Lyme disease is one of the most common antropozoonosis, about 10 000 new infections are reported in Hungary each year. The progress and clinical presentation can vary, and carditis can occur in later stages. A serologically verified Lyme disease caused third degree atrioventricular block in young male presenting with presyncope. Based on the tick-bites mentioned a few weeks prior to hospital admission, Lyme carditis was considered with the administration of antibiotics and monitor observation. Typical skin lesions were not recognized and laboratory findings showed no pathology. An electrophysiological study recorded a predominant supra-His atrioventricular block. Total regression of conduction could be detected later and the serological tests established an underlying Lyme disease. Currently no definite treatment recommendation is available for the potentially reversible Lyme carditis. The tick bite seemed to be the key on our way to diagnosis; however, serological tests proved the disease to be older than one year. A detailed medical history and serological tests are essential in identifying the cause and pacemaker implantation can be avoided.

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Re: Info about European chronic (=late) Lyme

Post by X-member » Wed 21 Dec 2011 20:01

More from Hungary:

http://www.lyme.no/25-years-of-experien ... orreliosis

25 years of experience with Lyme Borreliosis
Gradually we collected comprehensive data from a group of 250 patients suffering from chronic Lyme borreliosis here in Hungary. We followed these patients for 5 years, on average, and half of them were cured after one round of treatment, while others needed one or more repeated treatments.
More to read on the site!

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Re: Info about European chronic (=late) Lyme

Post by X-member » Sun 25 Dec 2011 1:01

Swedish info (from the Swedish recommendations) that help us understand chronic Lyme better:
Kronisk aktiv borrelios

En långvarig, under månader till år, aktiv borreliainfektion
ses numera sällan. Detta beror på en hög grad av uppmärksamhet
på fästingburna infektioner hos allmänheten och
sjukvården, vilket leder till snabbt avlägsnande av fästingar
och till tidig behandling. I Europa är 1–5 % av infektionerna
sena Lyme borrelioser, vanligast ACA, följt av kronisk artrit
och sällan kronisk enkefalomyelit.
A not soo perfect translation (with google translate):
Chronic active Lyme disease

A prolonged, over months to years, active Lyme disease
is now rarely seen. This is due to a high degree of attention
on tick-borne infections in the public and
health care, leading to rapid removal of ticks
and early treatment. In Europe, 1-5% of the infections
are Late Lyme borrelioser, most ACA, followed by chronic arthritis
and rarely chronic encephalomyelitis.
I have to add to this info, that when you suffer from a disseminated B Afzelii-infection you can have many more symptoms than ACA, and you don't even have to have ACA at all.

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Re: Info about European chronic (=late) Lyme

Post by X-member » Sun 25 Dec 2011 1:44

This is important info, at least it is for Swedish "Lymers". ;)

Many persons who suffer from Lyme in Sweden, and many physicians too, think that neuroborreliosis is another word for late/chronic Lyme. This is soo wrong!

I have spent soo much time to make them understand this, and a common answer from them is: "But I do have symptoms from nerves, so it must be a neuroborreliosis."

My answers are:

1: You can have symptoms from peripheral (=outside CNS) nerves, without having a neuroborreliosis at all.

2: And IF it is a neuroborreliosis, and you have had it for a long time, then it is a chronic (or late) neuroborreliosis!

Why they don't understand, is probably because they have "chosen" what they "think" is the most hard-to-cure infection and therefore think that "I am joking" or that I am not telling them the truth :roll: , but what they actually do, is to call their stage 3/late/chronic Lyme for an stage 2/early/acute infection.

The treatment for a neuroborreliosis (=stage 2/early Lyme) is in Sweden 14 days ABX.

But if they instead suffer from the most common chronic/late Lyme (=B Afzelii) they will have 21 days ABX.

So, use the right term for what you suffer from instead, and do not "guess" what it is called!

Don't go to your physician and "ask for a shorter treatment"! :roll:


This has also caused other problems for Swedish people!

Since they think that neuroborreliosis is another word for chronic/late Lyme, they think that the info regarding how it is diagnosed, is the info that they (or the physician) should follow.

When I told them (in a Swedish Lyme forum) that we actually have a clinical diagnosis (based only on symptoms) in Sweden, they said:

"Nope, you have to have "this and this" test positive otherwise you will not have the Lyme diagnose."

And to prove that I was wrong.....they gave me info about neuroborreliosis! :roll:

In Sweden multiple EM (=more than one erythema migrans) is a clinical Lyme diagnosis, and this is also a sign of a disseminated Lyme infection.

I have already had multiple EM rashes, so my Lyme diagnose don't have to be confirmed (at all) with any Lyme tests or a spinal tap. It is (of course) harder when it comes to Lyme cases that not have (or have had) those for Lyme soo specific symptom(s)!

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Re: Info about European chronic (=late) Lyme

Post by X-member » Sun 25 Dec 2011 19:30

http://www.ncbi.nlm.nih.gov/pubmed/9233667
Clin Infect Dis. 1997 Jul;25 Suppl 1:S64-70.
Why is chronic Lyme borreliosis chronic?
Aberer E, Koszik F, Silberer M.
SourceDepartment of Dermatology, University of Graz Medical School, Austria.

Abstract
Chronic Lyme borreliosis (CLB) can present not only in different organs but also in different patterns. Although many theories exist about the mechanisms leading to CLB, it is known that viable Borrelia burgdorferi can persist for decades and cause late skin manifestations of acrodermatitis chronica atrophicans (ACA). Thus, the immunopathogenetic findings in ACA can serve as a model for studying the chronic course of Lyme borreliosis. Recent findings indicate that the most important cell for antigen presentation, the epidermal Langerhans cell (LC), is invaded by B. burgdorferi in early Lyme borreliosis. Therefore, LCs were stained immunohistochemically with different markers to investigate their functional activity. Numbers of CD1a+ LCs were reduced in erythema migrans but normal or slightly elevated in ACA. In both diseases there was also a marked downregulation of major histocompatibility complex class II molecules on LCs, as measured by staining of human leukocyte antigen DR. This phenomenon might be a mechanism that protects against the presentation of autoantigens and may be the cause of the impaired capacity of LCs to eliminate B. burgdorferi antigens, thus explaining why CLB is chronic.

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Re: Info about European chronic (=late) Lyme

Post by X-member » Mon 26 Dec 2011 23:31

I wrote:
In Sweden multiple EM (=more than one erythema migrans) is a clinical Lyme diagnosis, and this is also a sign of a disseminated Lyme infection.
And this I now found info about it at PubMed too:

http://www.ncbi.nlm.nih.gov/pubmed/19367097

"Clinical manifestations and diagnosis of lyme borreliosis."

Quote:
Laboratory confirmation of a borrelial infection is needed for all manifestations of Lyme borreliosis, with the exception of typical skin lesions.

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Re: Info about European chronic (=late) Lyme

Post by X-member » Thu 29 Dec 2011 19:59

Maybe this info already is posted somewhere?

http://www.ncbi.nlm.nih.gov/pubmed/9701852
Acta Clin Belg. 1998 Jun;53(3):178-83.
Lyme borreliosis--a review of the late stages and treatment of four cases.
Petrovic M, Vogelaers D, Van Renterghem L, Carton D, De Reuck J, Afschrift M.
SourceDepartment of Internal Medicine, University Hospital Ghent, Belgium.

Abstract
Difficulties in diagnosis of late stages of Lyme disease include low sensitivity of serological testing and late inclusion of Lyme disease in the differential diagnosis. Longer treatment modalities may have to be considered in order to improve clinical outcome of late disease stages. These difficulties clinical cases of Lyme borreliosis. The different clinical cases illustrate several aspects of late borreliosis: false negative serology due to narrow antigen composition of the used ELISA format, the need for prolonged antibiotic treatment in chronic or recurrent forms and typical presentations of late Lyme disease, such as lymphocytic meningo-encephalitis and polyradiculoneuritis.

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