TY - JOUR
T1 - Higher mRNA levels of chemokines and cytokines associated with macrophage activation in erythema migrans skin lesions in patients from the United States than in patients from Austria with Lyme borreliosis
AU - Jones, Kathryn L.
AU - Muellegger, Robert R.
AU - Means, Terry K.
AU - Lee, Marshall
AU - Glickstein, Lisa J.
AU - Damle, Nitin
AU - Sikand, Vijay K.
AU - Luster, Andrew D.
AU - Steere, Allen C.
N1 - Funding Information:
Financial support. The National Institutes of Health (CA-69212 and AR-20358); the Centers for Disease Control and Prevention (CCU110 291); the English, Bonter, Mitchell Foundation; the Eshe Fund; and the Lyme/ Arthritis Research Fund at Massachusetts General Hospital. K.L.J. received support from a scholarship from the Walter J. and Lille A. Berbecker Foundation for the study of Lyme disease and from the National Institutes of Health (AR-007258). Potential conflicts of interest. All authors: no conflicts.
PY - 2008/1/1
Y1 - 2008/1/1
N2 - Background. Erythema migrans (EM) is caused primarily by Borrelia afzelii in Europe and solely by Borrelia burgdorferi in the United States. B. burgdorferi infection in the United States has previously been associated with faster expansion of EM lesions and with more associated symptoms, compared with B. afzelii infection in Europe. However, reasons for these differences are not yet known. Methods. We determined the Borrelia species infecting 67 US or Austrian patients with EM. The clinical pictures and chemokine and cytokine mRNA levels in lesional skin were then compared in the 19 B. burgdorferi-infected US patients and the 37 B. afzelii-infected Austrian patients, the 2 largest groups. Results. The 19 B. burgdorferi-infected US patients had faster-expanding EM lesions and a median of 4 associated signs and symptoms, whereas the 37 B. afzelii-infected Austrian patients had slower-expanding lesions and usually did not experience associated symptoms. Compared with the EM lesions of B. afzelii-infected Austrian patients, those of B. burgdorferi-infected US patients had significantly higher mRNA levels of chemokines associated with activation of macrophages, including chemoattractants for neutrophils (CXCL1), macrophages (CCL3 and CCL4), and T helper 1 cells (CXCL9, CXCL10, and CXCL11). In addition, compared with the EM lesions of Austrian patients, the EM lesions of US patients tended to have higher mRNA levels of the macrophage-associated proinflammatory cytokines interleukin 1β and tumor necrosis factor α, and they had significantly higher mRNA expression of the antiinflammatory cytokines interleukin 10 and transforming growth factor β. Conclusions. The EM lesions of B. burgdorferi-infected US patients expanded faster, were associated with more symptoms, and had higher mRNA levels of macrophage-associated chemokines and cytokines than did the EM lesions of B. afzelii-infected Austrian patients.
AB - Background. Erythema migrans (EM) is caused primarily by Borrelia afzelii in Europe and solely by Borrelia burgdorferi in the United States. B. burgdorferi infection in the United States has previously been associated with faster expansion of EM lesions and with more associated symptoms, compared with B. afzelii infection in Europe. However, reasons for these differences are not yet known. Methods. We determined the Borrelia species infecting 67 US or Austrian patients with EM. The clinical pictures and chemokine and cytokine mRNA levels in lesional skin were then compared in the 19 B. burgdorferi-infected US patients and the 37 B. afzelii-infected Austrian patients, the 2 largest groups. Results. The 19 B. burgdorferi-infected US patients had faster-expanding EM lesions and a median of 4 associated signs and symptoms, whereas the 37 B. afzelii-infected Austrian patients had slower-expanding lesions and usually did not experience associated symptoms. Compared with the EM lesions of B. afzelii-infected Austrian patients, those of B. burgdorferi-infected US patients had significantly higher mRNA levels of chemokines associated with activation of macrophages, including chemoattractants for neutrophils (CXCL1), macrophages (CCL3 and CCL4), and T helper 1 cells (CXCL9, CXCL10, and CXCL11). In addition, compared with the EM lesions of Austrian patients, the EM lesions of US patients tended to have higher mRNA levels of the macrophage-associated proinflammatory cytokines interleukin 1β and tumor necrosis factor α, and they had significantly higher mRNA expression of the antiinflammatory cytokines interleukin 10 and transforming growth factor β. Conclusions. The EM lesions of B. burgdorferi-infected US patients expanded faster, were associated with more symptoms, and had higher mRNA levels of macrophage-associated chemokines and cytokines than did the EM lesions of B. afzelii-infected Austrian patients.
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U2 - 10.1086/524022
DO - 10.1086/524022
M3 - Article
C2 - 18171218
AN - SCOPUS:39349110576
SN - 1058-4838
VL - 46
SP - 85
EP - 92
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 1
ER -