Tick-borne Borreliosis Research Articles

A Case of Complete AV Blockade in Patient with Lyme Borreliosis

Lyme disease (tick-borne borreliosis) is an infectious vector-borne natural focal disease that tends to a chronic and recurrent course with a predominant damage to the skin, nervous system, musculoskeletal system and heart. Cardiac features is manifested, as a rule, by a involvement of the conducting system as varying degrees of atrioventricular block, Bundle–branch block, dysfunction of the sinoatrial node. In case of untimely diagnosis and etiotropic treatment of tick-borne borreliosis, chronic lesions of the cardiac conduction system may occurs and implantation of a pacemaker may be required.

Tick bites in different professions and regions: pooled cross-sectional study in the focus area Bavaria, Germany

BackgroundAs the vector-borne diseases tick-borne encephalitis (TBE) and Lyme borreliosis (LB) are common in Germany and transmitted by tick bites, the aim of this study was to assess differences in the number of tick bites in various professions and regions across southern Germany to evaluate the differences in tick-associated risk.Materials and methodsThe analysis is based on three cross-sectional studies that were conducted in 2016 and 2017 in two real-life settings and in one medical setting in Bavaria. All participants filled in a paper-based questionnaire about their history with tick bites. Only adult participants (≥ 18 years) were included in this study.ResultsOverall, 3503 individuals (mean age 50.8 ± 15.2 years, median age 53.0 ± 12.2 years, 54.0% female) were included. Of these, 50% worked in an outdoor profession and 56% lived in environs. Around 70% of participants reported at least one previous tick bite. In comparison to indoor workers, forestry workers (OR = 2.50; 95% CI: 1.10–5.68) had the highest risk for a tick bite followed by farmers (OR = 1.22; 95% CI: 1.01–1.47). Furthermore, people living in rural areas (OR = 1.97, 95% CI:1.49–2.59) and environs (OR = 1.98, 95% CI: 1.54–2.55) were twice as likely to have a previous tick bite than people living in urban areas. In general, slightly more tick bites were reported by people living in eastern Bavaria.ConclusionRising numbers of TBE and LB indicate the need for further prevention strategies, which should focus on outdoor professions with a higher risk and people living in environs and rural areas.

Clinical variants of the non-erythema form of ixodid tick-borne borreliosis

The patients with the nonerythematous form of borreliosis (83 persons) were observed in the epidemic seasons of 19971999. The organ pathology often develops on the background of the general infections syndrome. The clinical variants of the early period are described: arthromyalgic, similar to influenza, regional lymphadenitis, neurologic, cardiovascular, hepatitis, mixed.

Modification of isothermal test for detecting DNA of pathogens of tick-borne borreliosis.

Early diagnosis of tick-borne borreliosis determines the indications for etiotropic therapy, and the detection of borrelia in a tick that has bitten you serves as the basis for antibiotic prophylaxis. To determine the causative agent of borreliosis, PCR methods are most widely used, which requires special conditions for organizing the work of laboratories and the use of expensive equipment. In addition, the procedure for isolating bacterial DNA and subsequent amplification takes several hours of working time. At the same time, methods for detecting borrelia in the isothermal LAMP-reaction are described, which makes it possible to significantly speed up the diagnosis, does not require complex equipment and highly qualified personnel. It is also known that LAMP in some cases allows analysis without prior extraction of nucleic acids. The purpose was a development of a modified test for isothermal detection of DNA of borreliosis pathogens for an accelerated result and the possibility of excluding the stage of nucleic acid extraction. We used 40 samples of Borrelia DNA and 11 Ixodes persulcatus ticks. To shorten the detection time for Borrelia, the previously described LAMP method was modified by the introduction of additional loop primers. The copy number of the positive DNA sample of the borrelia plasmid was estimated using digital PCR. The results of the LAMP reaction were compared with those of the commercial PRC-RT test. The additional use of loop primers approximately halved the detection time for Borrelia DNA without affecting the comparative diagnostic efficiency. The analytical sensitivity limit of the modified LAMP method was 4 copies/μl or 21 molecules of the plasmid standard added to the reaction. In comparative testing with RT-PCR, the sensitivity of the LAMP method is 90%, and the specificity is 100%. The possibility of detecting borrelia in ticks without the stage of DNA extraction has been demonstrated for the first time. A modified isothermal method for the detection of pathogens of tick-borne borreliosis has been developed, which allows analysis within 20-30 minutes, including in ticks without preliminary DNA extraction.

Lyme disease: modern approaches to treatment and prevention (based on international recommendations of 2020)

Lyme disease (LD) or tick-borne borreliosis affects thousands of people every year in different regions of the world, primarily in the United States and Europe. Given the great social and medical importance of this problem, an updated version of the clinical guidelines for the prevention, diagnosis and treatment of PD was published in November 2020 by a committee of experts of the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN) and the American College of Rheumatology (ACR). This article discusses the main issues of the use of antibacterial drugs in LD. The most commonly used medications are doxycycline, amoxicillin, cefuroxime axetil, and ceftriaxone. Patients with erythema migrans receive appropriate antibiotics for 7–14 days, depending on the medication used. In case of other clinical manifestations of LD, the duration of treatment is extended to 14–28 days. Antibiotic prophylaxis is carried out using a single oral dose of 200 mg doxycycline for adults and 4.4 mg/kg (with a maximum of 200 mg) for children. This treatment scheme is highly efficient, easy to administer, and has a relatively low risk of adverse events.

Epizootiological aspects of natural nidality of Ixodes tick-borne borreliosis in the Moscow region (Russian Federation)

Background and Aim:At present, tick-borne borreliosis is the most common infectious disease transmitted by ticks in Europe, Asia, and North America. This study aimed to examine the epizootiological aspects of the natural nidality of tick-borne borreliosis in Moscow region (the Russian Federation).Materials and Methods:A total of 2,537 ticks representing two species were collected, namely, Ixodes ricinus and Dermacentor reticulatus. The activity, number of ticks, and Borrelia infestation rates were investigated during a high season, that is, from early spring to mid-autumn.Results:In May, amount of I. ricinus spp. was found 2.5 times more than those representing D. reticulatus spp. (p≤0.01). In June, August, and September, the amount of I. ricinus was 9.0 (p≤0.0001), 2.0 (p≤0.05), and 5.0 times higher, respectively, compared to D. reticulatus. In the first 10 days of April, the amount of D. reticulatus was 3 times higher than that of I. ricinus (p≤0.02); in the next 10 days, their amounts were equal (p≥0.05) and in the last 10 days the amount of I. ricinus exceeded that of D. reticulatus (p≤0.05) by 1.5 times. In general, Borrelia afzelii, and Borrelia garinii, were detected. In addition, the naturally occurring tick-borne borreliosis pesthole was revealed in the Moscow region.Conclusion:Borrelia infection rates for ticks comprise 30%. An increase in Borrelia tick infestation was detected within the vicinity of populated areas. The amount of ticks directly depends on the temperature (20°C-25°C) and moisture (from 50%) values.

Borelis Pro phytomedicine for the complex treatment of Lyme borreliosis in children

IntroductionLyme disease, also known as Lyme borreliosis (LB) (tick (Ixodes)borne borreliosis) is a transmissible, natural-focal disease characterized by damage of the skin, nervous system, heart.Material and methodsUnder observation were 68 children – residents of Ternopil region, who applied to Ternopil Regional Children Hospital, and whose age range was 8–17 years. Two schemes of complex treatment of patients were tested: the 1st – patients received Doxycycline (Unidox Solutab®), tablets 100 mg, 10 pcs. 2 time/day after meals for 14 days at a dose 4 mg/ kg; the 2nd – patients received the treatment regimen like the 1st group and phytomedicine “Boreliss pro” capsules, 28.56g, 60 pcs. (Duo Life Boreliss Pro., Poland) 1 capsule 2 time/day after meals for 14 days.ResultsResults showed that was significantly (p < 0.05) lower severity of LB in patients who received antibacterial therapy in combination with doxycycline hydrochloride and phytomedicine “Boreliss pro” (1 caps. 2 times/day, after meals), compared with individuals in another group, on the 30th day after treatment. Complex therapy of patients by phytomedicine “Boreliss pro” causes a decrease of pro-inflammatory levels of cytokines IL-1β in the serum.ConclusionsComprehensive treatment of patients with an erythematous form of LB by phytomedicine “Boreliss pro” contributes to a significantly (p < 0.05) faster disappearance of clinical manifestations of LB, shortening the duration of doxycycline hydrochloride use, and reducing the likelihood of side effects from this drug.

Spatial and temporal distribution patterns of tick-borne diseases (Tick-borne Encephalitis and Lyme Borreliosis) in Germany.

BackgroundIn the face of ongoing climate warming, vector-borne diseases are expected to increase in Europe, including tick-borne diseases (TBD). The most abundant tick-borne diseases in Germany are Tick-Borne Encephalitis (TBE) and Lyme Borreliosis (LB), with Ixodes ricinus as the main vector.MethodsIn this study, we display and compare the spatial and temporal patterns of reported cases of human TBE and LB in relation to some associated factors. The comparison may help with the interpretation of observed spatial and temporal patterns.ResultsThe spatial patterns of reported TBE cases show a clear and consistent pattern over the years, with many cases in the south and only few and isolated cases in the north of Germany. The identification of spatial patterns of LB disease cases is more difficult due to the different reporting practices in the individual federal states. Temporal patterns strongly fluctuate between years, and are relatively synchronized between both diseases, suggesting common driving factors. Based on our results we found no evidence that weather conditions affect the prevalence of both diseases. Both diseases show a gender bias with LB bing more commonly diagnosed in females, contrary to TBE being more commonly diagnosed in males.ConclusionFor a further investigation of of the underlying driving factors and their interrelations, longer time series as well as standardised reporting and surveillance system would be required.

Early neuroborreliosis in children, Bannwart syndrome (clinical observations)

The problem of ixodic tick-borne borreliosis remains relevant due to its ubiquity, high incidence, especially in the Northwestern Federal District, a variety of clinical manifestations, as well as the possibility of chronization, including in children.Purpose: to describe our own clinical observations of Bannwart syndrome, which developed during the dissemination of the pathogen.Results. Bannwart syndrome is pathognomonic for borreliosis symptoms, including a triad of clinical manifestations: serous meningitis, single- or bilateral lesion of facial nerves, polyneuropathy. Timely clinical and adequate laboratory diagnostics determine the favorable course of the disease.

Results of epizootic monitoring of natural foci of particularly dangerous infections common to humans and animals in Rostov Oblast

Objective: To analyze the results of epizootic monitoring of natural foci of particularly dangerous infections common to humans and animals in Rostov Oblast to establish their activity.Materials and Methods: The data of epizootic monitoring conducted by zoologists; the results of laboratory research of field material obtained in natural foci of infectious diseases. Descriptive, zoological, genetic, serological methods, and retrospective epidemiological analysis were used.Results: The results of the conducted epizootic monitoring showed the presence in Rostov Oblast of natural foci of particularly dangerous infectious diseases common to humans and animals. While the natural focus of the plague is in a depressed state and does not show activity, in the foci of tularemia, West Nile fever (WNF), Crimean hemorrhagic fever (CHF), ixodic tick-borne borreliosis (ITB), hemorrhagic fever with renal syndrome (HFRS), Q fever, Batai fever, California serogroups, Syndbis revealed the antigens of these pathogens in biological material obtained from small mammals and blood-sucking insects, which indicates the epizootic activity of these foci. In the natural foci of WNF, CHF, ITB, HFRS, cases of these disease among the population were recorded, which confirms the epidemic activity of these foci.Conclusion: The obtained results of epizootic monitoring over the period from 2008 to 2020 emphasize the relevance and necessity of continuing these studies in natural foci in Rostov Oblast.

The Problem of Natural Focal Infectious Diseases in the Volgograd Region: A State-of-the-Art Review

Introduction: The importance of the problem of natural focal infections (NFIs) in the world is associated with their wide spread and a severe clinical course. The Volgograd Region, which is part of the Southern Federal District, is endemic for a whole number of NFIs. Regional epizootic and epidemic manifestations in foci of plague, tularemia, Q fever, ixodes tick-borne borreliosis (Lyme disease), hemorrhagic fever with renal syndrome (HFRS), Crimean – Congo hemorrhagic fever (CCHF), and West Nile fever (WNV) have been of varying degrees of activity over a long period of time. Objective: To study the features of epidemic and epizootic manifestations of natural focal diseases (plague, tularemia, Lyme disease, HFRS, WNV, CCHF, Q fever) in the territory of the Volgograd Region. Materials and methods: We analyzed the results of epizootologic and epidemiologic surveillance carried out in natural foci of contagious diseases in the Volgograd Region over the past decade, including data on the incidence of NFIs and the results of laboratory testing of zoological and entomological assays. We did an epidemiologic analysis of the ten-year rate, structure and changes in the incidence of natural focal diseases in the population of the Volgograd Region. Electronic databases were developed and analyzed in Microsoft Excel 2010 (Microsoft, USA). Results and discussion: We established that over the past decade, the number of endemic areas in the Volgograd Region has risen from 18 to 25 for СCHF and from 5 to 11 for Lyme disease. At present, all regional districts are endemic for tularemia, WNV, HFRS, and Q fever, 25 districts – for CCHF, and 11 – for Lyme disease. We observed a general promising tendency towards a decrease in incidence rates for all nosological forms. At the same time, the incidence of Q fever and Lyme disease remains low while that of HFRS and СCHF is somewhat higher. The West Nile fever, epidemic manifestations of which have been registered since 1999, is the main challenge in terms of NFIs in the Volgograd Region today.

Lyme disease: Modern approaches to prevention, diagnosis and treatment

Lyme disease (LD) or tick-borne borreliosis affects thousands of people every year in different regions of the world, primarily the United States and Europe. In endemic areas, early LD is a common disease that requires high medical vigilance. Considering the extreme relevance of this problem for public health, in November 2020, the committee of experts of three American scientific societies published an updated version of the clinical guidelines for the prevention, diagnosis and treatment of LD, the main provisions of which are presented in this article. It is emphasized that in the absence of vaccines, the risk of LD and other diseases transmitted by ticks can be reduced by using personal protective equipment and repellents. Antibiotic prophylaxis is carried out by a single oral administration of doxycycline. In the laboratory diagnosis of LD, the determination of antibodies to B. burgdorfery in the blood serum is a first-line study. At the second stage, serum samples are examined using an immunoblot for IgM and IgG. The basis of treatment of LD is rational antibiotic therapy. The choice of an antibiotic depends on a number of factors, including the presence of extracutaneous manifestations of LD (neuroborreliosis, carditis, arthritis). The most commonly used are doxycycline, amoxicillin, cefuroxime-axetil and ceftriaxone.

Lipid peroxidation and oxidative modification of proteins in tick-borne encephalitis and ixodic tick-borne borreliosis

BACKGROUND: In the South Ural region of Russia, the group of ITTB and TBE occupies the leading rank positions in the structure of infections that are ecologically associated with ixodic ticks. At the present stage, studies aimed at studying non-specific pathological biochemical processes that determine the degree of oxidative damage to cell membranes and organelle membranes, the reactivity of the body, its reserve-adaptive potential under the influence of a number of endogenous and exogenous factors are becoming particularly relevant. One of the most significant metabolic processes of this kind is the free radical oxidation of lipids and the oxidative modification of proteins.
 AIMS: To give a clinical and epidemiological characteristic and to study the role of oxidative stress in the pathogenesis of various clinical forms of tick-borne infections in an endemic region (on the example of the Chelyabinsk region).
 MATERIAL AND METHODS: The study was conducted at the clinical base of the Department of Infectious Diseases of the Southern State Medical University in the MAUZ GKB No. 8 in Chelyabinsk. The study randomly included 105 patients with tick-borne encephalitis, ixodic tick-borne borreliosis and mixed infection who were hospitalized in the hospital in the period from May to October 20182019. The diagnosis was verified by standard immunological methods (ELISA). Modern molecular genetic methods (PCR-RV) were used in the etiological diagnosis of ICD. Material for the study: leukocyte fraction and blood serum. The content of carbonyl products of oxidative modification of proteins was estimated by their reaction with 2.4-dinitrophenylhydrazine, followed by spectrophotometric registration of the interaction products-dinitrophenylhydrazones. When determining the content of primary and secondary products of lipid peroxidation, a method based on the phenomenon of rearrangement of double bonds into diene conjugates during the peroxidation of polyunsaturated fatty acids was used. Statistical processing of the obtained results was carried out by standard methods of nonparametric statistics using the Statistica 8.0 for Windows software package.
 RESULTS: In the structure of infections transmitted by ixodic ticks, ixodic tick-borne borreliosis was most often registered (50.5%), tick-borne encephalitis was observed in 44.8% of cases, mixed infection ― in 4.7%. Borrelia miyamotoi DNA was detected by PCR-RV in 8.6% of biological samples (blood serum, leukocyte fraction). When analyzing the results of oxidative modification of proteins and lipid peroxidation, a reliable picture of oxidative stress is observed, which is more pronounced in patients with ixodic tick-borne borreliosis.
 CONCLUSION: The revealed changes in the study of oxidative stress in patients with tick-borne encephalitis and ixodic tick-borne borreliosis not only indicate the prospects of developing new approaches to the pathogenetic therapy of tick-borne infections, providing for the use of antioxidants in complex therapy, but also suggest a greater effectiveness of direct-acting lipophilic antioxidants that limit diene conjugation, and thereby prevent the accumulation of secondary cytotoxic products of lipid peroxidation.

Multilocus Sequence Analysis of Isolates from Patients with the Erythemic Form of Ixodid Tick-Borne Borrelioses

Multilocus Sequence Analysis of Isolates from Patients with the Erythemic Form of Ixodid Tick-Borne Borrelioses

Gene-specific features of tick-borne borreliosis in Russia

Aim. To study the gene-specific composition of Borrelia spp. in ixodid ticks inhabiting the foci of ixodid tick-borne borreliosis (ITBB) in the south of Western Siberia.Materials and Methods. The gene-specific composition of Borrelia spp. in ixodid ticks was determined by inoculation on a BSK-H nutrient medium, real-time polymerase chain reaction, and sequencing (1148 specimens of ixodid ticks collected from vegetation and 2183 specimens withdrawn from humans).Results. Infection of ticks with borrelia ranged from 22.4% in the Altai Republic to 56.9% in the Novosibirsk Region. There were no significant differences in the levels of Borrelia infection between two major ixodides, I. persulcatus and I. pavlovskiy (average infection levels 40.0% and 38.8%, respectively). At least five gene species of pathogenic Borrelia (B. garinii, B. afzelii, B. bavariensis, B. miyamotoi, and B. spielmanii) have been identified. The GenBank database contains 45 nucleotide sequences of the intergenic spacer rrf (5S)-rrl (23S). Prevalence of gene species B. garinii and B. afzelii in different ticks (I. persulcatus and I. pavlovskiy) did not differ significantly, yet B. garinii was found to be more frequent than B. afzelii. The frequency of infection of I. persulcatus ticks with B. miyamotoi was significantly (3.5-fold) as compared to those of B. garinii and B. afzelii. In D. reticulatus ticks, the DNA of B. spielmanii and B. miyamotoi was detected.Conclusion. It is necessary to continue studies to assess the role of the meadow ticks D. reticulatus in the circulation of different Borrelia spp. in various natural foci within the Russian Federation.

Priority directions for non-specific prevention of tick-borne infections

Objective. An important role in the prevention of diseases, the causative agents of which are transmitted by ixodic ticks (tick-borne encephalitis, ixodic tick-borne borreliosis, human granulocytic anaplasmosis, human monocytic erlichiosis) is assigned to non-specific measures. To prevent infection by all pathogens of these infections at the same time, nonspecific preventive measures are of paramount importance. They include the extermination of hungry ticks on the vegetation of relatively small areas of natural biotopes, forest parks, health institutions, recreational areas, summer cottages or gardens; individual protection of the population from ticks and awareness-raising work.
 Materials and methods. The data of official statistics and materials of long-term observation of epidemic process were analyzed.
 Results. Despite the fact that since 2016 according to official data, there is observed a phase of decreased activity of the epidemic process of tick-borne infections, statistical analysis shows that in the forthcoming years an activation of epidemic situation is expected.
 Conclusions. In order to prevent tick attacks, specialists of medical organizations, departments of Rospotrebnadzor of the Russian Federation should intensify sanitary and educational work on non-specific protection of the population. In addition to standard activities, it is important to organize schools, courses for the public, schoolchildren, tourists and other population groups for the prevention of tick-borne infections, including the development of skills for correct tick removal using the Tick Removal Trainer and an algorithm for emergency measures in specific situation.

Detection of Coxiella burnetii and Borrelia spp. DNA in Cutaneous Samples and in Household Dust in Rural Areas, Senegal.

Q fever and tick-borne borreliosis are two zoonotic diseases rarely diagnosed in Senegalese health facilities, particularly in rural areas. Our study aims to better understand the circulation of Coxiella burnetii and Borrelia spp. DNA on human skin and the domestic environment in rural areas. Cutaneous swabs were taken from febrile patients being treated for borreliosis and/or Q fever, the members of patients' households and control households in the Niakhar area. Dust samples were also collected from 90 households where 54 cases of borreliosis and Q fever were reported as well as from the households of members of control populations in Dielmo, Ndiop, and Niakhar. C. burnetii and Borrelia spp. DNA were detected by quantitative PCR in cutaneous swabs and dust samples targeting spacers IS1111_IS30A and Bor 16S gene. Of 1365 persons tested, 76 were shown to carry C. burnetii, 13 Borrelia spp., and 6 were identified as carrying both C. burnetii and Borrelia spp. The prevalence of Borrelia spp. DNA in households was 16.7% in Dielmo, 6.7% in Ndiop, and 23.3% in all other villages in the Niakhar area, and the presence of C. burnetii in the same localities was 10%, 13.3% and 66.7%, respectively. Furthermore, C. burnetii genotyping identified the presence of Multispacer Sequence Typing group 6. These results revealed for the first time the carriage on the skin of C. burnetii and Borrelia spp. DNA in humans and its wide distribution across households. Our findings suggest that many populations are exposed to these diseases, with frequent contaminating cases of infectious origin arising from the domestic environment.

Review of the Epidemiological Situation on Ixodic Tick-Borne Borreliosis in the Russian Federation in 2010–2020 and Prognosis for 2021

Objective was to analyze the epidemiological situation on Ixodidae tick-borne borreliosis (ITBB) in the constituent entities of the Russian Federation in the dynamics over the period of 2010–2020, taking into account the features of the year 2020, associated with the spread of COVID-19, and to forecast the development of the epidemic process for 2021. In 2020, 4180 cases of ITBB were registered in the Russian Federation, which is 1.93 times less than in 2019 and 1.73 times less than the long-term average annual figure for the previous 10 years. A significant decrease was noted in all federal districts (FD), with the exception of the Central FD, where more than half of all cases occurred. Compared to 2019, 75 out of 78 subjects experienced a decrease in the incidence rate in 2020, while in 56 entities that decrease was statistically significant. The multiplicity of the decrease in the incidence of ITBB in 2020 for all FD was significantly greater than the multiplicity of the decrease in the frequency of contacts of the population with ticks. Infection of Ixodidae ticks of various species with borrelia in natural foci in 2020 was statistically significantly higher than in 2019. Probably, the decrease in the registered incidence of ITBB against the background of the COVID-19 pandemic is due not only to a decrease in the intensity of contacts of the population with natural foci, but also to a sharp redistribution of the volume of inpatient and outpatient medical care in favor of COVID-19 patients. Given the high degree of significance of the identified trends in the dynamics of the epidemic ITBB process during 2010–2020, there is reason to expect an increase in the incidence in the Bryansk, Voronezh, Ryazan, Tula and Saratov regions in 2021, which requires special attention in terms of strengthening preventive measures and monitoring of the activity and structure of natural foci. In the rest of the entities of the Russian Federation, provided that the volumes of preventive measures are maintained on the same level and in the absence of abnormal natural and climatic phenomena, preservation or a slight reduction in the incidence of ITBB is likely to occur in the short term. At the same time, despite the tense situation regarding the new coronavirus infection, there is an obvious need to draw close attention to the problems of diagnosis and prevention of natural focal infections.

Cognitive disorders in patients with nervous system injuries by persistent degrees

Purpose of the study. To study the severity of CP in patients with lesions of the nervous system by persistent pathogens.
 Materials and methods of research. Clinicalneurological and neuropsychological research. 53 patients were examined, including 42 (72,24%) women and 11 (20,75%) men. Among them, 32 (60,37%) patients with herpesvirus lesions of the nervous system and tickborne borreliosis (chronic form) – 21 (39,62%). Age of patients – from 19 to 64 years. The control group consisted of 30 people who had no history of herpesvirus lesions of the nervous system and tickborne borreliosis aged 20 to 60 years. According to the involvement of the central and peripheral nervous system in the pathological process, the clinical diagnoses were as follows: arachnoencephalitis, encephalitis, meningoencephalitis in 22 patients (41,5%), arachnoiditis 12 (22.64%), encephalomyelitis 1 (1,88%), diffuse encephalomyelitis 6 (11,32%), arachnoencephalomyelopolyneuropathy 3 (5,66%), encephalopolyneuropathy 5 (9,43%).

Development and application of the technique for identification of Borrelia miyamotoi surface antigens

Introduction. Borrelia miyamotoi is a pathogen causing erythema-free ixodid tick-borne borreliosis (ITBB), a disease widespread in Russia. The genome of B. miyamotoi contains genes of multiple variable major proteins (Vmps). Vmps fall into two families — Vsps and Vlps (with subfamilies δ, γ, α and β). At a particular time, a single B. miyamotoi expresses only one variant of Vmp gene.The purpose of the work is to develop a technique for identification of the Vmp present at the expression site.Materials and methods. The technique is designed in the format of a real-time multiplex PCR. It was tested by using B. miyamotoi DNA samples extracted from blood collected from 172 ITBB patients and 109 ticks. The samples were collected in 14 regions of Russia.Results. The new technique made it possible to identify the expressed Vmp in 82% of the examined samples, thus having demonstrated its efficiency. Negative results were much less often observed with samples from patients than with samples from ticks. At the same time, the percentage of samples with one type of Vmp is identical for clinical samples and ticks, while the percentage of samples containing concurrently two types of Vmps is significantly higher among samples from patients with the most frequent occurrence of the Vlp-δ and Vsp combination.Discussion. The frequent occurrence of the combination of two Vmp types in the blood samples can indicate the concurrent presence of several subpopulations of B. miyamotoi in ITBB patients. A new antigenic Vmp variant is synthesized after protective antibodies have been produced for the major protein of the strain transmitted by a tick. This phenomenon known as immune evasion allows the pathogen to persist within a host.Conclusion. The developed technique of real-time multiplex PCR allows to simultaneous detect of several antigenic variants of the variable basic surface proteins of B. miyamotoi. The study of the antigenic spectrum of B. miyamotoi strains in comparison with the characteristics of conserved regions of the genome by the method of multilocus sequencing will clarify the stages of evolution and distribution of B. miyamotoi sensu lato.