Tick-borne Borreliosis Research Articles

BORRELIOSIS: A HIDDEN THREAT FOR KAZAKHSTAN

Tick-borne borreliosis, commonly known as Lyme disease or Lyme borreliosis, is a natural focal zoonotic transmissive disease caused by the Borreliella burgdorferi sensu lato complex. If left untreated, the disease can cause damage to the nervous system, joints, or skin, as well as lead to development of chronic atrophic diseases. Diagnosis of borreliosis remains a challenge owing to variations in clinical symptoms and manifestations, simultaneous damage to several organs, and frequent latent persistence of the pathogen in the body, leading to misdiagnosis or late diagnosis. This situation results in defects or delays in the provision of medical care with a high frequency of residual consequences, resulting in temporary disability for the patient that imposes a significant social-economic burden. Ticks of the genus Ixodes are the main carrier of the disease, which inhabit the mountain regions of eastern and southeastern Kazakhstan. However, the distribution area of these ticks has been expanding in recent years owing to the effects of climate change, resulting in an increase of natural foci of tick-borne borreliosis. We here provide updated data on the epidemiology, etiology, pathogenesis, and diagnostic methods for Lyme borreliosis, along with an overview of modern molecular methods for the analysis of borrelia. Moreover, we offer an overall assessment of the risks associated with this disease for Kazakhstan.

Epidemiological Manifestations Ixodid Tick-Borne Borreliosies in Irkutsk and in other Parts of the Eurasian Area

Background . Ixodid tick-borne borrelioses (ITBB) is the most prevalent in Northern Hemisphere group of transmissible Spirochaetal infections, ecologically connected with Ixodid ticks. ITBB are etiologically associated with several agents, which determine epidemiological and clinical manifestations of these diseases. Research aim - the detection of ecological and epidemiological peculiarities of ITBB manifestations in the Baikal Region during the long-term period by comparison with that in the other parts of geographic range and the analysis of the manifestations dynamics. Material and methods. The database, developed by the authors, with information about ITBB cases in Irkutsk (1995-2017, n = 867) have been used in the work, and the similar studies in Russian and world literature have been reviewed. Statistical analysis was computed in Microsoft Excel Software. The map of infecting sites is made in ArcGis Soft (ESRI, USA). Results. The data have been analyzed on ecological and geographical (place and time of the infected tick bite), epidemiological (gender, age, localization of the tick bite, form of the disease), social and behavior (employment and circumstances of the infecting, including professional risk activities) signs. The interrelationship of some of them and their temporal evolution was studied. Similarities and differences of the ITBB manifestations in Baikal Region and other parts of the disease area have been revealed. The following peculiarities of ITBB in Baikal Region were found: 1) the average age of the patients is over 40; 2) a slightly higher number of males between the patients (57.3%); 3) increase (from several cases up to 40-47%) in the proportion of ITBB form without skin manifestations from the beginning to the end of the analyzed period; 4) the significant age difference between patients with and without skin manifestations (primarily persons over 50 and mainly the children respectively).

Erythematous ixodic tick-borne borreliosis in children over twenty-year monitoring period

We generalized the observed results obtained in the last twenty years from patients at the age of 1 to 14 years suffered from acute erythematous ixodic tick-borne borreliosis. Clinical characteristics of erythematous ixodic tick-borne borreliosis have not changed dramatically over twenty years. Key manifestations in children remain erythema at the site of a tick bite, fever, and regional lymphadenitis. These signs allow us to diagnose nosological form of the disease.

Structure and Peculiarities of a Clinical Course of Tick-Borne Infections in Children of the Irkutsk Region

At present there are few studies generalizing the clinical picture of infections, transmitted by Ixodid ticks, in children population. Tick-borne viral encephalitis is still one of the important natural focal infections and accounts for up to 27 % among other tick-borne infections. The aim of the study was to determine the structure and features of the clinical course of tick infections in children of the Irkutsk region. Materials and methods. We conducted a retrospective analysis of 58 cases over three-year period from 2015 to 2017 of children aged 1 to 18 years diagnosed with tick-borne viral encephalitis (TVE), ixodid tick-borne borreliosis (ITB), tick-borne rickettsiosis (TR) according to the data of Irkutsk Regional Infectious Clinical Hospital. Results and discussion. Among tick-borne infections, TVE was found in 43 % of cases, ITB – in 27.5 %, TR – in 29.5 %, there was one case of mixed infection: TVE + tick-borne typhus in North Asia. In TVE, feverish form was found in 40 % of cases, meningeal form – in 36 %, meningoencephalitic form – in 20 %, polyradiculonevritic form – in 4 %. Medium severity was observed in 56 % of cases, severe – in 28 %. In ITB, non-erythematous form was revealed in 62.5 % of cases, erythematous – in 12.5 %. Clinical and epidemiological TR was registered in 18 % of cases. In patients with TVE recovery was observed in 84 %, however, there were 4 % of neurological complications. With the diagnosis of ITB and TR, almost all children were discharged in a satisfactory condition. No deaths were reported within 3 years. According to the medical history: only 1 child was vaccinated against TVE, 2 children underwent seroprevention; ticks, who bit 4 patients, were studied. Medical history showed that 57 % of children had tick bites, and 7 % of cases associated the disease with consumption of non-boiled goat or cow milk. Residents of Irkutsk, Angarsk and Shelekhov comprised 47 %, residents of the Irkutsk region – 53 %. The most common localization of bites is the head and neck. Conclusion. There is a low public commitment to the vaccine prevention of tick-borne infections. Therefore, it is necessary to promote both specific and non-specific prevention of tick-borne encephalitis among children of the Irkutsk region.

Generation of Databases and Visualization of Current Epidemiological Information for Purposes of a Medical-Ecological Monitoring of a Region

The geo-ontology principles of identifying the functional connectivity of all components of the socio-biological system have been used as the basis for developing a unified and scientifically rigorous methodology of preprocessing epidemiological information and its preparation for further use. The specific features in epidemiological information are highlighted as well as the need for territorial linkage of the objects and situations under study in order to ensure the adequacy of management decisions. According to the principles of designing relational databases, an integrated epidemiological database has been generated, which includes the geographical coordinates of the objects and situations under study. Such a territorial linkage when implemented using GIS technologies provides a means of solving regional problems of estimating the probability of disease with due regard for the specific features of the location, which ensures competent and targeted work of the system of medical and environmental monitoring. The continually updated databases have been created and patented, which are compatible with ArcGIS and contain basic epidemiological data on the incidence of tick-borne encephalitis and tick-borne borreliosis, based on information received from hospitals in Irkutsk. For updating the integrated database with information on the occurrence of infections across landscapes, annual (since 2005) expeditions have been conducted in several key areas of Irkutsk oblast which are distinguished by landscape diversity, vector size, attendance and morbidity of the population. Ticks and their hosts are collected and analyzed for the presence of pathogens of natural focal infections. More than 25 thousand ticks were caught, whose infection with tick-borne encephalitis virus averaged 1.5%. Visualization of epidemiological information used the methods of end-to-end geographical mapping of the territory, the logic of which formulates the principles of geoinformation mapping and naturally includes a natural territorial component.

Identification of the Spectrum of Pathogens in Ixodid Ticks from Natural Co-Infection Foci of the Baikal Region

Ixodid ticks from different regions of the Baikal Region were examined for the presence of transmissive pathogens during 5 seasons (2013–2017). Frequency of occurrence of the revealed markers in ascending order: tickborne encephalitis virus (TBEV), human monocytic ehrlichiosis (HMC), human granulocytic anaplasmosis (HGA), ixodid tick-borne borrelioses (ITBB), and tick-borne rickettsioses (TBR). The most significant differences in the rate of infection were noted in relation to spatial-temporal and species parameters. In the Baikal Region, infected ticks Ixodes persulcatus were found significantly more frequently than Haemaphysalis concinna. Besides, from 2 to 4 pathogens in different combinations were found simultaneously in 15% of suspensions of the taiga tick.

IX0DIC TICK-BORNE B0RRELI0SIS IN THE SAMARA REGION

The article is devoted to the identification of regional peculiarities of tick-borne borreliosis in the Samara region. Over the past 10 years, the Samara region has seen an increase in the number of cases of ticks sucking by 2.5 times, as well as an increase in contamination of ixodic ticks by Borrelia. Infection of patients with tick-borne borreliosis was observed not only in forest area, but also in the city. Cases of the disease were recorded from May to October. In this region asthenovegetative syndromes, exanthema, fever and regional lymphadenitis were revealed in patients diagnosed with ixodic tick-borne borreliosis.

Seroprevalence of tick-borne encephalitis and Lyme borreliosis in a defined Czech population

Purpose: The South Bohemian Region of the Czech Republic is an endemic area of tick-borne encephalitis (TBE). In 2017, the inhabitants of Římov municipality developed a serious course of TBE and Lyme borreliosis (LB). This led experts to research and serology examinations of the inhabitants of Římov in order to detect the seroprevalence of TBE and LB. Methods & Materials: Římov is situated on the Malše river. A water dam has been built on the river, there are extensive deciduous and mixed forests around the waterways and the biotope allows for the development of ticks. A questionnaire was distributed to all the inhabitants of the municipality to get the basic information (life span, occupation, experience with TBE and LB, vaccinations against TBE, number of tick bites per year and the interest in detection of antibodies of TBE and LB). The questionnaires have been evaluated and participants, who gave their consent, were blood tested and serological tests have been done. A total of 114 people participated in the study. Results: From the questionnaires and the serological examination, it appeared that 4 persons (3.5%) experienced the manifest form of TBE and 5 people (4.4%) experienced the latent form of TBE. In total, 7.9% of the sample experienced the manifest or the latent form of TBE. 80% of the sample confirmed sufficient antibody levels after vaccination. 12.1% of the population remain vulnerable. 32.5% of the sample experienced Lyme disease (9 people, i.e. 7.9% manifested the disease, 22 people (19.3%) had latent disease, early phase of the infection was confirmed in 6 people (5.3%). 77 people (67.5%) remain vulnerable. Conclusion: A serological examination of the population's research sample revealed that of the people living in the focus point of TBE in Římov, approximately 8% have developed antibodies after being diagnosed the disease or having experienced the latent form and 80% have created antibodies after vaccination. Anamnestic antibodies after being diagnosed or having experienced the latent form of LB, or the early phase of the infection was demonstrated in 32.5% of the study sample. Further research will be focused on testing the ticks of the given site.

Іксодові кліщі: екологічні особливості, поширення та епідеміологічне значення

The hard-bodied ticks of the Ixodidae family are harmful blood-sucking animals and humans ectoparasites, as well as pathogens carriers, including tick-borne encephalitis and Lyme borreliosis. Their prevalence is extremely important in the Western region of Ukraine. Significant increasing of ticks incidence require protective proceeding. Therefore, the purpose of study is to analyze over the last decade scholars reports, regarding the Іxodіdae ticks biological and ecological features, the patterns of their biotopic distribution, epidemiological and medical significance. Reports analysis has shown that all stages of ticks highly dependent on three major natural factors: temperature, humidity and presence of nutrients. In May – June and August – September these factors are the most favorable. It has been found that behavioral responses of the perception of abiotic factors play a prominent role in ensuring the life cycle of Іxodіdae ticks. These reactions also lead to the prolongation of their seasonal activity in the climate change observed in the world and Ukraine. Moreover, the adaptive responses of ticks are related to the infection level by various pathogens that modify gene expression, affecting the ticks metabolism and contributing to the resistance of these arthropods to adverse environmental conditions. The prevalence of ticks is affected by the host density including rodents, other wild mammals and dogs, which has a particular effect on the Lyme-borreliosis incidence. Distinctive importance in the pathogens transmission is nymphs and imago, and there are multiple pathogens combinations, which in turn duration affects, course and prognosis of human diseases. Both the time of tick feeding and the bacteria strains has an impact on potency of the host borrelia infection in natural conditions. The larvae epidemiological status is ambiguous and require further study, moreover study of the tick salivary glands microbiotic components is favored

Этиологическая структура и особенности современного течения иксодовых клещевых боррелиозов в Челябинской области

Этиологическая структура и особенности современного течения иксодовых клещевых боррелиозов в Челябинской области

Urgent natural foci infections transmitted by ticks in Saint-Petersburg

Purpose: to conduct a comparative analysis and to identify the epidemiological and clinical features of tick-borne encephalitis (TBE) and Lyme borreliosis as a mono- and coinfections in St. Petersburg. Materials and methods. 718 cases of TBE, 4353 cases of Lyme borreliosis and 127 combined diseases registered by the St. Petersburg epidemiological bureau in 2006-2017 were studied. Identification of combined diseases was carried out by a special software that allows to identify co-morbid diseases from the array of monoinfections. To identify clinical and epidemiological features, 144 cases of TBE, 286 Lyme borreliosis, and 43 cases of co-infection were studied. Age and sex characteristics, places of human contagion, infection rates of ticks, clinical forms of mono- and associated diseases, morbidity dynamics changes and patients’ IgM seropositivity were studied. Results. The long-term dynamics of TBE and Lyme borreliosis incidence had did not have significant upward or downward trends, it was characterized by synchronous fluctuations. The priority of the incidence of men over women is revealed. 61–69% cases of TBE and Lyme borreliosis occurred in Leningrad region, 19–30% – in the adjacent territories of Russia, 5,7–6,7% of cases were imported from other countries. High tick infection rates of TBE virus and Borrelia was revealed. Borrelia аnd virus of TBE and were detected in 81,6–87,5% of the examined ticks removed from patients with a later established diagnosis. Seasonal distribution of Lyme borreliosis was shifted by a month to the right in comparison with TBE. The clinical forms of both diseases did not differ in their structure from the country data, however after 2012 subclinical forms were more common in women. The proportion of non-erythematous forms of Lyme borreliosis in 2011–2015 compared with the 2006–2010 observation period increased almost 1,5-fold mainly forms, including those with co-infection. The IgM seropositivity rate in the dynamics of the disease testifies to the incomplete rehabilitation of patients. Conclusion. The clinical and epidemiological characteristics of TBE, Lyme borreliosis and combined infection in the North-West region of Russia, with the example of St. Petersburg, have certain distinctive features. The reasons for the revealed features need further study.

EPIDEMIC AND EPIZOOTIC SITUATION OF NATURAL-FOCAL ZOONOTIC INFECTIONS IN VLADIMIR REGION

Aim. Assessment of the epidemiological and epizootic situation and the degree of danger of the territory of Vladimir region in terms of a complex of natural focal zoonotic infections. Materials and methods. In the work, a retrospective analysis of statistical data on the incidence of zooanthroponosis in the population, obtained from Reporting Form No. 2 «Information on Infectious and Parasitic Diseases» of Center for Hygiene and Epidemiology in the Vladimir Region for the period 1958 - 2016 was conducted. Studies of biological material for the presence of pathogens of natural focal infections were conducted in the laboratory of natural focal and especially dangerous infections of Center of Hygiene and Epidemiology in the Vladimir Region. Results. It is established that the following natural focal diseases are registered in the territory of the Vladimir region: rabies, heemorrhagic fever with renal syndrome (HFRS), tick-borne borreliosis (ТВВ), leptospirosis, pseudotuberculosis and tularemia. The largest share in the structure of morbidity falls on HFRS and ТВВ. Annual laboratory studies of biological material for the presence of pathogens of natural focal infections indicate the presence of epizootics among rodent mice, the dominant species among which is the red vole. The ratio of men to women with HFRS is about 3 to 1, the main risk factors for transmission are harvesting in summer cottages and visiting forest areas. As for the ТВВ, in the region there are persistent natural foci of this infection. It was established that there is no territorial dependence between the incidence and «riches» of the territory, and the main epidemiological significance is the iksodid mites I.ricinus and I.persulcatus. Conclusion. The cartographic mapping of the registered incidence allowed to show the territories with different degree of epidemic manifestation for individual natural-focal diseases and for a complex of morbidity in general. Positive laboratory results indicate epizootic activity and a constant risk of exacerbation of the epidemic situation of zooanthroponous infections, and the absence of human morbidity over a number of years is not evidence of the attenuation of the natural focus of infection and the basis for the curtailment of preventive measures.

BACTERIAL AND VIRAL PATHOGENS IN IXODES SP. TICKS IN ST. PETERSBURG AND LENINGRAD DISTRICT

Tick-borne infections are the most common group of zooanthroponotic diseases in the Northern Hemisphere. For the Baltic Sea region and Fennoscandia, the dominant infectious pathologies transmitted by ticks are tick-borne borreliosis and tick- borne encephalitis. The presence of vast forested areas, actively visited by people in St. Petersburg and the Leningrad region, contributes to a rather high level of encroachment on the flares and intelligence of the borreliosis and tick-borne encephalitis among the population of these regions. The relatively dangerous pathogens that can be transmitted with the tick bite are also of particular danger: Anaplasma sp., Ehrlichia sp., Coxiella burnetii, Rickettsia sp. In this work, detection was performed using molecular genetic methods of TBE virus, B. burgdorferi sensu lato and Rickettsia sp. in engorged ticksple, as well as questing ticks collected from vegetation. The established levels of infection of TBE on infected ticks, levels of infection by pathogenic Borrelia of questing and engorgeded ticks were approximately equal. Rickettsia was not found in the ticks. The conducted analysis of the pathogens prevalence in comparison with the data of russian and foreign authors. Monitoring the prevalence of tick-borne pathogens is an important issue in the prevention of tick- borne infections in the North-Western Russia.

EPIDEMIOLOGICAL FEATURES OF IXODES TICK-BORNE BORELIOSES IN THE KRASNOYARSK TERRITORY IN THE CONTEXT OF SEARCHING FOR THE CASES OF INFECTION CAUSED BY BORRELIA MIYAMOTOI

Aim. Estimation of the prevalence of Ixodes tick-borne borreliosis (ITBB) without erythema migrans in the Krasnoyarsk Territory in comparison with the prevalence of ITBB with erythema, that is Lyme disease (LD). Detection of cases of «new» infection caused by Borrelia miyamotoi (ITBB-BM) among patients with suspected tick-borne infection, primarily among patients with ITBB without erythema (ITBB-W/O-E). Materials and methods. We analyzed the database of Rospotrebnadzor containing individualized information about cases of ITBB officially registered in the Krasnoyarsk Territory in 2011 — 2016. Blood samples from 18 patients with suspected of tick-borne infection hospitalized in the Krasnoyarsk Emergency Hospital in 2017 were collected and studied. ITBB-BM was diagnosed if B. miyamotoi DNA was found in patient’s blood and/or the antibodies to specific antigens of B. miyamotoi were detected. Results. With an average annual incidence rate of ITBB of about 10 cases per 100,000 population, the proportion of ITBB-W/O-E among all ITBB in the Krasnoyarsk Territory is about 45%. Epidemiological characteristics of ITBB-W/O-E and LD are similar, but these diseases are very different clinically. All cases of ITBBW/O-E and some cases of tick-borne infections of unknown etiology, subjected to our enhanced laboratory diagnostics, were caused by B. miyamotoi. Conclusion. ITBB-W/O-E is a widespread disease in the Krasnoyarsk Territory, caused mainly by B. miyamotoi. The results of the study significantly expand the known geographic area of the ITBB-BM.

Utility of Borrelia burgdorferi sensu stricto C6 Peptide for Serologic Confirmation of Erythema-Free Ixodid Tick-Borne Borrelioses in Russia.

We evaluated the utility of Borrelia burgdorferi sensu stricto (Bb) peptide C6 for serologic confirmation of Ixodid Tick-Borne Borrelioses (ITBB) in Russia. Serum samples (N = 1089) were from erythema migrans (EM) (N = 327) and the EM-free (EMF) patients (N = 115); in some patients, the disease was accompanied by human granulocytic anaplasmosis or tick-borne encephalitis. The sera were investigated by multiplex phosphorescence analysis (PHOSPHAN) for IgM to Bb C6, recombinant OspC and VlsE proteins, and IgG to C6 from Bb, B. garinii (Bg), and B. afzelii (Ba). Detection of Bb C6 IgM/IgG provided effective serologic confirmation of ITBB in both EM and EMF patients early after disease onset. In the EM-free patients, however, this test needed to be supplemented with detection of VlsE IgM in convalescent-phase sera due to delay in development of the antibody responses for C6 IgG. In general, positive PHOSPHAN reactions were observed in 81.9% and 86.7% of the EM and EMF patients, respectively, as well as in 59 of 65 (90.8%) patients, whose blood contained B. burgdorferi sensu lato DNA. Additional detection of IgG to Bg C6 or Ba C6 had no significant contribution to serologic diagnosis of ITBB in both patient groups.

Forecasting next season\u2019s Ixodes ricinus nymphal density: the example of southern Germany 2018

The castor bean tick, Ixodes ricinus (L.) (Ixodida: Ixodidae), is the principal vector of pathogens causing tick-borne encephalitis or Lyme borreliosis in Europe. It is therefore of general interest to make an estimate of the density of I. ricinus for the whole year at the beginning of the tick season. There are two necessary conditions for making a successful prediction: a long homogeneous time series of observed tick density and a clear biological relationship between environmental predictors and tick density. A 9-year time series covering the period 2009–2017 of nymphal I. ricinus flagged at monthly intervals in southern Germany has been used. With the hypothesis that I. ricinus density is triggered by the fructification of the European beech 2 years before, the mean annual temperature of the previous year, and the current mean winter temperature (December–February), a forecast of the annual nymphal tick density has been made. Therefore, a Poisson regression model was generated resulting in an explained variance of 93.4% and an error of hbox {RMSE} = 21 ticks per 100,hbox {m}^2 (annual hbox {MEAN} = 260 collected ticks/100,hbox {m}^2). An independent verification of the forecast for the year 2017 resulted in 187 predicted versus 180 observed nymphs per 100,hbox {m}^2. For the year 2018 a relatively high number of 443 questing I. ricinus nymphs per 100,hbox {m}^2 is forecasted, i.e., a “good” tick year.

The Classical Complement Pathway Is Required to Control Borrelia burgdorferi Levels During Experimental Infection.

Activation of the classical complement pathway occurs to varying degrees within strains of the Borrelia burgdorferi sensu lato complex, which contain a group of pathogenic spirochetes that cause tick-borne Lyme borreliosis, including the agent of Lyme disease in the United States, B. burgdorferi. Despite this information, details related to the control of B. burgdorferi by the classical pathway are not clear. To address this question, we infected C1qα−/− mice, which cannot assemble the C1 complex and thus fail to activate the classical pathway, with B. burgdorferi sensu stricto strain B31. Using bioluminescent in vivo imaging, we found that C1qα−/− mice harbored more B. burgdorferi following 10 days of infection relative to their isogenic C57BL/6 parent. Quantitative PCR (qPCR) demonstrated that C1qα−/− mice harbored significantly more B. burgdorferi than parent mice did within lymph nodes, skin, heart, and joints. The increased B. burgdorferi load in C1qα−/− mice was observed at 21 and 28 days of infection, consistent with the classical pathway promoting complement-dependent, antibody-mediated killing following the development of a B. burgdorferi-specific humoral immune response. In addition, circulating borrelial-specific IgM was higher in C1qα−/− mice relative to their parent mouse strain and did not decrease at 21 and 28 days post-infection, indicating that IgG class switching was delayed in C1qα−/− mice. At day 28, both Borrelia-specific IgG1 and IgG3 levels were higher in infected C1qα−/− mice, but that these antibodies were not sufficient to control borrelial infection in the absence of the classical pathway. Furthermore, the lack of C1q also altered the balance of the Th1/Th2 response, as both circulating Th1 (MIP-1α, IL-2, IL-12, and TNFα), Th2 (IL-4, IL-10, and MCP-1), and Th17 (IL-17) cytokines were elevated in infected C1qα−/− mice. These data imply that C1q and the classical pathway play important roles in controlling borrelial infection via antibody and complement-dependent killing, as well as altering both antibody maturation processes and the T cell response following exposure to infectious B. burgdorferi.

Ixodic tick-borne borreliosis: clinical and laboratory features.

For a differentiation of clinical forms of ixodic tick-borne borreliosis clinical laboratory assessment of features of the most often defined hemostasis and complete blood count (CBC) indicators is carried out. Ixodic tick-borne borreliosis in the territory of the Republic of Bashkortostan is characterized by mainly erythematous forms of a disease with a medium-weight current. At the same time some increase in quantity of platelets was noted that could be caused by irritation of a megakaryocytic sprout of bone marrow in the conditions of infectious process and have compensatory character whereas other indicators of CBC and hemostasis at this clinical form practically didn't change. Not numerous cases of the ixodic tick-borne borreliosis non-erythematous forms clinically proceeded more hard, with significantly more expressed toxicinflammatory syndrome. At the same time it was followed by significant shifts in biochemical parameters, indicators of CBC and hemostasis. The clinical laboratory features of erythematous and non-erythematous forms of ixodic tick-borne borreliosis revealed as a result of the conducted researches reflect character of a course of disease and can serve for assessment of severity, the forecast of the infection and justification of this treatment.

Genetic polymorphism of cytogenetic effects of radon bath therapy in the patients presenting with gonosteoarthritis of different etiology based at the Belokurikha health resort

Borrelia infection is known to develop as a result of the bites of the ixodid ticks while the extremely difficult working conditions and low temperatures contribute to the development of chronic gonosteoarthritis (CGA) associated with ixodid tick-borne borreliosis (ITB) in the residents of the northern part of Siberia. The objective of the present study was to elucidate the frequency of occurrence of the synovial cells in the knee joints exhibiting the cytogenetic abnormalities with special reference to trisomy of chromosome 7 and the glutathione-S-transferase (GSTM1) gene polymorphism in the residents of the northern part of Siberia presenting with Lyme borreliosis (LB) whose genotype contains some alleles of the GSTM1 gene before and after the treatment of LB-associated CGA with the use of the radon bath therapy. The secondary objective was to compare the respective characteristics and the results of the treatment with those in the patients with post-traumatic gonosteoarthritis (PTGA) and to evaluate the influence of the above abnormalities on the severity of CGA. The study included 69 patients having gonosteoarthritis associated with ixodid tick-borne borreliosis and residing in the northern areas of Siberia; in addition, 52 other individuals presenting with post-traumatic CGA made up the control group. The synovial cells of the knee joints were obtained from all the participants of the study for their culturing, making preparations, and analyzing chromosomal aberrations. The polymorphism of the GSTM1 gene was investigated with the use of the real-time polymerase chain reaction. The frequency of cytogenetic abnormalities in the synovial cells obtained from the group of patients presenting with LB-associated CGA who were the carriers of the homozygous mutant genotype GSTM1(0/0) was significantly higher than that in the patients having the normal genotype GSTM1(+) before the course of radon bath therapy. This treatment resulted in a significant decrease of the severity of pain syndrome and the improvement of the locomotor function of the affected joints in all groups of the patients involved in the study. The correlation analysis has demonstrated the significant positive correlation between the decrease in the frequency of occurrence of the synovial cells with trisomy of chromosome 7 and the severity of the pain syndrome. The results of the present study give evidence of the significant association between the genetic polymorphism of the glutathione-S-transferase gene and the frequency of cytogenetic abnormalities in the synovial cells of the knee joints of the patients suffering from CGA associated with LB. The treatment based on radon bath therapy caused a considerable decrease in the frequency of synovial cells with trisomy of chromosome 7 which correlated with the reduction of the intensity of the pain syndrome in these patients.

Ixodid tick-borne borreliosis in the Republic of Tatarstan (analysis of morbidity)

Ixodid tick-borne borreliosis in the Republic of Tatarstan (analysis of morbidity)