[Fractalkine--structure, functions and biological activity]. / Fraktalkina--budowa, wlasnosci i biologiczna rola.

Although chemokines, as chemotactic factors, were already known in 70's of the past century, it was only the progress in molecular biology, genetics and immunology which occurred in the past few years that opened the way to discover new molecules, their chemical structure and biological functions. Fkn (fractalkine, CX3CL1) is a unique chemokine and the only representative of CX3C group. It exists as a membrane-bound and soluble form. It interacts with cells expressing CX3CR1, a G-coupled protein receptor. The polymorphism of CX3CR1 gene modulates Fkn affinity to its receptror, which influences the risk of development and progression of various diseases. Its unique character is determined by its functions. Fkn is not only a chemotactic factor, but it also participates in leukocyte trafficking, adhesion and cytotoxic activities, modulates expression of cytokines, adhesion molecules, free oxygen radicals, iNOS and influences apoptosis. Its elucidation should not only help understanding of molecular events occurring in many autoimmune inflammatory, neoplasmatic diseases, but would allow to use Fkn, its receptor, or anti-Fkn antibodies in treatment of those diseases.

[Transforming growth factor beta, metalloproteinase 2 and its tissue inhibitor 2 in the serum from patients with early and late boreliosis]. / Transformujacy czynnik wzrostu beta oraz metaloproteinaza 2 i jej tkankowy inhibitor 2 w surowicy chorych na wczesnq i pózna borelioze z Lyme.

UNLABELLED: Boreliosis is an arthropod transmitted, bacterial infection, known for its complicated pathogenesis and prolonged course. Boreliosis can be divided into early, localized type, early generalized type as well as late type. Cytokines control homeostasis of the organism by transmitting signals between cells. TGF (transforming growth factor) beta is one of the cytokines that modulates cell differentiation, proliferation and angiogenesis. In larger concentrations it blocks the expression of IL-1 and TNF-alfa. TGF-beta stimulates production of selectin, collagen, fibrinoectin and integrin. It inhibits metalloproteinase that causes degradation of the above mentioned proteins. THE AIM OF THE STUDY: We assessed a concentration of TGF-beta in the blood of patients presented with an early form of boreliosis Erythema Migrans (EM) as well as in patients with an advanced form of this disease Lyme arthritis (LA) In addition, levels of metalloproteinase (MMP-2), its tissue inhibitor (TIMP) was assessed. We attempted to analyze the effects of treatment by measuring specific markers of inflammation. MATERIAL AND METHODS: We tested a group of 40 patients with Lyme disease. The first group included 20 patients with an early form--(EM), while the second group of 20 patients, had a chronic form of the disease--(LA). The control group consisted of 8 healthy blood donors. The serum levels of TGF beta, metalloproteinase (MMP-2) and its tissue inhibitor (TIMP-2) were obtained using ELISA. Levels were obtained prior to treatment and after 4 weeks of treatment with Doxycyclin or Rocephin (Ceftriaxon). RESULTS: The results indicated that levels of TGF-beta were lower in the Lyme patients than in the healthy control. In the patients group, the early form of disease had higher levels of TGF-beta than in the chronic. Acute, early phase group had also higher serum levels of MMP-2 and TIMP-2 in comparison to the chronic stage group. LA group showed correlation between TGF-beta concentration and levels of MMP-2. It has not been the case in the acute stage of the disease. Both groups of patients had higher levels of IL-1-aRII and selectin E in comparison with control. CONCLUSIONS: As suggested by the results, decreased levels of TGF-beta in patients with boreliosis can be due to increased levels of MMP-2 and TIMP. The above markers and their concentration can be useful in the monitoring of the effectiveness of provided therapy and suggest that inflammation can persist in spite of the normalization of the clinical picture. The results suggest extremely complicated pathophysiology of Lyme disease where pro and antiinflammatory cytokines are as important as the pathogen itself.

[Cilliary neurotrophic factor in tick-borne encephalitis]. / Rzeskowy czynnik neurotrtropowy w kleszczowym zapaleniu mózgu.

THE PURPOSE OF THIS STUDY: To evaluate concentrations of cilliary neutrophic factor (CNTF) in serum and cerebrospinal fluid of patients with tick-borne encephalitis (TBE) and bacterial meningitis. MATERIAL AND METHODS: 49 patients (14 females and 35 males), aged 19 to 62 were examined. Patients were divided into three groups: group I--23 patients (47%) with diagnosed TBE, group II--16 patients (33%) with bacterial meningitis and 10 (20%) healthy individuals as control group. The examination was performed twice before and after 4-weeks treatment. In achieved results CNTF concentration in serum from group I and II in both examinations was significantly higher compared to control group. RESULTS: Patients with TBE showed higher serum CNTF concentration compared to group with bacterial meningitis in both examinations as well. In examination 1 cerebrospinal fluid CNTF concentration of both groups was significantly higher in comparison to control group. Examined cytokine CSF concentration was higher in group with bacterial meningitis. After treatment CNTF concentration decreased significantly in group I and II. In group I CNTF concentration was comparable to control group. CONCLUSION: Concentration of CNTF in csf could be used as a marker of the inflammatory process in the central nervous system.

[The evaluation of serum presence of antibodies reacting with West Nile Fever virus (WNV) antigens among inhabitants from Podlaskie and Swietokrzyskie region]. / Obecnosc przeciwcial reagujacych z antygenem wirusa Zachodniego Nilu (WNV) wsród mieszkanców województw podlaskiego i swietokrzyskiego.

Up to now there was no information about WNV infection of humans in Poland. Although specific diagnostic procedure has not been used and uncharacteristic clinical picture of infection might be mislead with other viral infections. 75 patient with acute febrile episodes were diagnosed for serum IgM antibodies reacting with WNV antigens. 93 sera of forestry workers (52 from swietokrzyskie region and 41 from podlaskie region) were tested for IgG antibodies reacting with WNV. All sera weretested using ELISA method, and all positive results were examined by immunofluorescent assay (IFA) based on virus stains isolated in Hungary. The analysis of both methods confirmed presence of IgG antibodies reacting with WNV antigens among 5 (17.24%) of 29 sera showing positive results in ELISA method. It can be presumed that Poland is the country where West Nile virus might be present and transmitted by mosquitos. WNV infection might be considered in diagnosis of fevers and meningitis.

[Concentration of sFas and sFasL in the supernatant of PBMC culture from the patients with late lyme borreliosis]. / Stfizenia bialek sFas i sFasL w hodowli komórek jednojadrzastych krwi obwodowej chorych z pózna borelioza z lyme.

OBJECTIVE: Persistent, inadequate inflammatory response present in late Lyme borreliosis may be driven by activated T lymphocytes. We estimated synthesis of extracellular proteins: soluble Fas receptor (sFas) and its ligand (sFasL), which might protect T lymphocytes from physiologic apoptosis, in the peripheral blood mononuclear cell (PBMC) culture from patients with late borreliosis. METHODS: Lyme borreliosis group (LB) consisted of 20 patients with Lyme borreliosis present for >6 months. Six patients without any active infection constituted the control group (K). PBMC were incubated for 7 days with phytohemaglutinine or suspension of Borrelia afzeli (Ba), B. garinii (Bg) and B. burgdorferi sensu stricto (Bss) spirochetes. sFas and sFasL concentrations were measured in the culture supernatant with ELISA. RESULTS: In LB mean sFasL concentration was increased significantly under stimulation with phytohemaglutinine, Ba and Bg, and, with borderline significance, with Bss, in comparison with unstimulated culture. sFas also tended to increase, which was significant with phytohemaglutinine and borderline with Bg. In K sFas and sFasL was not significantly increased under antigenic stimulation. CONCLUSIONS: Increased synthesis of antiapoptotic factors by PBMC from patients with late borreliosis incubated with B. burgdorferi antigens may suggest impaired apoptosis of T lymphocytes contributing to persistent inflammatory response in this patients.

[Clinical forms of neuroborreliosis--the analysis of patients diagnosed in department of infectious diseases and neuroinfection medical academy in Bialystok between 2000-2005]. / Analiza postaci klinicznych neuroboreliozy wsród pacjentów hospitalizowanych w Klinice Chorób Zakaznych i Neuroinfekcji Akademii Medycznej w Bialymstoku w latach 2000-2005.

Increased morbidity of viral tick borne encephalitis since the 90's indicates growing risk of Rother tick borne diseases, including neuroborreliosis. Analysis of demographical, epidemiological and clinical data of patients hospitalised in Departament on Infectious Diseases and Neuroinfections in years 2000-2005 revealed that among patients with Lyme disease 13% were with neuroborreliosis with broad spectrum of neurologic symptoms as cranial nerves paresis (mainly n.VII), as well concentration and memory disturbances, and general symptoms. Some of patiets did not recall tick bite and did not present earlier borreliosis symptoms. Imaging only supports recognitio.

Molecular and serological diagnosis of Borrelia burgdorferi infection among patients with diagnosed Erythema migrans.

The aim of the study was to assess the frequency of Borrelia burgdorferi DNA detection in the blood and urine of patients diagnosed with erythema migrans, and compare the results of PCR-based methods with ELISA methodology. The latter was used to detect serum antibodies against Borrelia burgdorferi of the IgM and IgG classes, before and after antibiotic therapy. The study included 86 patients hospitalized in the Department of Infectious Diseases and Neuroinfections in the Medical Academy in Bialystok, diagnosed with the erythema migrans phase of Lyme borreliosis. Examinations were carried out twice: the first at the moment of diagnosis (Trial 1), the second after 4 weeks of antibiotic therapy. The study showed that antibiotic therapy in the early phase of borreliosis does not decrease the sensitivity of PCR and that after 4 weeks of therapy (Trial 2), spirochete DNA is still detectable in most patients (45/86). There was no correlation between detectability of spirochete DNA and the presence of antibodies against B. burgdorferi s.l. (assessed by ELISA) during the course of erythema migrans. The largest percentage of positive results in the detection of B. burgdorferi s.l. DNA was observed in patients who simultaneously possessed IgM and IgG antibodies against B. burgdorferi, while the lowest percentage of PCR positive results was among patients with only IgM antibodies.

[Post-lumbar puncture syndrome--its pathogenesis, prophylaxis and treatment]. / Zespól popunkcyjny--przyczyny, profilaktyka i leczenie.

Post-lumbar puncture syndrome (PLPS) is a frequent and important complication of diagnostic lumbar puncture. PLPS is primarily caused by perforation of the dura mater, leading to persistent leak of the cerebrospinal fluid, and, as a result, intracranial hypotension. Effective therapeutic options are limited to symptomatic treatment until natural improvement occurs, or, in cases of prolonged complaints, invasive treatment (epidural blood patch with patient's own venous blood), which makes prophylaxis of PLPS essential. Prophylactic measures of confirmed efficacy are: reducing needle size, positioning the needle bevel parallel to the long axis of the spine, re-inserting the stilet before withdrawal of the needle, and, if possible, using a so-called "atraumatic" needle, minimizing the perforation of the meninx. The volume of the cerebrospinal fluid collected and the position of the patient after the procedure do not have a significant influence on PLPS frequency.

[Vascular adhesion protein-1 (VAP-1) in inflammatory process]. / Bialko adhezji naczyniowej-1 (VAP-1) w procesie zapalnym.

VAP-1 is an adhesion molecule expressed on the surface of endothelial cells. It plays an important role in the adhesion and migration of leukocytes to the sites of inflammation. The purpose of this article is to present current knowledge of structure, biological function of VAP-1 and its use in clinical practice.

[Concentration of interleukin 6 and 10 in tick-borne and purulend encephalomeningitis]. / Stezenie interleukiny 6 i 10 w kleszczowym oraz ropnym zapaleniu mózgu i opon mózgowo-rdzeniowych.

UNLABELLED: The aim of the study was to evaluate concentrations of interleukin 6 (IL-6) and interleukin (IL-10) in serum and cerebrospinal fluid (csf) of patients with tick-borne encephalitis (tbe) and purulent meningitis before and after 4 weeks of treatment. MATERIAL AND METHODS: Group I consisted of 23 patients with tbe and group II - 16 patients with bacterial meningitis. Group III (control) consisted of 10 healthy men. RESULTS AND CONCLUSIONS: In patients with tbe and purulent meningitis concentrations of IL-6 and IL-10 in serum and csf were initially increased and tended to remain increased after 4 weeks of treatment. It suggests significant role of IL-6 and IL-10 in inflammatory process within cns. Higher concentrations of IL-6 than IL-10 in csf than in serum suggests their local synthesis within cns and tendency to the limitation of the inflammatory response to the intratecal compartment. Concentrations of both IL-6 and IL-10 in csf and serum remained sgnificantly higher in patints with purulent meningits than in tbe, both before and after treatment. This observation may be helpful in diagnosing the ethiology of meningitis and meningoencephalitis and monitoring the course of the disease.

[Ultrasonography in diagnosing Lyme arthritis of the knee joints in correlation with anti-CCP antibodies]. / Ocena przydatnosci ultrasonografii w diagnozowaniu zmian w obrebie stawów kolanowych u pacjentów z Lyme arthritis w korelacji z obecnoscia przeciwcial anty CCP w surowicy (badania wstepne).

Lyme disease, a multi-system disorder may be associated with arthritis. Lyme arthritis most commonly affects the knee joints. Ultrasonography can show the inflammation changes of the knee joint and can be a usefull method in diagnosis of Lyme arthritis. The most freguent ultrasonographic finding was knee joint effusion. Because of Lyme arthritis similarities to rheumatoid arthritis, a serologic test antibodies against cyclic cytrulinated peptid (anty CCP) can be helpfull in distinguishing of these two diseases.

[Preliminary studies on presence of antineuronal antibodies in serum of patients with Lyme borreliosis]. / Wstepne badania dotyczace obecnosci przeciwcial anty-neuronalnych w surowicach od chorych z borelioza z Lyme.

Wide spectrum of autoantibodies reactive against neuronal antigens was detected in sera of 32 of 50 studied patients with Lyme borreliosis. This may be potentially of importance in the pathogenesis of neuroborreliosis.

[Complications of tick-borne encephalitis in 15-year long experience of the Department of Infectious Diseases and Neuroinfections]. / Powiklania kleszczowego zapalenia mózgu w 15-letniej obserwacji Kliniki Chorób Zakaznychi Neuroinfekcji AMB.

The clinical features of tick-borne encephalitis (tbe) were analyzed in the group of 477 patients hospitalized in the Department of the Infectious Disease and Neuroinfections of the Medical Academy in Bialystok. The group included 31.4% women and 68.6% men, aged from 15 to 76 years. Persistent neurological sequelae were noted in 10.9% of patients: paresis or plegia in 5.66%, spinal dysfunction with lower limbs paraparesis in 1.68%, significant paresis of upper extremities in 0.63%, brachial plexus paresis in 2.31%. Cranial nerves involvement was present in 2.93%, including uni- or bilateral facial nerve palsy in 2.73% and trigeminal nerve involvement in 0.21%. Cerebellar dysfunction was present in 2,09% of patients. No fatal cases of tbe occured.

[Assessment of antioxidative defense parameters in serum and age of patients showing antibodies anti-Borrelia burgdorferi presence--non-symptomatic carriers]. / Parametry obrony antyoksydacyjnej w surowicy krwi a wiek pracowników lesnictwa zakazonych kretkiem Borrelia burgdorferi- bezobjawowych nosicieli przeciwcial--doniesienie wstepne.

To evaluate in serum antioxidative deffence parameters--SOD EC.1.15.1.1 (superoxide dismutase), GSH-Px EC.1.15.1.1 (glutathine peroxidase), -SH (sulphhydryl groups) among patients previously diagnosed with borreliosis presently showing antibodies against Borrelia burgdorferi presence. The antioxidative deffence parameters were evaluated in 117 sera of patients with previously diagnosed borreliosis aged x = 43,07. Control group consisted of 39 persons aged x = 40,97 with no detectable anti-Borrelia burgdorferi antibodies in serum. Serologic diagnosis was performed with use of ELISA kit--Borrelia rekombinat IgM, IgG (Biomedica, Austria). Serum activity of antioxidative deffence parameters-- SOD EC.1.15.1.1 (superoxide dismutase), GSH-Px EC.1.15.1.1 (glutathine peroxidase), -SH (sulphhydryl groups) were detected in all patients from both groups. Obtained results were statistically analysed. There was showed no significant difference in serum activity of SOD and GSH-Px in group of former borreliosis patients and control group. Also serum -SH concentration did not differ significantly between both examined groups of patients. No correlation between SOD and GSH-Px serum activity as well as -SH concentration was detected.

[Intercellular adhesion molecules sICAM-1, sICAM-2, sICAM-3 and IFNgamma in neuroborreliosis and tick-borne encephalitis]. / Czasteczki adhezji miedzykomórkowej sICAM-1, sICAM-2, sICAM-3 oraz IFNgamma w neuroboreliozie i kleszczowym zapaleniu mózgu.

OBJECTIVE: The aim of this study was to evaluate the serum and CSF concentration of soluble intercellular adhesion molecules sICAM-1, sICAM-2, sICAM-3 and proinflammatory cytokine IFNgamma in patients with tick-borne encephalitis (TBE) and neuroborreliosis. METHODS: The study group consisted of 40: 20 with TBE meningitis and 20 with Lyme meningitis. The serum and CSF levels of adhesion molecules and IFNgamma were determined by ELISA assay twice: before and after treatment. RESULTS: Before treatment the concentrations of adhesion molecules and IFNgamma in serum as well as in CSF were significantly higher in both studied groups than in control group (with the exception of the serum level of sICAM-2 in TBE group). After the treatment, the serum parameters in TBE group decreased to the control level. CSF levels were also reduced, but still remained higher than in the control group. In patients with neuroborreliosis serum concentration of sICAM-1 and sICAM-2 did not change as compared with its level before treatment but other studied parameters in serum and CSF decreased significantly. CONCLUSIONS: The results of our study confirm the participation of intercellular adhesion molecules in the pathogenesis of viral (TBE) and bacterial (neuroborreliosis) neuroinfections.

[New aspects of pathogenesis of Lyme borreliosis]. / Patogeneza boreliozy--nowe aspekty.

B. burgdorferi can evade the destructive effects of the immune system by binding host's complement regulators, which leads to inhibition of the complement activation cascade. Complement activity is blocked by CRASPs--complement regulator acquiring surface proteins. Complement resistance might therefore represent one major pathogenic factor favoring spirochete transmission to the vertebrate host, as well as determine host reservoirs of Borrelia burgdorferi genospecies. The cause of neuro-psychiatric disorders developing in some patients with Lyme borreliosis is still unknown. One of the hypotheses links them to neuro-hormonal disturbances induced by B. burgdorferi infection.

[Comparison of two types of diagnostic test detecting antibodies against Borrelia burgdorferi: EIA based on one genospecies antigens and ELISA based on recombinant antigens]. / Porównanie testów wykrywajacych przeciwciala przeciw antygenom Borrelia burgdorferi opartych na jednym genogatunku (EIA) i antygenach rekombinowanych (ELISA).

The aim of the study was to compare the results of ELISA diagnostic kit detecting antibodies against B. burgdorferi based on combination of three genospecies recombinant and EIA kits based on one of three genospecies. Sera of 351 forest workers were evaluated with ELISA kit (Recombinant antigen, IgG). Seropositive samples were tested with EIA kits based on B. burgdorferi s.s., B. garinii, B. afzelii antigens. Diagnostic kits based on combination of antigens of three genospecies more often detect antibodies against B. burgdorferi and are more usefull as screening tests, in comparison with those based on one genospecies. Among diagnostic kits based on one genospecies, the most sesnitive in detection of antibodies against B. burgdorferi are those based on B. afzelii.

[Western-blot with VLSE protein and "in vivo" antigens in Lyme borreliosis diagnosis]. / Test Western blot z bialkiem VlsE oraz antygenami "in vivo" w diagnostyce boreliozy z Lyme.

The aim of the study was the evaluation of the efficiency of Western blot (EcoLine) test detecting simoultanous presence of IgM and IgG antibodies against B. burgdorferi in diagnosis of early and late stage of Lyme borreliosis. The comparison of results achieved by performing test Western-blot, ELISA (based on recombinant antigens of three genospecies of Borrelia) and EIA (based on antigens of one B. burgdorferi genospecies). The tests Western blot: EcoLine (Virotech) with antygens "in vivo", ELISA Borrelia IgM, IgG recombinant (Biomedica), EIA: B. b. ss. IgG, EIA B. garinii IgG, EIA B. afzelii IgG (TestLine) were used. Results showed efficacy of detecting IgM, IgG antibodies against VlsE simultanously and IgG antibodies against "in vivo" antigens in diagnosis of early stages of Lyme disease when atypical picture skin lessions arise diagnostic doubts and in discerning early and late stage of disease. The EIA tests based on one B. burgdoreferi genospecies seem less effective in comparison to ELISA tests based on 3 genospecies antigens.

[Tick borne encephalitis and enviromental changes]. / Zachorowania na kleszczowe zapalenie mózgu, a zmiany w srodowisku.

Currently observed markedly increased incidence of various tick borne diseases in many parts of Europe is due to documented climatic changes as well anthropogenic influence on habitat structure. One of the analyzed factors is tendency to increase of the spring temperatures, especially in the third decade of the April. Such conditions (spring temperatures above 7-10 degrees C) let the nymphs and larvae of Ixodes ricinus to feed simultaneously on rodents. This increases the risk of infection of Ixodes ricinus with TBE virus, so dangerous for humans.

[Infections caused by West Nile virus]. / Zakazenie Wirusem Zachodniego Nilu.

West Nile virus (WNV) is a flavivirus related to tick-borne encephalitis virus endemic in northeast of Poland. WNV circulates among wild birds, transmitted by wide range of haematophagous arthropods. Several mosquito species, especially Culex spp., can transmit WNV to humans. WNV is responsible for a broad range of clinical symptoms, from asymptomatic infection to severe encephalitis and polio-like myelitis. Elderly persons are at especially high risk of death and severe neurological complications, with mortality among patients over 65 years old with WNV-related encephalitis being as high as 35%. Warm and humid climate favors the spread of WNV, however, it can also be effectively transmitted in moderate climate zones. During the last decade a worldwide spread of WNV was observed, with establishment of new enzootic foci and growing number of human cases. WNV seems to be already present in several European countries, including Poland. We describe detection of anti-WNV IgM antibodies in serum of patient with acute febrile infection, which may constitute the first case of confirmed WNV infection in Poland.