Assessment of TLR-2 concentration in tick-borne encephalitis and neuroborreliosis.

The aim of the study was to check whether measurement of TLR-2 in serum or cerebrospinal fluid (CSF) can help differentiate between neuroborreliosis (NB) and tick-borne encephalitis (TBE). Eighty patients with meningitis and meningoencephalitis were divided into two groups: Group I - patients with NB (n = 40) and Group II - patients with TBE (n = 40). Diagnosis was based on the clinical picture, CSF examination and presence of specific antibodies in serum and CSF. The control group (CG) consisted of healthy blood donors (n = 25) and patients in whom inflammatory process in central nervous system was excluded (n = 25). Concentration of TLR-2 was measured using a commercial kit [TLR-2 Elisa Kit (EIAab, China)]. The serum and CSF TLR-2 concentration of NB patients was significantly higher than in CG. The serum and CSF TLR-2 concentration in TBE patients was significantly higher than in the CG. Receiver operating characteristic analysis of the serum TLR-2 concentration showed significant differences between the group of patients with NB and a group of patients with TBE. TLR-2 is involved in the development of inflammatory process in the CNS caused by both tick-borne pathogens: viral and bacterial as TLR-2 concentration in both CSF and serum differentiates these groups from healthy patients. Although TLR-2 cannot be used as a sole and reliable biomarker differentiating NB from TBE, results of our study are a step forward toward discovering such biomarker in the future.

Assessment of HMGB-1 concentration in tick-borne encephalitis and neuroborreliosis.

BACKGROUND: The aim of this study was to determine the concentration of HMGB-1 (high mobility group box 1) in the serum and cerebrospinal fluid (CSF) of patients suffering from tick-borne encephalitis (TBE) and neuroborreliosis (NB). Focus was placed on HMGB-1 measurement in the CSF or serum in order to establish whether this could help to differentiate between NB and TBE. METHODS: Eighty patients with meningitis and meningoencephalitis were enrolled in the study. The patients were divided into two groups: group I comprised patients with NB (n=40) and group II comprised patients with TBE (n=40). The diagnosis was made based on the clinical picture, CSF examination, and the presence of specific antibodies in the serum and CSF. The control group for the evaluation of the parameters in serum were healthy blood donors (n=25), while the control group for the evaluation of parameters in the CSF were patients in whom a central nervous system (CNS) inflammatory process was excluded. The concentrations of HMGB-1 were measured by ELISA method using a commercial kit (HMGB-1 ELISA Kit; EIAab, China). The results were analyzed using Statistica 10, Gretl, receiver operating characteristics curve (ROC), and the Pearson correlation coefficient. RESULTS AND CONCLUSIONS: HMGB-1 is associated with the development of inflammatory processes in the CNS caused by both tick-borne pathogens: viral (TBE) and bacterial (Lyme borreliosis). Measurement of the serum HMGB-1 concentration in the early stages of both diseases of the CNS may contribute to the differentiation between TBE and NB, which may have a clinical impact for patients bitten by ticks.

Borrelia burgdorferi ­ morphological structure and motility as adaptation for transmission and survival in the habitat of a tick-vertebrate setup

Lyme borreliosis is a multisystem chronic disease caused by Borrelia burgdorferi sensu lato (s.l.) spirochete transmitted by Ixodes. This bacterium has a remarkable ability to survive in tick-vertebrate setup. Its infection causes diagnostic and clinical difficulties. It was distinguished as a separate disease entity over 30 years ago. Observations made by Steere et al. proved to be a milestone since they found correlation between the occurrence of skin and joint lesions with tick bites. Further studies showed that the disease affects not only joints and skin, but also nervous and circulatory systems. Shortly afterwards, an etiological factor was identified ­ spirochete isolated by W. Burgdorfer (from ticks) as well as Steer and Benach (from blood). Research conducted by other authors confirmed that the spirochete named after its discoverer (Borrelia burgdorferi) is a common etiological factor for disease entities classified as Lyme borreliosis. The high incidence of Lyme borreliosis among the residents of endemic areas, along with diagnostic and therapeutic difficulties, make it a serious academic, clinical and social problem. The present article elaborates on bacterium structure and selected mechanisms facilitating the colonisation of particular hosts. Knowledge of those processes might be useful in understanding complex pathogenesis of lesions occurring in Lyme disease.

[High mobility group box I (HMGB1) and its effect on dendritic cells]. / Bialko o duzej ruchliwosci elektroforetycznej (HMGB1) i jego wplyw na komórki dendrytyczne.

It is known more and more about immunological mechanisms and one of the newly discovered events is a participation of alarmin in human immunology. One of them is high mobility group box 1 (HMGB1) which by their proinflammatory properties and influence on immune cells plays an important role in the pathogenesis inflammatory and infectious diseases. It is assumed that antibodies against HMGB1 or HMGB1 inhibitors with antibodies anti-TNF-alpha will form the core of a specific anti-inflammatory therapy. The mobilization of dendritic cells (DCs) from peripheral tissues is critical for the establishment of T cell-dependent immune responses which take place in lymph nodes. The autocrine/paracrine release of HMGB1 controls the outcome of the DC-T cell interaction. In this paper we present the role of HMGB1 on dendritic cells in the context of pathogenesis inflammatory diseases.

Borrelial lymphocytoma--a case report of a pregnant woman.

Borrelial lymphocytoma (BL) is a rare cutaneous manifestation of Lyme borreliosis. Epidemiological data show that BL is more common in children than in adults. It presents as a single bluish-red swelling located on the earlobe in children, near the nipple in adults. In our paper, we present a case of a pregnant woman with BL, which appeared after tick bite and disappeared completely after antibiotic therapy. The aim of the paper was to emphasize that in tick-borne disease endemic areas BL should be taken into consideration in cases of skin lesions.

ssICAM-1, IL-21 and IL-23 in patients with tick borne encephalitis and neuroborreliosis.

OBJECTIVE: There have been few reports on the role of Intercellular Adhesion Molecule 1 (ICAM-1), but not interleukin-21 (IL-21) and interleukin-23 (IL-23) in tick-borne encephalitis (TBE) and neuroborreliosis (NB). We postulate that these two interleukins may participate in the early phase of TBE and NB. The aim of the study was to measure serum and cerebrospinal fluid (CSF) concentration of ICAM-1, IL-21 and IL-23 in patients with TBE and NB before treatment and to assess their usefulness in the diagnosis and monitoring of inflammatory process in TBE and NB. METHODS: Forty-three patients hospitalized in The Department of Infectious Diseases and Neuroinfections of Medical University in Bialystok, Poland, were included in the study. Patients were divided into three groups: TBE, NB and CG. Pre-treatment blood and CSF samples were obtained from all patients. ELISA kits (DRG Instruments, Germany) were used to measure the concentration of IL-21, IL-23 and sICAM-1. RESULTS: Significant differences between TBE/CG and NB/CG concentration of sICAM-1 were found only in the CSF. CSF IL-21 levels in NB were lower than in TBE. In TBE, a strong negative correlation between CSF concentration of IL-21 and IL-23 and monocyte count in CSF was observed. Negative correlation between IL-21 in CSF and neutrophil count was also noted. Serum IL-23 correlated positively with leukocytes and platelet count in serum. In NB, a strong positive correlation between serum IL-21 and platelet count and negative correlation between IL-21 in serum and CSF with pleocytosis was observed. CONCLUSIONS: Increased sICAM-1 concentration in TBE and NB may be a proof of brain-blood barrier disturbances in the early phase of these diseases. IL-21 and IL-23 do not appear to play an important role in the pathogenesis of the early stages of TBE and NB.