[Unusual manifestations of Lyme borreliosis. A contribution to the clinical spectrum of this disease group]. / Ungewöhnliche Erscheinungsformen der Lyme-Borreliose. Ein Beitrag zum klinischen Spektrum dieser Krankheitsgruppe.

Since the discovery that EM (erythema migrans), ACA (acrodermatitis chronica atrophicans) and BL (borrelial lymphocytoma) have an infectious etiology, these syndromes have been receiving particular attention. This report describes four patients whose dermatological symptoms did not at first indicate borreliosis. In all four cases serological antibody tests proved that they were caused by Borrelia burgdorferi. In two of these cases these findings were confirmed by bacterial cultures. The unusual skin symptoms, i.e. multiple disseminated erythema, erysipelas-like manifestations, swelling and discoloration of the eyelids and lichenoid papules, extend the known clinical spectrum of cutaneous borreliosis in Europe.

Human glucagon and vasoactive intestinal polypeptide (VIP) stimulate free fatty acid release from human adipose tissue in vitro.

Glucagon, vasoactive intestinal polypeptide and secretin are strong stimulators of lipolysis in adipose tissue from laboratory animals. Yet, in human adipose tissue these data could not be confirmed under comparable experimental conditions. Using pH stat titration, an advanced in vitro test system for evaluating lipolysis, it was possible to demonstrate lipolytic activity for glucagon down to a concentration of 10(-8) mol/l. This is comparable to the minimal effective doses in rat adipose tissue and corresponds to the effect of equimolar concentrations of noradrenaline in man. Secretin with an amino acid sequence very similar to glucagon was not lipolytically active, while VIP stimulated free fatty acid release in a concentration of 10(-6) mol/l. Since the minimal effective dose of glucagon is only 30 times greater than the plasma levels a physiological significance of these finding may be suggested. The lipolytic activity of VIP seems to be only of pharmacological interest.

On the in vitro lipolytic activity of peptide hormones in human adipose tissue.

Peptide hormones are potent stimulators of lipolysis in incubated adipocytes or adipose tissue of laboratory animals. However, none out of 40 synthetic or highly purified peptide hormones or sequences from the pituitary, the gastrointestinal tract and of different origin was able to stimulate glycerol release from 'incubated' human adipocytes. Yet, this model of the 'incubated adipocyte' offers several disadvantages: rapid decrease of pH in the incubation medium, release and increment of lipolysis inhibiting substances such as FFA and adenosine and rapid unspecific degradation of the peptides. In an improved in vitro model--pH-stat titration--which avoids or diminishes the disadvantages of 'incubated adipocytes', a group of pituitary peptides was tested. One peptide hormone, beta-lipotropin, stimulated lipolysis significantly in human adipose tissue. Two other peptides which were highly active in adipose tissue of laboratory animals were ineffective in this system too. The lipolytic response to beta-lipotropin was comparable to the effect of noradrenaline at equimolar concentrations. The data indicate that results on the lipolytic activity of peptide hormones in adipose tissue of laboratory animals cannot be transferred to human adipose tissue. In advanced in vitro test systems the ability to stimulate lipolysis could also be shown for a peptide hormone suggesting a role of such substances in the endocrine regulation of adipose tissue mass in men.