RESUMO
A retrospective study of 109 skin biopsies with granuloma annulare (GA) or morphea histology from patients with suspected tick bite was performed. Biopsies were tested for cutaneous Borrelia burgdorferi DNA using PCR. The same biopsies were analysed for tick-borne novel agents, Chlamydia-related bacteria (members of the Chlamydiales order), using a PCR-based method. Borrelia DNA was detected in 7/73 (9.6%) biopsies with GA and in 1/36 (2.8 %) biopsies with morphea, while Chlamydiales DNA was found in 53/73 (72.6%) biopsies with GA and 25/34 (73.4%) biopsies with morphea. All Borrelia DNA-positive GA samples were also positive for Chlamydiales DNA. The Chlamydiales sequences detected in GA were heterogeneous and contained Waddliaceae and Rhabdochlamydiaceae bacteria, which are also present in Ixodes ricinus ticks, while the Chlamydiales sequences detected in morphea closely resembled those found in healthy skin. In conclusion, tick-mediated infections can trigger GA in some cases, while correlation of either Borrelia or Chlamydiales with morphea is unlikely.
Assuntos
Borrelia burgdorferi/isolamento & purificação , Infecções por Chlamydia/microbiologia , Chlamydia/isolamento & purificação , Granuloma Anular/microbiologia , Doença de Lyme/microbiologia , Esclerodermia Localizada/microbiologia , Pele/microbiologia , Picadas de Carrapatos/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Borrelia burgdorferi/genética , Criança , Chlamydia/classificação , Chlamydia/genética , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/transmissão , DNA Bacteriano/genética , Feminino , Granuloma Anular/diagnóstico , Humanos , Doença de Lyme/diagnóstico , Doença de Lyme/transmissão , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ribotipagem , Esclerodermia Localizada/diagnóstico , Pele/patologia , Picadas de Carrapatos/diagnóstico , Adulto JovemRESUMO
BACKGROUND: Hypersensitivity to raw fruits and vegetables is often associated with respiratory allergy to birch (Betula verrucosa) pollen and is considered to be the most prevalent form of food allergy in adults sensitized to birch pollen. OBJECTIVE: The aim of the study was to investigate the association of clinical allergy and IgE profiles in individuals with birch pollen allergy and hypersensitivity to raw fruits and vegetables. METHODS: A total of 59 adults with clinical and skin prick test confirmed birch pollen allergy were included in the study. All the subjects were interviewed by using a structured questionnaire and were examined in vivo by the open test, with the appropriate fruits and vegetables. ImmunoCAP and ImmunoCAP ISAC were used as in vitro diagnostics to assess sensitization profiles for each individual, and principal components analysis was used to analyze the IgE data sets. RESULTS: Of 59 individuals, 54 (92%) had positive prick-prick test with raw potato, carrot, apple, and/or hazelnut, and the skin prick test was always positive when the corresponding skin challenge was defined as positive. Specific IgE in the ImmunoCAP and inhibition assays with rMal d 1 and rBet v 1 demonstrated that Bet v 1 is driving the sensitization against pathogenesis related-10 proteins. However, positive IgE in vitro results could not be used to predict clinical reactivity to raw fruits and vegetables. CONCLUSIONS: The present study showed that component-based IgE profiling does not enhance the diagnostic potential in case of pollen-food syndrome, which may be associated with other as yet unidentified components.